Creating change, challenging structure: graduate and faculty perspectives on the implementation of an interprofessional education program in veterans affairs primary care

ABSTRACT

Interprofessional clinical education programs have the potential to impact participants’ professional expectations and practices related to team-based care. In this qualitative study, research team members interviewed 38 graduates and 19 faculty members from such an interprofessional training program, the Department of Veterans Affairs (VA) Centers of Excellence in Primary Care Education (CoEPCE). Semi-structured interviews with participants enquired about skills gained, impact on career expectations, and barriers to implementing interprofessional skills in the post-training workplace. Data were coded and analyzed using a hybrid inductive/deductive approach. Participants perceived that the program was successful in creating new norms of flattened team hierarchies, broadening graduates’ understanding of role interaction, and teaching interactional skills involving teamwork. Participants reported organizational and systemic barriers to changing existing primary care practice. Interprofessional clinical education programs may help new professionals recognize and act on opportunities for improvement in existing practice. Healthcare employers must recognize changed expectations and provide opportunities for interprofessional collaboration to attract graduates from such programs.

KEYWORDS:

• Interprofessional education
• primary care
• interprofessional outcomes
• evaluation
• roles

Additional information

Funding

This work was supported by the Quality Enhancement Research Initiative [PEC 15-247].

Notes on contributors

Elizabeth Hulen

Elizabeth Hulen is a Research Associate in the Center to Improve Veteran Involvement in Care at the VA Portland Health Care System.

Samuel T. Edwards

Samuel T. Edwards is a primary care physician and health services researcher for the Center to Improve Veteran Involvement in Care at the VA Portland Health Care System and an Assistant Professor of Medicine at Oregon Health & Science University.

Anne P. Poppe

Anne P. Poppe is the Director of Nursing, Education, and Specialty Rehab at the VA Puget Health Care System and Associate Director for Assessment & Innovations at Seattle Center for Excellence in Primary Care Education and a Clinical Assistant Professor in the School of Nursing at the University of Washington.

Mamta K. Singh

Mamta K. Singh is an Associate Professor of Medicine at Case Western Reserve University and has a primary appointment in the Division of General Internal Medicine at the Louis Stokes Cleveland Veteran Affairs Medical Center where she is the physician Director for the VA Center of Excellence in Primary Care Education.

Rebecca Shunk

Rebecca Shunk is the physician Co-Director of the Center of Excellence in Primary Care Education at the San Francisco VA Medical Center as well as Health Sciences Associate Clinical Professor of Medicine at the University of California, San Francisco, Medical Center.

Anais Tuepker

Anais Tuepker is a sociologist and health services researcher for the Center to Improve Veteran Involvement in Care at the VA Portland Health Care System.