Journal of Taibah University Medical Sciences (2023) 18(3), 639e651

Taibah University

Journal of Taibah University Medical Sciences

www.sciencedirect.com

Review Article

Conceptualisation, development and implementation of

Interprofessional Education programmes: A qualitative document
analysis
Farhin Delawala, PhD, Yolande Heymans, PhD and Christmal D. Christmals, PhD *

Centre for Health Professions Education, Faculty of Health Sciences, North-West University, Potchefstroom Campus, South
Africa

Received 24 May 2022; revised 29 October 2022; accepted 9 December 2022; Available online 21 December 2022

‫ﺍﻟﻤﻠﺨﺺ‬ team and represents a key step towards the realisation of

Interprofessional Collaborative Practice (IPCP) which, in
‫ﻳﺤﺪﺙ ﺍﻟﺘﻌﻠﻴﻢ ﺑﻴﻦ ﺍﻟﻤﻬﻨﻴﻴﻦ ﻋﻨﺪﻣﺎ ﻳﺘﻌﻠﻢ ﺍﺛﻨﺎﻥ ﺃﻭ ﺃﻛﺜﺮ ﻣﻦ ﺍﻟﻤﻬﻨﻴﻴﻦ ﺍﻟﺼﺤﻴﻴﻦ ﻣﻊ‬ turn, enhances the healthcare outcomes of patients. Many
‫ﺑﻌﻀﻬﻢ ﺍﻟﺒﻌﺾ ﻭﻣﻦ ﺑﻌﻀﻬﻢ ﺍﻟﺒﻌﺾ ﻟﺘﺤﺴﻴﻦ ﺍﻟﺘﻌﺎﻭﻥ ﺩﺍﺧﻞ ﻓﺮﻳﻖ ﺍﻟﺮﻋﺎﻳﺔ‬ health professions education institutions are taking on
‫ ﻭﻫﻲ ﺧﻄﻮﺓ ﻧﺤﻮ ﺗﺤﻘﻴﻖ ﺍﻟﻤﻤﺎﺭﺳﺔ ﺍﻟﺘﻌﺎﻭﻧﻴﺔ ﺑﻴﻦ ﺍﻟﻤﻬﻨﻴﻴﻦ ﻭﺍﻟﺘﻲ ﺑﺪﻭﺭﻫﺎ‬،‫ﺍﻟﺼﺤﻴﺔ‬ the challenge of developing IPE programmes and it is
‫ ﺗﻮﺍﺟﻪ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﻣﺆﺳﺴﺎﺕ ﺗﻌﻠﻴﻢ ﺍﻟﻤﻬﻦ‬.‫ﺗﻌﺰﺯ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻧﺘﺎﺋﺞ ﺍﻟﻤﺮﺿﻰ‬ essential to provide evidence-based information to guide
‫ﺍﻟﺼﺤﻴﺔ ﺍﻟﺘﺤﺪﻱ ﺍﻟﻤﺘﻤﺜﻞ ﻓﻲ ﺗﻄﻮﻳﺮ ﺑﺮﺍﻣﺞ ﺍﻟﺘﻌﻠﻴﻢ ﺑﻴﻦ ﺍﻟﻤﻬﻨﻴﻴﻦ ﻭﻣﻦ ﺍﻟﻀﺮﻭﺭﻱ‬ these institutions in their journey. We analysed the IPE
‫ ﻗﻤﻨﺎ ﺑﺘﺤﻠﻴﻞ‬.‫ﺗﻮﻓﻴﺮ ﻣﻌﻠﻮﻣﺎﺕ ﻗﺎﺋﻤﺔ ﻋﻠﻰ ﺍﻷﺩﻟﺔ ﻟﺘﻮﺟﻴﻪ ﻫﺬﻩ ﺍﻟﻤﺆﺳﺴﺎﺕ ﻓﻲ ﺭﺣﻠﺘﻬﻢ‬ programmes of six health professions education in-
‫ﺑﺮﺍﻣﺞ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﻤﻬﻨﻲ ﻟﺴﺘﺔ ﻣﺆﺳﺴﺎﺕ ﺗﻌﻠﻴﻤﻴﺔ ﻟﻠﻤﻬﻦ ﺍﻟﺼﺤﻴﺔ ﻣﻦ ﺍﻟﺒﻠﺪﺍﻥ ﺫﺍﺕ ﺍﻟﺪﺧﻞ‬ stitutions from High-Income Countries and Low- and
‫ ﻹﺩﺧﺎﻝ‬12‫ﺍﻟﻤﺮﺗﻔﻊ ﻭﺍﻟﺒﻠﺪﺍﻥ ﺫﺍﺕ ﺍﻟﺪﺧﻞ ﺍﻟﻤﻨﺨﻔﺾ ﻭﺍﻟﻤﺘﻮﺳﻂ ﻭﻓﻘﺎ ﻟﻠﺨﻄﻮﺍﺕ ﺍﻟـ‬ Middle-Income Countries according to the 12 steps of
‫ ﺗﻘﺪﻡ ﻫﺬﻩ ﺍﻟﻮﺭﻗﺔ ﻗﺎﺋﻤﺔ ﺧﻄﻮﺓ ﺑﺨﻄﻮﺓ‬.‫ﺑﺮﻧﺎﻣﺞ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﻤﻬﻨﻲ ﻓﻲ ﺍﻟﻤﻬﻦ ﺍﻟﺼﺤﻴﺔ‬ IPE programme introduction for health professions. This
‫ﻭﻗﺎﺋﻤﺔ ﻣﻬﺎﻡ ﻹﺭﺷﺎﺩ ﺍﻟﻤﻌﻠﻤﻴﻦ ﻓﻲ ﻭﺿﻊ ﺗﺼﻮﺭ ﻟﺒﺮﺍﻣﺞ ﺍﻟﺘﻌﻠﻴﻢ ﺑﻴﻦ ﺍﻟﻤﺤﺘﺮﻓﻴﻦ‬ paper provides a step-by-step guide and ‘to-do list’ to
‫ ﻧﻮﺻﻲ ﺑﺄﻥ ﺗﻘﻮﻡ ﺍﻟﻤﺆﺳﺴﺎﺕ ﺑﻤﺮﺍﺟﻌﺔ ﻫﺬﻩ ﺍﻟﻨﺘﺎﺋﺞ‬.‫ﻭﺗﻄﻮﻳﺮﻫﺎ ﻭﺗﻨﻔﻴﺬﻫﺎ ﻭﻣﺮﺍﺟﻌﺘﻬﺎ‬ help educators to conceptualise, develop, implement and
‫ﻭﻭﺿﻌﻬﺎ ﻓﻲ ﺳﻴﺎﻗﻬﺎ ﻭﺗﻨﻔﻴﺬﻫﺎ ﻓﻲ ﺑﺮﻧﺎﻣﺞ ﺍﻟﺘﻌﻠﻴﻢ ﺍﻟﻤﻬﻨﻲ ﻣﻦ ﺍﻟﻔﻜﺮﺓ ﺇﻟﻰ ﺍﻟﻤﺮﺍﺟﻌﺔ‬ review their IPE programmes. We recommend that in-
.‫ﺍﻟﻨﻬﺎﺋﻴﺔ‬ stitutions review and contextualise these findings and
implement them in their IPE programmes from concep-
‫ ﺗﺤﻠﻴﻞ ﺍﻟﻮﺛﺎﺋﻖ؛ ﺍﻟﻤﻤﺎﺭﺳﺔ ﺍﻟﺘﻌﺎﻭﻧﻴﺔ ﺑﻴﻦ ﺍﻟﻤﻬﻨﻴﻴﻦ؛ ﺍﻟﺘﻌﻠﻴﻢ‬:‫ﺍﻟﻜﻠﻤﺎﺕ ﺍﻟﻤﻔﺘﺎﺣﻴﺔ‬ tion to final review.
‫ﺍﻟﻤﻬﻨﻲ؛ ﺗﻄﻮﻳﺮ ﺑﺮﻧﺎﻣﺞ ﺍﻟﺘﻌﻠﻴﻢ ﺑﻴﻦ ﺍﻟﻤﻬﻨﻴﻴﻦ‬
Keywords: Document analysis; Interprofessional collabora-
Abstract tive practice; Interprofessional education; IPE Programme
development
Interprofessional Education (IPE) occurs when two or
Ó 2022 The Authors. Published by Elsevier B.V. This is an
more health professionals learn with, from and about
open access article under the CC BY-NC-ND license
each other to improve collaboration within a healthcare (http://creativecommons.org/licenses/by-nc-nd/4.0/).

