New IPEC Competencies, the State of the Science, and a Focus on Equity

Introduction

Since 2009, the Interprofessional Education Collaborative (IPEC) has worked to “promote and encourage constituent efforts that would advance substan­tive interprofessional learning experiences to help prepare future health professionals for enhanced team-based care of patients and improved population health outcomes”.¹ Over the course of the last 14 years, the group has grown to include 22 health professions education associations while also partnering with organizations to support and advance person/client-centered, community- and popula­tion-oriented interprofessional collaborative practice.¹ The greatest work of this collective has been the devel­opment and updates of the IPEC Core Competencies for Interprofessional Collaborative Practice, better known in brief as the IPEC Competencies.¹ These competencies have aided in creating a sense of belonging and culture as well as a common language among health professionals that allows for a unified team approach to health care. They are recognized amongst practicing providers and have become imperative in the training of health care professionals world­wide.¹ Additionally, the IPEC Competencies impact pol­icy development, collaborative research, and accreditation standards development. The competencies contain a total of four domains with 33 sub-competency statements. Overall, the 2023 revisions reveal a much more straightforward and streamlined approach to the ideals necessary for collabora­tive practice.

Substantive changes within health professions curricula across the United States have occurred in large part due to the IPEC Competencies. What once seemed rare—educating health professions students in interprofessional collabora­tive practice—has now become increasingly commonplace and even required. This change has had a notable positive impact on health outcomes for patients, communities, and populations.¹ With progress forward, IPEC will continue to work to identify best practices and improve quality over time through these competencies, monitoring learner progres­sion and aligning strategic goals of the university or other institution of learning with those of individual schools and programs. The continued use and adoption of these com­petencies will further advance the state of interprofessional practice, while also contributing positively to other critical parameters of patient care, such as improved patient/care­giver education, decreased medical errors, shorter length of hospital stay, and lower mortality.¹

What Has Changed

The latest iteration of the IPEC Competencies is written with the learner—be that student, academician, or practitio­ner—as the primary audience. The competencies emphasize the importance of engaging in collaborative practice over the entire continuum of learning in order to achieve more equi­table patient outcomes. The revisions and updates made to the IPEC Competencies emphasize the need for person/ client/family-centered care that is also community- and process-oriented, while being focused on relationships.¹ The competencies are created with outcomes in mind while maintaining careful consideration of the varying contexts, professions, and practice settings in which they may be utilized. Ultimately, the updates and revisions support and advance the original IPEC Competencies from 2011 while also being progressive in supporting current and future needs of health care professionals and their patients. As the collaborative group has grown over time, so has the need for the IPEC Competencies to support inclusivity of more pro­fessions, thus supporting successful interprofessional col­laborative practice.¹

The 2023 IPEC Competencies also emphasize the impor­tance of broader applicability that encompasses social determinants of health as well as equitable person-centered care. Using terms that reflect the importance of popula­tion health strategies in interprofessional care, the revised competencies continue to highlight the overarching domain of interprofessional collaboration, which prioritizes ethics and values; team roles and responsibilities; trusting, clear communication; and teamwork.¹ The previous competen­cies’ guidelines did not explicitly discuss the gaps in care that may occur because of inequitable care and differen­tial access to quality care. The new guidelines address the importance of teams caring for underserved patients being able to recognize cultural and social determinants of health and take culturally competent action to address them in their communities. A scoping review of the implementa­tion of interprofessional practice describes the importance of sustainable micro-, meso-, and macro-educational tech­niques and processes to facilitate application of concepts that allow for implementation of interprofessional education and care.² Examples of micro-level (teaching) techniques include curriculum and faculty development; meso-level (institutional) techniques include IPE leadership develop­ment and resources; macro-level (systemic) techniques include government policy and social and cultural values. All levels will benefit from using the new IPEC core compe­tencies as a framework. While there may be challenges to adopting such a broad scope of educational and institutional initiatives, the 2023 IPEC competencies offer goals to help with this process.

Using the framework of interprofessional competencies as well as evidence from the population health literature,¹ the 2023 revised competencies were more team-based than past iterations, emphasized advocacy, used common lan­guage between the professions, and focused more on pro­cess than outcomes. The committee of writers, with support from national and international partners, outlined a shared vison that may be a best practice for institutions attempt­ing to break down silos of care and unify teams around the patient as a person with varying needs.

Incorporating the “Quadruple Aim”,³ Quintuple Aim,⁴ and the concept of “One Health”⁵ into the updated competencies was necessary in order to help teams address many of the changes seen post-COVID-19 in the workforce, socioeconomic needs, academic guidelines, and provider and patient expectations. The IPEC core competencies will also be important as we develop safe and collaborative care using artificial intelligence, which will likely be a future source of information in medical care.

Key Updates

Gaps highlighted by the review committee in the 2016 IPEC core competency document that were addressed in the 2023 document include¹:

• A lack of focus on diversity, equity, inclusion, and justice;

• a desire to relate the competencies to outcomes;

• a need to incorporate language and concepts regarding shared leadership;

• accountability, and the creation of a caring, respectful clinical environment among and for the interprofessional team.

The 33 sub-competency statements in the 2023 docu­ment help clarify for the professions why interprofessional care must include self-awareness of one’s own compe­tency and professionalism and a willingness to be a lifelong learner. This emphasis on flexibility and continued learn­ing helps make these 33 tenets not a mountain to climb as an interprofessional team, but rather a continued field of opportunities that can be adjusted to the varying needs of the community, providers, socioeconomic environment, and individual patient/person care needs.

Key word changes in the 2023 document include: Actively listening to your team and respecting opinion dif­ferences (compared to “active hearing”); Feedback on team goals rather than individual feedback; Applying the science of teamwork with understanding of team roles that is evi­dence-based; Leadership of teams should support and high­light collaboration; Celebrating the diversity of the team members and encourage the same; Encouraging teams to support resiliency, safety, well-being, and efficacy.

As all health professions consider competency guidelines for accreditation, the 2023 IPEC core competency update provides appropriate, needed guidance that allows team goals to be emphasized over individual goals, is patient/per­son-centered and evidence-based, and identifies the impor­tance of not just discussing equitable care but making it an essential competency for all who are privileged to care for patients and each other.

Acknowledgments

Both authors report no conflicts of interest.