title: Interprofessional education: effects on professional practice and healthcare outcomes (update).
abstract: BACKGROUND
  The delivery of effective, high-quality patient care is a complex activity. It demands health and social care professionals collaborate in an effective manner. Research continues to suggest that collaboration between these professionals can be problematic. Interprofessional education (IPE) offers a possible way to improve interprofessional collaboration and patient care.
  
  
  OBJECTIVE
  To assess the effectiveness of IPE interventions compared to separate, profession-specific education interventions; and to assess the effectiveness of IPE interventions compared to no education intervention.
  
  
  METHODS
  For this update we searched the Cochrane Effective Practice and Organisation of Care Group specialised register, MEDLINE and CINAHL, for the years 2006 to 2011. We also handsearched the Journal of Interprofessional Care (2006 to 2011), reference lists of all included studies, the proceedings of leading IPE conferences, and websites of IPE organisations.
  
  
  METHODS
  Randomised controlled trials (RCTs), controlled before and after (CBA) studies and interrupted time series (ITS) studies of IPE interventions that reported objectively measured or self reported (validated instrument) patient/client or healthcare process outcomes.
  
  
  METHODS
  At least two review authors independently assessed the eligibility of potentially relevant studies. For included studies, at least two review authors extracted data and assessed study quality. A meta-analysis of study outcomes was not possible due to heterogeneity in study designs and outcome measures. Consequently, the results are presented in a narrative format.
  
  
  RESULTS
  This update located nine new studies, which were added to the six studies from our last update in 2008. This review now includes 15 studies (eight RCTs, five CBA and two ITS studies). All of these studies measured the effectiveness of IPE interventions compared to no educational intervention. Seven studies indicated that IPE produced positive outcomes in the following areas: diabetes care, emergency department culture and patient satisfaction; collaborative team behaviour and reduction of clinical error rates for emergency department teams; collaborative team behaviour in operating rooms; management of care delivered in cases of domestic violence; and mental health practitioner competencies related to the delivery of patient care. In addition, four of the studies reported mixed outcomes (positive and neutral) and four studies reported that the IPE interventions had no impact on either professional practice or patient care.
  
  
  CONCLUSIONS
  This updated review reports on 15 studies that met the inclusion criteria (nine studies from this update and six studies from the 2008 update). Although these studies reported some positive outcomes, due to the small number of studies and the heterogeneity of interventions and outcome measures, it is not possible to draw generalisable inferences about the key elements of IPE and its effectiveness. To improve the quality of evidence relating to IPE and patient outcomes or healthcare process outcomes, the following three gaps will need to be filled: first, studies that assess the effectiveness of IPE interventions compared to separate, profession-specific interventions; second, RCT, CBA or ITS studies with qualitative strands examining processes relating to the IPE and practice changes; third, cost-benefit analyses.
authors.affiliation: Center of Innovation in Inteprofessional Education, University of California, San Francisco, San Francisco, California, USA. scott.reeves@ucsf.edu.
authors.forename: Scott
authors.initials: S
authors.lastname: Reeves
authors.forename: Laure
authors.initials: L
authors.lastname: Perrier
authors.forename: Joanne
authors.initials: J
authors.lastname: Goldman
authors.forename: Della
authors.initials: D
authors.lastname: Freeth
authors.forename: Merrick
authors.initials: M
authors.lastname: Zwarenstein
mesh_terms: D001291:Attitude of Health Personnel; D006282:Health Personnel / Q000193:education*; D006801:Humans; D007400:Interprofessional Relations; D005791:Patient Care; D010348:Patient Care Team; D011364:Professional Practice; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
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