Interprofessional Education for Whom? — Challenges and Lessons Learned from Its Implementation in Developed Countries and Their Application to Developing Countries: A Systematic Review

Abstract

BackgroundEvidence is available on the potential efficacy of interprofessional education (IPE) to foster interprofessional cooperation, improve professional satisfaction, and improve patient care. While the intention of the World Health Organization (WHO) is to implement IPE in all countries, evidence comes from developed countries about its efficiency, challenges, and barriers to planning and implementing IPE. We therefore conducted this review to examine challenges of implementing IPE to suggest possible pathways to overcome the anticipated challenges in developing countries.MethodsWe searched for literatures on IPE in PubMed/MEDLINE, CINAHL, PsycINFO, and ERIC databases. We examined challenges or barriers and initiatives to overcome them so as to suggest methods to solve the anticipated challenges in developing countries. We could not conduct a meta-analysis because of the qualitative nature of the research question and the data; instead we conducted a meta-narrative of evidence.ResultsA total of 40 out of 2,146 articles were eligible for analyses in the current review. Only two articles were available from developing countries. Despite the known benefits of IPE, a total of ten challenges or barriers were common based on the retrieved evidence. They included curriculum, leadership, resources, stereotypes and attitudes, variety of students, IPE concept, teaching, enthusiasm, professional jargons, and accreditation. Out of ten, three had already been reported in developing countries: IPE curriculum, resource limitations, and stereotypes.ConclusionThis study found ten important challenges on implementing IPE. They are curriculum, leadership, resources, stereotypes, students' diversity, IPE concept, teaching, enthusiasm, professional jargons, and accreditation. Although only three of them are already experienced in developing countries, the remaining seven are potentially important for developing countries, too. By knowing these challenges and barriers in advance, those who implement IPE programs in developing countries will be much more prepared, and can enhance the program's potential success.

Academics’ knowledge and experiences of interprofessional education and practice

“…These strategies are corroborated by the findings of a systematic review, which identified that curriculum, leadership, resources, student diversity, teaching and accreditation are important challenges for IPE in developing and developed countries. [13] Implementing a competency framework, based on the competencies of teamwork, responsibilities, communication, learning, patient focus and ethics, could assist the Faculty in setting explicit competencies for the implementation of IPECP. [11] Easing the framework into the curriculum by capitalising on what already exists, effective communication, respect for others and shared decisionmaking, as well as collaborative leadership, problemsolving and conflict resolution, are also important considerations.…”

Toward an Interprofessional Mentoring Program in Palliative Care - A Review of Undergraduate and Postgraduate Mentoring in Medicine, Nursing, Surgery and Social Work

“…This program must be housed within a formal program [52] in order to facilitate personalized matching of mentee and mentor [34]. Use of a formal approach facilitates inculcation of training programs for mentors [53,54] and instilling a robust curriculum design that aligns mentoring values and education goals [45,53].…”

“…The presence of mosaic mentors strengthens the benefits of the 4 components of the IPE program. Meetings between mentee and mentors can allow for clarification of didactic content, reinforcement of learning points and most importantly, resolution of conflicts [53] that the mentee may have encountered during clinical rotations. The mentors can enhance the learning value of simulations by providing individualised feedback after the session.…”

“…logistics and scheduling) [40]. Common challenges to both mechanisms include clashes in scheduling [39,49,53] and the lack of trained mentors [44,45,53]. This is particular relevant when data suggests that mentoring relationships ought to last at least 6 months.…”

Using a meta-ethnographic approach to explore the nature of facilitation and teaching approaches employed in interprofessional education

“…While there has been a growth of IPE reviews reporting the effectiveness of this type of education on participants' collaborative competence and ability to deliver safe and effective care (Brandt et al, 2014;Lawlis et al, 2014;Reeves et al, 2013Reeves et al, , 2016Sunguya et al, 2014), little attention has been placed on the facilitation/teaching processes employed by individuals who deliver IPE. In addition, while there has been a growth of qualitative IPE studies, there has been no attempt to synthesise this type of research to assess the nature of the growing qualitative evidence base.…”