Original Research

This article was previously published in The Journal of Continuing Education in the Health Professions Volume 29, Summer 2009, Issue 3

Faculty Development for Continuing

Interprofessional Education and Collaborative
Practice
Ivan l. Silver, MED, MD; Karen Leslie, MED, MD

Abstract: This article proposes a framework for faculty development in continuing interprofessional education (CIPE) and
collaborative practice. The framework is built on best practices in faculty development and CIPE. It was informed by local experience in
the development, delivery, and evaluation of a faculty development program to promote capacity for dissemination of concepts relating
to interprofessional education (IPE) and interprofessional collaboration (IPC) in health care environments. Interprofessional education
has been demonstrated in clinical contexts to enhance interprofessional collaboration, patient care, and health outcomes. With
curriculum design, teaching methods, and educational strategies in faculty development, it is possible to enhance the impact of IPE in
clinical contexts. Faculty development activities themselves can model effective interprofessional education methods and practice. An
IPE curriculum and teaching and education strategies are outlined. Strategic planning, including the application of a systems
approach, attention to the principles of effective learning, and an outcomes-based curriculum design are recommended for the
development of continuing IPE faculty development programs that enhance interprofessional collaboration.
Keywords: continuing interprofessional education, faculty development, staff development, interprofessional collaboration
DOI: 10.1097/CEH.0000000000000178

INTRODUCTION culture in an emergency department and patient satisfaction,

the reduction of errors in an emergency department, improved
Defined as occasions when “two or more professions learn
with, from, and about each other to improve collaboration and care delivered to victims of domestic violence, and improve-
the quality of care,”1 interprofessional education (IPE) may be ment of the knowledge and skills of mental health pro-
the most direct approach to enhance the quality of interpro- fessionals.6 However, the majority of studies provide little
fessional collaboration (IPC) in health care settings. IPC is discussion of methodological limitations associated with their
defined as when the health disciplines come together around research, and most studies pay little or no attention to sampling
patient care issues, whereby decision-making happens within techniques in their work or issues relating to study attrition.
the group, and a transformation occurs.2 During the past 10 This undermines the quality of evidence they can offer.6 In
years, IPE curricula have been developed for health professions addition, there are a small number of randomized controlled
students in multiple settings.3 Educating students in IPE in trials (RCTs) to indicate that IPE has little or no effect on pro-
practice-based settings suggests that there be effective health fessional practice or patient outcomes.6 There is continued
care teams in place that role model best practices in team interest on many fronts to design better studies and to look at
functioning and collaborative practice.4 Concern has been maximizing the educational impact of IPE on health care teams.
expressed that there is a gap in the number of best-practice Little attention has been paid in the literature defining con-
health care teams who role-model effective team learning. tinuing IPE curricula in practice-based settings and to estab-
Similarly, health professional educators may not have the lishing best practices in IPE for practicing clinicians.7 Faculty
knowledge, skills, and attitudes to facilitate team training and development, the broad range of activities that institutions use
learning.5 to renew or assist faculty in their multiple roles, has the potential
Interprofessional education has been associated with for improving the practice of IPC and for building capacity in
enhanced patient care and health outcomes in a range of clinical the provision of IPE. The term faculty development in some
contexts.6 These outcomes include improving the working jurisdictions (United Kingdom) may refer only to faculty
development within university departments. However, for the
purposes of the article a broader definition would include the
Disclosures: The authors declare no conflict of interest.
development of all health professional staff who have teaching
Dr. Silver: Vice-Dean, Continuing Education and Professional Development,
Director of the Centre for Faculty Development at St. Michael’s Hospital, roles in health care settings and organizations.7 There is little
Department of Psychiatry, Faculty of Medicine, University of Toronto. Dr. Leslie: evidence-based literature available to guide faculty develop-
Associate Director, Centre for Faculty Development at St. Michael’s Hospital, ment in IPE, especially within health care institutions. There are
Department of Paediatrics, Faculty of Medicine, University of Toronto.
few studies to suggest which types of IPE programs are most
Correspondence: Ivan Silver, Office of Continuing Education and Professional effective at improving team functioning, health outcomes of
Development, 500 University Avenue, Suite 650, Toronto, Ontario M5G 1V7,
Canada; e-mail: silveri@smh.toronto.on.ca. patients, or the performance of health organizations and
Copyright ª 2017 The Alliance for Continuing Education in the Health Professions,
systems.
the Association for Hospital Medical Education, and the Society for Academic This article brings a faculty development perspective to
Continuing Medical Education continuing IPE for health professionals, outlining a conceptual

