Interprofessional education: First steps

Not long ago, we took our first steps and introduced Anatomical Sciences Education (ASE) at the 2007 Association for Medical Education in Europe (AMEE) Conference in Trondheim, Norway. At this unveiling we outlined goals and objectives of, at the time, an unborn education journal which would debut the following year. We recall how exciting/challenging it was to have our exhibit placed next to the more well-established journals at this conference, but, with logos of the American Association of Anatomists (AAA) and Wiley adorning our booth, great excitement was generated, fliers announcing the new journal rapidly disappeared, and new relationships with future authors were established (AMEE, 2007). Today, eight years and 45 issues later, ASE is a mature and well-established journal and we are excited as we take another first step and introduce our readers to the first ASE special issue on “Interprofessional Education in the Anatomical Sciences”. To the best of our knowledge, this is the first special issue for an education journal that publishes in the classically defined basic science field (anatomy, physiology, microbiology, pathology, and/or biochemistry) on interprofessional education (IPE). Some background information as IPE may be a topic that is relatively new to many of our readers. Interprofessional education is defined as and is regarded as an activity that “occurs when two or more professions learn with, from and about each other to improve collaboration and the quality of care” (CAIPE, 2002). There is a small but growing group of anatomists who can provide examples from their gross anatomy laboratories where medical students are learning anatomy side-by side with other health care professional students (i.e., physical therapy, physician assistants, nursing, etc.,). However, the frequency of IPE activities in anatomy laboratories are increasing around the country as evidenced by a growing number of presentations occurring at the annual meetings of the AAA and other anatomical societies. A quick search of the PubMed database for the term “interprofessional education” reveals a recent explosion of articles related to interprofessional education. More than 750 articles have been published since 2011. In comparison, we found only 10 articles identified by the same criteria before 1990, 26 between 1991 and 2000, and 427 between 2001 and 2010. Studies in Australia and UK show that the majority of IPE experiences are implemented in the later years of a program's curriculum (Thistlethwaite, 2015), so it is not surprising that most IPE publications relate to clinical activities and learning within the interprofessional team in the health care environment. Very few articles have discussed IPE integration into the basic sciences, especially in anatomy, which brings up the question of why a special issue of ASE on the topic of IPE. Because this is a rapidly expanding field in health care education and anatomists are leading the way. Found along with the research and descriptive articles and short communications published in this special issue, we would like to call your attention to three excellent viewpoint commentaries that have been included. In the first commentary Professor Ronald H. Harden from the United Kingdom, who is the Secretary General for AMEE, shares his reflections on interprofessional learning as an educational strategy and outlines several reasons why the introduction of IPE is now favored in the early years of medical education (Harden, 2015). He also underscores observations that the implementation of IPE seems to be valued in schools that clearly articulate interprofessional approaches to education in their institutional vision and mission statements. Furthermore, Professor Harden notes that positive attitudes among faculty are one of the most fundamental pre-requisites for favorable perceptions of IPE among students (Wilhelmsson et al., 2010; Harden, 2015). The second viewpoint commentary comes from the president and CEO of the Association of American Medical Colleges (AAMC), Dr. Darrell G. Kirch, who discusses IPE in the context of the needs of the United States' health care system. It's his feeling that interprofessional care delivery is an essential vehicle to achieve the “triple aim” of health care, improving the patient experience, the health of the population, and the per capita cost. If this is to occur the educational system must prepare health care professionals to comfortably work in this environment in the future (Kirch and Ast, 2015). The importance of IPE in health education and the role of anatomy in the early implementation of IPE with health care students is also highlighted in this insightful commentary (Kirch and Ast, 2015). The third viewpoint commentary is by Australian Professor Jill Thistlethwaite, a Fulbright senior scholar at the National Center for Interprofessional Practice and Education at the University of Minnesota who has published several books on leadership development for IPE and collaborative practice. In her commentary, Dr. Thistlethwaite examines specific basic science competencies against the criteria published in the Core Competencies for Interprofessional Collaborative Practice (IPEC Expert Panel, 2011). Dr. Thistlethwaite provides examples of IPE competencies that can be adapted to fit the basic sciences, pre-clinical courses, and non-patient learning activities (Thistlethwaite, 2015). She also offers astute recommendations for IPE course development and its subsequent evaluation. Besides these excellent commentaries, this special issue provides a glimpse into the collective experience anatomy teachers have had in implementing IPE into gross anatomy courses. There are reports from all over the world featuring health professional students' experiences with IPE and a report from experts on how to develop appropriate learning space for IPE (Cleveland and Kvan, 2015). The last piece in this issue is a review which reminds all anatomy teachers that “good teaching is good teaching” (Berman, 2015). Teachers should follow best practice standards and articulate clearly their goals and objectives to students. A skillful and well-trained medical educator is one of the key elements to the success of IPE (Oandasan and Reeves, 2005). In conclusion, during this challenging time of transforming health professions education, as Kirch and Ast (2015) state, “anatomy education is already showing [us] how to initiate these first steps.” The journey of a thousand miles takes a first step, and we have been truly proud, since our own first steps here at ASE, to lend our inspiration to others through the collective voices of our most valuable resources—our authors, the pilgrims of interprofessionalism. Wojciech Pawlina, M.D.* Department of Anatomy, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, Minnesota Richard L. Drake, Ph.D.* Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic, Cleveland, Ohio