Australian Medical Council: Accreditation as a Lever for Change in Improving Interprofessional Learning and Practice

The issue: the Australian health system is complex with many different professions contributing to the delivery of healthcare. Both professional and consumer groups

have raised concerns about this complexity, lack of co-ordination between different sectors of the system and the need to better ensure that communities receive the healthcare they expect.

The way forward

In 2022-2024 the Health Professions Accreditation Collaborative Forum, a coalition of the 15 accreditation authorities providing accreditation functions for the National Registration and Accreditation Scheme under the Health Practitioner Regulation National Law, undertook a research project focused on creating the collaborative health practitioner and the provision of safe and quality care to the Australian health system through the formation of co-ordinated and collaborative ways of working. The project was managed by the Australian Pharmacy Council (APC) and the Australian Medical Council (AMC) who partnered with the other thirteen Australian accreditation authorities for registered health professions.

Nineteen focus groups were conducted in 2022 with 84 participants consisting of education providers (n=62), consumers (n=10), representatives from the Health Professions’ Education Standing Group (n=8), and health service practitioners (n=4). Analysis was undertaken to understand enablers of, and barriers to, collaborative practice and learning. In addition, a series of case studies on interprofessional education and practice in universities and health services were developed. Three manuscripts detailing the outcomes of this research were also prepared.

A key finding of the research was that:

Despite the evidence supporting a contribution of Interprofessional Education (IPE) to the development of collaborative practitioners, the implementation of IPE within health profession education programs has faced challenges. Fundamentally, interprofessional collaboration requires health professions to work together. From a practical perspective, inclusion of IPE has been difficult to achieve, with reasons cited including timetable challenges, a lack of leadership and funding and a limited ability to ‘add’ IPE to an already crowded profession specific curriculum. Consequently, the inclusion of IPE in existing full curricula has been less than optimal and remains inconsistent both across and within health professional programs.

A further challenge, which this research outlined, is how to implement successful work-based learning programs providing graduates with the necessary experiences to transition into practice as collaborative practitioners. This means that universities, health services and accreditors have work to do to ensure that they all have a commitment to improved support for IPE. The accreditation authorities are now embarking on a second

phase of the project, led by the AMC, designed to create practical guidance for accreditation authorities and education providers around how to better foster interprofessional practice including more rigorous approaches to workbased learning and assessment across health education settings and health services.

The policy context

Over the last year, three large scale independent reviews - the Kruk Report, Scope of Practice Review and Complexity Review, have called accreditation authorities, education providers and health services into action to improve interprofessional practice.

Interprofessional Education (IPE) and Interprofessional Collaborative Practice (IPCP)

are important in addressing workforce challenges which come from multiple different

professions working within the system. Some of the themes which the reviews raised related to IPE and IPCP include:

These themes build on earlier work of the World Health Organisation (2010) and the definition of interprofessional collaborative practice by O’Keefe (2017). Interprofessional collaborative practice has been described as “when multiple health workers from different professional backgrounds work together with patients, families, carers and communities to deliver the highest quality of care.”

More recently, the Australian Health Practitioner Regulation Agency (Ahpra) has developed an Interprofessional Collaborative Practice Statement of Intent (2024).

• Achieving interprofessional collaborative practice is fundamental to deliver effective

team-based, coordinated care for patients and healthcare consumers.

• Interprofessional Collaborative Practice refers to healthcare practice where multiple health workers from different professional backgrounds work together, with patients, families, carers and communities to deliver the highest quality of care that is free of racism and other forms of discrimination.

Why this work matters

For Education providers clearer guidance around the standards by which to achieve interprofessional education and collaborative practice is important. In particular, how to provide their students with authentic learning and assessment opportunities in

diverse health settings as part of the education programs to better equip them for work readiness on graduation. A further concern which this work addresses is how to include the patient voice as part of the interprofessional team in education experiences rather than positioning them as passive recipients of care.

Health services need the professions to work together as high functioning and integrated teams. Health services are under pressure with complex and high-volume workloads. Aged care settings are particularly challenged and the need for interprofessional practice is vital as many patients have complex health needs and require interprofessional collaboration and care.

Health professionals need to understand the roles and responsibilities of their colleagues and show respect and draw on each other’s expertise to share decision making and care for their patients.

Health professionals need to be empowered to work at the top of their scope of practice and do so without experiencing conflicts with other professions. They need to support educational programs and organisational learning in interprofessional practice.

Consumers and communities particularly those with chronic disease who spend a lot of

time in the health system have salient advice for education providers and health systems about their expectations of the health professions and why it is so important for health professionals to work together. They don’t want to have to explain in detail their health conditions repeatedly. They want professionals to use digital systems responsibly and treat other colleagues’ advice with respect and actively listen to what their patients are saying to them.

What are the next stages in our project

The practical guide to accreditation aims to further strengthen interprofessional practice across educational providers in Australia through using accreditation as a lever for change. The key focus of this guide will be cross-profession consistency in accreditation expectations for IPE, including the definition of IPE; and language used to describe

program expectations.

Strengthening IPE in accreditation standards and accreditation assessments also includes developing specific questions for accreditation assessment/evaluation teams; developing key messages and questions for evidence guides; exploring implementation models; and considering how accreditation authorities could further collaborate on the assessment of programs of study against IPE standards and requirements.

Some of the challenges

The curricula of health profession programs are crowded with many competing priorities. It will be important to ensure that the revised accreditation standards and requirements focus on priority issues and don’t result in a proliferation of too many requirements which can’t be practically implemented.

Interprofessional education involves substantial cross-department and cross-discipline planning, in addition for IPE to succeed it needs significant resourcing and leadership support.

Accreditation authorities have a huge task to ensure that their professions meet quality

standards. There are opportunities as well as significant resourcing challenges in further

collaboration across the professions to conduct interprofessional accreditation processes.

The planned impact

Stage two of the project aims to bring the 15 health accreditation authorities together to

develop common guidance and to further enhance interprofessional education and practice across Australian health profession programs.

We aim to see clearer and stronger guidance and support for IPE from accreditors; improved educational programs with more resourcing and leadership support and education focused on workplace learning and assessment in interprofessional workplace teams; stronger buy-in from health services; and most importantly positive downstream impacts for consumers with better healthcare.

For further information

Further information about this project can be gained from the Health Professions Accreditation Collaborative Forum (HPAC) website http://hpacf.org.au/

02 6270 9777

amc.org.au

References

The three manuscripts developed as part of stage one of this research include: Kent, F., Cardiff, L., Clark, B., Gustavs, J., Jolly, B., Maundu, J., & Meiklejohn, S. (2024). Accreditation as a lever for change in the development of the collaborative practitioner in the Australian health system. Australian Health Review, 48(6), 705-710. Meiklejohn, S., Cardiff, L., Clark, B., Jolly, B., Maundu, J., Walters, T., & Kent, F. (2024). “The patients first and foremost” collaborative practice in the Australian healthcare system. MedEdPublish, 14(131), 131. Kent, F., Cardiff, L., Clark, B., Maundu, J., Wilkinson, G., & Meiklejohn, S. (2024). Attributes of a collaborative practitioner in the Australian healthcare system. Focus on Health Professional Education: A Multi-Professional Journal, 25(4), 49-59.