262 JCEHP n Fall 2017 n Volume 37 n Number 4 www.jcehp.org

Copyright ª 2017 The Alliance for Continuing Education in the Health Professions, the Association for Hospital Medical Education,
and the Society for Academic Continuing Medical Education. Unauthorized reproduction of this article is prohibited.
Faculty Development for Continuing Interprofessional Education and Collaborative Practice Silver and Leslie 263

framework, a planning guide, suggestions for a curriculum, and

teaching strategies and formats for planning and design. The
work of Steinert forms the basis of the model, contextualized for
health professionals in practice.8

Conceptual Framework
There are significant conceptual similarities between effective
faculty development and effective IPE.9,10 Both focus on the need
to effect change at the individual and organizational levels, are
experientially based, and require expert facilitation and an edu-
cation and organizational climate that values these interventions.
The IPE literature describes aligning the micro- (learner, educa-
tor, and learning context), meso- (leadership and administrative),
and macrofactors (accreditation and institutional structures).10
The faculty development literature describes addressing the
individual, instructional, and organizational development
needs.9 To assure success in both contexts, faculty developers
planning IPE programs must be especially aware of the individual
context, the environment, and the system in which education
interventions are being planned.
FIGURE 1. Individual and team curricular opportunities for faculty develop-
ment in IPE.
Setting the Stage for Faculty Development in
Continuing IPE
1. The attitudes, knowledge, and skills that underpin
Before implementing a faculty development program, an edu- effective collaborative practice. This can include the
cation plan adapted to an IPE environment needs to be con- beliefs of staff that would enhance or impede collabora-
sidered.10 Effective education design—needs assessment; clear, tive practice and an examination of the various roles of
measurable learning objectives; outcomes-based curriculum team members. Knowledge-based competencies can
design; interactive teaching methods; and an evaluation typol- include knowledge about interprofessional learning,
ogy must be adapted for IPE.7 group dynamics, the competencies of effective teams,
Arguably, the use of reflecting on the readiness of inter- and the skills of practitioners to work and learn collab-
professional teams to accept a faculty development program oratively.15,16 Teams can benefit from articulating their
can help direct the planning of the program.11 For example, common competencies, their complementary competen-
teams that have not perceived a need for change may resist an cies that distinguish one profession from another, and
interprofessional program.7 their collaborative competencies that are necessary to
Engaging physicians in IPE has been consistently noted as work effectively with others.16 Skills training should
a challenge for planners.12 Many reasons for this have been focus on effective team communication skills.17 Attitude
noted, including how physicians have been socialized in medical building, including respect for each other’s roles and
school and the perception by physicians that their authority in recognition that teams require work, are important
the hierarchy is being challenged by the new focus on collabo- components to successful teams.17
ration. One approach to engage physicians is to identify team- 2. Building capacity for health professional teams to self-
based education programs that can be linked to demonstrable assess their functioning periodically. This process can be
improvements in patient outcomes, such as quality improve- assisted with the use of a variety of new tools, including
ment (QI) or patient safety projects.12,13 The Healthy Teams Model and the Team Survey.18,19
A well-planned and -executed needs assessment can both The Healthy Teams model was developed with the use of
introduce prospective learners to some of the concepts of IPE rigorous qualitative methodology.18 The Team Survey
(and thus is an intervention in itself) and at the same time has 4 subscales. This instrument was found to be reliable
identify enablers and potential challenges that can be addressed (reliability coefficients between 0.70 and 0.93 were
through curricular development.14 obtained for each sub-scale). Construct validity measures
supported to a large degree the 4 subscales. The tool was
tested with the use of a wide range of specialties, including
Planning a Faculty Development Curriculum
surgical and medical teams, management, and service
As noted above, planning a curriculum requires attention to the support.
different education needs at different levels of a health organi- 3. Updates on health professional care issues that are
zation—micro/meso/macro. A faculty development program relevant to the team. The goal of these sessions would
can be directed at the front-line health care team, health pro- be different from traditional forms of multiprofessional
fessional teachers and educators, administrators, managers, CE, where 2 or more health professionals might be
and policy makers. learning together but not from and about each other. In
As Figure 1 illustrates, at an individual and team level, faculty continuing IPE, the goal of the sessions would include
development can be directed at: how a team works together to determine how new

