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http://informahealthcare.com/jic
ISSN: 1356-1820 (print), 1469-9567 (electronic)
J Interprof Care, Early Online: 1–8
Published with license by Informa UK Ltd. DOI: 10.3109/13561820.2015.1040875
ORIGINAL ARTICLE
Setting a research agenda for interprofessional education and
collaborative practice in the context of United States health
system reform
May Nawal Lutfiyya
1
, Barbara Brandt
1
, Connie Delaney
2
, Judith Pechacek
2
, and Frank Cerra
1
1
Academic Health Center—Office of Education, R6685 Children’s Rehab Center, University of Minnesota, Minneapolis, MN, USA and
2
School of Nursing, University of Minnesota, Minneapolis, MN, USA
Abstract
Interprofessional education (IPE) and collaborative practice (CP) have been prolific areas of
inquiry exploring research questions mostly concerned with local program and project
assessment. The actual sphere of influence of this research has been limited. Often discussed
separately, this paper places IPE and CP in the same conceptual space. The interface of these
form a nexus where new knowledge creation may be facilitated. Rigorous research on IPE in
relation to CP that is relevant to and framed by health system reform in the United States (US) is
the ultimate research goal of the National Center for Interprofessional Practice and Education at
the University of Minnesota. This paper describes the direction and scope for a focused and
purposive IPECP research agenda linked to improvement in health outcomes, contextualized by
health care reform in the US that has provided a revitalizing energy for this area of inquiry. A
research agenda articulates a focus, meaningful and robust questions, and a theory of change
within which intervention outcomes are examined. Further, a research agenda identifies the
practices the area of inquiry is interested in informing, and the types of study designs and
analytic approaches amenable to carrying out the proposed work.
Keywords
Health services research, interprofessional
research, IPECP research agenda, research
History
Received 6 October 2014
Revised 1 April 2015
Accepted 10 April 2015
Published online 31 July 2015
Introduction
The National Center for Interprofessional Practice and Education
at the University of Minnesota (hereafter the National Center)
(https://nexusipe.org/) is committed to nurturing and producing an
evidence-base on the impact of interprofessional education and
collaborative practice (IPECP) on both health-related and pre- and
post-licensure education outcomes. These efforts are contextua-
lized by the current reform of health care in the United States
(US). Underlying this reform is a shift in the focus of the health
care delivery system from disease to health and wellness
accompanied by the recognition that engaging individuals,
families and communities in the redesign of health care is
essential. Presently, health care reform efforts are focused on
health-related outcomes that entail improving patient experiences
of care (including quality and satisfaction), improving the health
of populations, and reducing the per capita cost of health care: the
triple aim (Berwick, Nolan, & Whittington, 2008).
In comparison to other developed countries, healthcare in the
US costs more without having a corresponding positive reflection
in quality or health outcomes (Schoen et al., 2007). Moreover, the
US health care system is fragmented and uncoordinated (Berwick
et al., 2008). The triple aim has galvanized health care reform to
focus on population health improvement, reducing the per capita
cost of care and improving health care quality. Interprofessional
collaborative practice and team based care have been identified as
possible integral components of health care reform that might
contribute to achieving the triple aim (Sullivan, Kiovsky, Mason,
Hill, & Dukes, 2015).
While IPECP has been an area of scholarly inquiry for over 40
years, the actual sphere of influence emanating from this research
has been limited (Baldwin, 2007; Gilbert, 2013; Goldman,
Zwarenstein, Bhattacharyya, & Reeves, 2009; Hall & Weaver,
2001; Reeves et al., 2011) in large measure because of scant
research efforts investigating the connection of IPECP to health-
specific outcomes such as those identified by the triple aim
(Berwick et al., 2008). Nevertheless, despite this short-coming,
there is sufficient evidence to suggest that with well-designed and
focused research studies the contribution of IPECP (if any) to
improved health care delivery, health and education outcomes,
and reduction in the cost of care could be identified (Gilbert,
2013). Along with well-designed studies, data need be rigorously
generated and analyzed to ascertain the contributions of IPECP to
current health care reform efforts.
