Journal of Interprofessional Care, 2013, 27: 123–130

q 2013 Informa UK, Ltd.

ISSN 1356-1820 print/ISSN 1469-9567 online
DOI: 10.3109/13561820.2012.718295

ARTICLE

Interprofessional education accreditation standards in the USA:

A comparative analysis
Joseph Zorek and Cynthia Raehl

Texas Tech University Health Sciences Center, School of Pharmacy, Amarillo, TX, USA
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obligation to engage in interdisciplinary education” and “the

Interprofessional education (IPE) and interprofessional
need for governmental and professional support of
collaborative practice (IPCP) will play a prominent role in the
interdisciplinary education for health care delivery teams.”
future of health professions’ education and healthcare delivery
While the terminology has evolved, advocates of interprofes-
in the USA and internationally. To assess the accreditation
sional education (IPE) and interprofessional collaborative
mandate for IPE in the USA, content analysis of IPE-related
practice (IPCP) in the USA have much to celebrate as
accreditation statements for all practice-level degrees in
this seminal report approaches its 40th anniversary.
dentistry, medicine, nursing, occupational therapy, pharmacy,
Influential IOM reports released in the last 10 years
physical therapy, physician assistant, psychology, public health
identified team-based healthcare delivery as the future of
and social work was performed. Eighteen keywords were used
For personal use only.

US health professions’ education and a potential answer to

to locate potentially relevant IPE statements within each
accreditation document. Identified statements were
independently categorized by each author into one of three
mutually exclusive categories: accountable, non-accountable or
non-applicable (k ¼ 0.79; 95% CI 0.69– 0.89). Eighteen of 21
accreditation documents analyzed contained applicable IPE
statements. The Commission on Collegiate Nursing Education
and Accreditation Council for Pharmacy Education documents
contained 77% (46/60) of accountable IPE statements. Two-
thirds (14/21) of documents contained two or fewer
accountable IPE statements. Statement categorization using
inductive methodology identified four IPE student competency
and organizational structure/process domains, respectively.
Collectively, US health professions’ graduates are not required
to complete IPE and, therefore, may not be prepared for IPCP.
US accrediting bodies are encouraged to collaborate to create a
common IPE accreditation standard.
Keywords: Accreditation, collaboration, content analysis,
interdisciplinary, interprofessional education,
interprofessionality, teamwork
INTRODUCTION
The Institute of Medicine (IOM) in the USA published
“Educating for the Health Team” in 1972 (IOM, 1972). This
report emphasized “the importance of recognition of an
looming healthcare delivery and affordability problems
(IOM, 2003, 2008).
Subsequent contemporary events further propelled IPE
and IPCP in the USA. Formation of the Interprofessional
Education Collaborative (IPEC) in 2009 signaled an
important commitment to IPE within academia. Comprised
of the professional associations representing US colleges and
schools of dentistry, medicine, nursing, pharmacy and public
health, IPEC is positioned to have a major impact on IPE and
IPCP in the future. Their expert panel published its first report
in 2011 outlining core competencies for IPCP (IPEC, 2011).
IPE and IPCP were further propelled by formation of
influential partnerships centered on team-based healthcare
delivery (PCPCC, 2011), and, most importantly, passage of
the Patient Protection and Affordable Care Act (ACA) of 2010,
which includes specific provisions for both (HOLC, 2010).
Although the push for greater IPE and IPCP may strike
many in the US health professions as new, the movement is in
fact a decades-old global phenomenon. Organizations such
as The Network: Towards Unity in Health (TUFH, 2012), the
Center for the Advancement of Interprofessional Education
(CAIPE, 2012), the European Interprofessional Education
Network (EIPEN, 2012), the Canadian Interprofessional
Health Collaborative (CIHC, 2009) and the International
Association for Interprofessional Education and Collabora-
tive Practice (InterEd, 2012) have shaped policy debates for

Correspondence: Joseph Zorek, Texas Tech University Health Sciences Center, School of Pharmacy, Amarillo, TX, USA.
E-mail: joseph.zorek@ttuhsc.edu
Received 20 March 2012; revised 12 July 2012; accepted 31 July 2012

