The Relationship between Interprofessional Leadership Education and Interprofessional Practice: How Intensive Personal Leadership Education Makes a Difference

OBjECTIvEs To study the effects of the University of North Carolina at Chapel Hill (UNC) Interdisciplinary Leadership Development Program (ILDP) on interprofessional attitudes, beliefs, and use of skills. ILDP is a collaboration among five campus-based U.S. Maternal and Child Health Bureau-funded training programs. These programs included Leadership Education in Neurodevelopmental and Related Disabilities (LEND), Nutrition, Pediatric Dentistry, Public Health, and Social Work. METHODs Using a post-test design, participants in the ILDP from the five training programs were contacted to complete a web-based survey. LEND and Public Health graduates who had not participated in the ILDP were recruited for comparison. Using scales and open-ended questions, we asked graduates to rate the influence of ILDP on their attitudes/beliefs about interprofessional practice, to report the frequency of use of interdisciplinary skills, and to describe those influences on the use of skills in some detail. REsULTs The 208 respondents represented 60% of the graduates from 2001 through 2008. Graduates reported that the yearlong Interdisciplinary Leadership Development Program, a supplement to conventional discipline-based training influenced their interprofessional attitudes, beliefs, and the use of interprofessional skills. In particular, a 3-day Leadership Intensive workshop enhanced graduates’ understanding of individual leadership practices and heightened their appreciation of the assets and challenges of others working in groups. COnCLUsIOns With increasing focus on interprofessional health teams, many evaluations of training neither describe nor measure explicitly the elements of training that enable students to develop interprofessional attitudes, beliefs, and skills. In an evaluation that demonstrated these outcomes, we have described the key role of intentional, personal leadership training in producing these outcomes. Interprofessional training programs should be expected to provide logic models for the relationship between training and the desired outcomes. Received: 08/24/2014 Accepted: 02/08/2015 Published: 04/08/2015 © 2015 Margolis et al. This open access article is distributed under a Creative Commons Attribution License, which allows unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. H IP & Interprofessional Leadership Education and Interprofessional Practice EDUCATIONAL STRATEGY 2(3):eP1071 | 2 Introduction To address the increasing complexity of public health and medical care, national and international entities and scholars have encouraged educators to develop programs to enhance the capacity of professionals to collaborate. Each group has suggested that some combination of dedicated interprofessional and interdisciplinary education and intentional practice are critical in creating competent interdisciplinary professionals. For example, To Err is Human calls for organizations to “establish interdisciplinary team training programs for providers” (Kohn, Corrigan, Donaldson, & McKenzie, 2000, p. 14), while Crossing the Quality Chasm advocates that “clinicians and institutions should actively collaborate and communicate to ensure an appropriate exchange of information and coordination of care” (Committee on Quality of Health Care in America, 2001, p. 209). Frenk et al. promote a competency-based approach to educating health professionals in which teamwork or collaboration is a core competency (Frenk et al., 2010), while the Interprofessional Education Collaborative recently underscored the need for a seamless transition from education to collaborative practice (Interprofessonal Educaton Collaborative Expert Panel, 2011). In a recent commentary, Berwick (2014) underscores the fundamental role of collaboration at the level of health systems, beyond clinical care. The first training programs supported by the United States federal Maternal and Child Health Bureau (MCHB) in the late 1940s were motivated by the need to develop professionals who could build services that enable children to benefit from the perspectives of multiple disciplines, such as physicians, nurses, and public health workers (Athey, Kavanaugh, Bagley, & Hutchins, undated). In recent years, the MCHB articulated 12 core leadership competencies (Table 1), six of which seem especially relevant to creating an interprofessional environment: communication, negotiation and conflict resolution, cultural competency, family-centered care, developing others through teaching and mentoring, and interdisciplinary team building (MCH Leadership Competencies Workgroup, June 2009). While the field of Maternal and Child Health (MCH) has produced many graduates who have provided interprofessional leadership, there is a paucity of research on the specific elements of interprofessional training Table 1. Core MCH Leadership Competencies 1. MCH Knowledge Base/Context 2. Self-reflection 3. Ethics & Professionalism 4. Critical Thinking 5. Communication 6. Negotiation & Conflict Resolution 7. Cultural Competency 8. Family-Centered Care 9. Developing Others through Teaching and Mentoring 10. Interdisciplinary Team Building 11. Working with Communities and Systems 12. Policy and Advocacy Source: Maternal and Child Health Leadership Competencies (Version 3.0). http://leadership.mchtraining.net/?page_id=132 that facilitate the development of interprofessional competencies. As reported elsewhere (Margolis et al., 2012) the MCH Leadership Consortium at the University of North Carolina at Chapel Hill has demonstrated that interprofessional training improved graduates’ attitudes and beliefs about the value of interprofessional practice, and increased their frequency of use of interprofessional skills in practice. The items used to elicit attitudes and beliefs and the frequency of skill use are shown in Table 2 (following page). Most importantly, graduates who reported stronger attitudes or beliefs about the value of interprofessional practice and more frequent use of interprofessional skills were statistically more likely to report that they had contributed to improvements in a specific program, organization, or partnership. This article addresses two questions: (1) how do graduates rate the impact of the Interdisciplinary Leadership Development Program (ILDP) on their attitudes/beliefs and use of skills? and (2) what components of the ILDP were influential in developing attitudes/beliefs and skills for interprofessional practice? We have identified themes that have the potential to inform interprofessional leadership training efforts by the MCH Bureau and other entities committed to workforce development.