Copyright ª 2017 The Alliance for Continuing Education in the Health Professions, the Association for Hospital Medical Education,
and the Society for Academic Continuing Medical Education. Unauthorized reproduction of this article is prohibited.
264 JCEHP n Fall 2017 n Volume 37 n Number 4 www.jcehp.org

information or policies and procedures would be adopted learning by limiting interruptions, but practically speaking, this
by team members individually and by the team as a whole. is very difficult for most teams to arrange.25
Working together to master the practical “know-how” Multiple teaching formats can be considered that vary in
for sharing patient care is essential for effective team intensity and duration.8 A recent systematic review of the fac-
functioning.17 ulty development literature revealed that effective programs are
4. Quality and systems improvement and patient safety. characterized by 4 key features: (1) experiential learning, (2)
Optimal interprofessional collaboration is a basic com- provision of feedback to participants, (3) well-designed inter-
petency for health systems improvement. Team-based QI ventions based on established principles of teaching and
projects can be effective methods of enhancing team learning, and (4) diversity of educational methods.26
functioning and a particularly effective method of engag- Choosing a teaching format depends on the goals of the
ing physicians in continuing IPE.20–22 Including this as faculty development intervention. A variety of team-based
a part of an interprofessional curriculum requires new rounds’ formats have been developed that focus on patient
conversations and collaboration between educators and care, quality improvement, team functioning, and teaching
QI and patient safety leaders in institutions and in the improvement (Table 1).13,27
community. In addition to the well-established interactive learning
5. Leadership and organizational change. Focusing on approaches such as case-based workshop28–30 and team-
team-based learning can facilitate shifts in individuals’ building exercises,31 there are a range of many other
roles on teams and lead to increased interest in leadership approaches.
and management skills, organizational change and devel- Peer coaching and mentoring in the workplace can promote
opment, and conflict management and negotiation.8,13 continuing IPE and support for health professionals function-
6. Teaching and learning. Addressing general topics on ing on teams. It can stimulate critical reflection by orienting
teaching and learning in a multiprofessional context can practitioners to see, act, and think in new ways through
enhance the common bond that ties health professionals reflecting on the “languages of practice”—the sets of implicit
to their teaching assignments with health professional and explicit rules that guide a clinician’s practice.
students and provide a much valued team-building It is a particularly appropriate method to consider in an
exercise. Teaching topics can include curriculum design, interprofessional context because of the range of different dis-
interactive teaching, and giving and receiving feedback.8 ciplinary languages of practice that exist on teams. Coaching to
Addressing general topics in teaching can set the stage for promote peer collaboration can enhance learning in the work-
faculty development that addresses specific topics on place because it offers opportunities for language change.32,33
teaching in an interprofessional context.8 Mentoring relationships that are built around the completion of
IPE projects in the workplace and that are based on principles of
Engaging management, ie, nursing and professional practice knowledge translation may be particularly effective.34,35
leaders and hospital administrators, in the development and Web-based learning to prepare staff teachers to teach in an
delivery process of faculty development sessions can be an IPE context is being developed.36,37 Faculty developers may be
effective method of creating an organizational culture of IPE. reluctant to use this as a primary teaching tool because of the
Faculty development interventions directed at management and nature of IPE teaching where face-to-face contact is so essential.
administrative leadership can emphasize the linkages between Web-based learning may be best used as a supplement to other
IPE, quality and systems improvement, and patient safety. The teaching formats.8 There are also developmental issues that
administrative leadership also needs to provide the resources to need to be considered. Faculty development programs that
support the education activities, including appropriate pro- engage learners over an extended period of time where trust,
tected time for faculty and staff and clinical replacement costs, collaboration, and a community of learners is well established
provide incentives to pursue faculty development, support may find the uptake of Web-based communication and col-
mentoring and professional networks for staff and faculty, and laboration to be very effective.8
address systems issues that would impede a faculty develop- Preceptorship training programs that focus on preparing
ment program.23,24 interprofessional teams to provide interprofessional education
At a government and health policy level, there is considerable to students from multiple disciplines are being developed.38
evidence that IPE will not be sustained without the necessary These programs aim to assist staff in designing and
policy changes accompanied by core funding to assist institu-
tions to embed sustainable changes in ways that health pro-
fessionals are educated.23 IPE faculty developers need to
TABLE 1.
collaborate with institutional leadership to lobby policy makers
Teaching Formats and Strategies for IPE
to make these systems-based changes.
Team-based rounds
Team-building exercises
Settings, Formats, and Teaching Strategies Case-based workshops
Unlike traditional continuing medical education (CME) that Peer coaching and mentoring
takes place in conference centers, university seminar rooms, and Web-based learning
hotels, faculty development for continuing IPE should ideally Preceptorship training
Longitudinal programs
take place in situ, in the clinical settings where teams work and
Communities of practice
practice and at times when teams would otherwise be meeting.8 Teaching tools and resources
Leaving the clinical setting may be advantageous for team

