Dr. Judith Buchanan, Associate Dean for Academic Affairs, University of Minnesota School of Dentistry
Interprofessional education (IPE) for health professionals has been around since the early ‘70s, but interest in IPE has escalated tremendously in the last three to four years, and leaders in dental education have championed this movement. Nevertheless, conversations with colleagues around the country make clear that many of us in dental education are still not entirely sure what constitutes IPE. Some are asking why dentistry needs to play a leading role in IPE, and others (perhaps overwhelmed by the all the changes occurring in dental education) are asking, why now?
So what constitutes IPE? The Center for the Advancement of Interprofessional Education (CAIPE) defines IPE this way: “Interprofessional Education occurs when two or more professions learn with, from and about each other to improve collaboration and the quality of care.” Note that the ultimate goal of IPE is to improve the quality of care. IPE programs involve much more than students from different professions learning side by side. They emphasize teamwork, understanding other professions’ roles and responsibilities, respectful communication and clinical experience delivering interprofessional collaborative care. Leaders in the field recommend introducing IPE experiences early in the curriculum, reinforcing them consistently throughout programs and including interprofessional clinical experiences prior to graduation.
Why dentistry? In my view, dentistry cannot afford to not be a part of the IPE initiatives happening across the nation. Many of our academic health centers have major IPE programs in place or in development, and participation in these will increase our worth as valued and respected members of our institutions. IPE also gives us an opportunity to reinforce the link between oral health and systemic or general health and to overcome our profession’s previous isolation from medical care and its reimbursement programs. The other health professions’ knowledge of basic oral health is limited. We have much to teach them, and this interaction will foster respect for our profession and further strengthen the link between oral and systemic health care.
Dentistry is also seen by other health professionals as being a leader in prevention and in intraprofessional collaboration, even if many in the profession feel we have room for improvement. With the introduction of new members to the oral health team, as I have witnessed firsthand here in Minnesota, the importance of collaboration within teams cannot be overstated. Those of us in oral health can draw on our experience working in teams as we engage our colleagues in the other health professions to extend collaborative care to patient encounters that reach beyond dentistry.
Why now? Changes happening in our profession and trends in health care delivery make it urgent that dental education embrace IPE so the next generation of oral health providers are prepared for a future where dentistry will be more closely linked with medicine. More than 50% of physicians are now employees, and recent research into the size and structure of group dental practices suggests that dentists are heading in that same direction. Meanwhile, the rapid development of salivary diagnostics may open up more opportunities for dentists to participate in general health screening. Recent articles report that Illinois dentists are interested in administering vaccine injections, dental hygienists are testing for HIV, and some legislators see a role for dentistry in disaster response. Changes in dentists’ scope of practice are being discussed with the vision that dental offices might take on some of the screening functions performed by primary care providers and serve as portals into the health care system.
The other health professions are also showing interest in expanding their scopes of practice to include oral health procedures. Maine, for example, is responding to its shortage of oral health care providers by training physicians to extract teeth. In short, the borders that separate one profession’s scope of practice from another’s are becoming less clear. This can be of benefit to patients, but only if all professions participate in discussions in a collaborative way with the health of the public as the highest priority.
How do we make IPE a reality? Each program will find its own answer to this question, but supports are in place to help us achieve this goal. The new accreditation standards for pre-doctoral dental programs state that “Graduates must be competent in communicating and collaborating with other members of the health care team to facilitate the provision of health care,” and make clear that interprofessional education is expected to play an important part in our curricula.
ADEA and its sister organizations in medicine, pharmacy, nursing and public health have also collaborated on a set of Core Competencies for Interprofessional Collaborative Practice, which we can use in shaping our IPE programs. These competencies will likely prompt future changes in our standards that will further strengthen the role of IPE in dental education.
The federal government is also throwing its weight behind IPE. The Health Resources and Services Administration (HRSA) recently joined with four leading health care foundations to create a National Coordinating Center for Interprofessional Education and Collaborative Practice at the University of Minnesota. The Center has received more than $12 million to provide leadership, scholarship, evidence, coordination and national visibility to advance IPE and collaborative practice. This substantial funding speaks to the belief of those in government and philanthropy that interprofessional collaboration is essential to a viable, effective and efficient health care delivery model moving forward.
Now is a time of challenges and opportunities for dentistry. If you are not currently part of an IPE initiative, it’s time to get on board. You must be in the tent to influence what happens there, and schools that do not engage with their Academic Health Centers around IPE risk becoming vulnerable. IPE gives us a welcome opportunity to better integrate dentistry within health care teams. It also gives us an opportunity to leverage our leadership in intraprofessional collaboration in the interprofessional sphere. Now is the time to seize these opportunities. Now is the time to embrace IPE.