* Corresponding address: Centre for Health Professions Educa-

tion, Faculty of Health Sciences, North-West University, Potch- Introduction
efstroom, 2530, South Africa.
E-mail: christmal.christmals@nwu.ac.za (C.D. Christmals)
Peer review under responsibility of Taibah University. Interprofessional Education (IPE) occurs when two or
more health professions students learn with, from and about
each other to improve collaboration within a healthcare team
and represents a key step towards the realisation of Inter-
Production and hosting by Elsevier
professional Collaborative Practice (IPCP) which, in turn,
1658-3612 Ó 2022 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/). https://doi.org/10.1016/j.jtumed.2022.12.006
640 F. Delawala et al.

enhances the healthcare outcomes of patients37.1 As Materials and Methods

discussed by van Diggele,2 IPE has been highlighted by
various health organisations as necessary to reach several A Qualitative Document Analysis (QDA) research method
health outcomes. The need to collaborate is well recorded was used in this study. A QDA is a systemic method to assess,
by Buring3 and Reeves,4 especially when a healthcare evaluate and synthesise relevant information in selected doc-
system is increasingly complex. Roberts and Kumar5 uments.22 Using this methodology, the researcher interprets
expressed urgency for students and graduates to experience the meaning of the data and the data is coded for analysis.22
IPE before graduation or professional registration. In an This study sought to analyse IPE programmes globally,
earlier study, Jorm6 stated that higher education using the QDA method, to guide institutions to conceptu-
institutions have the responsibility to provide opportunities alise, develop, implement, and review their IPE programmes.
for all health professions’ students to collaborate in IPE The institutional document analysis was performed by
activities. employing a document analysis manual described by Wach
Several studies have presented IPE programmes or et al.23 The steps for the QDA according to Wach et al.23
models implemented in learning institutions.7e12 In South include setting the inclusion criteria, document searches,
Africa (SA), health professions education has historically articulating focus of document analysis, coding and
been undertaken in professional silos, thus limiting the analysis of documents, verification and data analysis.
opportunities for students from various professions to According to O’Leary,24 evidence can fall into one of three
learn with, from and about each other.13 Nevertheless, major categories where analysis can be conducted: public
universities have started to recognise the need to implement records, personal documents and physical evidence.
IPE in South Africa.14 Currently, there are four universities
in SA that have implemented IPE: the University of the Setting the inclusion criteria
Western Cape (UWC), the University of the Free
State (UFS), the University of Witwatersrand (Wits)
The researcher used institutions that are affiliated to
and the Stellenbosch University (SU).15e18 At North-West
Interprofessional.Global, a global confederation backing
University (NWU), there is only one semester in which un-
engagement between organisations advocating for IPE and
dergraduate students experience IPE through the second-
IPCP25 globally. The reason for this was to ensure that the
semester module: Know the world of Health (WVGW 222).
content was scientifically sound and internationally
This experience is not enough for students to be adequately
acceptable. We regrouped the networks on the
equipped with the required competencies for IPCP as
Interprofessional.Global website which were
professionals.
reconceptualized into five major regions based on
It is recommended that institutions developing IPE pro-
geographical similarities (Table 1). Out of the five regions,
grammes learn from those that have implemented them suc-
we selected one institution by balloting (Table 1). We also
cessfully.19 Areas of learning include content, development
realised that Africa had 55 institutional representations in
process, facilitators, and challenges to developing and
the Africa Interprofessional Education Network
implementing IPE programmes.19,20 Higher Education
(AfrIPEN); therefore, we decided to select an additional
Institutions have implemented different IPE activities so that
institution from Africa. Institutions from High-Income
students are well equipped with the knowledge and skills to
Countries (HIC), such as the USA, UK and Australia
improve healthcare systems.2,3 For example, teamwork in
(Au), as well as Low- and Middle-Income Countries
large classes, small groups, clinical simulations in university
(LMIC), such as India, SA and Malawi, were selected.
simulation laboratories, and practice in clinical settings.2
Müller and Couper14 reported that SA is an upper-middle-
Frameworks published on IPE can guide the development of
income country with a record number of inequalities. Thus,
learning outcomes required to gear IPE activities.2 Generally,
comparing and matching healthcare training in institutes
IPE frameworks resort to common themes that govern the
from other countries ranking higher and lower would pro-
development of IPE activities. For example, the
vide better insight into the context of SA. The inclusion of
Interprofessional Education Collaborative’s (IPEC) core
HIC and LMIC ensured that all possible contexts were
competencies: interprofessional teamwork, roles and
studied for relevant and rich data findings. Those selected
responsibilities, values and ethics, and communication are, in
that did not include their programmes on their web pages
many cases, used as themes or as guidelines to develop
were replaced. All of the programmes included had data that
themes.21 Beyond frameworks, IPE peogrammes developed
were openly available.
and implemented by institutions provide esssential
information on contextual challenges and opportunities that Document searches
other institutions can harness in devloping and implementing
new programmes.
It is, therefore, imperative for the programmes developed A primary search was conducted on Inter-
professional.Global network institutional websites, for in-
and implemented to be reviewed to provide a foundation for
the development of other IPE programmes. This study formation on their IPE programme development, content,
