What is the Design?
Education Theory or Framework
Different pedagogical approaches may be used to achieve the defining features of interprofessional education. The theory, framework, and delivery should consider the learning objectives and best matched approach. Some pedagogical approaches may include:
- Competency-based learning
- Problem-based learning
- Case Based Learning
- Experiential learning
- Team-based learning
- Reflective Practice
- Simulation-based Learning
Many of these approaches have overlapping elements, and you may use more than one as the foundation of an IPE experience. However, regardless of which approach you use, interprofessional education should involve students “from two or more professions learn[ing] about, from, and with each other” (WHO, 2010).
Caution should be taken to avoid opportunities that only allow for ‘shared learning’, where professions are learning the same material together in the absence of collaboration and opportunities to learn from each other, as this is not a true interprofessional education experience (Hill et al., 2019). Being interested in the same topic or sitting in the same classroom does not meet the definition or standards for IPECP. Students need to interact to learn about, from and with each other.
In competency-based learning models, students become competent in understanding the roles and limitations of their own health profession, while collaborating with other professions. Students from different health care professions learn from and support one another.
Competency-based learning models focus on the theoretical and social components of interprofessional education. This involves learning about the other professions and comparing them to one’s own profession. The current competency framework for interprofessional education in Canada (CIHC, 2024) includes competencies in:
- Team Differences/Disagreements Processing: Address differences and disagreements constructively to maintain team cohesion and relationships.
- Role Clarification and Negotiation: Understand and negotiate individual and team roles effectively.
- Team functioning: Optimize team efficiency and effectiveness towards shared goals.
- Collaborative Leadership: Promote shared decision-making and accountability within the team.
Key Features of Competency-Based Learning
- Focus on making IPE courses a required component of health curriculum (Barr, 1988)
- Students work alongside other health professionals to learn about the roles of one another, and become competent in teamwork, problem-solving and communication skills (Barr, 1988)
Problem-Based Learning (PBL) allows students to use their knowledge to address problems as a group with the help of peers from different professional backgrounds (Barrows & Tamblyn, 1980). PBL requires participants to apply their knowledge to solve a particular problem or case, and thus, promotes critical thinking about the issue (Cooke et al., 2003). PBL uses contextualized problems related to a specific learning objective, promotes self-directed learning and critical thinking, and develops life-long learning skills (Rideout & Carpio, 2001). Students are presented during the session with a problem, usually a clinical case to stimulate the discussion. There is a strong emphasis on a “student-centered” discussion and learners are given time to think through, struggle and define the problem. The facilitators play a minimal role and do not guide the discussion. Many refer to this style of small group work as an open inquiry approach. (Srinivasan et al., 2007).
Collaborative work with participants from other professions in addressing clinical problems develops understanding of individual roles within teams, respect for perspectives of other professions during patient care, and acquisition of team skills to achieve common goals (Maddock et al., 2022). This approach promotes active involvement and consideration of various perspectives (Maddock et al., 2022).
Examples of IPEs involving problem-based learning:
Peer-led problem-based learning in interprofessional education of health professions students (Lehrer et al., 2015) [NewTab]
Evaluation of an interprofessional problem-based learning module on care of persons living with HIV/AIDS (D’Eon et al., 2010) [NewTab]
Key Features of Problem-Based Learning
- Students apply their knowledge to address a problem.
- The ‘problem’ is related to a specific learning objective or learning outcome.
- Addressing the problem should require the developing comprehension about individuals’ roles within teams, respect for perspectives of other professions, and acquisition of team skills to achieve common goals (Maddock et al., 2022).
- The facilitators plays a minimal role in the discussion
Case Based Learning (CBL)
The interprofessional small group has the opportunity to do some advance preparation, as they are given some general information about the content to be discussed during the session. The students then work together as a group on a case designed around specific learning objectives. The facilitator(s) are involved in the discussion and have guiding questions to help keep the learners on task. Some will refer to this style of session as a guided inquiry approach (Srinivasan et al., 2007) The strengths of CBL over a traditional PBL style session are that it allows for greater time efficiency, enables the students to focus on the specific learning points of the case, and provides a more structured format for the session. Since the learners have had a chance to prepare in advance for the case, they can be “content experts” for a portion of the discussion. The facilitators are able to intervene and correct students as needed during the discussion (Srinivasan et al., 2017). Similar to PBL, this type of small group work facilitates teamwork, collaboration and encourage curiosity.
