Barriers in the implementation of interprofessional continuing education programs--a qualitative study from Germany

Area of Science:

• Healthcare Management
• Medical Education
• Health Services Research

Background:

• Poor communication and coordination in German healthcare negatively impact patient outcomes.
• Interprofessional continuing education (CIPE) is increasingly recognized in German health policy to improve service quality and patient safety.
• Evidence on CIPE implementation and effectiveness in Germany is limited.

Purpose of the Study:

• To describe the objectives and characteristics of CIPE trainings in Germany.
• To identify factors influencing the successful implementation of CIPE from the perspective of training providers.
• To map determinants hindering CIPE implementation in the German healthcare system.

Main Methods:

• A structured web search identified 49 institutions offering CIPE.
• Semi-structured interviews were conducted with directors/managers of 19 participating institutions (38.8% response rate).
• Summarizing content analysis (Mayring) was used to analyze interview data and develop a paradigm of hindering factors.

Main Results:

• Participating institutions offered 85 CIPE trainings focused on enhancing domain, social, and personal competencies.
• Key training objectives included improved care for severely ill patients, enhanced patient safety via risk management, and more patient-centered care.
• Hindering factors for CIPE implementation were identified as systemic (e.g., lack of incentives), behavioral (e.g., hierarchy issues), and methodological (e.g., limited quality assurance).

Conclusions:

• CIPE is an emerging concept in German healthcare, facing implementation hurdles.
• Specific health policy interventions, like mandatory CIPE and integrated pre-license interprofessional education, could mitigate these difficulties.
• Successful CIPE implementation requires addressing systemic, behavioral, and methodological barriers to improve healthcare delivery.