change. Mesosystems enable interdependent functioning of multiple microsystems and confront impediments to good patient care—for example, from poor information systems or from relationships that do not recognize true interdependence. The macrosystem sets a vision and goals to guide the micro- and mesosystems by providing an enabling context and leadership for change. Professional development strategies and alignment of incentives are fostered at the macrosystem level. They are a natural point of accountability for the care outcomes of a community (Nelson et al., 2007).

Interprofessional, Team-Based Care

A concept underlying the CPDI is that by bringing together diverse participants, it will support and advance the team-based nature of health care. Health care often requires coordination among multiple practitioners, both intraprofessionally and interprofessionally. Today, care is often not practiced in teams, not because teams are not useful or effective, but because people are not trained in such a fashion. As the health professions are increasingly recognized as interdependent, a new team-based culture will emerge. The professional environment will also change as patients become more active partners in their health care. To embody the principles of effective interprofessional education, the CPDI will need to pursue four goals:

  1. Articulate a coherent rationale for implementing interprofessional continuing education,

  2. Promote collaboration to achieve patient-centered aims,

  3. Reconcile competing objectives between the professions in a way that is accepted by all of them, while reinforcing collaborative competence, and

  4. Support the development of methods to recognize interprofessional activities in the credentialing of individual professions.

A number of interprofessional experiments in CPD have been developed, resulting in pockets of interprofessional programs. It is important that these experiences could be supported, built on, and expanded in clinical practices in settings such as integrated health care systems and academic health centers. Academic health centers would be particularly interesting, given their important roles in undergraduate and graduate education. Applying these principles



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