WHAT IS INTERPROFESSIONAL EDUCATION?

One of the aims of Leathard’s (1994) publication was to help clarify and define the ambiguous terminology in this developing area of education and work. In the last chapter the terminology surrounding working together was discussed and it was concluded that no particular agreed definition has emerged from the literature but that Rawson’s ‘interprofessional working’ definition (see chapter 2) appears to have greatest utility. The

debate surrounding the definitions used for when professions learn together has taken a rather different course.

As Leathard (1994) has described in the last chapter there were 54 terms used to describe situations when professions learn and work together. Barr and Shaw (1995) helped to focus the definitions debate for ‘learning together’ down to two key terms which were emerging from the literature in continental Europe, the United States and the U.K. These terms were multiprofessional and interprofessional education. They stated that multiprofessional education was defined by the World Health Organisation (1988), and adopted by the European Network for Multiprofessional Education in Health Sciences (EMPE). It was also used widely in Continental Europe and is described as

“….initiatives involving three or more professions.”

Barr and Shaw (1995)

The Barr and Shaw (1995) definition for interprofessional education, which they note is more common in the USA, has been adapted in the UK by the national Centre for the Advancement of Interprofessional Education (CAIPE). This specifies the type of education method, which should be interactive and encourages professions to learn from and about each other.

In a later seminal work by Barr (1996) he uses this CAIPE adopted definition and neatly differentiates between multiprofessional and interprofessional by saying:

"There is, therefore, a need to distinguish between those occasions when students simply learn together

(multiprofessional education) and those where they do so with

the object of promoting collaborative practice

(interprofessional education)." [Emphasis added]

The key difference being that in multiprofessional education the learning method is not specified whereas in interprofessional education the learning should be interactive in nature in order to enable the professions to learn from and about each other.

The other term, which is often used in the context of joint learning and working and was used at University College Salford in the late eighties and early nineties during the

development of multiprofessional education, was ‘shared learning’. A definition for this, adopted by CAIPE (Barr 1994), is

"All opportunities where two or more professions within and across health and social care studies together."

This would appear to be similar to the broad multiprofessional term but distinct from the interprofessional one in that it does not specify the degree of interactivity of the study.

To summarise multiprofessional education and shared learning are all embracing terms encompassing educational initiatives where two or more (shared learning) or three or more (multiprofessional education) professions study together. Interprofessional education is a specific form of the above two educational initiatives whereby the learning is focused towards the other professions involved in using an interactive teaching and learning strategy. The concepts surrounding these three terms can be found throughout the literature and even though the terms used are not always consistent with these emerging definitions the concepts appear to be well understood by many in this field of work.

In the early years of multiprofessional education learning situations were set up which placed learners together but the outcome was more focussed towards saving resources than promoting collaborative practice. In 1997 the education purchaser local to Salford University, the Lancashire and South Cumbria Education and Training Consortium published a visionary document entitled “A prospective view of the National Health Service in the year 2005: Implications for the Education and Training of the total workforce.” This document clearly articulated the desire of the purchaser to buy education and training from the higher education institutions that was designed with the aim of promoting collaborative practice. They state:

“This needs to be genuine shared learning where students gain real common understanding (not just shared teaching where different students happen to sit in the same lecture)”

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It is interesting to note that the terminology used by the consortium is not congruent with that in parts of the literature. However as practice is the ‘real world’ of interprofessional work it might be better to say that the literature is not aiding the understanding and

communication of information regarding this type of work in the field. Nonetheless the consortium have ably demonstrated the education that they wish to purchase to prepare the professionals for practice.

When making reference to the literature this thesis will use the term offered by the author of the work. When describing activities that the author of this thesis has been involved in where students learn together, the definitions adopted by CAIPE (1996) will be used.

The nomenclature surrounding multiprofessional education continues to be debated however and Harden (1998) quotes the WHO definition (1988) which is similar to the interprofessional education definition adopted by CAIPE (1996). He makes the point that this may be an unduly restrictive definition. He quotes Rogerson and Harden (1998) who suggest that even though learners may not interact with their fellow healthcare professionals they could still gain valuable learning that could promote collaborative practice from the teachers and staff of other professions.

By way of expanding upon the possible contexts within which valuable multiprofessional education could be offered Harden (1998) set out an 11 step multiprofessional continuum (appendix 2). This framework for multiprofessional education is a theoretical one put forward by Harden (1998). This classification system is valuable in that it provides a framework for assessing the amount of multiprofessional/interprofessional activity being undertaken on a programme. Yet it is a very scientific approach to classification. There are types of multiprofessional activity which do not fall into the neat divisions that Harden presents. There is also no evidence offered to support the notion that this continuum of multiprofessional activity is one of increasing effectiveness towards the transprofessional end.

There is much literature on the different forms of multiprofessional education that have and are being delivered. The following section will discuss some examples of these educational initiatives from across the field and where possible, classify them using the Harden nomenclature. It will also discuss issues which might impact upon the design of future MPE/IPE curricula.