123
 124 J. ZOREK AND C. RAEHL
years. Importantly, the Accreditation of Interprofessional
Health Education (AIPHE) initiative in Canada has recently
produced a guide for the incorporation of IPE language into
the accreditation process (AIPHE, 2011). This guide provides
specific examples of IPE standards, as well as examples of
evidence to document compliance for assessment purposes.
Its intent is to provide suggestions rather than to be
prescriptive.
Focus on health professions’ accreditation processes is
necessary as a mechanism to promote and advance IPE.
Indeed, prior research has highlighted its largely untapped
potential (Ho et al., 2008; UMN, 2009). Consecutive meta-
analyses point toward academic institutions as one of the
remaining bottlenecks to large-scale implementation of IPE
and IPCP initiatives (Reeves et al., 2008; Zwarenstein et al.,
2001). Since academic institutions must adhere to the
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requirements published by their respective accrediting body,
the extent to which the various health professions’ educational
programs incorporate IPE is, therefore, driven by accredita-
tion standards and guidelines. This connection makes the
accreditation process a powerful tool for educational change.
This study assessed the current accreditation mandate for
IPE in the USA, and thus the potential collective readiness of
US health professions’ graduates for IPCP. Secondary goals
included identification of best practices of incorporating IPE
standards into US accreditation processes, as well as
For personal use only.
identification of common themes in IPE accreditation
standards across US health professions. Finally, the results of
this study were compared with prior IPE competency
development approaches to formulate recommendations for
the advancement of IPE initiatives.
METHODS
Using content analysis, we conducted a comparative analysis
of the IPE- and IPCP-related accreditation statements for US
colleges and schools of dentistry (CDA, 2010), medicine
(COCA, 2011; LCME, 2011), nursing (CCNE, 2008, 2009;
NLNAC, 2008a –f, 2011), occupational therapy (ACOTE,
2010a,b), pharmacy (ACPE, 2011), physical therapy (CAPTE,
2011), physician assistant (ARC-PA, 2010), psychology
(APACOA, 2009), public health (CEPH, 2011) and social
work (CSWE, 2010).
The definitions of IPE and IPCP published by the World
Health Organization (WHO, 2010) and adopted by IPEC
were employed in this analysis:
“Interprofessional Education: When students from two or
more professions learn about, from and with each other to
enable effective collaboration and improve health
outcomes.
Interprofessional Collaborative Practice: When multiple
health workers from different professional backgrounds
work together with patients, families, carers [sic], and
communities to deliver the highest quality of care.”
Content analysis of documents is a powerful research
methodology for identifying trends and patterns across texts
(Stemler, 2001). Inferences drawn from a content analysis of
the lengthy accreditation documents (“raw data”) helped
identify specific IPE expectations that transcend the various
health professions’ accreditation standards. This study used
inductive content analysis methodology as there was little
prior knowledge about accreditation expectations for IPE
among the US health professions (Elo & Kyngäs, 2008). The
categories identified by our inductive approach were then
compared with the approaches advocated by IPEC in the
USA and CIHC in Canada (CIHC, 2009; IPEC, 2011).
Preparation phase
The unit of analysis selected for this content analysis was the
accreditation documents of the respective US health
professions. The organizations responsible for accrediting all
practice level degrees for these professions were identified via
an online search and their respective accreditation documents
were downloaded (October, 2011). Additional documents
explicitly stated as mandatory by the primary accreditation
document were also evaluated. For example, the Commission
on Collegiate Nursing Education (CCNE) mandates com-
pliance with the “Essentials” documents published by the
American Association of Colleges of Nursing (AACN, 1996,
2006, 2008, 2011). By contrast, the National League for
Nursing Accrediting Commission (NLNAC) addresses the
need to adhere to curriculum guidelines, but does not
mandate compliance with a specific guideline. Therefore, only
the accreditation documents for each practice-level degree
published by NLNAC were evaluated.
Data search and emergent coding
A keyword search using the terms “provider,” “professional,”
“inter-,” “interprofessional,” “interdisciplinary,” “multi-,”
“multiprofessional,” “multidisciplinary,” “collaborate,” “col-
laborating,” “collaborative,” “collaboration,” “cooperate,”
“cooperating,” “cooperative,” “cooperation,” “team” and
“teamwork” was carried out to locate IPE and/or IPCP
statements within each accreditation document. Keywords
were chosen using emergent coding methodology based on
their frequent use in the IPE/IPCP literature. Identified
statements were considered for further analysis if they
appeared related to IPE and/or IPCP concepts; for example,
“educating other professionals” (ACOTE, 2010a,b) was
selected for further analysis, whereas “In professional
practice, critical thinking enables the dentist to recognize
pertinent information,...” (CDA, 2010) was not. Statements
located within tables of contents, glossaries and reference
sections were excluded as these sections do not require action
by the college or school.
Statements were first determined to be applicable or non-
applicable. The remaining applicable statements were
subsequently assigned to one of two mutually exclusive
categories: accountable or non-accountable.
Elimination of non-applicable statements
Since all statements potentially related to IPE and/or IPCP
concepts were identified using the keyword search method-
ology, non-applicable statements were identified and then
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 US INTERPROFESSIONAL EDUCATION ACCREDITATION STANDARDS 125