analysed and described the conceptualisation, development, and implementation.
and implementation processes of IPE programmes from The web pages and documents uploaded on the IPE
selected institutions globally towards the development of an programmes from the selected institutions were retrieved for
IPE programme for the North-West University in South evaluation and synthesis. The document extraction process
Africa42. took place between January 2021 and March 2021 and any
 Conceptualisation, development and implementation 641

updates or changes made on the institutional websites was in-expensive, and unified healthcare.17,28e31 Moreover, the
understood to be outside of the study timeframe. evidence supported the fact that IPE strengthened the
healthcare system and students were encouraged to find
Articulating focus of document analysis innovative ways to meet health goals.30 IPE promoted
health, the well-being of the patient, their families and the
Data and evidence relating to IPE implementation were communities, enhanced health outcomes and delivered
then extracted onto a data matrix for easy visualisation, effective healthcare services, teamwork and the understand-
comparison and synthesis (Table 2). The information ing and appreciation of professional expertise.17,28e32
extracted was in line with the 12 Steps of introducing IPE
into Health Professions Education.26 How were the main stakeholders brought together and who
were they?
Analysis of documentation
We found that the main stakeholders were from different
Best fit framework analysis27 was applied using the 12 health schools/departments of the Health Sciences faculties.
steps of IPE programme introduction into health Interprofessional Education and Collaborative Practice
professions education outlined by El-Awaisi et al.26 as the (IPECP) experts were invited based on their conference in-
analytical framework. A predetermined set of themes was puts. These experts contributed their expertise and institu-
drawn from the analytical framework in best-fit synthesis. tional knowledge to the programme’s development.
The analytical process also allowed for additional themes Furthermore, frameworks that have been published on IPE
that emerged outside the framework to be reported.27 programme development were consulted.
Deductive coding used the predetermined codes based on Specifically, Indiana University (IU) (USA) mentioned the
the 12 steps of IPE programme introduction into health pro- president gathering Deans from different health schools to
fessions education outlined by El-Awaisi et al.26 as explained partner up for the IPE.28 King’s College London (KCL) (UK)
earlier. The first author printed and read the data matrix noted that one person from each health school was invited to
several times to familiarise herself with the content, trends, come on board with the programme.29 At Monash
similarities, and differences in the programmes extracted. University (Au), the Faculty of Medicine, Nursing and
The predetermined codes were then applied to the data Health Sciences (FMNHS) agreed on the curriculum and
matrix by the first author. The coding was verified by the consulted the “Collaborative Learning Outcomes 2016
other authors, differences were discussed, and a consensus Accreditation Document” as an opening point.30 Monash
was reached. Similar codes under each of the 12 steps of IPE University also sourced current IPE curricula such as the
programme introduction into health professions education Canadian Interprofessional Health Collaborative Competency
were assimilated and described under the steps. No sub- Framework and the Curtin University Framework. In addition
categories were created apart from the 12 steps of IPE pro- to these frameworks, Monash university used the four-
gramme introduction into health professions education. The dimensional curriculum framework described by Lee et al.33
findings were presented iteratively under various steps in the UWC (SA) developed a programme via inputs from the
analytical framework.26 Apart from the 12 steps presented, this director, deputy dean, lecturer and coordinator of the
study described the benefits and challenges associated with the Interprofessional Education Unit (IPEU).17 A consultation
development and implementation of IPE programmes. with faculty members took place for the Kamuzu College of
Nursing (KCN) at the University of Malawi, followed by
Verification and data analysis the creation of an interprofessional team to develop the
IPE case study in their programme.31 The faculty from
The first author conducted the search and performed the the University of Malawi included experts from
extraction. The second and third authors reviewed the search biosciences, statistics, reproductive health, public health
and extracted documents. The analysis and writing of the and gender. Manipal Academy of Higher Education
scripts were undertaken in a collaborative manner. The re- (MAHE) in India opted to partner with organisations
sults were examined and evaluated for relationships and such as the Foundation for Advancement of International
variations. Medical Education and Research (FAIMER) and
stakeholders from the higher education sphere that
Results included professors, chancellors, vices, presidents and
directors.32
Benefits of IPE
How did they define and implement a definition, values and
We learned that IPE was beneficial because it gave stu- standards of IPE?
dents the platform to work together to provide optimal
healthcare to patients.17,28e30 It also improved patient safety Although the IPE definitions were harnessed from
through collaboration and communication with other health different organisations by the institutions included, they were
professionals, and students could identify the roles and fundamentally analogous in nature. Of the six universities
responsibilities of different professions and how they included in this study, four17,28,31,32 used the World Health
contribute to the overall well-being of a patient.17,28,29 IPE Organization (WHO) definition of IPE.1 The WHO defined
fostered positive working attitudes in teamwork and IPE as when students from two or more professions learn
collaborative care whilst incorporating the delivery of safe, from, with and about each other for effective collaboration
642 F. Delawala et al.