The aim of this paper is to provide direction and scope for a
focused and purposive research agenda addressing what IPECP
may add in shaping the transformative redesign of the process of
health care and in aligning education and clinical practice
(Goldman et al., 2009; Thistlethwaite & the GRIN working
ßM. N. Lutfiyya, B. Brandt, C. Delaney, J. Pechacek, F. Cerra. This is an
Open Access article. Non-commercial re-use, distribution, and reproduc-
tion in any medium, provided the original work is properly attributed,
cited, and is not altered, transformed, or built upon in any way, is
permitted. The moral rights of the named author(s) have been asserted.
Correspondence: Dr. May Nawal Lutfiyya, Academic Health Center –
Office of Education, R6685 Children’s Rehab Center, University of
Minnesota, 426 Church Street SE, Minneapolis, MN 55455, USA. E-mail:
nlutfiyy@umn.edu
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group, 2012; Zwarenstein, Goldman, & Reeves, 2009). The
essential characteristics of a strong and well-developed research
agenda should include a purpose and a focus, emphasize
meaningful and robust questions, and provide a framework of
change when interventions aimed at modifying or adapting
behaviors and/or institutions are being examined (Bartholomew,
& Mullen, 2011; Ertmer & Glazewski, 2013). In establishing a
research agenda, it is also essential to identify and differentiate
between types of study designs amenable to carrying out the
proposed work. In order to delineate a research agenda for IPECP,
understanding where the area of inquiry has been and currently
resides are important. As such, this paper begins by briefly
commenting on the current state of the science/art of IPECP
research before fleshing out the elements essential to establish a
research agenda and make recommendations about best prac-
tices to implement research in a way that fosters sustainable,
meaningful, and beneficial health care redesign (Ertmer &
Glazewski, 2013; Gilbert, 2013; Thistlethwaite, 2012).
What is IPECP?
Shared definitions of interprofessional education and interprofes-
sional collaborative practice are a crucial starting point for any
discussion of IPECP. Some scholars engaged in the inquiry of the
impact of IPECP on health care and health outcomes have noted
that there continues to be inconsistency in defining interprofes-
sional education as well as collaborative practice (Gilbert, 2013;
Reeves et al., 2011; Thistlethwaite, 2012). In 2010, the World
Health Organization (WHO) adopted a definition of interprofes-
sional education that has been widely accepted, and is used by the
National Center. Accordingly, interprofessional education
‘‘occurs when two or more professions learn about, from, and
with each other to enable effective collaboration and (to) improve
health outcomes’’ (WHO, 2010, p. 3). In addition, the National
Center has adopted the United Kingdom’s Centre for the
Advancement of Interprofessional Education’s (CAIPE) definition
of collaborative practice which is: ‘‘interprofessional collabora-
tive practice happens when multiple health-related workers from
different professional backgrounds work together with patients,
families, care givers and communities to deliver the highest
quality of care’’ (Barr & Waterton, 1996, p. xx). Adopting these
specific definitions not only contributes to achieving consensus on
the terms that underpin intervention development (a key compo-
nent of the National Center’s knowledge creation strategy) but
establishes a base understanding to help define measurement (an
essential component for data collection). Furthermore, established
and shared definitions ensure that we are talking about and
assessing the same things.
Ultimately, interprofessional education is a means to an end just
as collaborative practice is (Frenk et al., 2010; Hall, et al., 2001;
Reeves, Perrier, Goldman, Freeth, & Zwarenstein, 2013). The first
(IPE) is an intervention that may take on many different forms that
could ostensibly create transformative learning (Frenk et al., 2010)
resulting in the second (CP). Collaborative practice is the means,
with other factors and variables, by which outcomes of the triple
aim related to patient health care cost, health care quality, and
eventual improvement in population health could be impacted.
Why the current interest in IPECP?
Since the 1970s, there have been periodic cycles of interest
(Brandt, Lutfiyya, King, & Chioreso, 2014; Schmitt, 1994) in the
potential of IPECP to substantively influence the reshaping of
both the process of health care and health outcomes; we are now
experiencing another resurgence. The National Center arose out
of this resurgent interest in IPECP. The establishment of the
National Center resulted from a national competitive process
with funding from the US Health Resources and Services
Administration (HRSA) and a group of private foundations.