Copyright ª 2017 The Alliance for Continuing Education in the Health Professions, the Association for Hospital Medical Education,
and the Society for Academic Continuing Medical Education. Unauthorized reproduction of this article is prohibited.
Faculty Development for Continuing Interprofessional Education and Collaborative Practice Silver and Leslie 265

implementing a clinically based IPE curriculum for the students TABLE 2.

training with them. University of Toronto IPE Faculty Development Course
Longitudinal programs in faculty development are well Planning and Design
established at many health professional schools.39–41 Longi-
tudinal programs in CE also have an established evidence base Setting: Centre for Faculty Development, Faculty of Medicine, University of Toronto.
of effectiveness.42 These types of programs are particularly Collaborators: Office for Interprofessional Education, the Office for Continuing
Education and Professional Development, University of Toronto, and the Toronto
suited for educating teachers and scholars in faculty devel-
Academic Health Sciences Network Partnership.
opment for IPE. Participants from different professions from Program goal: To train trainers in IPE faculty development.
different hospital and community settings have an opportu- Participants: Forty health care practitioners/clinical educators with existing knowledge/
nity to learn from each other, share resources, and potentially experience in IPE.
collaborate on interinstitutional faculty development projects. Planning group: IPE faculty developers, curriculum design expert, project manager.
When a course is extended over time, participants have an Needs assessment: Sample of prospective participants. Curricular goals aligned with
opportunity to implement faculty development programs and identified needs.
return to the group to present their programs and receive Course format: Longitudinal course was run over a 6-month period in 2008–2009.
feedback.9 Curriculum design: The course was designed with the use of a curriculum mapping
Communities of practice (COP) in IPE are developing as approach.52 The curriculum was aligned with an outcomes-based design.
Teaching formats: Large group, small group, online, teleconference call “coaching”
a means of connecting a wider collaborative community of IPE
sessions, interactive exercises, opportunity to apply learning to own context, joined
practitioners and scholars.43,44 These groups are often highly a pre-existing community of practice in IPE/IPC postcourse.
motivated practitioners in the field who come together to gen- Resources: Web-based discussion forum and social networking site used by
erate new knowledge, have a specific interest and identity in the participants between face-to-face sessions; resource manual aligned with each
field, and share ideas, information, tools, and resources with component of the curriculum.
each other.45 A community of practice can be a successful Assessment and evaluation: “Realistic approach” used in order to focus on
outcome of longitudinal and train the-trainer programs where examining contextual factors associated with the development of the program.53
participants have built trust and collaborative relationships Program outcomes and impact were measured with the use of an interprofessional
over time.43 Communities of practice can also structure team- outcomes typology.16 At the end of the course, participants demonstrated their
based journal clubs and case conferences, leading to practice expertise by presenting a faculty development project they had completed at their
local clinical setting.
changes.46
Teaching tools and resources are needed to support faculty
development programs. These tools can include Power-Point
presentations,47,48 ice-breakers, games, role-plays, and IPE facilitators, and an opportunity to participate in interprofes-
cases to stimulate reflection on effective team functioning; DVD sional program planning.25
trigger tapes to foster discussion on effective facilitation of Using 2 facilitators (cofacilitation) is very common in IPE.25