Key Features of Cased Based Learning
- Learners are given some general content information prior the session and are able to prepare in advance
- The facilitators serves as a guide during the discussion and are able to provide direction to the discussion
Experiential Learning (Kolb, 1984)
Experiential learning involves learners learning by doing. While learning can start at any phase, learners engage in concrete experience, reflective observation, conceptual thinking, and active experimentation (Kolb, 1984). Learning activities may include direct provision of care, team huddles, and reflective activities, usually in small groups of interprofessional students (Nagel et al., 2024). The experiential learning model invites learners to be actively engaged in experiences and promotes knowledge and develops practical skills by dealing with the experiences.
Key Features of Experiential Learning
- Learners engage in concrete experience, reflective observation, conceptual thinking, and active experimentation.
- Learning may start at any phase but include all elements of the cycle
- Has students engaging in learning experiences in small, interprofessional groups.
Resources for IPE based on Kolb’s Experiential Learning Framework:
Kolb’s Experiential Learning Theory as a theoretical underpinning for interprofessional education [NewTab]
An example of IPE based on Kolb’s Experiential Learning Framework (Fewster-Thuente & Batteson, 2018)
Kolb’s Experiential Learning Cycle diagram [NewTab]
The 4 Components of Kolb’s Experiential Learning Cycle (Brock University Centre of Pedagogical Education, 2024)
Team-based learning provides an opportunity to facilitate cooperation among healthcare providers (Van Diggele et al., 2020). It is effective at the initial phase of learning by focusing participants’ attention on the learning process, cultivating teamwork skills, and developing communication skills (Van Diggele et al., 2020; Thompson et al., 2017). Through an interprofessional team-based approach, educators can model collaborative teaching and promote practical application of theoretical knowledge in clinical settings (Burgess et al., 2020).
The TBL design includes activities that promote teamwork and collaboration among various disciplines. Interprofessional education that focuses on the improvement of teamwork skills facilitates the attainment of the increased safety in the healthcare environment, enhanced patient outcomes and patient and healthcare provider satisfaction (Fox et al., 2017).
Example of an IPE using Team-Based Learning:
Playing interprofessional games: reflections on using the Interprofessional Education Game (iPEG) (Joseph & Diack, 2015) [NewTab]
Key Features of Team-Based Learning
- Effective at the initial phase of learning by focusing participants’ attention on the learning process, cultivating teamwork skills, and developing communication (Van Diggele et al., 2020; Thompson et al., 2017).
- Includes activities that promote teamwork and collaboration among various disciplines.
- Activities can cover a range including trust-building exercises, communication games, and problem-solving tasks, all designed to foster dynamic and harmonious interaction among professionals from different fields (Cook, 2005; Nakamura et al., 2017).
Donald Schön’s reflective practice model includes self-assessment and group work in safe learning environments (Third, 2022). According to Drinka and Clark (2000), these reflective practices enable formation of understanding and respect of the multifaceted roles, different backgrounds, and distinctive professional points of view that are a part of clinical decision-making processes. This model accentuates the dual aspects of reflection in action and reflection on action, encouraging professionals to practice real-time flexibility and post-performance analysis.
![This image compares "Reflection in Action" and "Reflection on Action". Reflection in action is "reflecting as something happens", we must: "consider the situation, decide how to act, [and] act immediately". Reflection on action is "reflecting after something happens". This involves "reconsider[ing] the situation, [and] think[ing] about what needs changing for the future".](https://caul-cbua.pressbooks.pub/app/uploads/sites/137/2024/06/reflective_practice-300x258.png)
Figure 6: The two components of Schon’s Reflective Practice Model: Reflection in Action, and Reflection on Action (Third, 2022)
Through the inclusion of these reflective approaches into learning activities, participants can develop an understanding of their actions and decisions and value the unique roles of different healthcare professionals. This reflective mode is an underpinning for students to negotiate challenging healthcare situations and operate efficiently in interprofessional environments. This method promotes self-assessment, reflection, and professional behaviors and skills (Van Diggele et al., 2020).
Modified Kirkpatrick Model: Best suited to evaluate different desired outcomes from a given SBE (Aldriwesh, Alyousif, & Alharbi, 2022; Barr et al., 2000).
Benner’s Novice to Expert: Students start as a novice learner improving competencies to an expert level as they progress through an IPHEC SBE. Having interprofessional experiences as early as possible in the course of education is seen as essential for competency development (Bell and Fredland, 2020).
Michener readiness to practice model (Bell & Fredland, 2020)
Practice Theory: Based on premise that different material arrangements in the environment lead to different learning opportunities (Bell and Fredland, 2020)
Transformational Learning Theory (Bell & Fredland, 2020)
