Interprofessional Education Issue

The triple aim of improving health of populations, reducing cost, and enhancing quality was introduced by the Institute for Healthcare Improvement and its founder, Dr. Donald Berwick, about a decade ago. A recent suggestion in the medical literature has now added an additional aim, that of improving the work life of clinicians and staff.[1] One of the strategies proposed for addressing these issues is the development of interprofessional practice. In recent years, recognition that these collaborative team approaches have been underutilized in most clinical practice settings has created a significant interest in the development of approaches to interprofessional education.

Within speech-language pathology, and within the rehabilitation fields, there has been commitment to this discussion, and providers and scholars within the field have recognized their potential contribution to these aims. Despite the interest, early discussions of interprofessional practice have focused on the roles of physicians, nurses, and pharmacists working together. There is some face value to the discussion because of the historic conflicts among these groups of professionals, as well as their obvious need to work together in the most complex and demanding settings of surgery, intensive care, and emergency environments. The high rate of errors, potential risk to patients and providers, and need for urgent moment-to-moment communication in these settings certainly creates a context requiring attention to topics that are central to interprofessional care: teams and teamwork, negotiation, communication, handoffs, group decisions, and leadership.

More recently, groups outside of the physician, nurse, pharmacist triad have begun to be included in discussions regarding interprofessional care and practice. Of interest to readers of this issue of Seminars in Speech and Language is the preparation of speech-language pathologists for interprofessional practice. Inclusion as a member of a team or as its leader requires professional preparation that has not traditionally been carefully addressed in the curriculum in any of the health fields, including speech-language pathology. The new attention to interprofessionalism in medicine and nursing creates an opportunity for engagement of other professionals in levels and types of care, which were previously not considered. Attention to the interprofessional role of the speech-language pathologist across all levels of care has the potential to affect patients and the health system in positive ways. Because speech-language pathologists practice in these settings—acute, psychiatric, rehabilitative, outpatient, home care, palliative, and hospice—the ability to develop skills and knowledge regarding interprofessionalism is no longer optional. Colleagues will (and should) expect speech-language pathologists to come to their setting prepared for leadership and practice skills that reflect interprofessionalism in addition to their specialized expertise in speech, language, and swallowing. Similarly, it is important that speech-language pathologists develop expectations about interprofessionalism from those in other professions. Interprofessional skills and practice go well beyond “good conduct” and professional courtesy.

Thus, this issue provides a glimpse into the ways some institutions are preparing students for interprofessional practice. The first article serves as an introduction to the topic of interprofessional education and provides an overview of the way in which the faculty of the MGH Institute of Health Professions has developed a comprehensive curricular approach to introducing the topic to its entry-level graduate students in nursing and physician assistant studies, physical and occupational therapy, and speech-language pathology. In the second part of this article, the authors describe the experience of a typical speech-language pathologist student as she moves through this curriculum. In the subsequent articles, descriptions of innovative activities and instructional approaches, clinical and classroom experiences, and application to the school setting are discussed. We hope these examples inspire active development of innovative experiences in graduate education programs.

• Reference

• 1 Bodenheimer T, Sinsky C. From triple to quadruple aim: care of the patient requires care of the provider. Ann Fam Med 2014; 12 (06) 573-576