Interprofessional education in primary health care

It is a logical aspiration to combine undergraduate students, in need of authentic team based clinical education, with patients in need of multi-faceted health care. However, the infrastructure and justification to situate interprofessional education within the traditions of discipline specific education and public health care is not yet in place. The aim of this body of work was to determine if final year students from different disciplines could work together in a primary care setting to deliver useful patient healthcare. A systematic literature review and five studies in community health, general practice and residential care were conducted to investigate student learning and patient outcomes resulting from interprofessional consultations. An economic analysis was conducted to compare cost to traditional single discipline hospital placements. Students from the final years of medical, nursing, pharmacy and allied health programs were recruited, predominately as volunteers, and worked in mixed discipline teams to consult older and/or chronic disease patients. Student teams were required to collaborate in patient assessment and suggest appropriate management strategies or make referrals to services and support. Data were gathered on student experiences and learning outcomes, patient experiences and health outcomes, health services delivered by students, educator reflections, costs and logistics of clinic operations. There are procedural challenges, and solutions, for implementation of interprofessional student clinics within primary health care. Patients, students and educators positively perceive participation in interprofessional consultations. The major limitation to sustainability is the cost of clinic operations, with a comparison to usual hospital-based education finding the interprofessional option to be more expensive. Operational costs can be mitigated with a clinic design that minimises costs associated with student and patient recruitment. Despite the challenges of logistics, cross-institutional and discipline barriers, a student clinic provides an exciting opportunity to reconsider the single discipline model of undergraduate education in primary health care, with potential gains for student learning, organisational practice and patient care. As a potentially resource intensive endeavour, the balance between service delivery and student learning must be carefully considered to maximise sustainability.