Historically and presently, forces in the marketplace of health
and health care have driven interest in IPECP. Currently, change
in the health care marketplace is being compelled by: the
transition from treating disease to the prevention and maintenance
of health with greater individual and community responsibility,
increased numbers of people with long term chronic conditions
requiring complex care, the desire to reduce the per capita cost of
care while adding value to the health care process, the continued
integration of systems of care with providers as employees, and
the need for increased access to care as the number of health
insured increases.
Understandably the recent resurgence of interest raises the
question of why IPECP has not already been embraced and fully
adopted. A now 20-year-old editorial summarized four reasons for
IPECP not catching fire: (1) a widespread lack of training of care
providers in an interprofessional approach, (2) the complexity of
implementing interprofessional care, (3) the increasing demand
for documentation of cost effectiveness, and 4) the lack of
systematic study of the process and outcomes of the interprofes-
sional approach (Schmitt, 1994). Despite numerous IPECP
programs in universities and Academic Health Centers throughout
the US, these challenges remain and in many ways accurately
describe the current state of the art/science.
Berwick et al. (2008) proposed the triple aim as the health
outcomes that should be used in transforming the direction and
purpose of the redesign of health care. Similarly, in a 2010 World
Health Organization report, a connection was made between
IPECP, in particular interprofessional health care teams, and the
provision of better health care services that would eventually lead
to improved health outcomes (WHO, 2010). Unequivocally,
interest has grown in integrating interprofessionalism into the
redesign of health care, including aligning education and clinical
practice to form a learning collaborative focused on improving
health care and health-related outcomes. A critical motive for the
creation of the National Center in 2012 was the resurgence of
interest in IPECP in a health care environment energized by
significant practice and health policy changes.
What do we know about IPECP?
With such a long history, a plethora of reviews has been conducted
on the status of IPECP research from numerous perspectives.
At this juncture we know that very little IPECP research has dealt
with big picture outcomes (Brandt et al., 2014) and the literature
on the effectiveness of health care teams (interprofessional or not)
has yielded mixed results (Lemieux-Charles & McGuire, 2006).
IPECP competencies have been defined and partially adopted
(Interprofessional Education Collaborative, 2011) but there is
increasing recognition that additional competencies are needed.
Moreover, there remains a gap between the identification and
subsequent application of educational (pre- and post-licensure)
best practices (Weaver et al., 2010). Further, sound, reliable and
validated assessment instrument tools are in short supply
(Canadian Interprofessional Health Collaborative, 2012).
Systematic reviews of the research literature regarding the
impact of IPECP reveal that much of the inquiry has been focused
on examining three levels of impact – individual immediate or
short-term changes on learner knowledge, skills, and attitudes;
practice level for practice-based processes–but not outcomes; and
organizational level for intermediate policy changes (Brandt
et al., 2014; Goldman et al., 2009; Reeves, Goldman, &
Zwarenstein, 2009). There is little in the literature that explicitly
maps IPECP interventions to the outcomes of population health,
a reduction in the cost of health care, the engagement of patients,
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families and communities, and better linkage between education
and clinical practice. (Brandt et al., 2014). Gilbert (2013) noted
that one of the most frequently asked questions regarding
interprofessional education (and we would extend this to include
collaborative practice) is – does it make a difference to health care?
He averred that the best response, attributed to DeWitt Baldwin,
is: ‘‘interprofessional education [and collaborative practice] is a
great truth awaiting scientific confirmation’’ (p. 283).
Early results demonstrating the success of teams in the health
delivery system (Salas et al., 2008) and the Patient-Centered
Medical Home (PCMH), or health home, model (Cronholm et al.,
2013) add credence that IPECP could add value in the shift to a
focus on outcomes-based systems of health. Other research,
however, has demonstrated that achieving a positive impact of
collaborative practice is not consistent and often context-specific
(Gilman, Chokshi, Bowen, Rugen, & Cox, 2011).