Table 1: Reconceptualization of the Interprofessional. Global networks.

Networks Number of institutions Number of institutions randomly selected
reported on the Interprofessional.
Global website
Canada, South and Central 13 1 United States of America
America and Caribbean
United Kingdom, Nordic 19 1 United Kingdom
Network of Europe and
German speaking countries
Australasia 4 1 Australia
Africa 55 2 South Africa and Malawi
India 2 1 India

and enhanced health outcomes.1 One university29 followed and across teams, students were required to understand and
the definition of the Centre for the Advancement of apply team dynamics and group processes standards.
Interprofessional Education (CAIPE). CAIPE defined IPE The UWC required students to explain their expertise to
as occurring through occasions when two or more other professions; identify limitations with roles, re-
professions learn from, with and about each other for sponsibilities and competence; identify and respect other
improvements in collaboration and quality treatment.34 professions’ competencies and functions, collaborate for
Another study,30 drew from the standard IPE definition change, and provide conflict resolutions to provide care and
and formulated their own definition. In terms of values and treatment; work with others to assess, plan, and provide;
standards, it was identified that IPEC competencies were collaborate to examine, strategize, offer and analyse patient
profoundly used as overarching principles and to guide the care; mitigate differences, misunderstandings and shortfalls
development of IPE programmes. in other professions; and participate in case conferences and
meetings.
What outcomes were formulated? The University of Malawi required students to show
knowledge of different components and respect for human
Outcomes for faculty in terms of development and rights; create new promotion plans for reproductive health-
implementation, together with outcomes for students during care; show knowledge and understanding of various man-
IPE, were identified. agement issues impacting the delivery of healthcare;
IU required the students to collaborate with others to advocate for the health of individuals, families and groups
facilitate common respect and values; use their expertise and through activities on community development using support,
those of other professions to facilitate the healthcare needs of commission, education and guidance, and perform research
a patient and promote health; communicate with patients, to advance reproductive healthcare.
families, communities, and professionals in health and other Apart from student outcomes, both Monash University
fields responsively and responsibly to support teamwork in and MAHE indicated outcomes that were in place for fac-
promoting and maintaining health and preventing and treat- ulty. The faculty at Monash University was required to
ing disease; apply relationship-building standards of team determine a predominant education framework for out-
dynamics to act productively in teams to strategize, offer, and comes and practice the three levels, i.e., novice, intermediate
examine patient care and health programmes; and regulations and entry-to-practice; back interprofessional learning in
that are safe, timely, of quality and value, and are fair. profession-specific curriculum; back educational research in
KCL required students to work collaboratively in teams the strategy, distribution and valuation of the Collaborative
for patient-centred care; understand the roles and re- Care Curriculum and direct the development of resources for
sponsibilities of other professions and how they contribute to the outcomes. MAHE required the faculty to improve
the overall care of individuals, families and communities; knowledge of Interprofessional Education and Practice
produce expert care and treatment in a holistic context, (IPEP); serve in joint ventures when it comes to the health
including human factors; improve patient safety through requirements of the community, and create faculty that will
enhanced communication and collaboration between pro- champion IPE.
fessions who are responsible for a common patient. Analysis of the outcomes from each university was un-
Monash University determined the learning outcomes in dertaken and a consolidated outcomes list was formed
four primary categories: person-centred care, role under- (Table 3). The researcher merged common outcomes based
standing, interprofessional communication and collabora- on the findings under Table 2 sub-heading ‘what outcomes
tion within and across teams. The outcome for person- were formulated?’
centred care required students to seek out, integrate and
value, as a partner, the input and engagement of the person/ How was the participation and selection of students and
family/community. For role understanding, students had to faculty undertaken?
understand their roles and the roles of others. Under inter-
professional communication, students from different pro- The stakeholders from the different universities were
fessions were required to communicate in a collaborative, gathered from other health schools or were invited to partner
receptive and considerate manner. For collaboration within in the venture. Monash University, for instance, included
Table 2: Data matrix e data comparison.
Indiana King’s College Monash University of University of Manipal Academy
University e United London e United University e Australia the Western Malawi e Malawi of Higher
States of America Kingdom Cape e South Africa Education e India
How were the main Assembled from One person from each FMNHS. Director, deputy dean, Consultation with Partnering with
stakeholders brought different health schools. health school. lecturer, field coordinator faculty members who Foundation for
together and who who were part of the IPEU. were experts in Advancement of
were they? biosciences, statistics, International Medical
reproductive health, Education and
public health, and Research (FAIMER)
gender followed by and stakeholders from
setting up an the higher education
interprofessional team e.g., professors,
to develop the chancellors, vice-

