LCME Element 7.9 – Interprofessional Collaborative Skills
The faculty of a medical school ensure that the core curriculum of the medical education program prepares medical students to function collaboratively on health care teams that include health professionals from other disciplines as they provide coordinated services to patients. These curricular experiences include practitioners and/or students from the other health professions.
I have seen a LOT of different ways to satisfy this element as every school needs to work with what they’ve got accessible. Key takeaways are that just sitting together is not enough and assessments that assess colleagues actually interacting are really important!!!
Hidden Curriculum
Schools get into trouble for not having specific interprofessional education (IPE) objectives as part of their overall program objectives. Specific learning objectives (KSBA: knowledge, skills, behaviors, attitudes) should be present in some courses and clerkships as well.
IPE learning objectives require an assessment like any other learning objective. Assessment of student attainment should be specific to the objectives, not just a general “works well with other team members.” Most schools get a citation on this element due to INADEQUATE ASSESSMENTS. Students need to be evaluated on their performance as a team, working with others.
Interprofessional education is not passive. In other words, students completing clerkships where they happen to work side-by-side with other professionals within the same clinical environment does not qualify as interprofessional education. The LCME expects there to be intentionality behind the design of this aspect of the curriculum.
Note the focus of the element is on development of IPE KSBA skills which includes foundational knowledge in preparation for real and simulated skill-building activities. Schools should have real experiences to help students build skills. Simulation can help in forming the skills but would not be seen as being sufficient. Don’t make this mistake either.
Best Practice
It is important to keep the end goal of the element in mind, which is to prepare students for the professional landscape that awaits them in residency programs. The AAMC has identified “Collaborate as a Member of an Interprofessional Team” as one of its core entrustable professional activities (EPAs) that residents must be able to demonstrate on day one of their internships, and ACGME CLER program has also made “Teaming” a focus area.
As such, schools should aim to sequence the delivery of its content from the preclinical to clinical curricula in a way that grows students’ skill sets to match increasing responsibility. In other words, they should deliberately build IPE KSBA in a stepwise fashion. All medical students must experience IPE in a comparable manner, a factor that schools with branch campuses must take into account.
Curricular activities should have students from different health professions (e.g., nurses, pharmacists, dentists) jointly interacting in a way that matches their stages of development so that they learn with, about, and from each other to enable effective collaboration and improve health outcomes.
With respect to assessment, there should be direct observation of how well a student is meeting the objectives as a best practice. Other forms of assessment could incorporate metacognition as a part of the assessment, which includes activities like self-reflection, receiving peer feedback to expose a student to how others perceive their words and actions, and setting goals for improved performance.
Finally, schools should not forget that faculty development is necessary so that preceptors can model, teach, and assess IPE in a proper manner.
A good resource is https://www.ipecollaborative.org/
Continuous Quality Improvement
Like any element, 7.9 needs vigilance. This element can be especially vulnerable when course leadership changes, placing well-planned activities at risk of being cut because their purpose is not well-understood. Therefore, schools should review their IPE curriculum on an annual basis as a part of the CQI process. Part of the process should be revisiting the “map” or curriculum inventory of IPE activities to ensure they are occurring and being assessed throughout all four years. Apart from the less frequent CQI process, programs should monitor student performance on IPE objectives through regularly scheduled course evaluations where assessment data and student feedback is aggregated for review.
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