The CAIPER Blog
At the Intersection of Interprofessional Education and Collaborative Practice: The Making of the Preceptor’s Guide to the Nexus
July 18, 2019
By Teri Kennedy
This is the story of a journey that began when I joined the Arizona State University Center for Advancing Interprofessional Practice, Education and Research, or CAIPER, as Faculty Lead of Clinical Partnerships. It ended two years’ later with the publication of The Preceptor’s Guide to the Nexus: Where Interprofessional Education Meets Collaborative Practice. At the time, I had no idea where this path would lead.
The resulting guide supports the important role of practitioners across health professions who serve as preceptors for health professions students and teams. It honors their role in advancing learner competencies within clinical learning environments. As I reflect, I am grateful to those who shared this adventure and for the opportunity to capture this practice wisdom in the form of a resource for preceptors.
The Adventure Begins
My mission was to forge a series of academic-clinical partnerships. The goal was to develop pilot interprofessional practice sites where health professions students from different disciplines and universities could learn to work together as members of high-quality collaborative teams. I quickly grew to appreciate the critical role of the clinicians within these sites who agreed to serve as preceptors for health professions students. I also saw their potential to serve as agents of change, catalyzing transformation within the organizations in which they served.
When Resources are Needed
I was also aware that most current practitioners were trained within a specific discipline with traditional roles and chains of command. Only upon entering the workforce did they begin learning to work in teams, mostly through example, trial, and error. As a result, health professions students entered siloed, hierarchical clinical learning environments that did not reflect the interprofessional competencies practiced in the classroom.
A resource was needed to retrofit interprofessional content missing from the professional preparation of these preceptors and support their important role in advancing learner competencies through guided, intentional, and contextual experiences within an interprofessional clinical learning environment. To achieve this, I needed to journey to the nexus.
In Search of the Nexus
Every meaningful journey involves a search. This was a search for a true academic-practice partnership, or nexus. To understand the concept of a nexus, imagine sitting in the intersection of two major highways. One highway represents interprofessional education, the other represents collaborative practice. The nexus lies at the intersection where these highways intersect.
My search led to the co-creation of a true academic-practice nexus through the development of pilot interprofessional clinical learning environments (IP-CLE) in which two or more health professions were represented. Clinical partners represented a range of practice sites including Wesley Community & Health Centers (Federally Qualified Health Center), Cigna Medical Group (primary care), Dignity Health Center for Transitional Care, St. Joseph’s Hospital & Medical Center (outpatient/transitional care), and Open Hearts Family Wellness (integrated care).
Next Steps
After establishing relationships with preceptors and administrators, I conducted site visits and held in-depth conversations with preceptors, students, and administrators with each site at least three times each year over two years, with additional visits as needed to address site- or student-specific challenges. A lot of that time was spent listening so I could appreciate each site’s unique approach to, and opportunities and challenges with, interprofessional team-based practice. The sign that I had reached the nexus was that we formed an academic-practice learning community and broadened our understanding of how, together, we could advance an optimal interprofessional clinical learning environment.
My travels to hospitals and clinics to meet with preceptors, administrators, and students led to the identification of core and site-specific tailored approaches to interprofessional collaborative practice, or CAIPER Core ©. I developed this IPE model based on the assumption that there are core interprofessional learning experiences that are portable and can be replicated across the wide variety of practice sites and contexts in which students receive their clinical training.
CAIPER Core ©
I identified three core learning opportunities across the range of participating pilot sites. Each of these clinical sites presented opportunities for students to participate in the following:
- Patient Panels,
- Student leadership development, and
- Interprofessional projects that could be presented as part of an annual interprofessional student symposium.
In addition to these core activities, each site offered an opportunity for interprofessional student projects that could be tailored to each site’s model of care and unique approach to interprofessional collaborative practice by including population health management, social determinants of health, or quality improvement.
Finally, each site was already engaging in clinical learning through standard practices including observing, interviewing, shadowing debriefing, demonstrating, discussing, simulating, practicing, presenting, and reflective writing. Students were extremely helpful in pointing out learning opportunities, particularly related to leadership, that were not currently being maximized. Through my conversations with preceptors and students, I developed a simple process for identifying learning opportunities, then transitioning them from uni-professional to interprofessional.
Full Circle
In February 2019, the National Collaborative for Improving the Clinical Learning Environment (NCICLE) released a new guidance, Achieving the Optimal Interprofessional Clinical Learning Environment. In it, clinicians, clinical faculty, and health educators recommended the introduction of tools, programs, and essential elements of models of IPE to achieve an optimal IP-CLEs. The Preceptor’s Guide to the Nexus addresses this need for tools, programs, and a portable, practical model of IPE important to achieve an optimal IP-CLE.
A Guide for All
Preceptor's Guide to the Nexus: where interprofessional education meets collaborative practiceThis guide is not just for preceptors. It is useful for clinicians and healthcare organizations seeking to interprofessionalize their organizational culture and can prepare preceptors to serve as effective agents of change within their practice settings.
The guide can also serve as a valuable resource for health professions educators seeking to better understand and infuse IPE content into health professions courses and curriculum. Focusing on the nexus of academic-practice partnerships is an important reminder that the learning in learning organizations goes both ways. Faculty engagement with clinical partners offers rich opportunities to learn about, from, and with one another as we travel together to advance interprofessional collaborative practice within the evolving healthcare landscape.
Guide author, Teri Kennedy, and guide producer and developer, Jinnette Senecal, M.Ed., will be presenting at the National Center for Interprofessional Practice and Education 2019 Nexus Summit.
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