Conceptualisation, development and implementation

curriculum. presidents, presidents,
and directors.
How did they define World Health Centre for the Own definition with IPEC WHO definition. WHO definition. WHO definition, IPEC
and implement a Organization (WHO) Advancement of competencies. competencies and
definition, values and definition and Interprofessional emphasis on the
standards of IPE? Interprofessional Education (CAIPE) development of
Education and definition. leadership
Collaborative (IPEC) competencies for
competencies. Interprofessional
Practice (IPP).
What outcomes were Collaborate with others Work collaboratively in Learning outcomes based Explain the expertise to Show knowledge on Improve faculty
formulated? to facilitate common teams for patient- on person-centred care, other professions. different components understanding of
respect and values. centred care. role understanding, Identify limitations in and respect for human interprofessional
Use own expertise and Understand the roles interprofessional relation to role, rights; create new education and practice.
those of other and responsibilities of communication and responsibilities, and promotion plans for Implement
professions to facilitate other professions and collaboration within and competence. reproductive collaborative projects
the healthcare needs of how they contribute to across teams. Identify and respect the healthcare; show in Interprofessional
a patient and promote the overall care of competencies and roles of knowledge and Education relevant to
health. individuals, families, other professions. understanding of the health needs of the
Communicate with and communities. Collaborate for change and various management community.
patients, families, Produce expert care provide conflict resolutions issues impacting the Develop faculty who
communities, and and treatment in a to provide care and delivery of healthcare; lead in the practice of
professionals in health holistic context, treatment. advocate for the health Interprofessional
and other fields in a including human Work with others to assess, of individuals, families, Education.
responsive and factors. plan, provide and analyse and groups through
responsible manner Improve patient safety care. Collaborate to activities on community
that supports a team through improved examine, strategize, offer, development through
approach to promoting communication and and analyse patient care. support, commission,
and maintaining health collaboration between Mitigate differences, education and
and preventing and professions who are misunderstandings, and guidance; perform
treating disease. responsible for a shortfalls in other research to advance
Apply relationship- common patient. professions. reproductive
building standards of Indulge in case healthcare.

643
(continued on next page)
 644
Table 2 (continued )
Indiana King’s College Monash University of University of Manipal Academy
University e United London e United University e Australia the Western Malawi e Malawi of Higher
States of America Kingdom Cape e South Africa Education e India
team dynamics to act conferences, meetings and
productively in teams so on.
to strategize, offer, and Embark on interdependent
examine patient care relations with other
and health programmes professions.
and regulations that are
safe, timely, of quality
and value, and are fair.
How was the Curriculum part of the Part of health The health professions Health schools in Students and faculty The selection criteria
participation and studies. curriculum. represented in the faculty undergraduate level. Part who were part of the were as follows:
selection of students were medicine, midwifery, of health curriculum. reproductive health Be associated with a
and faculty done? nursing, nutrition and programme higher education
dietetics, occupational participated. institution.
therapy, paramedicine, Have a graduate or
pharmacy, physiotherapy, professional degree
psychology, radiography, (e.g., medicine,
radiation therapy, dentistry, alternative

F. Delawala et al.
ultrasound, and social medicine,
work. Thus, the course physiotherapy,
required the participation occupational therapy,
of these professions. nursing, nutrition,
veterinary sciences,
agricultural sciences,
engineering,
humanities, law, social
sciences, or
management).
Have at least five years’
work experience as a
faculty member after
completing formal
academic training.
Have institutional
endorsement.
Which themes were IPEC competencies: Year 1: promoting Person-centred care; Role Primary healthcare; Theoretical, clinical Emphasizes
selected? Roles and patient safety, patient- understanding; interdisciplinary health and research model. development of
responsibilities; values centred communication interprofessional promotion; shared biosciences (advanced leadership
and ethics; within a team communication; research module; physiology/ competencies for IPP.
communication; and approach. Year 2: collaboration within and interprofessional world pharmacology), It provides
teams and teamwork Interprofessional pain across teams. Real world café; interprofessional conceptual and opportunities for
through the phases of education. Year 3: problems, e.g., safe use of supervision. theoretical interaction with
exposure, immersion Interprofessional medicine. frameworks/models, recognized leaders in
and entry-to-practice. learning in practice. leadership and IPP, collaboration with
Year 4: clinical management, bioethics, peers, and
simulation and keeping education for health implementation of
 patients safe from professionals, research interprofessional
medication errors. methods and statistics, projects.
maternal and neonatal
care, men’s and
women’s reproductive
health, and integrated
reproductive health
practicum.
How was collaborating The Exposure phase Work collaboratively; Facilitator guide; small Students engaged with Theoretical component: Guidance was through
in case and activity focused on the devise a pain group learning; discussion each other and Each profession the involvement of
design encouraged Interprofessional management plan; and collaboration; active stakeholders to deliver conducted a profession- Foundation for
and how was mixing Education and identify roles and learning tasks; facilitated interprofessional services specific seminar so Advancement of
up the learning Collaborative responsibilities of reflections. Simulated in rural and urban students could evaluate International Medical
methods done? competencies in an different professions; patient; bag of medicines; communities as well as at philosophical Education and
online setting lasting teamwork in quizzes; case studies. primary, secondary, and approaches of Research (FAIMER),

