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The need for an interprofessional approach, which requires the healthcare team to work cooperatively to improve patient care outcomes, has been acknowledged for decades.  The American Association of Colleges of Nursing (AACN) joined with other health professions in 2009 to establish competencies for interprofessional education (IPE), through the Interprofessional Education Collaborative (IPEC). Prior to the establishment of IPEC the AACN included an educational essential regarding interprofessional communication and collaboration in their 2006 Essentials of Doctoral Education for Advanced Nursing Practice and in their 2008  Essentials of Baccalaureate Education for Professional Nursing Practice.  In 2021 the AACN revised the educational essential regarding interprofessionalism to be Interprofessional Partnerships.  The change to use of the word partnerships in regards to being interprofessional implies a strong recognition of the need for health professionals to harmonize their work with patients to optimize care outcomes.

Challenges of IPE

Clearly, the complexity of delivery of health care supports an interprofessional approach to care. However, it may be difficult to develop an interprofessional mindset in health professionals as many institutions of higher education have totally separated educational tracks for medicine, nursing, social work, rehabilitative medicine, and other professions involved in the delivery of health care. Shared educational experiences provide support for development of collegial relationships and respectful communication as well as a partnership approach in which the expertise of various health professions can be leveraged to the benefit of the patient. Understanding how to work in partnership is a skill that requires practice to develop patterns of respectful communication, understanding of team dynamics, knowledge of the strengths of each healthcare profession, and an ability to work together in a climate of safety. Therefore, integrated educational experiences to develop skills for interprofessional partnership are recommended for entry to practice and advanced practice healthcare educational programs. However, how to schedule such educational experiences within complex curriculums and for institutions of higher education that may concentrate on just one of the health professions is challenging.

Shared Core Course

One approach to IPE is to have learners from different professions take a core course, such as pathophysiology or pharmacology, together.  However, merely having learners from different professions have a shared educational experience doesn’t guarantee development of skills in how to work as interprofessional partners. A purposeful inclusion of assignments focused on development of such skills is needed within the shared course.  A group project in which groups are created by the instructor to include learners from each profession enrolled in the course as well as ensuring diversity within the group is ideal. Including requirements within the assignment for which the learner needs to share what their profession’s focus and/or approach to the issue at hand would be is another way to be purposeful.  An IPE case study with the patient being from an underserved group would reinforce awareness of the need to develop respect for diversity, equity, and inclusion (DEI) as well as help the learners identify unconscious biases. Another element to include in any group assignment would be a reflection about how the group process evolved as well as a self-assessment measure of sense of competency. Inclusion of an element about group process would support an understanding of team dynamics necessary for developing a partnership approach. A self-assessment measure of competence reflects the focus of the new AACN essentials on development of competency rather than a focus on measurement of knowledge.  A drawback to this approach is that learners may be resistant to such an assignment not being related to the subject at hand even when the purpose of development of interprofessional skills is shared as a course leaning outcome. Also, relying on having learners from different professional tracks take a course together is challenging for institutions of higher education that concentrate on just one of the health professions. Such institutions could perhaps partner with another institution to develop a shared online course for their curriculums.

Adding an Interprofessionalism Course and Follow-up IPE Experiences to the Curriculum

Development of a course on interprofessionalism to be scheduled early in the curriculum and interspersing interprofessional experiences later in the curriculum to reinforce learning from the interprofessionalism course would be another approach to consider. Introducing how to function as an interprofessional team early in the program of study will establish the importance of interprofessionalism as a baseline requirement for all healthcare professionals. Simulation to develop interprofessional skills as well as to measure competency through both observation and self-assessment can be used for an interprofessionalism course as well as in IPE experiences scheduled for later in a program of study. Use of escape rooms (originally designed for recreational gaming in which the player or players need to discover clues to solve a puzzle to obtain the key to escape the room) have been incorporated for educational purposes in healthcare.  When the escape room concept is used for IPE simulation the interprofessional healthcare team needs to work together (in partnership) to solve the puzzle, such as discovering how to best manage a patient’s care, in order to leave the room. The escape room simulation is designed to encourage teamwork and development of communication skills. Concepts of DEI and respect for the knowledge each profession contributes to provision of care can also be interwoven into the design of the IPE simulation.  Inclusion of these concepts supports AACN competencies and subcompetencies identified as within the domain.

IPE Resources

Resources to assist educators with IPE are readily available online. The IPEC has a number of publications available on the site’s resources section. The National Center for Interprofessional Practice and Education has guidebooks available (for a fee) for beginner to advanced IPE simulations using an escape room format. IPE escape room simulations can be developed as either in-person or virtual experiences.  For educators who want to establish their own virtual escape room simulations Dittman and colleagues (2021) describe development of a virtual IPE experience using technology freely available online.  

Zaccagnini & White's Core Competencies for Advanced Practice Nursing: A Guide for DNPs, Fifth Edition

Zaccagnini & White's Core Competencies for Advanced Practice Nursing: A Guide for DNPs, Fifth Edition continues to be the must-have resource for students to understand what it means to be a DNP and achieve mastery of the revised AACN Essentials.

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About the Author:

Diane M. Schadewald, DNP, MSN, RN, WHNP-BC, FNP-BC, CNE, is the author of several textbooks and currently Clinical Professor Emerita at the University of Wisconsin-Milwaukee.