eliminated from further analysis because they did not meet
the WHO definitions of IPE and/or IPCP. A general example
is the use of “multidisciplinary” to describe different
disciplines within the same profession. A more specific
example is the statement: “At minimum, a graduate must be
able to... demonstrate interpersonal and communication
skills with patients and other healthcare professionals”
(COCA, 2011). Although this statement addresses inter-
action with other healthcare professionals, it does not address
students from different professions “learning about, with and
from each other” (IPE) or different professionals “working
together... to deliver the highest quality of care” (IPCP).
Therefore, this was coded as a non-applicable statement.
Definition of accountable statements
Once a statement was deemed applicable to IPE, it was then
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determined that this statement was accountable. However, had
the accreditation documents defined “team” as only consisting
of nurses, it would have been categorized as non-applicable.
Definition of non-accountable statements
Applicable keyword usage located within titles was deemed
non-accountable. Likewise, applicable statements located in
introductory, explanatory or summative sections, as well as
those located within examples, samples, annotations or
descriptions of intent or interpretation were categorized as
non-accountable. Consider the following example: “As
recommended by the IOM for all health care professionals,
pharmacists must be educated to deliver patient-centered
care as members of an interprofessional team,...” (ACPE,
2011). While this statement is clearly applicable to IPCP, it
appears in the introductory background for a particular set

categorized as either accountable or non-accountable. An
accountable statement was defined as a directive or
requirement aimed at ensuring a specific IPE or IPCP learner
outcome that the accrediting body could reasonably hold the
college or school accountable to, based on the statement itself
or the context within which it occurred. An example of an
accountable statement is: “The baccalaureate program
prepares the graduate to... apply leadership concepts, skills,
and decision making in the provision of high quality nursing
care, healthcare team coordination,...” (AACN, 2008).
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of standards. As such, the accrediting body could not
reasonably hold a college or school accountable to this
background comment. Similarly, “consultations with other
professionals” is listed as an example for what compliance to
a mandatory statement might look like, but the example itself
is not mandatory for accreditation (ACOTE, 2010a,b).
Additional examples of statement categorization are included
in Table I.
Categorization of statements