Conceptualisation, development and implementation

between 90 and simulations; learn tertiary clinical sites. knowledge Philadelphia together
120 min. In the medicine management development and care with the support of the
immersion phase, focus in a team through in their disciplines. university leadership
was placed on digital resources and Clinical component: and team.
application of expertise workshops; case study students allocated to
with the use of with virtual characters. reproductive health
simulated or real units/wards in teams,
patients. The entry-to- other clinical
practice phase put experiences related to
students in professional care of patients with
settings so that they had STI. Research
direct experiences. component: students
worked individually by
choosing a problem on
a particular area but
attended research
seminars together for
the purpose of sharing
topics and approaches
to research projects.
What levels and stages Throughout their Undergraduate and Novice (First year of an First year to final year. Master of Sciences The fellowship includes
were determined? learning. graduate level. undergraduate degree) (MSc) coursework and two annual one-week
Intermediate (Second or dissertation (2 years). residential sessions and
Third year of an two 11-month online
undergraduate degree, or learning sessions
First year of a graduate following the
entry) residential sessions.
Entry to practice (Final
year).
How was the learning Facilitators to guide the Facilitators to guide the Facilitators to guide the Facilitators and student Faculty teaching and The fellows were
facilitated? students. students. students. supervisors. guest lecturers during provided one-to-one
theoretical component. mentorship and their
Clinical components role was to facilitate,

645
(continued on next page)
 646
Table 2 (continued )
Indiana King’s College Monash University of University of Manipal Academy
University e United London e United University e Australia the Western Malawi e Malawi of Higher
States of America Kingdom Cape e South Africa Education e India
included guide, supervise and
multidisciplinary ward role-model. They were
teaching rounds. responsible for
monitoring the progress
and completion.
How were the Prepare individually. Appreciation in Challenging and Shaped the education and No mention. They learned
expectations and Learning objectives learning with a multi- interactive learning. training of students for a sequentially and
experiences of aligned to disciplinary team with Brainstorming solutions to strong, flexible, and progressively which
students raised? competencies. Active the understanding that complex issues, that collaborative health facilitated skills. Self-
learning with team- it could improve patient required the engagement of workforce, that was able to directed learning was
building experiences. care. Each student was multiple disciplines. confront the highly established together
Assessments and individually responsible complex health challenges with collaborative
evaluations followed by and for the team. of today. learning.
reflections and Knowing the
debriefings. importance of working
with other health
professionals and how

F. Delawala et al.
beneficial a multi-
disciplinary team could
be to enhancing patient
care. Inquiry-based
learning promoted
collaboration, directed
learning and offered
reflection on learning.
How was the feedback Formative assessment, Year 1: presentation; Evaluation survey and Reflections. Theoretical A modified form of
assessed and utilised? competency-based Year 2: online reflections. Student and components; Objective Structured
evaluation. questionnaire, feedback staff evaluation. Share Assessment through Clinical Examination
Reflection, debriefing. posted on website; Year evaluation feedback with examinations, seminar (OSCE) e
3: concept map; Year 4: the education team and presentations and Interprofessional Team
presentation. make necessary curriculum projects. The clinical Objective Structured
changes. component was Clinical Examination
assessed through (ITOSCE), reflections,
clinical portfolios. The clinical exams,
students provided care questionnaires.
to patients with various
reproductive health
conditions and wrote
up according to
guidelines. The students
were graded based on
written and oral
presentations.
No community No community No mention. No mention. No mention. No community
evaluation. evaluation. evaluation.
 Conceptualisation, development and implementation 647

academic and clinical staff from nursing, pharmacy and

curricula for all levels,

medicine to design and deliver the programme. Having IPE

buy-in, accreditation.
Logistic, developing

suitable assessment,
Conferences and
become part of the health curriculum was another way to
organisations or

faculty training,
include staff and students.
networks.
Which themes were selected?

Although the underlining themes were interprofessional

collaboration, communication, patient safety, and team-
nurses and midwives by

programme that would

departing from its core
expressed concern that
Some faculty members

work, each institution was specific in its content and mode of

include other cadres

mandate of training

such as doctors and

initiating an IPE delivery of the IPE programme. This study identified and
Dissertation and

consolidated themes from the six institutions, including lived

clinical officers.
the college was

experiences e clinical simulations, case studies of patients

presentation.

with complex needs; patient safety, medical errors; inter-

professional communication and IPEC competencies; pri-
mary healthcare e diagnosis, treatment and support; and
interprofessional health promotion and advocacy.
shortcoming of professions
and tolerating differences.
Staff, misunderstandings,
Networks, conferences,

How was collaborating in case and activity design

encouraged and how was mixing up the learning methods
undertaken?
universities.

