experiential learning is a critical component of IPE because it is where the imprinting of health professions education takes place. However, imprinting can also take place through a “hidden curriculum” which was identified by a number of workshop speakers. Students may be formally taught to work collaboratively, but within the hidden curriculum, experience educational and health care systems remain mostly siloed. The existence of this hidden curriculum risks sending conflicting messages to students regarding the value of collaboration, said workshop speaker Barbara Brandt from the University of Minnesota. One way to avoid these conflicting signals is to expose students only to well-functioning teams. For example, Brandt described sending students to the Broadway Family Medicine Clinic in North Minneapolis, where they experience a unique culture in terms of both language and behavior. The front desk receptionist leads the staff meeting, and physicians interact fully with nurse practitioners. Although student education is not the primary focus of the clinic, Brandt said, learners internalize the values and behaviors expressed in this nonhierarchical, collaborative environment.

Another technique for dealing with the hidden curriculum was described by workshop speaker Mark Earnest from the University of Colorado. He uses the hub-and-spoke model (described in Appendix D) in which students learn how to work interprofessionally in clinical settings and then return to the university preceptor to discuss their experience. The preceptors tell their students they will learn by negative as well as positive examples of collaboration. A goal of this program, as Earnest described it, is to help keep students focused on the positive examples and to be agents of change to create such environments wherever they go.

Culture

Cultural entrenchment within education and practice remains a significant barrier to collaboration in and across these environments. This was one message from Forum member Warren Newton of the American Board of Family Medicine, who led the small group discussing the initiation of collaborative partnerships. From Thibault, the message was, “We’ve built up cultures that actually reinforce separation, actually sometimes rejoice in separation and in citing differences rather than the commonality that we have across the health professions with a common goal of improving patient care.” Those silos are manifested by poorly aligned calendars, inadequate collaborative space, the perceived lack of time necessary to do interprofessional work, and the need for new models of education, he said. Overcoming these challenges means understanding the different incentives, drivers, and reward systems that exist within the two worlds of education and practice. Once these are recognized, Thibault said, strategies can



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