Assessing Performance and Learning in Interprofessional Health Care Teams.

PURPOSE: Teamwork has become an integral part of health care delivery. Such emphasis on teamwork has generated the need to systematically measure and improve the learning and performance of health care teams. The purpose of this study was to develop a comprehensive assessment instrument, the Interprofessional Education and Practice Inventory (IPEPI), to evaluate learning and performance in interprofessional health care teams. METHODS: The 12month study commenced in three 4-month phases: (1) a panel of 25 national and international experts participated in the Delphi process to identify factors influencing team learning and team performance; (2) the research team analyzed the findings from the two Delphi rounds to develop the IPEPI; and (3) a cohort of 27 students at the university engaged in clinical simulations to test and refine the IPEPI. RESULTS: Findings suggest key factors that significantly influence team learning and performance include whether the group is able to foster a climate of mutual respect, adopt effective communication strategies, develop a sense of trust, and invite contributions from others. Additionally, in assessing organizational factors, participants indicated those factors that significantly influence team learning and performance include whether the organization is patientcentered, creates a culture of safety (not blame), and supports individual and team learning. CONCLUSIONS: These findings highlight the critical role assessment plays in enhancing not just interprofessional education or interprofessional practice, but in essence advancing interprofessional education and practice-which requires an integrated examination of how health care professionals learn and perform in teams. J Allied Health 2015; 44(4):236-243.TEAMWORK has become an integral part of health care delivery since the turn of the 21st century, when focus was placed on enhancing patient safety and quality improvement.1 Such emphasis has resulted in a greater number of primary care practices in the United States employing team-based models2 to improve patient outcomes.3 In addition, the complexity of care has increased during the same period, as patients live longer with chronic conditions, requiring an interprofessional care approach that links education and practice to manage multifaceted care.4The Affordable Care Act5 supports accountable care organizations (ACO), which promote coordinated care by multiple providers6 and greater interdependence of patient care team members. This landmark legislation stipulates that interprofessional education (IPE) and expertise is a national priority, and it provides federal financing to support the development of transformative curricula.5 Fostering interprofessional collaboration during the education process also supports the Institute of Healthcare Improvement "Triple Aim" initiative of improving the patient care experience, improving popu- lation health, and cost containment.7 Such emphasis on teamwork has generated the need to systematically measure and improve learning and performance of health care teams,8 as both learning and performance are integrated dimensions of team and organizational dynamics.9 This is a distinct departure from the current education model in the U.S. that has prevailed in medical schools since publication of the Flexner Report in 1910. The Flexner Report emphasized physician-tophysician exchange of science and practice only, to the exclusion of other nonphysician care providers.10While formal education provides knowledge, it may not always address situational topics and skills,11 such as how to treat patients as part of an interprofessional team.12 Research suggests IPE results in more collaborative behavior that eventually leads to higher satisfaction and productivity,13-15 lower patient morbidity rates, fewer hospitalizations, and decreased costs,16-19 demonstrating that students studying medicine and health sciences would greatly benefit from opportunities to learn and practice together. …