The CAIPER Blog

September 27, 2022

By Barret Michalec

When I arrived at ASU’s Edson College of Nursing and Health Innovation in 2020, I assumed that I would immediately be able to offer all the health-sociology-oriented  courses I had been offering at my previous institution that were popular among health pre-profession students. Sociology of Health & Illness, Comparative Health Systems, Disparities in Health & Healthcare, Mental Health & Well-Being, Race & Health, (among others) – courses that I was positive would be eagerly sought by students within Edson College and around ASU, and aligned with the social and community-based values expressed by the College and University. 

I was met with the harsh reality that, although some aspects of these courses overlapped with certain courses already offered within the College, the undergraduate curricula for Edson students, especially those pursuing a BSN, was so saturated that any “new” courses would be put through a rigorous review process and most likely would have low enrollments unless classified as “required” in particular degree program or general education requirements.  This is primarily due to strenuous accreditation and regulation standards that create a somewhat stagnant closed-off system for innovating and invigorating health professions curriculum – including the impaired nature of integrating humanities, social sciences…and interprofessionalism.

Relatedly, we faced similar barriers when we designed a graduate-level Certificate Program in Interprofessional Education & Practice.  We were told it was essential to utilize courses that were already “on the books” and that were already required among the participating health profession programs (in participating colleges).  The end result was an uninspiring Frankenstein’s monster design that would no doubt be plagued with time, scheduling, space, and ownership-related disputes. It currently sits in curriculum version of the Phantom Zone.

These are primary persistent barriers to robust, consistent, and institutionalized interprofessional education – overburdened and saturated health professions curriculum so packed to the brim with courses and trainings that program leaders and students alike struggle to jam in one more course, event, or experience, or even non-profession-distinct course content.

Similarly, issues related to scheduling conflicts between programs, preceptor requirements, and adequate physical space all plague the development and implementation of effective interprofessional opportunities that could be threaded throughout the education and training of the healthcare workforce of the future. 

Moreover, IPE is not cost-effective in the business model of higher education as interprofessionalism is a long-term value-based investment in the health, safety, and wellbeing of providers and patients that rarely breeds more immediate capital gains for health profession program leaders, colleges or universities.  In turn, interprofessional centers, programs, courses, events, and even IPE-based leadership positions, if not “profitable” and/or self-sustainable, are often at the whim (and guillotine) of program, college, and university executive leadership.

Health profession students are therefore often left to ascertain interprofessional competencies and develop an interprofessional identity through the sporadic offerings of an IPE-based course or event here, and maybe an IPE-based simulation there.  And we wonder why we’re seeing cracks in the interprofessional education-to-practice pipeline with health profession students arriving at practice sites unprepared and struggling to engage in team-based, collaborative healthcare delivery.   

Yes, existing reimbursement systems, culpability chains-of-command, embedded occupational status hierarchies, and the general design of the health systems are certainly not the quintessential breeding ground for professional-level real-time interprofessional practice. However, and perhaps more importantly, interprofessional education continues to exist as an additive feature of profession-specific education, an “if there’s time and it doesn’t cost too much” supplemental activity – rarely nested within and throughout each profession’s curriculum and training despite IPE-based accreditation requirements for each health profession, and the touting of the value and importance of IPE by profession-specific leaders. 

Moreover, beyond resource-based constraints and barriers, interprofessional education clearly struggled through COVID-19 related curriculum and training alterations and transformations (i.e., necessitated “pivoting”) and, whereas new dynamic opportunities developed from these challenges, the aftermath is still being felt by interprofessional program leaders at almost every institution.

Put simply, the future of interprofessional education comes down to Resources, Sustainability, Innovation, and Institutionalization – threading it throughout health professions education and training. 

We simply cannot go about as business as usual with episodic, one-off IPE events and courses that are hanging by mere capital-based threads and are persistently in peril, in question, and/or in danger of being simply dropped by health profession programs, Colleges, or Universities.

How can we offer consistent, high-quality, evidence-based interprofessional education to our learners, and embed those opportunities consistently throughout their professional development and trajectory?  There are a few potential pathways. 

Certain universities have been able to categorize IPE courses and training opportunities as requirements for most, if not all, of the health profession programs on their campus, and in turn, have threaded these opportunities throughout students’ professional development and trajectory making it a standard, integral part of the program itself.  Such an “institutionalization” approach is not only a massive structural and administrative undertaking, but requires a shared understanding of and respect for each program’s needs and standards and a related willingness to alter course maps and schedules and forego discipline-specific resources for long-term value-based goals related to the promise of interprofessionalism.

IPE Champions and Leaders can continue to seek and attain external and internal funding to develop and provide IPE courses and opportunities at the undergraduate and graduate-levels. These funding opportunities are no doubt few and far between, limited in their level of financial support, and would still require executive leadership buy-in in order to institutionalize the opportunities when the funding dries up.

Rather than building new courses and new events, nest interprofessional-based eLearning into existing courses and training. Similar to assigning learners readings (e.g. a series of articles, or a book) or practice-based exercises within a course, faculty can utilize the multidimensional space of learning (highlighted during the pandemic) and embed innovative IPE-based eLearning modules into existing syllabi. Peppering existing courses with interprofessional learning and practice-based opportunities not only threads interprofessional values and competencies throughout the educational pathway, but also aligns professional-specific and interprofessional identity development. eLearning can be done in individual and group settings – and objectives and goals can be reinforced in in-person events, seminars, and workshops.

We all, CAIPER included, strive to Change the System - and while we all work towards that goal, it is important to remember that at any given moment a new Dean, Provost, or President could come in and, with the snap of their fingers, *poof*. Moreover, we continue to Work within the System, identifying funding opportunities to support research and program development…and basically to keep the lights on.  Given the scarcity of funding sources for IPE however, that approach is simply unsustainable.

That’s why CAIPER’s focus has shifted towards Infiltrating the System - our goal is to advance the science of interprofessionalism and, in turn, translate that science into engaging and evidence-based IPE eLearning programs for all health profession learners.

CAIPER is known for our eLearning programming and trainings that are easily integrated into existing (inter)professional curriculum and faculty development programs – such as the Introduction to Interprofessional Team-Based Care, Interprofessional Practice in Primary Care, the Teamwork Toolkit for the Clinical Learning Environment, our Digital Magazines on Moral Distress and Moral Injury and Team-Based Care for Vulnerable Populations, and our newest eLearning Program – I-TEAM By Design™ - Interprofessional Training in Empathy, Affect, and Mindfulness. 

These programs range from 2-4hrs in duration, include individual and group-based exercises and applied learning activities, and are accompanied with continuing education credits, digital badges, and/or certificates of completion. 

To date, CAIPER has served over 44,000 health profession learners around the world through our eLearning modules, courses, and digital training magazines. Given the extensive interest in our eLearning programs, CAIPER has evolved to now offer direct consulting services to assist institutions interested in integrating our programs into their curriculum and training. 

Integrating interprofessional eLearning opportunities into existing health professions curriculum is not only innovative and forward thinking, but requires minimal resources to support and integrate, is self-sustaining, and promotes institutionalization of IPE by embedding interprofessional competencies and values throughout the curriculum and training. 

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