The definition of “healthcare team” provided elsewhere in After assigning a random order to the accreditation
the accreditation document (“the patient plus all of the documents, the authors independently categorized each
healthcare professionals who care for the patient”) ultimately statement based on the aforementioned categorization scheme.
Table I. Examples of accreditation statement categorization.
Categories Examples
Accountable* Standard 2– 19, page 25: “Graduates must be competent in communicating and collaborating with other members of the
health care team to facilitate the provision of health care” (CDA, 2010)
Essential VI, page 22: “The baccalaureate program prepares the graduate to... demonstrate appropriate teambuilding and
collaborative strategies when working with interprofessional teams” (AACN, 2008)
Curricular content – CC-4, page B-29: “The physical therapist professional curriculum includes clinical education
experiences for each student that encompass... opportunities for involvement in interdisciplinary care” (CAPTE, 2011)
Non-accountable† Educational environment – collaboration with other health care professionals, page 12: “Health care professionals educated
to deliver patient-centered care as members of an interdisciplinary team present a challenge for educational programs”
(CDA, 2010)
Essential VI – rationale, page 22: “Interprofessional education is defined as interactive educational activities involving two
or more professions that foster collaboration to improve patient care” (AACN, 2008)
Introduction, page 1: “The needs of patients and society must be considered by the ARC-PA, the sponsoring institutions and
the programs. Education should be provided in a manner that promotes interprofessional education and practice” (ARC-
PA, 2010)
Non-applicable‡ Standard B.4.8, page 8: “Interpret the evaluation data in relation to accepted terminology of the profession, relevant
theoretical frameworks, and interdisciplinary knowledge” (ACOTE, 2010b)
Introduction – master’s education in nursing and areas of practice, page 5: “... further development of the knowledge and
skills embedded in Essential IV... will prepare the nurse to manage research projects for nurse scientists and other healthcare
researchers working in multi-professional research teams” (AACN, 2011)
Educational policy M2.2 – advanced practice: “Advanced practitioners refine and advance the quality of social work practice
and that of the larger social work profession. They synthesize and apply a broad range of interdisciplinary and
multidisciplinary knowledge and skills” (CSWE, 2010)
* “Accountable”: An applicable statement that is a directive or requirement aimed at ensuring a specific interprofessional education or IPCP learner outcome that
the accrediting body could reasonably hold the college or school accountable to, based on the statement itself or the language preceding it; † “Non-accountable”:
An applicable statement that is located within introductory, explanatory or summative sections of the accreditation document describing the background or
rationale for a set of standards/guidelines, as well as those located within titles, examples, samples, annotations or descriptions of intent or interpretation, to
which an accrediting body could not reasonably hold a college or school accountable; ‡ “Non-applicable”: Statements used within the accreditation document
that do not conform to the definitions of interprofessional education and/or IPCP as defined by the World Health Organization (WHO, 2010).

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 126 J. ZOREK AND C. RAEHL

All statements were reviewed in the context of their inclusion
within the respective accreditation document. Proximity
analysis of statements was also conducted. Definitions
contained within the accreditation documents aided statement
categorization. The inter-rater reliability of the categorization
scheme was assessed using Fleiss’ k (StataCorp, 2009), and final
categorization of discrepant statements was determined by an
independent third party. To facilitate this process, the third
party adjudicator was provided a brief description of the
project along with the Methods Section and Table I. Finally,
inductive reasoning techniques were then applied to the
statements deemed accountable in order to identify potential
best practices and/or common themes in IPE accreditation
processes across US health professions.
RESULTS
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study (the primary accreditation documents for CCNE and
NLNAC were excluded as they direct readers to additional
documents specific to each practice-level degree). A total of
205 statements were identified as potentially relevant to IPE
accreditation requirements. The frequency and categoriz-
ation for all identified statements are included in Table II,
with profession-specific rankings based on the number of
accountable IPE statements provided in Table III. Inter-rater
reliability was substantial with 181/205 statements agreed
upon (k ¼ 0.79; 95% CI 0.69 –0.89). Final categorization
resulted in 60 (29%) accountable, 118 (58%) non-
accountable and 27 (13%) non-applicable statements.
When combined, the CCNE nursing and Accreditation
Council for Pharmacy Education (ACPE) pharmacy accred-
itation documents comprised 77% (46/60) of all accountable

statements. Two-thirds (14/21) of documents contained

Twenty-three accreditation documents were identified for two or fewer accountable statements. Nearly 43% (9/21) of
the 10 health professions. Of these, 21 were analyzed in this documents did not contain a single accountable statement.