In 2009 six national education associations of health profes-
sions schools (American Association of Colleges of Nursing,
American Association of Colleges of Osteopathic Medicine,
American Association of Colleges of Pharmacy, American Dental
Education Association, American Association of Medical
Colleges, and Association of Schools and Programs of Public
Health) formed a collaborative to promote and encourage efforts
advancing essential interprofessional learning experiences aimed
at preparing future health professionals to provide team-based
care. The resultant organization was the Interprofessional
Education Collaborative (IPEC) and represented allopathic and
osteopathic medicine, dentistry, nursing, pharmacy, and public
health. IPEC has defined competencies for interprofessional
practice (Interprofessional Education Collaborative, 2011). These
competencies have been generally accepted by health care
professions accrediting bodies in the US and encompass the
domains of values and ethics, roles and responsibilities,
interprofessional communications, teams and teamwork. Since
their publication, we have observed that additional competencies
have been identified as essential including: understanding popu-
lation health, informatics, evidence-based patient centered care,
quality improvement processes and technology, an understanding
of systems, and cost-effective practices.
With defined competencies adopted by multiple health
professional accreditation entities, there is a great demand for
answers to the question: How do we do IPECP? Absent is a sound
evidence base regarding what the specific education and training
should be for all learners – students and clinicians. Furthermore,
there is also a lack of tools for assessment of site readiness for
interprofessional education work, for measuring what is and
should be learned, what team dynamic and interactions are,
as well as what outcomes should be planned for and actually
achieved (Canadian Interprofessional Health Collaborative, 2012;
Reeves et al., 2013; Salas et al., 2008). Moreover, exactly how
health care teams should be constituted to achieve desired
outcomes also requires more clarification (Weaver et al., 2010).
We have observed that an increasing number of stakeholders
are enthusiastic about IPECP involved in the redesign of the
health system, e.g. educational institutions, health systems,
payers, policy makers and regulators. The major criteria for
success mostly remain outcomes achieved with some assessment
of learner satisfaction with their interprofessional experiences
(Brandt et al., 2014). However, most stakeholders are interested in
more definitive evidence of the effectiveness of IPECP, return on
investment, what the most effective team models are, and what
essential factors are needed for sustainable change within their
distinctive environments. Additional information is needed
about how IPECP impacts population health as well as engages
patients, families and communities (Garr, Margalit, Jameton, &
Cerra, 2012).
New enthusiasm for IPECP and identified gaps underscore the
need to establish a research agenda that can produce a relevant
and scientifically sound evidentiary base identifying if and how
IPECP might lead to health and education outcome improvement.
Establishing such an agenda demands the redirection of the
research from the current program/project process specific level
to the assessment of the impact of IPECP on outcomes defined by
the triple aim.
What do we need to know to establish IPECP as an
effective approach to health and education outcome
improvement?
At present, knowledge creation linking IPECP to improvements in
education and health outcomes is occurring in local geographies
and settings. While the creation of the National Center is moving
a national coordination effort ahead, these local efforts lacked
coordination, a platform for creating opportunities for meaningful
team interventions, a trusted source of information, and a national
database focused on the efficacy and effectiveness of IPECP
linked to outcome improvement. Also needed are relevant
research questions and suitable methodologies that can produce
generalizable and translational knowledge with clinical and
educational application. For research findings to influence the
transformation of the health care system, they must be rigorously
generated employing quantitative, qualitative and mixed methods,
and be based on sufficient sample sizes to achieve generalizabil-
ity, trustworthiness, and external validity. Moving this area of
inquiry forward requires asking questions about the impact
of IPECP in new ways that call for the examination of as yet
untested associations and sequential pathways between and
among the domains of interprofessional education, collaborative
practice, and health care delivery, health outcomes, and health
care costs.
Among the untested associations we foresee are those that posit
and develop triple aim (Berwick et al., 2008) health-related
outcomes as dependent variables, data collected on multiple
dimensions of interprofessional education interventions and
dimensions of collaborative practice as independent variables,
and demographic and ecological variables as covariates. Of
equal importance is high quality qualitative research that docu-
ments context specific experiences with implications for other
settings, particularly when the transportability and scalability of a
success intervention is achieved. While generating and collecting
these data will require a serious commitment of resources, the
ultimate value of understanding the extent to which – and in what
ways – IPECP may affect the cost of delivered care, the quality and
patient experience of delivered care, and population health should
make the commitment of time and resources worthwhile.
