Team-based learning: a strategy for interprofessional collaboration

Abstract

Context and setting Team-based learning is content-grounded and allows for problem solving and mastery of concepts for large groups within a small-group setting. We developed an innovative method of expert-presented content followed by collaborative team-based learning, to teach health-care leaders in the National Academies of Practice (NAP) skills for effective interprofessional patient care. The NAP, an honorific, national group comprised of elected members in 10 academies representing medicine and 9 other health care professions, serves as a distinguished policy forum that advises governmental bodies on interprofessional approaches to problems in health care. Our objective was to create an interactive team-based learning experience for a large group of interprofessional health care leaders that provided them with the opportunity to: (a) examine the process of creating a patient interprofessional care plan and (b) collaborate with interprofessional colleagues to develop effective ways to co-ordinate patient care. Why the idea was necessary The ability of health care providers to work effectively in interprofessional teams is a key component of quality health care. The Institute of Medicine reports that health care team communication failures cause mistakes that endanger patient safety. Interprofessional communication, taught rarely in traditional health care settings, is learned usually through a hidden curriculum of experiences. While there is growing interest in team-teaching for specific content areas, few programmes utilise team-teaching to teach the process of interprofessional care. We describe an efficient team-teaching strategy to teach skills for interprofessional care of patients. What was done We developed a 3-h interactive session, presented at the 2004 NAP National Forum, to address interprofessional issues with leaders from 10 health-care professions. Participants (n = 98) studied the case of a diabetic woman with medical and psychosocial issues. Experts from each discipline gave short presentations (8 min each) relevant to their discipline's contribution to the patient's care. Participants were then divided into 8 interprofessional groups and asked to discuss the process of creating a co-ordinated care plan (rather than actually creating one) from their diverse perspectives. Each group answered one of the following two questions: (1) how might this patient be helped through the current system to receive comprehensive and co-ordinated care by all these disciplines? And (2) what are the benefits and barriers to an interprofessional approach to this patient's needs? All groups answered a third question: (3) what policy recommendations should NAP make to governing bodies to promote a more effective means for interprofessional care? Each small group reported to the larger group, which then discussed the process of effective interprofessional collaboration. Evaluation of the results and impact Participants were enthusiastic about the opportunity to participate in a team-based learning process. They identified lack of training in the skills necessary for effective collaboration as a common barrier to interprofessional practice, and improving communication among diverse providers as the key to optimising interprofessional care. Participants were uniformly positive in their support of this interdisciplinary team-learning model as an efficient and effective way to gain exposure to the perspectives and knowledge of those in related professions, and to learn important skills for interprofessional collaboration.