Table II. Frequency and categorization of accreditation statements relevant to IPE.

Statements with Accountable* Non-accountable‡ Non-applicable{
potential IPE IPE statements IPE statements IPE statements
Profession (degree) [accrediting body] relevance [No.] [No. (%†)] [No. (%†)] [No. (%†)]
Dentistry (DDS) [CDA] 8 1 (12.5) 4 (50) 3 (37.5)
Medicine (MD) [LCME] 5 1 (20) – 4 (80)
For personal use only.

Medicine (DO) [COCA] 2 – – 2 (100)

Nursing (BSN) [CCNE] 57 13 (22.8) 42 (73.7) 2 (3.5)
Nursing (MSN) [CCNE]§ 47 14 (29.8) 31 (65.9) 2 (4.3)
Nursing (MSN) [CCNE]k 11 3 (27.3) 5 (45.4) 3 (27.3)
Nursing (DNP) [CCNE] 14 3 (21.4) 7 (50) 4 (28.6)
Nursing (practical – LPN, LVN) [NLNAC] 1 – 1 (100) –
Nursing (diploma – LPN) [NLNAC] 1 – 1 (100) –
Nursing (associate – ADN) [NLNAC] 1 – 1 (100) –
Nursing (BSN) [NLNAC] 1 – 1 (100) –
Nursing (MSN) [NLNAC] 1 – 1 (100) –
Nursing (DNP) [NLNAC] – – – –
Occupational therapy (MOT) [ACOTE] 4 1 (25) 2 (50) 1 (25)
Occupational therapy (DOT) [ACOTE] 6 1 (16.7) 4 (66.6) 1 (16.7)
Pharmacy (PharmD) [ACPE] 22 13 (59.1) 9 (40.9) –
Physical therapy (MPT and DPT) [CAPTE] 10 4 (40) 3 (30) 3 (30)
Physician assistant (variable) [ARC-PA] 5 2 (40) 3 (60) –
Psychology (PhD and PsyD) [APACOA] – – – –
Public health (MPH) [CEPH] 8 4 (50) 3 (37.5) 1 (12.5)
Social work (BSSW and MSW) [CSWE] 1 – – 1 (100)
Totals 205 60 (29.3) 118 (57.5) 27 (13.2)
Notes: DDS, Doctor of Dental Surgery; MD, Doctor of Medicine; DO, Doctor of Osteopathic Medicine; LPN, Licensed Practical Nurse; LVN, Licensed
Vocational Nurse; ADN, Associate’s Degree in Nursing; BSN, Bachelor of Science in Nursing; MSN, Master of Science in Nursing; DNP, Doctor of
Nursing Practice; MOT, Master of Occupation Therapy; DOT, Doctor of Occupational Therapy; PharmD, Doctor of Pharmacy; MPT, Master of
Physical Therapy; DPT, Doctor of Physical Therapy; PhD, Doctor of Philosophy; PsyD, Doctor of Psychology; MPH, Master of Public Health; BSSW,
Bachelor of Science in Social Work; MSW, Master of Science in Social Work.
CDA, Commission on Dental Accreditation; LCME, Liaison Committee on Medical Education; COCA, Commission on Osteopathic College
Accreditation; CCNE, Commission on Collegiate Nursing Education; NLNAC, National League for Nursing Accreditation Commission; ACOTE,
Accreditation Council for Occupational Therapy Education; ACPE, Accreditation Council for Pharmacy Education; CAPTE, Commission
on Accreditation in Physical Therapy Education; ARC-PA, Accreditation Review Commission on Education for the Physician Assistant; APACOA,
American Psychological Association Commission on Accreditation; CEPH, Council on Education for Public Health; CSWE, Council on Social Work
Education; * “Accountable”: An applicable statement that is a directive or requirement aimed at ensuring a specific interprofessional education or IPCP learner
outcome that the accrediting body could reasonably hold the college or school accountable to, based on the statement itself or the language preceding it;
†
Percentages reported for each individual accreditation document only; for example, dentistry: [(1 accountable utilization)/(8 total utilizations) ¼ 12.5%];
‡
“Non-accountable”: An applicable statement that is located within introductory, explanatory, or summative sections of the accreditation document describing
the background or rationale for a set of standards/guidelines, as well as those located within titles, examples, samples, annotations, or descriptions of intent or
interpretation, to which an accrediting body could not reasonably hold a college or school accountable; { “Non-applicable”: Statements used within the
accreditation document that do not conform to the definitions of interprofessional education and/or IPCP as defined by the World Health Organization (WHO,
2010); § “The essentials of master’s education in nursing” (AACN, 2011); k “The essentials of master’s education for advanced practice nursing” (AACN, 1996).

