Key Words: Interprofessional, education, professional practice, healthcare outcomes, systematic review
What is the effectiveness of Interprofessional Education (IPE) interventions compared to separate, profession-specific education interventions and/or no education intervention?
IPE can be defined as two or more professionals in health and social care coming together with the purpose of establishing or building upon interprofessional collaboration or improving client/patient healthcare outcomes. The benefit of IPE continues to be explored worldwide. The general assumption is that when IPE is undertaken, the overall safety and wellbeing of patients/clients improves. A systematic review of the available research on IPE is needed in order to move this assumption into an evidence base.
This is a summary of a recently updated (2013) Cochrane systematic review that included 15 studies, eight randomized controlled trials (RCTs), five controlled before-and-after studies, and two interrupted time series studies.
The intervention of interest was IPE which was classified as all types of educational, training, learning or teaching initiatives, involving more than one profession in joint, interactive learning, as described in the IPE definition above. Any professionals with a health or social care background were eligible to participate in the study. This included, but was not limited to: nurses, doctors, midwives, allied health professionals and complementary therapists. All studies compared interventions to no educational intervention. The primary outcomes of interest were:
- Client/patient healthcare outcomes (e.g. complication and readmission rates)
- Healthcare process measures (e.g. interprofessional collaboration, teamwork).
Outcomes could be self-reported or objectively measured. The risk of bias in the 15 included studies was variable. Overall there was a lack of consistency in the timeframes used to assess IPE. Duration fluctuated from a few hours to programs that were conducted over an extended period of time. There was significant variation in the mix of professionals and the objectives of the interventions were likewise diverse.
Summary of Key Evidence:
Due to the heterogeneity and methodological limitations among the included studies, meta-analysis was not possible and results were presented narratively.
The following outcomes were measured: patient outcomes (six studies); adherence rates (three studies); patient satisfaction (two studies); clinical process outcomes (one study); collaborative behaviour (three studies); error rates (one study); and practitioner competencies (one study).
Of those, results suggested that IPE may improve patient outcomes, adherence to guidelines, patient satisfaction, and clinical processes however caution must be taken when interpreting these results.
Best Practice Recommendations:
Despite this review identifying an array of positive effects for IPE, it is difficult to conclude from the findings that IPE positively impacts client/patient healthcare outcomes or professional practice. The review does however highlight the need for more rigorous studies containing larger sample sizes and appropriate control groups.
Director of Nursing, HMC / Sickkids Partnership
Hamad Medical Corporation
Gregory is a member of the Cochrane Nursing Care Field (CNCF)
Reeves S., Perrier L., Goldman J., Freeth D., & Zwarenstein M. (2013). Interprofessional education: Effects on professional practice and healthcare outcomes (update). Cochrane Database of Systematic Reviews 2013, Issue 3. Art. No.: CD002213. DOI: 10.1002/14651858.CD002213.pub3. Available at:http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD002213.pub3/full