Organizational structure and resources of IPE programs in the United States: A national survey

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Abstract

Interprofessional education (IPE) initiatives are growing due to the Interprofessional Education Collaborative's core competencies being incorporated into health professions educations programs' accreditation criteria. This investigation examined organizational models and structures of US IPE programs using mixed methodology of quantitative survey and qualitative analysis. Responses (61% response rate from the 131 institutions surveyed) were examined to identify relationships between IPE program organizational factors. Despite marked heterogeneity in most aspects of IPE program infrastructure including administrative structure, financing, and role of the academic health center (AHC), several key relationships emerged. A centralized administrative structure was most common and was associated with dedicated resources. The majority of programs were in AHCs and this was associated with financial structure, annual budget size, program maturity, number of students participating, and references to IPE in promotion and tenure guidelines. IPE learning experiences occurred predominantly in academic settings, identifying a critical need for development of clinical IPE learning experiences. Clinical IPE learning experiences were generally not in mainstream healthcare delivery systems but filled gaps or complemented healthcare efforts for underserved populations. Qualitative analysis results supported the survey results. Continued research in IPE organizational structures is needed to determine external and internal drivers associated with program success and continued trends in the IPE field.

Introduction

After a nearly sixty-year history,1, 2, 3, 4 there has been a growth of interprofessional practice and education (IPE) initiatives. Historically, IPE in the United States was developed in academic health centers (AHCs) served as new models of health and education delivery.5 Near the turn of the 21st century, seminal Institute of Medicine reports on patient quality and safety6,7 sparked another wave of interest in IPE. Over the first decade of the new century, continued growth occurred in the IPE field and in 2009 the American Interprofessional Health Collaborative (AIHC) was formed.8 The development of interprofessional core competencies by the Interprofessional Education Collaborative (IPEC) in 20119 and 201610 and adoption of these core competencies into health professions education program accreditation criteria11, 12, 13, 14, 15 has led to increased development of IPE programs, centers, and initiatives; curricula; and student experiences across the United States (US).16,17 According to the interactive IPE Centers, Programs, and Initiatives map available on the website of the National Center for Interprofessional Practice and Education (National Center), 145 health professions IPE program, centers, and formally charged initiatives (here after referred to collectively as IPE programs) are currently (as of August 2021) active nationally, with the number of IPE programs in individual states ranging from none to 10.18 We foresee that IPE programs will grow in the US and will continue with national initiatives in the field. As an example, the Health Professions Accreditors Collaborative and the National Center recently produced a guidance document with a framework to encourage institutions to develop, implement, and evaluate systematic IPE approaches and IPE plans.19 With this growth, given local contexts and histories, vast differences in IPE programs and practices have been observed.20,21

While previous research has examined the prevalence of IPE program content in specific health professions education programs,16,22,23 investigation into relative similarities and differences in the organizational structure of IPE centers is limited and more remote.20,21 To gain a better understanding of the breadth of current organizational models and structures of US IPE programs, the AIHC and National Center created a taskforce to gather this information. This taskforce collected and analyzed the institutional organizational models and structures of US-based IPE programs using a national survey. We sought to examine the associations among IPE program organizational structure, leadership model, financial structure, budget, maturity (defined as the years of IPE center operation), size (defined as the number of participating students), and inclusion in an AHC. This paper describes the results from this taskforce's investigation and provides baseline information about the organizational models and structures of US IPE programs prior to the outbreak of the COVID-19 pandemic.

Section snippets

Methods

Survey Development. Members of the AIHC Organizational Models of IPE Taskforce were appointed by the AIHC executive leadership team based on their expertise, positions, relevant past publications, and experience with IPE surveys, involvement with Conversation Cafes on this topic at past National Center annual conferences (Nexus Summits) or their appointment on certain AIHC committees. Conversation Cafes are structured, facilitated discussions on topics identified as critical to advancing the

Results

Characteristics of Respondent Institutions. Final surveys were distributed in November to the 131 member institutions registered on the on the National Center IPE Initiative list-serve as of July 2019 and 80 institutions from 39 states returned completed surveys (response rate 61%). The majority of respondents reported their institution is designated as a doctoral degree-granting institution (81%), and their IPE programs were located in an AHC (65%), had been in existence for six years or more

Qualitative data

Several important themes emerged from the respondents' comments that further elucidated the variability in IPE program infrastructure, institutional alignment, dedicated resources, implementation, and aligning IPE in practice and creating interprofessional clinical learning environments. Detailed examples of specific comments supporting the qualitative analyses have been described in the American Interprofessional Health Collaborative's 2020 report Organizational Models of Interprofessional

Discussion

This mixed-methods investigation describes the national landscape of IPE program organization and resources as it existed in late 2019 in the US. It builds upon prior work16,23 and further explores the factors impacting program development and sustainability, including financial resources. Characteristics related to IPE program leadership, administrative structure, financing, and the role of an AHC varied among programs. Several important themes emerged associated with program infrastructure,

Conclusion

This survey revealed marked heterogeneity in most aspects of IPE program infrastructure including IPE program leadership, administrative structure, financing, and the role of the AHC. However, the most common characteristics regarding the organization of IPE programs in the U.S. include a centralized administrative structure with a dedicated leader and budget for the IPE program. The heterogeneity underscores the importance of institutional context when implementing IPE programs and the need to

CRediT authorship contribution statement

Sarah Shrader: Conceptualization, Data curation, Investigation, Methodology, Project administration, Supervision, Roles/Writing – review and editing. Patricia J. Ohtake: Conceptualization, Investigation, Roles/Writing – original draft, Writing – review and editing.. Scott Bennie: Conceptualization, Methodology, Writing – review & editing. Amy V. Blue: Conceptualization, Methodology, Writing – review & editing. Anthony P. Breitbach: Conceptualization, Methodology, Writing – review & editing.

Acknowledgments

We thank the National Center for Interprofessional Practice and Education and the American Interprofessional Health Collaborative for their generous support of this project.

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