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 US INTERPROFESSIONAL EDUCATION ACCREDITATION STANDARDS 127

Table III. Accreditation document ranking* according to accountable† IPE statements.

Accountable† Profession (degree)
Rank* utilizations (No.) [accrediting body]
1 14 Nursing (MSN) [CCNE]‡
2 13 Nursing (BSN) [CCNE]
2 13 Pharmacy (PharmD) [ACPE]
3 4 Physical therapy (MPT and DPT) [CAPTE]
3 4 Public health (MPH) [CEPH]
4 3 Nursing (MSN) [CCNE]{
4 3 Nursing (DNP) [CCNE]
5 2 Physician assistant (variable) [ARC-PA]
6 1 Dentistry (DDS) [CDA]
6 1 Medicine (MD) [LCME]
6 1 Occupational therapy (MOT) [ACOTE]
6 1 Occupational therapy (DOT) [ACOTE]
7 – Medicine (DO) [COCA]
7 – Nursing (practical – LPN, LVN) [NLNAC]
7 – Nursing (diploma – LPN) [NLNAC]
7 – Nursing (associate – ADN) [NLNAC]
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7 – Nursing (BSN) [NLNAC]

7 – Nursing (MSN) [NLNAC]
7 – Nursing (DNP) [NLNAC]
7 – Psychology (PhD and PsyD) [APACOA]
7 – Social work (BSSW and MSW) [CSWE]
Notes: DDS, Doctor of Dental Surgery; MD, Doctor of Medicine; DO, Doctor of Osteopathic Medicine; LPN, Licensed Practical Nurse; LVN, Licensed
Vocational Nurse; ADN, Associate’s Degree in Nursing; BSN, Bachelor of Science in Nursing; MSN, Master of Science in Nursing; DNP, Doctor of
Nursing Practice; MOT, Master of Occupation Therapy; DOT, Doctor of Occupational Therapy; PharmD, Doctor of Pharmacy; MPT, Master of
Physical Therapy; DPT, Doctor of Physical Therapy; PhD, Doctor of Philosophy; PsyD, Doctor of Psychology; MPH, Master of Public Health; BSSW,
Bachelor of Science in Social Work; MSW, Master of Science in Social Work.
CDA, Commission on Dental Accreditation; LCME, Liaison Committee on Medical Education; COCA, Commission on Osteopathic College Accreditation;
For personal use only.

CCNE, Commission on Collegiate Nursing Education; NLNAC, National League for Nursing Accreditation Commission; ACOTE, Accreditation Council for
Occupational Therapy Education; ACPE, Accreditation Council for Pharmacy Education; CAPTE, Commission on Accreditation in Physical Therapy
Education; ARC-PA, Accreditation Review Commission on Education for the Physician Assistant; APACOA, American Psychological Association
Commission on Accreditation; CEPH, Council on Education for Public Health; CSWE, Council on Social Work Education; * The order of rank for tied
documents was determined alphabetically; † “Accountable”: An applicable statement that is a directive or requirement aimed at ensuring a specific interprofessional
education or IPCP learner outcome that the accrediting body could reasonably hold the college or school accountable to, based on the statement itself or the language
preceding it; ‡ “The essentials of master’s education in nursing” (AACN, 2011); { “The essentials of master’s education for advanced practice nursing” (AACN, 1996).

