Toward a transtheoretical model of interprofessional education: stages, processes and forces supporting institutional change.

The history of interprofessional education (IPE) in the USA is a checkered one, characterized by boom and bust cycles of advancement and retrenchment, expansion and contraction. The successful development, implementation and continuation of IPE in health and social care in US higher education institutions all depend on a number of factors related to how individuals and organizations do or do not support it in the academic setting. Deliberate and planned change to advance IPE requires a comprehensive theoretical framework to guide it and insure its success. A transtheoretical model (TTM) of institutional change is proposed as a comprehensive framework of the stages, processes and forces that can facilitate and maintain change in support of IPE. The TTM framework recognizes the complexity of change, and captures and organizes important elements from different organizational theories. It also provides a structure for conceptualizing the multiple dimensions needed for change, offering intervention strategies and leverage points to be used by leaders in promoting and maintaining it. Finally, the TTM model suggests that the stabilization of IPE programs over the long term is dependent on a real and significant shift in institutional values in response to forces from both within and without the organization.