E. Paradis is assistant professor, Leslie Dan Faculty of Pharmacy, Department of Anesthesia, and Department of Sociology, University of Toronto, and scientist, Wilson Centre, Toronto, Ontario, Canada; ORCID: http://orcid.org/0000-0001-9103-4721. C.R. Whitehead is associate professor, Department of Community and Family Medicine, University of Toronto, director and scientist, Wilson Centre, and vice president for education, Women's College Hospital, Toronto, Ontario, Canada; ORCID: http://orcid.org/0000-0002-0134-9074.
Acad Med. 2018 Oct;93(10):1457-1463. doi: 10.1097/ACM.0000000000002233.
Interprofessional education (IPE) is an increasingly popular educational model that aims to educate health care students to be better collaborators by enabling them to learn with, from, and about each other. IPE's rising popularity is evident in the increase in scholarship on this topic over the last few decades. In this Perspective, the authors briefly describe three historical "waves" of IPE: managing the health workforce through shared curriculum, maximizing population health through health workforce planning, and fixing individuals to fix health care. Using insights from the social sciences and past practice, they then discuss six reasons why the current third wave of IPE is likely to fall short of meeting its goals, including that (1) IPE is logistically complex and costly, (2) IPE is developmentally inappropriate, (3) the link between IPE and key outcomes is still missing, (4) IPE insufficiently engages with theory, (5) IPE rarely addresses power and conflict, and (6) health care is an inertial system that IPE is unlikely to change. The authors conclude by sharing their vision for a fourth wave of education for collaboration, addressing workplace systems and structures, which would combine undergraduate, uniprofessional education for collaboration with practice-based interventions.
跨专业教育(IPE)是一种日益流行的教育模式,旨在通过使学生能够相互学习、相互借鉴和相互教育,培养医疗保健学生成为更好的合作者。在过去几十年中,关于这个主题的学术研究不断增加,这表明 IPE 的日益普及。在本文观点中,作者简要描述了 IPE 的三个历史“浪潮”:通过共享课程管理卫生人力,通过卫生人力规划最大化人口健康,以及通过个体治疗来解决医疗保健问题。然后,他们利用社会科学的见解和过去的实践经验,讨论了当前 IPE 浪潮可能无法实现其目标的六个原因,包括:(1)IPE 在后勤方面很复杂且成本高昂;(2)IPE 发展不成熟;(3)IPE 与关键结果之间的联系仍然缺失;(4)IPE 对理论的参与不足;(5)IPE 很少解决权力和冲突问题;(6)医疗保健是一个惯性系统,IPE 不太可能改变它。作者最后分享了他们对合作教育的第四波浪潮的展望,即解决工作场所的系统和结构问题,将合作的本科、单一专业教育与基于实践的干预措施相结合。