Interprofessional education – considering the research agenda

Guest blogger Scott Reeves is Professor in Interprofessional Research at the Centre for Health & Social Care Research, Kingston & St George’s, University of London, UK. He is also Editor-in-Chief of the Journal of Interprofessional Care. Here he talks about the research landscape within interprofessional education.

Over the past 20 years of undertaking research in the interprofessional field, I have witnessed an impressive expansion in the use of interprofessional activities across the globe.  (For those who are unaware of this field, interprofessional education and interprofessional practice are types of interventions that involve groups of different health care providers learning and working together to improve problems with the delivery of safe patient care such as  communication failures, medication errors, fragmented coordination). From countries geographically spread as far apart as Australia, the UK, Canada, Japan, Sweden, USA and Taiwan I have seen a range of interprofessional activities being developed and implemented during this time (e.g. online education, simulation, checklists, pathways) to help alleviate the challenges of providing patients with effective care.

While we have made some extremely valuable progress in the field and built evidence, there are still a number of research elements which need to be addressed. Importantly, there continues to be an ongoing uncertainty linked to the use of interprofessional terminology. While there is broad agreement with the use of the term ‘interprofessional education’, there is far more limited stability with the terms such ‘interprofessional collaboration’ and ‘interdisciplinary teamwork’. This imprecise use of language actually generates a whole range of differing ideas and misassumptions about the nature of interprofessional interventions. We therefore need to generate good quality evaluative evidence, from our interprofessional activities to help us determinate their impact. Without a clear and consistent conceptualization of these outcomes, the evidence base will remain limited and fragmented. In addition, our evidence base is restricted by a historical trend to undertake our interprofessional evaluation studies in isolation from one another. We therefore continue to engage in single-site studies which can have a propensity to duplicate the work our colleagues are doing, while never providing any larger data set which would generate better quality evidence to infer results from one setting to others. There also continues to be a limited use of theory to help us illuminate and understand underlying issues (e.g. professional hierarchies, power imbalances, gender differences) linked to the development and implementation of interprofessional activities. As a result, we continue to have only a partial comprehension of the complexity of the social world we are attempting to positively affect.

So what direction should we aim for with interprofessional research over the next few years? To begin resolving the limitations outlined above, there some key routes we should consider. First, conceptually, we need to work on a common language and set of shared concepts and terms to ensure we are talking about the same thing, rather than contributing to ongoing confusions. Second, empirically, we should look for opportunities to develop multi-sited interprofessional studies where we can collate generalisable evidence. This in turn will help identify the rigorous interprofessional education and practice models which are scalable in nature. Third, theoretically, we ought to begin identifying and drawing upon key social science theories to help us understand the socio-economic and political nature of interprofessional activities.  This will help produce more insightful understandings of the complexities we are dealing with in the interprofessional field.

In attempting to move forward with our scholarly activities, there is one key factor to address: we need to improve our own ability to collaborate. There is, unfortunately, a central tension which often impedes our interprofessional work – we are all competing for limited research resources, so working together to overcome this competition can be difficult. However, one should not forget that undertaking interprofessional research is not a simple zero sum game with winners and losers. A more coordinated approach between all members of the interprofessional research community will help us build and share knowledge in a synergistic manner, rather than the more piecemeal and insular approach we have traditionally undertaken. Therefore research collaboration is essential – open dialogue, negotiation and agreement are all needed to begin this process.

Many thanks to Scott Reeves. The need for clarity of terms and language is a theme that also appeared in a recent guest blogpost by Dr Christopher John Ferguson, and you can also read about “Mapping Educational Specialist knowHow” in Kate Reynolds’ recent post.

Image credit: SAS-2009 Oxford, 2009, [CC BY-SA 2.0], via Flickr