The Role of Interprofessional Education in Training Healthcare Providers for Integrated Healthcare: A Scoping Review

Background Longer lifespans and living with multiple chronic conditions are driving necessary change in healthcare systems. There is an increasing shift towards team-based integrated care, to provide person-centred care that is accessible, continuous, and of high quality. Health professional roles are changing rapidly; traditional educational approaches no longer suffice. New models of care require new models of learning – from a focus on workforce planning for professionals to workforce planning for patients and populations. The World Health Organization and the Institute of Medicine acknowledge that preparation of the healthcare workforce has not kept pace with these changes. Interprofessional education (IPE) and professional development training that includes partnering with patients, providers, and communities are identified as key solutions. However, understanding how IPE supports workforce development for integrated care remains unclear. This scoping review aimed to answer the question: What is the role of IPE in training healthcare professionals to work in integrated care? The focus of this review was on post-licensure health care professionals (HCPs) in the current workforce versus preparation of students in academic settings.


Background
Longer lifespans and living with multiple chronic conditions are driving necessary change in healthcare systems. There is an increasing shift towards team-based integrated care, to provide person-centred care that is accessible, continuous, and of high quality. Health professional roles are changing rapidly; traditional educational approaches no longer suffice. New models of care require new models of learning -from a focus on workforce planning for professionals to workforce planning for patients and populations. The World Health Organization and the Institute of Medicine acknowledge that preparation of the healthcare workforce has not kept pace with these changes. Interprofessional education (IPE) and professional development training that includes partnering with patients, providers, and communities are identified as key solutions. However, understanding how IPE supports workforce development for integrated care remains unclear. This scoping review aimed to answer the question: What is the role of IPE in training healthcare professionals to work in integrated care? The focus of this review was on post-licensure health care professionals (HCPs) in the current workforce versus preparation of students in academic settings.

Theory/Methods
We followed the Arksey and O'Malley method for conducting scoping reviews. The CINAHL, MEDLINE, ProQuest Nursing and Allied Health, and Scholars Portal databases were searched using key search terms (interprofessional education, interdisciplinary education, integrated care, integrated health care delivery). Articles included were peer-reviewed, from all sectors, published in English, from the year 2000 to 2020 and comprised post-licensure health care workers. Study selection and data extraction were conducted by two independent reviewers using a standardized data extraction form. Data were collated, summarized, and key themes were identified.

Results
A total of 32 papers were included in the review consisting of primary research studies (16), reviews (10), and reports/position papers (6). Integrated care was described as having multiple definitions, various models, key principles, and competencies.

Key Themes
The role of IPE in training health care professionals to work in integrated care was elucidated through qualitative thematic analysis. Four key themes were identified: 1) laying the foundation, 2) providing a building block, 3) acting as a catalyst, and 4) generating practice change.
A Scoping Review

Discussion
The findings have implications for education and practice. IPE should begin in academic programs and continue as workplace learning that is flexible and context specific. Multi-component interventions based on theory and evidence should be used to reinforce learning in the practice setting.

Conclusions
IPE has a unique and important role in training health and social care providers to work in various models of integrated care. However, IPE is only one part of a larger program of training that is necessary.

Lessons Learned
IPE is a critical component in training current health and social care providers to work in increasingly complex health care systems. Extending IPE beyond traditional roles and settings is crucial.

Limitations
A formal evaluation of the quality of the evidence was not conducted and only papers written in English were included.

Future Research
More rigorous research designs that clearly link IPE in integrated care to provider and patient outcomes are required.