Transformative Education
for Health Professionals

International Classification of Functioning, Disability and Health (ICF) framework to facilitate Interprofessional education and collaborative practice

Interprofessional education and collaborative practice (IPECP) is regarded as one of the key components for instructional and institutional reform needed in health professions education globally to ensure graduates are equipped with the competencies to address the health needs of populations in the 21st century.

During the past five years comprehensive competency frameworks saw the light for IPECP as well as a ground-breaking WHO publication “Framework for Action on Interprofessional Education and Collaborative Practice clear para:”.

One of the domains in interprofessional competency frameworks is communication and the ability to ensure the common understanding of care decisions and shared goals setting. But how does one do this if team members have different conceptual framework in approaching service users and are using different terms for the same thing? Rather, students are often taught numerous, potentially contradicting, approaches to patients and communities, which can serve as a barrier to interprofessional communication and a bio-psycho-social-spiritual approach to person-centred care.

In 2001 the WHO launched the International Classification of Functioning, Disability and Health (ICF) as a comprehensive coding system for functioning and disability, a conceptual framework and a “common language between all professions” (WHO, 2001, p.3).

The Functioning and Disability Reference Group (FDRG) and other committee of the WHO Family of International Classifications are taking various initiatives to promote the ICF as common language and approach between all professions by developing training materials, a mobile application and to continuously update the classification.

Numerous studies over the past 10 years demonstrated the ICF framework’s value in facilitating IPECP, but for one or other reason it is not (yet) incorporated in other WHO initiatives, e.g. IPE and transformation of health professionals’ education. The WHO transformative education (TE) initiative provides mechanisms to address this (See recommendation 9 of the WHO guidelines and recommendation)). The WHO TE website and interactive map provides a valuable platform to engage with stakeholders to gather case studies of best practice at a country level.

Close collaboration between the FDRG and WHO TE could be synergistic to promote IPECP and build capacity of service providers worldwide.

Just recently 200 people from 36 countries signed up to collaborate in the development of mobile application based on the ICF. The main aim of the application will be to foster collaboration thus enhancing coordinated and person-centred practice. The next meeting of this collaborative will be on 9 & 10 October in Barcelona prior to the WHO-FIC Network Annual Meeting. A Practical Guide how to use the ICF will hopefully also be launched at this meeting.

WHO hosted a side event and co-hosted a main programme session at the2014 Prince Mahidol Award Conference (PMAC), Thailand on the theme of IPE in transformative health workforce education. The sessions demonstrated that interprofessional education for collaborative patient centred practice and care presents itself as one solution for transforming and scaling up health professionals’ education and training (WHO, 2010, 2013). For interprofessional education to successfully lead to a workforce that practices collaboratively, certain policy levers must be in place at the government level, within health systems and at the hospital and community level. As noted at the PMAC sessions, a number of high-level policy barriers exist, which makes facilitating and implementing interprofessional education and collaborative practice (IPE/IPC) very difficult. These policy barriers further complicate implementation at local and/or regional levels. One outcome of the PMAC meeting is the development of IPE as on of the six thematic areas address on the TE website, and on the WHO health workforce website.

By offering a biopsychosocial perspective the ICF framework enables multidisciplinary models of practice with definitions that facilitate understanding and communication about functioning. ICF has been integrated into assessment and goal-setting practices which may serve to clarify clinical roles.

Students of physical therapy when introduced to ICF as the framework for evaluating the needs of a paediatric population are able to identify and treat more effectively, however person-centred outcomes remain to be assessed

Using the ICF to relate data from multiple sources enabled unmet need for therapy and equipment to be estimated for people with cerebral palsy and like disabilities and new information on the experience of living with HIV/AIDS .

We need to decide how FDRG partners and TE can work close together. The FDRG are meeting from 11-17 October in Barcelona.

ICF users are encouraged to post and share their IPE case studies on the WHO TE interactive map.

In South Africa, Stellenbosch University’s Interprofessional Education and Collaborative Practice (IPECP) strategy has promoted using ICF since 2010 (WHO, 2014. Chapter 8). In one study, students on clinical placement in rural settings are expected to use ICF in approaching and managing patients. Students’ ability to develop interprofessional care plans using ICF is assessed by a team of preceptors representing various health professions. Students found ICF enabled a person-centred approach. Patients felt listened to and cared for. Preceptors came to appreciate the advantages of interprofessional care; promoting mutually beneficial teamwork and job satisfaction. The value of integrating IPECP as an authentic learning experience was demonstrated as was ICF as a catalyst in pushing boundaries for change