As one of the first bilingual studies on the subject, this study allowed perspectives to be heard from more inclusive and diverse communities across Canada. Further, this is the first published study to explore how HASC academic programs are meeting their profession-specific IPE accreditation standards and to illustrate the impacts of accreditation on the Canadian IPE experience. Thus, our findings are not meant to be generalizable. Rather, our hope is that the themes that emerged from this study have relevance to the global HASC academic community where IPE may be less developed.
Given the qualitative nature of this study, the rich quality of responses is more invaluable compared to the low response rate. It was encouraging to see the array of evidence provided to demonstrate innovative and theoretically grounded interprofessional learning opportunities offered within and among pre-licensure HASC professional programs. It was also promising that respondents believed that accreditation serves as an enabler of IPE implementation. This position was also seen in a recent Australian-Dutch study by Akdemir et al. , who examined the impacts of accreditation in practice on postgraduate medical programs from the perspectives of accreditors, clinicians, and trainees. Akdemir et al. stated that,
All participants acknowledged the necessity of accreditation to evaluate quality of training, despite its substantial costs, time-consuming nature, and emotional burden. Many participants argued that without standards it would be difficult to assure a minimum level of quality. […] Trainees mentioned the need for an impartial and objective perspective on training quality by an accreditation authority. In addition, supervisors find accreditation reports useful to demand changes or resources from the hospital administration. (p. 3)
IPE is defined by the Centre for the Advancement of Interprofessional Education (CAIPE) as “occasions when members or students of two or more [HASC] professions learn with, from and about each other to improve collaboration and the quality of care and services” (, p. 1). By definition, IPE is therefore an educational strategy that requires interaction and active engagement among learners from different HASC professions. That being said, current IPE-relevant accreditation standards only capture occasions for IPE, but do not capture evidence of the quality of these interprofessional learning opportunities. As such, this study could not assess the quality of implemented IPE activities; consequently, data may not have been readily made available to us. Further, the AIPHE projects  emphasized that,
Something must be exchanged among and between learners from different professions that changes how they perceive themselves and others. These changes must positively affect clinical practice in a way that enhances interprofessional collaboration, client involvement in care, and ultimately improves health outcomes. (p. 8)
Subsequently, the reported exemplars involving interprofessional practice-based learning are particularly noteworthy. Moving forward and to show the impacts of IPE activities on the achievement of IPE competency domains by program graduates leading to IPCP, there is a need for IPE-relevant accreditation standards to request evidence of the quality of IPE application in both didactic and practice-based settings. One study suggests that clinician team facilitation and mentorship of senior pre-licensure learners participating in interprofessional clinical placements lead to greater clinician personal awareness of interprofessional teaming, reflection, and changes in their own practice and mentorship of students . In parallel with the growing IPE movement, the hope is that health services delivery accreditation standards further catalyze IPCP. It is encouraging that the Canadian Health Services Organization (HSO), responsible for developing protocols for accreditation of health services delivery, has recently written Clinical Governance Standards  to guide clinical management and service providers. A major theme throughout the guide is to ensure that,
Everyone in and associated with the organization (leaders, providers, patients/clients, families including caregivers, community members and partners in the system) work collaboratively in a team-based and interprofessional manner to provide clients with the right care at the right time for the best possible client experience and outcomes.
Additionally, it is somewhat concerning that the focus of IPE accreditation standards evidence is on the Educational Program domain with a much lower emphasis placed on other accreditation standards domains (Organizational Commitment, Faculty, Students, and Resources). These findings are consistent with the Canadian review of IPE-relevant accountable statements which reported emphasis primarily on the Students and Educational Program domains . At both the macro-level and meso-level, the D’Amour framework  suggests that IPE program sustainability is threatened by a lack of a collective vision and sincere organizational commitment to IPE. Additionally, non-supportive administrative processes, including siloed resources and tenure and promotion criteria that do not reward IPE pose challenges to sustainability. At the micro-level, lack of faculty development in IPE and inclusion of patients as facilitators of IPE , limited student engagement, and learning contexts not grounded in adult learning theories stifle innovation and threaten program quality .
Most of the challenges cited by the respondents are not surprising and have been reported previously . The use of an adoption model framework, such as the D’Amour framework , by program planners would facilitate diffusion of an innovation such as IPE within and between organizations and sectors, and prospectively identify and address anticipated challenges . The lack of mandatory student engagement and/or varying student/faculty perceptions regarding the importance of IPE noted as challenges in this study are micro- level education and socialization factors identified in the D’Amour framework. Similarly, the challenges of scheduling and collaboration among other (francophone) academic, vocational, or technical institutions and practice environments reported in this study can be anticipated as meso-level, institutional factors (leadership, resources, administrative processes) within the D’Amour framework.
Accreditation of IPE was viewed very positively by survey respondents with a sentiment that this external review process facilitates resource allocation to support IPE innovation, drives program implementation, and promotes ongoing program reflection and improvement. The inclusion of accountable IPE-relevant language in the accreditation standards for 10 HASC professions and the reported engagement of over 16 different HASC professions in IPE exemplars suggests that the AIPHE projects [11, 12], involving six of these HASC professions (medicine, nursing, pharmacy, physical therapy, occupational therapy, and social work), had significant influence on those academic programs not involved in the AIPHE projects (e.g., chiropractic, dentistry, dietetics, and psychology) as well as those HASC professions that reportedly participate in IPE activities but are neither regulated in all 10 Canadian provinces nor accredited by a pan-Canadian organization (e.g., audiology, dental hygiene, healthcare aides, physician assistant, respiratory therapy, and speech language pathology).