Two broad themes emerged from the inductive analysis of
the 60 accountable IPE statements: (1) structure and process
(SP) elements required for IPE and (2) student competencies
(SC) required for IPCP. Most SP elements were located in the
pharmacy accreditation document. These were categorized
into the following four domains: (SP-1) IPE inclusion in
mission and goals, (SP-2) IPE responsibilities of the Dean,
(SP-3) allocation of budgetary and fiscal resources to IPE and
(SP-4) IPE inclusion in curricular programs and defined
learning outcomes.
Statements related to SC for IPCP were common to all health
professions’ accreditation documents, and were also categor-
ized into four domains: (SC-1) interprofessional communi-
cation, (SC-2) team practice and coordination, (SC-3) team
leadership and (SC-4) team members’ roles and responsibilities.
Although the overlapping nature of multiple SC domains
within single accountable IPE statements complicated further
analysis [e.g. “demonstrate leadership and communication
skills” (AACN, 2008)], some profession-specific trends
emerged. For example, the bachelor’s and master’s degree
CCNE nursing statements placed the greatest emphasis on team
practice, leadership and coordination (AACN, 1996, 2008,
2011). The doctorate CCNE statements placed emphasis on
graduates’ ability to lead teams (AACN, 2006). Pharmacy
statements emphasized an overall culture of IPE and
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collaboration (ACPE, 2011). Dentistry’s singular statement
stressed communication and collaboration (CDA, 2010).
Medicine’s singular statement was a broad expectation of
medical faculty to set achievement standards in interdisciplin-
ary and interprofessional learning experiences (LCME, 2011).
DISCUSSION
This study demonstrates that US accrediting bodies lack a
collective mandate for IPE, which is regrettable given that
academic institutions must respond to accreditation
requirements. This deficiency is evident in the sporadic
nature of university initiatives and public –private research
partnerships attempting to advance IPE in the USA (Bridges,
Davidson, Odegard, Maki, & Tomkowiak, 2011; Howell,
2010; JMJF, 2012; MUSC, 2007; RWJF, 2012; TTUHSC, 2009;
Young et al., 2011). While encouraging, isolated successes
such as these are insufficient to address the current need and
demand for IPCP. The few progressive US academic
institutions that embrace IPE will certainly produce
graduates prepared for IPCP; however, this approach will
only leave the healthcare landscape dotted with IPCP-ready
professionals rather than transforming it.
The four SC domains identified in this study, albeit with
slightly different wording, were also identified in IPEC’s
 128 J. ZOREK AND C. RAEHL
Expert Panel Report and CIHC’s National Interprofessional
Competency Framework (IPEC, 2011; CIHC, 2009).
However, two additional domains were identified by CIHC:
patient/client/family/community-centered care and inter-
professional conflict resolution. The explicit Canadian focus
on patient/client/family/community-centered care is often
understood to be the focus and foundation of team practice
as described within US documents. Similarly, interprofes-
sional conflict resolution may be considered a subset of
interprofessional communication. The four SC study
domains also overlapped with those developed by IPEC,
with the exception of the IPEC domain devoted to
values/ethics for interprofessional practice.
The isolated nature of the four SP domains identified in
this study was noteworthy, given that accrediting bodies
often rely on assessment of SP elements when evaluating
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programs. While not a substitute for assessment of actual IPE
student learning outcomes, these elements do provide
concrete language and resultant-specific criteria evaluated
by accrediting bodies. SP, therefore, emerged as an untapped
potential resource for the promotion of IPE/IPCP in the
accreditation process.
We recommend that the accrediting bodies representing
the US health professions collaborate to create a common
IPE standard. This would address the “dotted landscape,” and
offer the best opportunity, en masse, for graduates to “see the
For personal use only.
world through the eyes of other professions,” which Clark
aptly described as one of the main challenges in IPE (2006).
A bold move like this would not only ensure baseline
preparation across the professions, but would also send a
powerful signal to all US health professions’ colleges and
schools. The IPEC and CIHC documents provide a solid
foundation for competency development, and the AIPHE
initiative provides potential language for a common standard
complete with examples to demonstrate compliance.