While randomized control trials (RCT) are often considered the
gold standard for advancing scientific knowledge creation (Safford,
2014), this methodology is expensive, time intensive, and
frequently not an appropriate approach for most research questions
(Dreyer et al., 2010; Safford, 2014) because, the results from RCTs
do not always match what is observed in real-world practice or can
account for meaningful changes in the local environment as the
study progresses (Dreyer et al., 2010). Comparative effectiveness
research (CER) consisting of observational studies that are well-
designed and which analyze data from large population samples
can address questions that are not possible to answer using a RCT
methodology alone (Dreyer et al., 2010; Safford, 2014).
Intervention research is a significant CER study design and has
been adopted by the National Center as the favored approach to
generate data, produce information translated into knowledge.
Since the redesign of health care delivery is occurring rapidly,
the data generated for decision making requires a CER approach
DOI: 10.3109/13561820.2015.1040875 IPECP research agenda 3
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relying on an informatics platform for the generation and
subsequent use of large scale databases that are amenable to
both cross-sectional and longitudinal analyses. The data collected
also need to capture sentinel events that when analyzed can
produce timely and actionable information to facilitate making the
best decisions possible in a rapidly changing health care
environment. In practice, outcome goals and metrics are estab-
lished and interventions are implemented and modified on an
ongoing basis to quickly move toward desired outcomes. Time is
of the essence, as is an understanding of the impact of ecological
factors that affect the ability of an intervention to be successful.
The National Center’s Nexus
The National Center’s approach is one of the aligning education
and collaborative practices in a way that creates a dynamic and
transformative interaction and produces interprofessional teams
capable of substantively improving both education and health
outcomes. The alignment of health-related education and collab-
orative practice represents an IPECP Nexus that informs change at
the micro, meso and macro levels and both informs and facilitates
the redesign of health and education. This dynamic of the
National Center’s Nexus is depicted in Figure 1.
The US current health care delivery and education systems
could be described as consisting of: health care professions and a
delivery system fragmented and siloed and not clearly mapped to
triple aim outcomes (Berwick et al., 2008); health science
academic training and health system re-design disconnected at
many junctures (Cerra & Brandt, 2011); persons of local
communities not engaged in health care delivery system redesign
(Berwick et al., 2008); interprofessional outcome-orientation
under-developed (Brandt et al., 2014); health care workforce
planning disconnected from an interprofessional team-based
orientation (Schuetz, Mann, & Everett, 2010); and health care
related knowledge creation by interprofessional research teams as
less than optimal (Lakhani, Benzies, & Hayden, 2012; Robinson,
Erlen, Rubio, Kapoor, & Poloyac, 2013). These are all among the
elements of the health care delivery system that current health
care reform in the US seeks to change.
Change occurs at multiple levels three of which are: micro,
meso and macro (D’Amour & Oandasan, 2005). Micro level
changes in clinical settings entail health care professionals
interacting with one another in new and different ways to improve
the quality and outcomes of care provided to patients. In
educational settings, micro level change involves students and
faculty from a variety of health-related professions learning with
one another in new and different ways in didactic offerings,
simulated clinical experiences and experiential activities.
Organizational change constitutes the meso level. An example
is a clinic or constellation of clinics undergoing a concerted effort
at re-designing their care delivery process and/or approach.
In education, an example is an academic health center or a
regional collaborative of universities and colleges transforming
curricula to incorporate interprofessional education.
Macro level change encompasses societal level changes at
the institutional, state and/or national levels supported by policy
changes. An example of macro level change includes new
accreditation criteria for different professions impacting education
and credentialing.
Fostering deliberate behavior change through IPECP interven-
tions, a CER study design strategy, which improve triple aim
outcomes encompasses the work of the Nexus. The National
Center has established a dynamic incubator network that consti-
tutes a living laboratory to explore the impact of IPECP
interventions with outcomes clearly mapped to those of the
triple aim. The logic of interventions (Figure 2) is that as they are
implemented, they will influence behavior change in those
exposed and may result in subsequent changes impacting micro,
meso or macro levels of the process of care. If the resulting
change is desired it may become institutionalized and an
infrastructure will emerge to support and maintain the change.
