Two reports from six national health professional education associations and three private foundations are urging that new competencies for interprofessional health education be adopted, along with action strategies to implement them in academic institutions across the country. That's good news for family physicians and their patients, according to one AAFP medical educator, who cites this development as signaling a growing appreciation for the value of team-based care -- a key component of the patient-centered medical home -- and its benefits to health care consumers.
Medical and nursing students at Case Western Reserve University, Cleveland, have been training together during a pilot of the university's Student-run Free Clinic that will officially open in October.
The first report, Core Competencies for Interprofessional Collaborative Practice(www.aamc.org), identifies four domains of core interprofessional competencies that various health professionals should demonstrate to ensure their ability to provide integrated, high-quality care to patients in the U.S. health care system. Thirty-eight subcompetencies describe the behaviors across the four competency domains.
Overall, the report contends that future health professionals, including physicians, nurses, pharmacists, dentists and public health leaders, should be able to:
- assert values and ethics of interprofessional practice by placing the interests, dignity and respect of patients at the center of health care delivery and embracing the cultural diversity and differences of health care teams;
- leverage the unique roles and responsibilities of interprofessional partners to assess and address the health care needs of patients and populations;
- communicate with patients, families, communities and other health professionals in support of a team approach to preventing disease and disability, maintaining health and treating disease; and
- perform effectively in various team roles to deliver patient- and population-centered care that is safe, timely, efficient, effective and equitable.
The core competencies are similar to the concepts embodied in the Joint Principles for the Patient-Centered Medical Home(ssl3.ama-assn.org), or PCMH, and the Joint Principles for the Medical Education of Physicians in Preparation for Practice in the PCMH(12 page PDF), which have been adopted by the AAFP and other primary care organizations.
"An appreciation of the value of team-based care is growing," AAFP Vice President for Education Perry Pugno, M.D., M.P.H., told AAFP News Now. "The delineation of competencies into smaller components facilitates understanding of how those competencies can be approached, taught and evaluated.
"These are relatively new concepts for many within the medical community, and it will take some time to be broadly embraced and implemented," he added.
The report was produced by an expert panel convened in 2009 by the Interprofessional Education Collaborative, or IPEC, which comprises six associations: the Association of American Medical Colleges, the American Association of Colleges of Osteopathic Medicine, the American Association of Colleges of Nursing, the American Association of Colleges of Pharmacy, the American Dental Education Association and the Association of Schools of Public Health.
The second report, Team-based Competencies: Building a Shared Foundation for Education and Clinical Practice(www.aamc.org), resulted from a conference sponsored by HHS' Health Resources and Services Administration, the Josiah Macy Jr. Foundation, the Robert Wood Johnson Foundation and the American Board of Internal Medicine Foundation, in partnership with IPEC.
More than 80 leaders from different health professions met in February 2011 to preview the IPEC core competencies and create action strategies for implementing them. Those strategies include:
- disseminate the core competencies to key stakeholders, including academic deans, policymakers and health care leaders, and launch an education campaign that establishes the need for interprofessional collaboration in education and practice;
- prepare faculty to teach students how to work effectively as part of a team and how to use the competencies to meet that goal;
- develop metrics for interprofessional education and team-based care;
- forge partnerships among the academic community, health care professionals, government agencies, and consumer groups to advance interprofessional education and care; and
- explore funding to support interprofessional education and research initiatives.
Although many medical schools now are pursuing small initiatives in interprofessional education, Pugno said more organized efforts are expected in the future. Faculty development will be the first step toward implementing interprofessional education.
"The barriers include resource limitations -- time and faculty availability -- as well as the conceptual shift away from traditional approaches emphasizing individual responsibility to one of shared responsibility," said Pugno.
"Team-based care is important to a successful implementation of the PCMH in an environment in which primary care physicians, including family physicians, are in great demand," he added.
Pugno said if students are trained to provide team-based care in their health professional schools and colleges, they can more easily make the transition to practice that way. "Preparation for practice is a priority," he said.