IPE;49,50 access to actors that can simulate health professional The cofacilitators’ relationship with each other becomes
teams to practice team facilitation and provide feedback; and a potential modeling opportunity for effective collaboration.
resources to support program development, implementation, This process can be debriefed with participants during the
and sustainability.51 course of a workshop and is an opportunity to use a “parallel
Following the best practices and principles of program process” in facilitating to illustrate best practices in collabora-
planning for faculty development for continuing IPE, Table 2 tion. This type of modeling has been noted as a critical factor for
describes a program recently offered at the Centre for Faculty the success of an IPE workshop.54
Development in Toronto. Program planning and implementation for any IPE activity
requires special attention to process.51 For example, at the
DISCUSSION planning committee level, the same normative group dynamic
issues will emerge that facilitators will face when they are
One of the challenges in organizing faculty development pro- facilitating IPE such as forming, storming, norming, and per-
grams for continuing IPE is in embedding the principles of IPE forming.55 Effectively dealing with these stages as they emerge
into every aspect of the program, from facilitator preparation, will ensure a successful planning process. One recommended
to curricular and program planning, to delivery and evaluation method is to debrief every planning committee meeting.
processes.
Effective facilitation in IPE requires significant training with
opportunities for practice and feedback. Several themes CONCLUSIONS
emerged from a recent study25 on essential features of successful Faculty development can play an essential role in enhancing
facilitation in IPE. These themes illuminate the need for facili- interprofessional collaboration and in building capacity for the
tators to demonstrate the ability to be self-aware, to respect and provision of continuing IPE. Strategic planning includes
value differences, to be conscious of the impact of group a careful needs assessment, application of a systems approach
dynamics on learning, to manage issues around power and (micro/meso/macro) to identifying the target audience of
hierarchy, to plan interprofessional learning, and to integrate learners, incorporation of principles of effective learning, mul-
the facilitator’s learning philosophy.25 The training of facili- timodal teaching methods, incorporation of an IPE-based cur-
tators should include shadowing experienced IPE facilitators, riculum and an outcomes-based curriculum design. Special
cofacilitating and buddy teaching, opportunities to engage in attention needs to be paid to ensuring the teachers of these
formative evaluation of IPE activities, a mentoring opportunity programs are well trained in IPE facilitation. It is important to
from an experienced IPE facilitator or from a peer group of embed the principles of IPE, with attention to “process” at every

Copyright ª 2017 The Alliance for Continuing Education in the Health Professions, the Association for Hospital Medical Education,
and the Society for Academic Continuing Medical Education. Unauthorized reproduction of this article is prohibited.
266 JCEHP n Fall 2017 n Volume 37 n Number 4 www.jcehp.org

level of program planning and delivery. Comprehensive eval- 17. Sargeant J, Loney E, Murphy G. Effective interprofessional teams:
uation of faculty development programs in IPE is currently “Contact is not enough” to build a team. J Contin Educ Health Prof.
2008;28(4):228–234.
needed to provide more direction to program planning. 18. Mickan S, Rodger S. Effective health care teams: A model of six
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21. Rubenstein LV, Parker LE, Meredith LS, Altschuler A, DePillis E,
the professional development activities related to faculty’s
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