Interprofessional education (IPE) has been identified as a critical component in the development of a collaborative, practice-ready health care workforce in Australia.1 According to the Centre for the Advancement of Interprofessional Education in the United Kingdom, IPE “occurs when two or more professions learn with, from and about each other to improve collaboration and the quality of care”.2 Its purpose is to improve patient outcomes by providing a learning environment that enables undergraduates (and postgraduates, where appropriate) to gain a better understanding of teamwork, and of how each discipline contributes to team-based care without losing its professional identity.

It seems reasonable to assume that IPE is an effective way for professionals to learn how to work in teams. However, it is important to establish whether there is an evidence base that supports the link between IPE, improved interprofessional practice (IPP) and better patient outcomes.

The World Health Organization’s Framework for action on interprofessional education and collaborative practice cites research evidence for the benefits of IPE to collaborative practice.3 These benefits include improved access to and coordination of health services, better use of specialist resources, and improved health outcomes for people with chronic disease. They also include improved patient care and safety, reduced patient complications and length of hospital stay, and reduced suicide rates in patients with mental illness. However, evidence for the link between IPE and improvements in collaborative care is tenuous. A Cochrane review of the impact of interprofessional collaboration on professional practice and health care outcomes found only five studies that met randomised controlled trial (RCT) inclusion criteria.4 While the review found that practice-based interprofessional collaboration interventions can improve health care processes and outcomes (eg, patient satisfaction and professional competence), its conclusions were limited by the small number of studies and sample sizes, and because many of the studies were confined to medicine and nursing. The review recommended the need for longitudinal, more rigorous, cluster-based RCTs.4

Advocacy for the introduction of IPE into medical, nursing and health science curricula around Australia is being driven by several factors. These include workforce shortages, concerns about patient safety, the need for team-based care to meet the growing burden of chronic disease associated with ageing, and the pressing need to improve shared care of patients with mental illness.

Australia has lagged behind comparable countries in systematically introducing IPE and promoting IPP. There has been a lack of government policy initiatives to fund the development of such programs.5 In contrast, for more than a decade, Sweden has been conducting IPE in clinical environments by establishing hospital wards dedicated to interprofessional learning and practice. Students across medicine, nursing, physiotherapy, occupational therapy and social welfare have been collaboratively managing patients in orthopaedic and geriatric wards, under the supervision of a multidisciplinary team.6 Graduates have indicated increased confidence in working collaboratively following their interprofessional learning experiences.7 A recent Australian initiative is the Health Care Team Challenge, which brings together undergraduates from a range of disciplines to work in interdisciplinary teams to develop a management plan for a clinical case study scenario. The purpose of this program is to increase students’ exposure to, immersion in and mastery of interprofessional practice.8

However, there are barriers to introducing IPE in the clinical environment.9 The most significant are logistic difficulties with timetabling, student recruitment and finding suitable clinical environments such as wards or practices for conducting programs. Student-related barriers include balancing numbers from each discipline, role uncertainty and lack of relevant joint assessment tasks. Other challenges include recruitment, training and workload of staff; structural and policy issues (eg, curriculum development, joint accreditation and validation); and funding.

Team-based care is essential to meeting Australia’s growing burden of chronic disease associated with ageing, and the burgeoning health problems of obesity, diabetes and mental health. The government is now encouraging and funding this need through a range of initiatives, particularly in general practice through the Enhanced Primary Care Program and the Better Access to Mental Health Care initiative. The current health care reform proposals place an emphasis on primary health care, and Health Workforce Australia identifies interprofessional learning as a way forward in promoting collaborative practice. The challenge is to ensure that this does not merely become a logistic exercise. It is clear that much successful health professional learning is based on the principle of “learning by doing”, and has occurred in the absence of RCT evidence establishing its efficacy and effectiveness. In this instance, it may prove fruitless and time-wasting to wait for sufficient evidence from RCTs before proceeding with IPE and IPP programs.