The Slow Creep Back: Threats and Opportunities for IPE Posed by COVID-19.

Interprofessional education (IPE) prepares current and future health care professionals for interprofessional collaborative practice (IPCP). IPCP results in increased quality of care demanded by patients and reimbursed in value-based care models when appropriately operationalized. The COVID-19 pandemic forced rapid and unprecedented changes in higher education and healthcare, although the impact on IPE delivery in the U.S. is unknown. Analyses of qualitative survey data collected from U.S. IPE leaders (n = 21) identified the impact and challenges of the pandemic on IPE programs. Three primary themes emerged: transition to a virtual environment, uncertainties and fears regarding finance and program sustainability, and opportunities for improvements in programming, delivery, instructional design, experiential learning, and assessment. Programs faced existential pandemic-related challenges. Concurrently, the pandemic accelerated innovation in IPE curricula, illuminated opportunities for IPE to improve the work life of healthcare providers, and raised awareness of the need to extend the Quadruple Aim to eliminate health inequities.

Development of the Barriers to Error Disclosure Assessment Tool.

OBJECTIVES: An interprofessional group of health colleges' faculty created and piloted the Barriers to Error Disclosure Assessment tool as an instrument to measure barriers to medical error disclosure among health care providers. METHODS: A review of the literature guided the creation of items describing influences on the decision to disclose a medical error. Local and national experts in error disclosure used a modified Delphi process to gain consensus on the items included in the pilot. After receiving university institutional review board approval, researchers distributed the tool to a convenience sample of physicians (n = 19), pharmacists (n = 20), and nurses (n = 20) from an academic medical center. Means and SDs were used to describe the sample. Intraclass correlation coefficients were used to examine test-retest correspondence between the continuous items on the scale. Factor analysis with varimax rotation was used to determine factor loadings and examine internal consistency reliability. Cronbach α coefficients were calculated during initial and subsequent administrations to assess test-retest reliability. RESULTS: After omitting 2 items with intraclass correlation coefficient of less than 0.40, intraclass correlation coefficients ranged from 0.43 to 0.70, indicating fair to good test-retest correspondence between the continuous items on the final draft. Factor analysis revealed the following factors during the initial administration: confidence and knowledge barriers, institutional barriers, psychological barriers, and financial concern barriers to medical error disclosure. α Coefficients of 0.85 to 0.93 at time 1 and 0.82 to 0.95 at time 2 supported test-retest reliability. CONCLUSIONS: The final version of the 31-item tool can be used to measure perceptions about abilities for disclosing, impressions regarding institutional policies and climate, and specific barriers that inhibit disclosure by health care providers. Preliminary evidence supports the tool's validity and reliability for measuring disclosure variables.

Reliability of Peer Review of Abstracts Submitted to Academic Family Medicine Meetings.

PURPOSE: To assess the reliability of peer review of abstracts submitted to academic family medicine meetings in North America. METHODS: We analyzed reviewer ratings of abstracts submitted: 1) as oral presentations to the North American Primary Care Research Group (NAPCRG) meeting from 2016 to 2019, as well as 2019 poster session or workshop submissions; and 2) in 12 categories to the Society of Teachers of Family Medicine (STFM) Spring 2018 meeting. In each category and year, we used a multi-level mixed model to estimate the abstract-level intraclass correlation coefficient (ICC) and the reliability of initial review (using the abstract-level ICC and the number of reviewers per abstract). RESULTS: We analyzed review data for 1554 NAPCRG oral presentation abstracts, 418 NAPCRG poster or workshop abstracts, and 1145 STFM abstracts. Across all years, abstract-level ICCs for NAPCRG oral presentations were below 0.20 (range, 0.10 in 2019 to 0.18 in 2016) and were even lower for posters and workshops (range, 0.00-0.10). After accounting for the number of reviewers per abstract, reliabilities of initial review for NAPCRG oral presentations ranged from 0.24 in 2019 to 0.30 in 2016 and 0.00 to 0.18 for posters and workshops in 2019. Across 12 STFM submission categories, the median abstract-level ICC was 0.21 (range, 0.12-0.50) and the median reliability was 0.42 (range, 0.25-0.78). CONCLUSIONS: For abstracts submitted to North American academic family medicine meetings, inter-reviewer agreement is often low, compromising initial review reliability. For many submission categories, program committees should supplement initial review with independent postreview assessments.

The COVID-19 crisis silver lining: interprofessional education to guide future innovation.

Globally, the advent and rapid spread of the COVID-19 virus has created significant disruption to health professions education and practice, and consequently interprofessional education, leading to a model of learning and practicing where much is unknown. Key questions for this ongoing evolution emerge for the global context leading to reflections on future directions for the interprofessional education field and its role in shaping future practice models. Health professions programs around the world have made a dramatic shift to virtual learning platforms in response to closures of academic institutions and restrictions imposed on learners accessing practice settings. Telemedicine, slow to become established in many countries to date, has also revolutionized practice in the current environment. Within the state of disruption and rapid change is the awareness of a silver lining that provides an opportunity for future growth. Key topics explored in this commentary include reflection on the application of existing competency frameworks, consideration of typology of team structures, reconsideration of theoretical underpinnings, revisiting of core dimensions of education, adaptation of interprofessional education activities, and the role in the future pandemic planning. As an international community of educators and researchers, the authors consider current observations relevant to interprofessional education and practice contexts and suggest a response from scholarship voices across the globe. The current pandemic offers a unique opportunity for educators, practitioners, and researchers to retain what has served interprofessional education and practice well in the past, break from what has not worked as well, and begin to imagine the new.

Addressing the Irreducible Needs of Interprofessional Education: Creating and Sustaining an Institutional Commons for Health Professions Training.

Leaders in health professions education schools and programs are under pressure to respond to new accreditation requirements for interprofessional education (IPE). The work of creating and sustaining an IPE program at an academic health center is in many ways analogous to the challenge of creating and sustaining a "commons"-a set of resources shared by many, but owned by none. In this Commentary, the authors borrow from the work of Nobel Laureate Elinor Ostrum to describe the "design principles" necessary to build and maintain the set of common resources needed to successfully implement and sustain an IPE program. They interpret these principles in the context of their own experiences implementing IPE programs and recommend three institutional structural elements necessary to build and sustain an IPE program: (1) a representative governance body, (2) an accountable director or leader, and (3) a structure supporting vertical and horizontal communication and authority.