A multiplicity of ecological variables influence the develop-
ment of such an infrastructure – it is multifactorial and not
always predictable. This flows from goals to objective to
initiatives or activities to process outputs and then health and
education outcomes, while tracking for sustainable change,
creates a database from which analytics can then inform and
shape the conversations and actions of the redesign of health
and education.
Meaningful and robust research questions and
study designs
Five research questions have been identified by the National
Center and are currently being addressed within the National
Center’s Nexus of Inquiry. These are: Does intentional and
concerted interprofessional education and interprofessional
practice:
Improve the triple aim outcomes on an individual and
population level?
Result in sustainable and adaptive infrastructure that supports
the triple aim outcomes of both education and practice?
Identify ecological factors essential for achieving triple aim
outcomes?
Identify factors essential for systematic and adaptive infra-
structure in the transformation of the process of care and
education?
Identify changes needed in policy, accreditation, credentialing
and licensing for health care provision and education?
The National Center has developed and is currently populating
a relational database, named the National Center Data Repository
(NCDR), to collect and house not only incubator project specific
data but also data from entities across the nation involved in
interprofessional education and collaborative practice initiatives.
The former will support the analysis of data generated from
intervention focused work while the latter will facilitate the
generation of additional big data for observational studies – either
cross-sectional or longitudinal studies (matched or unmatched)
(Last, 1995) and commensurate with the principles of CER. Their
application is presented as follows.
The Nexus Innovation Incubator Network and
National Center Data Repository
To generate and gather the data, the National Center has created a
national network of nexus sites, each with one or more projects or
interventions employing the nexus model linking interprofessional
Figure 1. The national center vision. ßThe National Center for
Interprofessional Practice and Education. Reproduced by permission of
The National Center for Interprofessional Practice and Education.
Permission to reuse must be obtained from the rightsholder.
4M. N. Lutfiyya et al. J Interprof Care, Early Online: 1–8
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education, collaborative practice, and health outcome improve-
ment. An essential related component is the National Center Data
Repository (NCDR). The National Center Nexus Innovations
Incubator Network is a collaborative of higher education and
health system partners in the US committed to studying and
advancing interprofessional practice and education together.
Incubator members are: testing new organizational, care delivery
and learning models in real-world settings; identifying, collecting
and analyzing data to create an evidence base for IPECP;
identifying evidence-based models to educate health professions
students and practitioners; and training faculty, students, clin-
icians and staff as teams to build leadership skills and develop the
capacity for data collection and intervention research (www.nex-
usipe.org). The landscape of the Incubator Network is constantly
in flux as new sites and new intervention projects are added to the
network. Presently, all of the sites and interventions are in the US.
The process for becoming an incubator site is described elsewhere
(Pechacek, Cerra, Brandt, Lutfiyya, & Delany, 2015).
The NCDR was designed to address the decades-old challenge
of the lack of data to test the effectiveness of interprofessional
models. The NCDR and the Incubator Network are inseparable,
forming a knowledge generation community. The NCDR houses
or stores the data generated from interventions and incubator sites.
These data, once analyzed, will enable the National Center to
demonstrate if and what the relationship is between IPECP and
triple aim outcomes. Moreover, once there are sufficient data in
the NCDR, researchers outside of the National Center and its
networks will be allowed access to the NCDR to perform
analyses.
The NCDR resides in the University of Minnesota Academic
Health Center’s Information Exchange and is built on a robust
information architecture platform. The Academic Health Center
Information Exchange has existing policies and procedures in
place to manage privacy, access to and governance of data.
Further, an NCDR Advisory Council, comprised of recognized
experts in the field representing clinical practice, education and
informatics advises National Center staff on implementation,
metrics, and evaluation of the NCDR. The NCDR:
Focuses on outcome achievements for both education and
health
Includes surveys that capture the environmental and ecological
factors influencing interventions
Supports identifying the linkages between the educational
intervention to outputs and outcomes achieved
Facilitates producing a return on investment analysis
Ensures data are collected longitudinally during and after the
intervention
Produces information from data collected using available and
validated assessment tools.