In IU, developmental sessions were offered where faculty

were initially trained in design delivery, the evaluation of IPE
and to develop and enhance their skills. The sessions were
focused on different collaborative topics to foster practice
around patient-centred care. At KCL, faculty met to answer
Logistics (time, timetable,
and space), staff learning

questions on the programme by paying close attention to the

presentation to broader

teaching, the type of activities and how they impact knowl-

edge and skills, and the assessment thereof. KCL was more
Workshops and

explicit in the interprofessional activities and learning

methods. KCL required students to develop a pain man-
material.

agement plan, use digital resources, have workshops and be

group.

issued with virtual case studies. At Monash University, a 45-

min module was designed to assist staff in designing and
delivering interfaculty activities. Furthermore, Monash
University used facilitator guides and provided an atmo-
sphere for students to undergo small group learning. In
Disagreements and
Conferences and

addition to this, simulated patients were made available

along with quizzes, case studies and innovative activities. At
the UWC, academic staff, currently part of the IPEU, were
networks.

conflicts.

involved in developing, implementing, and coordinating the

IPE curriculum and convened for its ongoing development.
At KCN, the faculty dean oversaw academic matters.
IPE literature was reviewed, and consultation took place
Implementation due to
online experiences for
Preparing students to

Creating meaningful

with staff involved in reproductive health and interviewing

fulfil requirements.

students. Two faculty members from midwifery then

conferences and

developed the Interprofessional Master of Sciences (MSc)

Publication,

in Reproductive Health programme. Three components

Covid-19.
networks.

students.

were then established: theoretical, clinical and research. In

the theoretical component, the health professions steered
profession-specific seminars so that the rest of the pro-
fessions could evaluate philosophical aspects. The philos-
ophies were then scrutinised for similarities and variations
experiences shared?

and how they could be utilised for quality care. For the
clinical component, students were assigned to reproductive
intervention

How were the

How was the

evaluated?

health wards or allocated patients with Sexually Trans-

Challenges

mitted Infections (STIs); this was undertaken in teams of

three or four. For the research component, students worked
individually by choosing a problem related to a specific
topic and then attended research seminars to share their
648 F. Delawala et al.

findings and views. MAHE designed the programme professions on health-related issues to come up with solu-
through the partnership, leadership, expertise and support tions collaboratively.28e30 Students had to take responsibility
of FAIMER. The faculty in charge were drawn from as individuals and for what the team achieved, which followed
different disciplines who championed innovative education. reflections on the learning whilst understanding the benefits of
MAHE stressed the advancement of leadership compe- a collaborative approach to patient care.28,29 Challenging
tencies for Interprofessional Practice (IPP), offering pros- students was one technique to keep them motivated as
pects for collaboration with recognised leaders in IPP, students needed to brainstorm solutions by accounting for
collaboration with associates, and interprofessional project complex matters collaboratively.17,30
implementation.
How was the feedback assessed and utilised?
What levels and stages were determined?
Students were graded by examinations, clinical examina-
Most universities offered IPE in their first to their final tions, reflections and oral presentations. At IU, students
years. Only two universities31,32 from the LMIC were found were assessed through formative assessment, competency-
to have IPE in their postgraduate levels. based evaluations, reflections and debriefing.28 KCL used
three different forms in the different year levels. In year 1,
How was the learning facilitated? students had to give presentations; in year 2, students
completed online questionnaires and feedback was posted
Learning was facilitated by facilitators/lecturers, guest on the website; in year 3, a concept map was completed
lecturers and student supervisors. Facilitators were and in year 4, a presentation was given.29 Monash
commonly seen as enablers rather than directly influencing University used surveys and reflections by evaluating
the learning and allowing the students to take over. For one students and staff and by sharing feedback with the
of the universities that offered IPE at a postgraduate level, education team to make necessary changes to the
mentorship was provided to guide, supervise, model, and curriculum.30 UWC mentioned reflections as part of
monitor progress. assessments,17 whereas the University of Malawi
incorporated different assessment tools and methods
How were the expectations and experiences of students depending on the component they wished to evaluate.
raised? Thus, for the theoretical components, assessment was
undertaken through examinations, seminar presentations
At IU, the IPE curriculum was presented throughout and projects; for the clinical component, assessment was
student learning and provided students with the opportunity undertaken through clinical portfolios, and students
to participate actively and collaborate effectively.28 Similarly, provided care to patients with various reproductive health
at UWC, IPEU was developed to offer opportunities for conditions and write up according to guidelines.31 The
IPECP.17 At Monash University, on the other hand, the students were then graded based on written and oral
curriculum was structured on a continuum basis so that the presentations.31 MAHE used the Interprofessional Team
learning needs of programmes were targeted and students Objective Structured Clinical Examination (ITOSCE) with
were prepared to meet the collaborative needs of patients.30 reflections, clinical exams and questionnaires.32
Students were given opportunities to interact with other
How was the intervention evaluated?

Overall, none of the universities analysed mentioned

Table 3: Consolidated outcomes from different universities. evaluating the effect of the IPE intervention on the com-
Consolidated outcomes from qualitative document analysis munity. Therefore, no data could be gathered for the inter-
vention or how it was evaluated.

