Response to Paradis: “Health Care Education Must Be More of a Team Sport”

To the Editor: We appreciate the provocative response to our challenge to the academy to increase the quantity and improve the quality of teamwork in health professions training.¹ It is exactly the type of thoughtful debate we hoped the piece would stimulate.²

We agree that interprofessional education (IPE) is necessary but not sufficient for high-quality care delivery. As Dr. Paradis suggests, other structural elements also must change. We caution that the absence of evidence regarding strong causal links should not be interpreted as evidence of absence. A 2013 update to the Cochrane Reviews outlined specific research targets to improve the quality of evidence relating to IPE and patient outcomes or health care process outcomes.³ These should be heeded.

Still, the recent change to conditional support by the World Health Organization probably speaks more to the lower efficacy of initial iterations of the IPE concept. Like therapeutics, earlier interventions are frequently less potent than those of later generations; however, the initial experimentation is still critical. Better IPE—created and tested through discussion, debate, and research—will likely solve some of the problem. And precisely because resources are limited, we argue that it is worthwhile to sacrifice some single-profession educational study to focus more effort on the study of the contributions of teamwork to high-quality care.

However, regarding the futility of embracing the transformative power of education for changing social or system problems, we suggest that there are many inspiring examples historically of learners working together to serve as change agents in exactly these areas.⁴ Today, we are following closely the health professions’ learner-led movements in the areas of social justice and medicine counterfeiting.^5,6 Returning to the sports analogy introduced in the original piece, legendary coach Vince Lombardi said, “People who work together will win, whether it be against complex football defenses or the problems of modern society.”⁷

• © 2016 American Association of Colleges of Pharmacy