The approach to generating the data that can be used to provide
the information and evidence for the analysis of these questions
constitutes the National Center Nexus Learning System.
Achieving the production of meaningful and relevant information
and evidence requires the integration of the disciplines of
evaluation, outcomes research, and informatics. Such an integra-
tion achieves the development of data inputs and analytics that
have the ability to produce insights and answers to the core
questions of the National Center.
The National Center Data Repository architecture has several
components, described in Table I. The NCDR has been through
end-to-end testing and is now being populated.
As soon as a critical amount of data is achieved, the analytical
work will begin and reports generated for use in informing the
redesign process. The NCDR, as it becomes populated, will
provide a sound informatics foundation for the generation of new
knowledge regarding the impact of interprofessional education
and collaborative practice over time. Figure 3 illustrates the
working process of the NCDR.
Figure 2. Nexus research logic model. ßThe National Center for Interprofessional Practice and Education. Reproduced by permission of The National
Center for Interprofessional Practice and Education. Permission to reuse must be obtained from the rightsholder.
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Concluding comments
This paper sought to provide direction and scope for a focused and
purposive research agenda for IPECP in the current context of
health care reform in the US. For the better part of the past four
decades inquiry into interprofessional collaborative practice and
education has been prolific, although mostly limited to exploring
research questions grounded in local program and/or project
assessment. Because of the limited scope of the research
questions, despite this long history, the actual sphere of influence
Figure 3. Depiction of the National Center’s Data Repository. ßThe National Center for Interprofessional Practice and Education. Reproduced by
permission of The National Center for Interprofessional Practice and Education. Permission to reuse must be obtained from the rightsholder.
Table I. National Center for Interprofessional Practice and Education Data Repository (NCDR) architecture components.
Component Description
Input Data are entered into a secure data environment through a user-friendly web interface
All Nexus sites and intervention projects receive training and assistance with data entry
Core data set There are six core data surveys:
Student survey
Network user survey
Technology readiness survey
Inputs survey
Education survey
Education survey
Critical incidents survey
IPECP intervention specific
data survey
There are two parts to this survey:
common data elements or variables for all interventions or projects
outcomes specific elements or variables for each individual intervention or project
Outcomes All NCDR surveys are designed to collect pertinent data for analysis to answer the research
questions constituting the National Center’s research agenda
Outcome data are clearly defined and collected for analysis
All data entered into the NCDR are de-identified.
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stemming from interprofessional collaborative practice and edu-
cation research has been limited.
The research agenda proposed in this paper, for this area of
inquiry, should produce a significant and scientifically sound
evidentiary base tying interprofessional education and collabora-
tive practice to meaningful health-related outcomes and as a result
could extend the sphere of influence of the produced knowledge.
Ultimately, the proposed research agenda represents a paradigm
shift that has been long in the making and calls for the elevation of
the research foci from that of program/project specific level
impacts to the impact of interprofessional collaborative practice
and education on outcomes related to patient health care cost,
health care quality, and eventual improvement in population
health. The knowledge generation community needs to be
thoughtfully expanded using the platform and tools that have
been and are being created in order to achieve the threshold of
‘‘big data’’ needed to successfully inform and shape the redesign
of both education and health care.
Declaration of interest
The authors report no conflicts of interest. The authors alone are
responsible for the writing and content of this paper.
This work was produced at the National Center for Interprofessional
Practice and Education, which is supported by a Health Resources and
Services Administration Cooperative Agreement Award
No.UE5HP25067. In addition, the Josiah Macy Jr. Foundation, the
Robert Wood Johnson Foundation (RWJF), and the Gordon and Betty
Moore Foundation have collectively committed additional funding over
five years to support and guide the Center, which will work to accelerate
teamwork and collaboration among health professionals—as well as
patients—and break down the traditional silo-approach to health profes-
sions education. This information or content and conclusions are those of
the authors and should not be construed as the official position or policy
of, nor should any endorsements be inferred by HRSA, HHS or the US
Government.
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