As health care and interprofessional educators and practitioners, we find ourselves at a crucial time for making change in how we educate and how we deliver services that are most impactful. Interprofessional education (IPE) is grounded in four competency areas that expect us to build teams and teamwork, establish values and ethics for interprofessional practice, use our roles and responsibilities to advance and promote the health and well-being of all populations, and communicate as interprofessional teams to connect with those impacted by our work (IPEC, 2016). These competencies provide a pathway for education and clinical practice, but they may fall short if we fail to bring an equity lens to the discussion. It is this intersection—equity with interprofessionalism—that is the focus of this discussion.
Audiologists and speech-language pathologists devote themselves to making changes in people’s lives—changes that are understood, that are welcomed, and that have lasting impact. Multiple cultural, political, racial, economic, and social influences impact our ability to advance these changes. Although it is a difficult task, if we highlight diversity, equity, and inclusion as values that we believe are important in both the educational and clinical training we deliver, then audiologists and speech-language pathologists can have a broad impact. We must embed equity in our teaching and learning experiences if we expect it to be an outcome of interprofessional practice.
In working with our students, we should be asking questions like . . .
- Do we know the cultural experiences that our students bring to their learning?
- Do we ensure a level playing field for learners, especially for those who may come from backgrounds different than our own?
- Are we helping students learn to listen to each other in respectful ways and to value the differences that they bring to the learning context?
- Are we ensuring that students are learning to use tools and resources that are evidence based and that are culturally and linguistically appropriate?
- Are we providing safe spaces for learners to discuss their own concerns or questions about issues of social justice, anti-racism, gender-based equity issues, and similar topics?
- Are those in charge of educational programs ensuring that admissions practices, examinations, criteria for progression, and the curriculum itself reflect the values of equity, inclusion, and cultural competence?
In working with interprofessional teams, we should be asking questions like . . .
- Do we understand the many ways that the voices of those we serve are impacted by the power and hierarchy of our educational and health care systems?
- Do we honor different perspectives in developing curricula and content for team learning experiences?
- Are team members valuing the context and values of the patient/client at the center of the team?
- Is the unique contribution of each team member valued and respected?
- Are positional (power) issues within the team discussed, recognized, and clear?
- Is there a possibility that team members’ racial identity, gender identity or expression, or other personal characteristics make them more vulnerable or less valued?
To deliver equitable care for all people, regardless of their racial, gender, sexual, ethnic, religious, social, or economic identities—we are called to create an integrated educational model that not only emphasizes the four key IPE competencies but also is grounded in our commitment and action for diversity, equity, and inclusion (Leslie et al., 2017). Our students, our patients, our clients, and their families are calling on us to increase the education and experience that we provide related to several health equity concepts—including an awareness and understanding of microaggressions, power, privilege, and health disparities.
The task before us is not an easy one, but in our interprofessional effort to change how we educate and prepare our practitioners, this is the right time to up the ante in terms of our expectations for educational training that has a diversity, equity, and inclusion pathway to practice. We propose several ways in which we might consider the intersection of anti-racism and IPE work as we prepare students in our discipline:
- Develop complex case scenarios that represent different identities and the health or educational disparities that individuals with these identities have experienced. As we review these cases, we need to be explicit in highlighting the effects of discrimination and inequity on decision making and outcomes of care delivery.
- Examine the power and privilege of different professional roles—and how these roles impact the formation of IPE teams and communication with one another, and the individuals served by those teams.
- Identify ethical issues facing IPE teams when interacting with different cultural groups around decision making and implementation of assessment and treatment options. Always ensure that the patient/family perspective is brought into focus, paying special attention to issues that provide insight into their values.
- Describe instances of racism in health care and in our own discipline. Be honest and forthright in considering these perspectives, and allow learners to offer personal, programmatic, or systemic solutions that could impact change.
- Provide examples of IPE teams successfully and unsuccessfully demonstrating dignity, respect, and inclusion in their interprofessional practice—and offer multiple opportunities to identify those behaviors that led to equitable outcomes.
- Role-play attitudes and practices that contribute to disparities in service delivery. Develop simulation scenarios that provide for problem solving and reflection on the intersection of team practices and social justice/equity issues.
As we consider our efforts to embed diversity, equity, and inclusion into IPE content and
training, we must have systems in place to ensure that our discipline is representative of the diverse populations we serve. We must reexamine and improve our strategies for both faculty and student recruitment. We must reconsider the very systems and structures that we use to hire—and retain—educators and service providers, and that we use to admit students into our CSD training programs. In selecting learners or employees, do we consider questions about the values of importance—not just the four IPE competency areas and what they mean, but what each of those competencies would look like from an equity lens? Are we prepared to address a conflict when we witness a microaggression or an attempt at using one’s power to disparage the identity of another? Are we satisfied with being bystanders, or are we willing to step up and say, “This is not how we engage, learn, and lead in a culturally rich and diverse world that expects better of us”? Finally, we must affirm that the role of leaders in this environment is to provide focus and open opportunities for discussion on any potential disruptors to equity. Careful programming, instruction, and coaching to make systematic changes in the learning or work environments are important tactics to bring about change.
Our academic community has the opportunity to tackle these important issues. As IPE teams, we can model what it means to bring diverse voices together, to equip our instructors with the content they need and with relevant, real-life examples that consider different racial, gender, sexual, ethnic, religious, social, or economic identities. We need to take the time and make the effort to develop and use explicit and implicit instructional examples that foster an equity lens in all that we do. As audiologists and speech-language pathologists and as members of IPE teams, we want to model a learning context in which we ask questions, challenge practices, and welcome differences in beliefs—while expecting others to do the same!
Interprofessional Education Collaborative. (2016). Core competencies for interprofessional collaborative practice: 2016 update. https://www.ipecollaborative.org/ipec-core-competencies
Leslie, K. F., Steinbock S., Simpson, R., Jones, F., & Sawning, S. (2017, March 10). Interprofessional LGBT health equity education for early learners. MedEd PORTAL: The Journal of Teaching and Learning Resources, 1–7.