Inclusion of SP elements such as those that emerged from
this study would be an important element of a successful
common IPE standard. We propose that it is essential for
each college/school’s mission statement and goals to
explicitly acknowledge IPE. Furthermore, we believe that
accrediting bodies should clearly state the expectation that
each Dean is responsible for the mandatory IPE education of
their students. Deans can demonstrate such commitment by
allocation of faculty time, space and resources. Furthermore,
deans of the varying health professions’ programs can work
together to meet shared accreditation requirements, which
would lead to faster adoption than if left to each programs’
curriculum committee, for example. Importantly, presidents
and provosts can collectively hold their deans accountable for
promoting and providing IPE. Using the categorization
scheme devised for this study to guide the common IPE
standard’s development would further ensure accountability.
The primary limitation of this analysis is the assumption
that the health professions’ accrediting bodies hold their
respective colleges and schools accountable to their standards
and guidelines. Furthermore, variation in the formatting and
style of the accreditation documents may have influenced the
authors’ assignment to the accountable, non-accountable
and non-applicable categories. For example, only two
accreditation documents define “interprofessional.”
In addition, the inductive methodology used to identify
themes throughout the accreditation documents was applied
only to the accountable IPE statements. As reported, over
three-quarters of these statements originated from 2 of the
10 professions analyzed. These themes, therefore, are not
representative of all 10 professions’ accreditation documents.
A final limitation is that both authors practice within the
same profession, which introduced the potential for observer
bias. However, a priori rigorous definition of the mutually
exclusive categories and use of an independent third party
adjudicator reduced this risk.
CONCLUSIONS
If one accepts the assumption that accreditation documents
serve as a surrogate marker of a profession’s readiness for a
particular type of practice, collectively, US health professions’
graduates may not be currently prepared for IPCP. Based on
the frequency of accreditation statements that clearly hold
colleges and schools accountable to IPE, nursing and
pharmacy graduates may be most prepared for IPCP.
However, no single best practice for the incorporation of
IPE-related language into the accreditation process emerged.
The student competency domains related to IPE that
emerged paralleled those produced by IPEC and CIHC.
A combination of IPEC and CIHC domains may yield final
terminology. The SP domains identified in this study, largely
derived from the pharmacy accreditation document, deserve
further attention from the accrediting bodies of other health
professions and should play a prominent role in development
of a common IPE standard should this take place.
Large-scale transformation of healthcare along team-
based lines will not take place until academic institutions are
held accountable to this change. At minimum, US health
professions’ graduates should be required to demonstrate
competency in the following domains identified by IPEC,
CIHC and this study: values/ethics for interprofessional
practice, roles/responsibilities for collaborative practice,
interprofessional communication practices, interprofessional
teamwork and team-based practice, collaborative
leadership and interprofessional conflict resolution (CIHC,
2009; IPEC, 2011). The choice of domains is secondary to the
commitment to unequivocally address IPE as a requirement
for all health professions’ students, which would most
powerfully be addressed if the accrediting bodies representing
the US health professions act in unison to create a common
IPE standard. Should the current uniprofessional approach
to IPE accreditation persist, accrediting bodies are encour-
aged to reference the nursing and pharmacy accreditation
documents as models of accountable IPE language use. Either
approach would certainly address the observed lack of
“deep intellectual roots in the commitment to IPE,” as well as
barriers to its progress (Axelsson & Axelsson, 2009; Baldwin,
2007a,b; Clark, 2011).
Journal of Interprofessional Care
 US INTERPROFESSIONAL EDUCATION ACCREDITATION STANDARDS
ACKNOWLEDGEMENT
The authors gratefully acknowledge Dr Eric J MacLaughlin
for serving as our third party adjudicator.
Declaration of interest
The authors report no conflicts of interest. The authors alone
are responsible for the content and writing of the paper.
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