Work together in interprofessional teams for optimal
patient-centred care

Awareness of the diverse roles and responsibilities of the How were the experiences shared?
different health professions and respecting professional
expertise The IPE programme experiences of students were shared

Adopt the Interprofessional Education and Collaborative on many different platforms and in many ways. Most
competencies in healthcare whilst following ethical commonly, experiences were shared at conferences,17,28,29,32
principles with networks17,28,29,32 and organisations.17,32 The media

Identify barriers to interprofessional collaboration and
incorporated included dissertations,31 publications,28
how to overcome them so that treatment and care can be
provided
workshops30 and presentations.30,31

Overcome arising disagreements and conflicts through a
team management plan Challenges encountered

Create interprofessional healthcare plans that are patient-
specific and innovative in approach Challenges were not a component of the steps described by

Support and employ interprofessional collaborative care at El-Awaisi et al.26 However, ‘challenges’ were another theme
the individual and community level identified whilst conducting the analysis. Logistic
challenges,17,30,32 such as lack of time, timetabling issues and
limited space to carry out IPE were evident. Staff
 Conceptualisation, development and implementation 649

challenges17,30 were also stated as it became difficult as they did in guiding the development of the programmes. It could be
not want to come on board or agree to IPE benefits in health deduced that the institutions included sought to make their
curricula. Having appropriate learning material30 where programmes internationally accepted. Furthermore, the
aspects of all health schools were merged was a challenge. common themes we identified from the programmes could be
IU28 found that implementing IPE during the Coronavirus classified into theory, practice and research. Frantz and
(Covid-19) pandemic was a challenge. Other challenges Rhoda41 supported the implementation of the three categories.
include disagreements and conflicts29 amongst team In terms of case and activity design, bringing together
members, misunderstandings, professional shortcomings, and stakeholders and facilitators to work on the programme was
tolerating differences.17 The University of Malawi31 an important step. Innovative learning strategies were neces-
identified faculty members expressing apprehension as sary to stimulate student thinking and support collaborative
accommodating IPE meant that there had to be a shift from practice. When comparing the different IPE programmes, it
their school’s core mandate. Buy-in32 from the included was quite evident that the overarching aim of facilitating an
institutes was crucial so that there was support in developing environment that harboured IPE for health professions’ stu-
and implementing IPE. Another challenge was that dents was necessary so that the collaborative healthcare needs
developing curricula to be implemented for all year levels32 of patients and populations were met. Additionally, impor-
was a problem and this was factored around logistical tance was placed on enhancing the IPE programmes regularly.
challenges. Training the faculty32 was a challenge too, as Differences amongst the universities were found in terms of
facilitators needed to be guided through the process of IPE. the learning methods used and how students were trained for
Suitable assessments32 were required to measure the the world of work. Furthermore, intervention in terms of
programme and to accredit the programme was necessary so community evaluations was a scarcity, whereas student and
that there was another reason to support participation in IPE. staff evaluations were given preference.

Limitations
Discussion

This paper served as a guide for educators; however, much

Interprofessional education programmes are evolving
attention was placed on development and implementation
across the world and especially in Africa. AfrIPEN is
without considering all of the challenges of IPE programme
advocating and building the capacity of health science edu-
development and implementation. Before considering devel-
cators on the continent to develop and implement IPE pro-
oping the programme, faculty and potential stakeholders need
grammes. This paper provides an analysis of how six,
to be consulted for input. Although evidence was gathered
globally recognised institutions introduced IPE programmes
from different institutions from the HIC and LMIC, data on
into their health science faculties, using the 12 steps of IPE
effective IPE programmes needs to be contextualised so that
programme introduction into health professions education
students can be trained in the immediate healthcare needs of
outlined by El-Awaisi et al.26
the community. We determined that developing an IPE pro-
We found that although getting the stakeholders together
gramme for an institution meant that evidence needed to be
to participate in the primary development of the programme
collected from other local institutions rather than selecting
varied from institution to institution, the underlining prin-
specific HIC and LMIC institutions. However, due to the
ciple was that it should be done in a way that all stakeholders
limited number of publications in the local context, feasible
felt involved and contributed their expertise to the pro-
data findings became a challenge.
gramme. Branch-Mays et al.,35 Teodorczuk et al.,35 Herrera
et al.,9 and Prast et al.36 resonated with the involvement of all
Conclusion
stakeholders who needed to accept and contribute to the
development and implementation of the IPE programme.
Key stakeholders were the university’s leadership, whose Interprofessional education is instrumental in making
buy-in was necessary for the programme’s initiation, as re- health professions’ students competent IPCP practitioners of
ported in many studies.26,36,38,39 the future. Many institutions are taking on the challenge of
We found that the benefits reported in the evaluated developing IPE programmes and it is essential to provide
programmes had many commonalities and peculiarities, evidence-based information to guide these institutions in
depending on the programme’s nature, level, and scope. The their journey. This paper provides a step-by-step guide and
WHO1 Framework for Action on Interprofessional Education ‘to-do list’ to facilitate educators in the process of con-
& Collaborative Practice emphasised that the needs of a ceptualising, developing, implementing and reviewing their
health systems were greatly influenced by the nature of the IPE programmes. We recommend institutions review and
IPE programme; hence IPE programmes in different contextualise these findings and then implement them in their
contexts must differ. The common benefits reported IPE programme conceptualisation, development, imple-
included improved collaboration, improved attitudes mentation and review.
towards other healthcare team members and reduced
medical errors which also fell within the core competencies Recommendations
of the IPE reported in the WHO1 Framework.
Furthermore, IPE also challenged students to think Based on the findings on processes and experiences of
critically and engage in high-level problem solving.40 introducing IPE programmes into the health sciences
This study found that the WHO definition for IPE was the curricula by the institutions included in this study, we
most used and that the IPEC competencies were fundamental recommend:
650 F. Delawala et al.

Gaining appropriate buy-in from the Faculty, University BMC Med Educ 2020; 20(2): 455. Available from: https://doi.
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