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Interprofessional Practice and Education in Clinical Learning Environments: Frontlines Perspective
Paul N Uhlig1, Joy Doll, Kristy Brandon
1P.N. Uhlig is associate professor, Department of Pediatrics, University of Kansas School of Medicine-Wichita, Wichita, Kansas. J. Doll is associate professor of occupational therapy and executive director, Center for Interprofessional Practice, Education and Research (CIPER), Creighton University, Omaha, Nebraska. K. Brandon is assistant clinical professor-contributed service, Department of Family Medicine, Creighton University School of Medicine, and physical therapist, Creighton University Medical Center-University Campus, CHI Health, Omaha, Nebraska. C. Goodman is assistant professor, Department of Medicine, University of South Carolina School of Medicine, Columbia, South Carolina. J. Medado-Ramirez is administrative nurse manager and codirector, Integrated Medical Unit, Beaumont Hospital, Royal Oak, Michigan. M.A. Barnes is associate professor of medicine, Oakland University William Beaumont School of Medicine, and codirector, Integrated Medical Unit, Beaumont Hospital, Royal Oak, Michigan. M.A. Dolansky is associate professor, Frances Payne Bolton School of Nursing, and director of interprofessional education, Louis Stokes Cleveland VA Medical Center of Excellence in Primary Care, Cleveland, Ohio. T.A. Ratcliffe is associate professor, Division of General and Hospital Medicine, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas. K. Kornsawad is assistant professor, Division of General and Hospital Medicine, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas. W.E. Raboin is organization development practitioner and principal, CareQuest Consulting, Danville, California. M. Hitzeman is clinical staff pharmacist, Nebraska Medicine, Omaha, Nebraska. J. Brown is applied human factors practitioner and principal, Safer Healthcare, LLC, Belfast, Maine. L. Hall is professor of medicine, University of South Carolina School of Medicine, Columbia, South Carolina.
Abstract:
This Invited Commentary is written by coauthors working to implement and study new models of interprofessional practice and education in clinical learning environments. There are many definitions and models of collaborative care, but the essential element is a spirit of collaboration and shared learning among health professionals, patients, and family members. This work is challenging, yet the benefits are striking. Patients and family members feel seen, heard, and understood. Health care professionals are able to contribute and feel appreciated in satisfying ways. Learners feel included. Care interactions are richer and less hierarchical, and human dimensions are more central. A crucial insight is that collaborative care requires psychological safety, so that people feel safe to speak up, ask questions, and make suggestions. The most important transformation is actively engaging patients and families as true partners in care creation. A leveling occurs between patients, family members, and health professionals, resulting from closer connections, deeper understandings, and greater mutual appreciation. Leadership happens at all levels in collaborative care, requiring team-level capabilities that can be learned and modeled, including patience, curiosity, and sharing power. These abilities grow as teams work and learn together, and can be intentionally advanced by reconfiguring organizational structures and care routines to support collective team reflection. Collaborative care requires awareness and deliberate practice both individually and as a team together. Respectful work is required, and setbacks should be considered normal at first. Once people have experienced the benefits of collaborative care, most "never want to go back."
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