The American Speech-Language-Hearing Association defines interprofessional education (IPE) as “an activity that occurs when two or more professions learn about, from, and with each other to enable effective collaboration and improve outcomes for individuals and families whom we serve” (ASHA, n.d.). Recognizing the importance of IPE in the provision of a comprehensive education model, ASHA’s Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA) recently added a standard (Standard 3.1, 2017) related to knowledge and skills acquisition for IPE accrediting bodies. Other organizations in the allied health disciplines also incorporate IPE as a critical component of educational practices and require interprofessional preparation for accreditation. Examples of these organizations include the American Association of Colleges of Nursing, the American Occupational Therapy Association, the American Physical Therapy Association, and the Council on Social Work Education. Additional support is provided by the Health Professions Accreditors Collaborative (HPAC) in a recently released guidance document for developing IPE for the health professions.
Does IPE Work? A View Toward Outcomes
With the inclusion of IPE practices in many communication sciences and disorders (CSD) programs and in other allied health programs, educators are seeking out research to support their curricular decisions about IPE. Numerous international and interdisciplinary researchers have examined the potential of IPE programs and case-based learning to improve preparation for future health care professionals. High-quality systematic reviews in allied health (including CSD) and medical education report improved student learning outcomes such as increased interprofessional confidence, knowledge, and communication skills (see, e.g., Reeves et al., 2016). Recommendations from this body of literature suggest that IPE experience is considered best practice for educating future allied and health care professionals.
Does IPE Lead to Improved Practice?
A more important consideration, perhaps, is whether the positive results for IPE extend to improved interprofessional practice (IPP) skills of CSD program graduates and, ultimately, whether they translate to improved client outcomes and improved health care costs and benefits. The relationships among IPE, IPP, and positive health care outcomes are not yet clear. In 2015, the Institute of Medicine (IOM) published a report providing recommendations for expanding the evidence base for IPE outcomes beyond student perceptions and knowledge. These recommendations included dedicating resources to high-quality mixed-methods studies that examine the impact of IPE on practice behavior and health care costs at both university and medical system levels.
An Illustration: The Michigan Health Endowment Fund
Despite IOM’s 2015 call for funding high-quality research, there are limited resources that are designed specifically to examine the long-term efficacy of IPE and IPP. We can, however, leverage other health care grants that do not particularly require an interprofessional focus—for example, grants supporting patient outcome research can include IPP components to assess delivery models of IPE. Another example is the Michigan Health Endowment Fund (https://www.mihealthfund.org)—also known as “the Health Fund”—which was expressly created to improve health care. A current Health Fund project addresses the costs and benefits of an IPE program for aging seniors in a university rehabilitation center. In a series of 8-week classes, professionals and students representing audiology, occupational therapy, physical therapy, social work, speech-language pathology, and nursing collaborate to assess and then provide strategies for managing issues related to falls—issues such as cognition, hearing, balance, medications, daily living barriers, and depression status. To measure the program’s efficacy, researchers collect pre- and post-participation information about students’ IPP knowledge and seniors’ health status. Researchers also collect data 6 months later or after the students enter the workforce. Preliminary results indicate positive results for students’ understanding of IPP and for seniors’ improved health status. Improvements in health care status were even apparent for seniors who previously reported repeated emergency department visits and hospitalizations for falls.
Even with increased availability of resources for IPP research, the challenge of reduced third-party reimbursements may be barriers to high-quality IPE training of graduate students. For example, reduced third-party reimbursements may affect the ability for two or more disciplines to co-treat during the same session. This circumstance likely will negatively impact the provision of key IPP clinical educational experiences. Although ASHA’s new certification standards encourage IPP experience (Standard V- B), hospitals and rehabilitation centers may not be able to fully support interprofessional practices for health care professionals. Until third-party payers are convinced that IPP is indeed cost effective with increased patient benefit, the availability of IPP in health care settings may be somewhat limited.
Looking Ahead: How Should We Proceed?
Still more work is needed to raise awareness and visibility of the role that Auds and SLPs bring to the interprofessional team table. Many IPE studies incorporate professions that are typically associated with medical settings—such as nursing, medicine, pharmacy, and dentistry—while not necessarily involving CSD professionals. This situation continues to exist despite the critical role that audiologists and speech-language pathologists could play in IPE assessment and rehabilitation training scenarios. Furthermore, IPE that does involve audiologists and speech-language pathologists often occurs in a medical context, suggesting the potential for considerable IPE growth in school-based settings. IPE research opportunities are available for school settings, with team collaboration among general and special educators, psychologists, social workers, and others (see, e.g., Strunk, Kipps-Vaughn, & Pavelko, 2019).
With the understanding that IPE and IPP are increasingly becoming the norm in allied health care training and delivery, we in the CSD professions must demonstrate—with well-designed research—the positive effects of IPE and IPP on client outcomes. A greater number of dedicated research funding opportunities would likely accelerate the generation of these data. Health care and education professionals, administrators, third-party payers, universities, and professional organizations need to continue their dialogue and then act to collaboratively dedicate resources for this purpose (see, e.g., Mladenovic & Tilden, 2017; West et al., 2016). Ultimately, we need collaboration among all parties in order to determine whether IPE does, indeed, change health care and education practices and outcomes.
References
American Speech-Language-Hearing Association. (n.d.). Interprofessional Education/Interprofessional Practice (IPE/IPP). Retrieved from https://www.asha.org/Practice/Interprofessional-Education-Practice/
Institute of Medicine. (2015). Measuring the impact of interprofessional education on collaborative practice and patient outcomes. Washington, DC: The National Academies Press.
Mladenovic, J., & Tilden, V. P. (2017). Strategies for overcoming barriers to IPE at a health
sciences university. Journal of Interprofessional Education and Practice, 8, 10–13. https://doi.org/10.1016/j.xjep.2017.05.002
Reeves, S., Fletcher, S., Barr, H., Birch, I, Boet, S., Davies, N., . . . Kitto, S. (2016). A BEME systematic review of the effects of interprofessional education: BEME Guide No. 39. Medical Teacher, 38, 656–668. https://doi.org/10.3109/0142159X.2016.1173663
Strunk, J., Kipps-Vaughn, D., and Pavelko, S. L. (2019). Interprofessional education for pre-service school-based professionals: Faculty and student collaboration. Teaching and Learning in Communication Sciences & Disorders, 3(1), 1–17. https://doi.org/10.30707/TLCCSD.3.1Strunk West, G., Graham, L., Palmer, R.T., Miller, M.F., Thayer, E.K., Stuber, M.L., …Carney, P.A. (2016). Implementation of interprofessional education (IPE) in 16 U.S. medical schools: Common practices, barriers, and facilitators. Journal of Interprofessional Education and Practice, 4, 41-49. DOI 10.1016/kjep.2015.05.002.
