This quasi-experimental study has shown a substantial baseline pre-intervention understanding and readiness of the undergraduate medical, dental and health sciences students about IPE. The impact of the online educational intervention further enhanced the readiness and receptiveness of the representative cohort in all subscales of the RIPLS inventory. Though we did not prefer online intervention for IPE, the restirctions by COVID-19 pandemic left us with no other choice except for an online workshop. Nevertheless, our study signifies the impact of an online intervention with remarkable teamwork and collaboration. The recruited cohort of students from a range of disciplines virtually met and worked in small groups for the first time during their undergraduate training. Finally, the post-intervention data analysis showed a significantly positive impact of the online workshop where small groups of students from diverse disciplines envisaged to collaboratively solve a scenario under the supervision of multidisciplinary facilitators. The mechanics and harmony of the learning environment, observed in this study, paves the way to introducing further collaborative interprofessional training in medical colleges. Likewise, the effectiveness of the online intervention encourages the utilization of distance learning in future teaching IPE courses.
In this study, students scored a pre-intervention highest mean of 4.17 for the subscale TC. Literature has argued that IPE takes place when different healthcare professionals work collaboratively with patients, relatives, caregivers, and societies to deliver the highest level of care (16). Historically, medical and health sciences students are taught in silos. Once they graduate, they suddenly face a different working environment of clinical practice where they anticipate uncertainties in their new roles, show poor interprofessional communication, less respect for colleagues’ roles, and misconception of one another's scope of practice (17). All such challenges endanger patient safety and dissatisfaction towards working in teams. To circumvent this misconception, Hallin et al., have evaluated the medical, nursing, physiotherapy and occupational therapy students’ attitudes after attending a clinical teamwork training (18). The study has shown that all students’ groups reported increased perceived knowledge of the other three professions (p = 0.000000). Additionally, the authors have proposed that the intervention had positively contributed to the understanding of communication and teamwork for the improved healthcare outcomes (effect size 1.0; p = 0.00002). Such active interventions for IPE courses during undergraduate training carry great promise in breaking professional barriers and in harmonizing the collaborative practice.
In our study, w have observed that, during the pre-intervention phase, 63% respondents strongly agreed with the RIPLS statement ‘for small-group learning to work, students or professionals need to respect and trust each other’. This resonates well with our study design where the online educational workshop was structured to adapt small group learning in a case-based discussion format. Our post-intervention analysis has shown a significant improvement of the students’ attitudes towards IPE by working in small groups. A plethora of published reports have endorsed the impactful role of small group learning in the medical field (19) (20) (20,21). From a different perspective, we have observed that 42% students showed strong disagreement with the statement, ‘I don't want to waste time learning with other health and social care students / professionals. Again, this indicates the readiness of the participating cohort of students for further development and implementation of IPE in their curriculum.
For the PI subscale of the RIPLS inventory, we have noticed a highest agreement by 35% students about the role of effective communications among the professionals, patients, families, and community stakeholders in IPE. The overarching concept of compassionate patient care relies on effective communication, which aims at developing meaningful and purposeful relationships among patients and professionals (21). Nevertheless, a professionally competent physician with poor communication skills can create misunderstanding, judgemental errors, and dissatisfaction among patients resulting in overall substandard clinical care. Therefore, enhancing communication skills of undergraduate medical students within an IPE context is essential (22).
In our study, a pre-intervention analysis of gender differences towards three subscales of the RIPLS inventory has highlighted a better understanding of female students for TC (4.21 ± 0.54) than male students (3.95 ± 0.77). In contrast, male students’ readiness for PR (3.22 ± 0.81) was significantly higher than female students (3.05 ± 0.73). Similarly, the subgroup analysis of the students’ perceptions from three colleges has shown significantly more readiness for TC among the CoM female students than males. By and large, we did not find a significant difference in opinions of male and female students from CHS and CDM. In the study by Falk et al., the authors have deduced that male students from different programs were slightly, but significantly, less positive than female students during an interprofessional training ward course (23). The authors have argued that gender should be considered during interprofessional clinical training as well as during the development of IPE curricula. Using simulation sessions in an IPE climate, Tamás et al., have reported that female students showed better communication skills and teamwork than their male counterparts (24). Furthermore, the investigators have maintained that simulation scenarios were more inspirational and motivating for female participants. These findings of gender differences in attitudes towards IPE closely articulate with our findings, which may reflect a stereotype difference in the approach towards IPE and collaborative practice. Literature has not provided a logical justification for such gender differences. However, in institutions with a dominant gender representation, such findings may be of significance for the implementation of the IPE curriculum.
Overall, we have found that senior students’ readiness to accept PR was significantly higher than junior students. This finding is at par with the evolutionary phases and progressive maturity that medical students attain during their educational journey. MacDonald et al., have investigated the degree of knowledge about the role of others in an IPE atmosphere and have introduced a set of behavioural indicators that can facilitate educators in evaluating students in IPE courses (25). These behavioural indicators for the interprofessional competency include a recognition of professional territories when the scope of one’s profession ends and another’s begins, resolving misconceptions, and respecting others’ roles during collaborative efforts. Recognition of distinct professional roles and identities among a team of diverse healthcare professionals is also crucial for an ideal environment of IPE (26).
The moderators in our educational intervention awarded a high median of 4 to most statements. This reasserts the value of integration, harmony, and collaborative learning among students from different medical disciplines. Finally, a comparative analysis of the responses from pre-post workshop for the subscales of TC, PI and PR has reported a significant improvement in understandings and attitudes of students towards IPE with p values 0.03, 0.00 and 0.00, respectively. Similar studies have shown a long term (27) as well as a short term (28) positive impact of IPE interventions on medical students and healthcare professionals. Regrettably, the positive impact cannot be sustained longitudinally. This is attributed to several obstacles and challenges that educators face during the implementation phase of IPE due to diverse disciplines, overcrowded timetables (29), inadequate resources (30), faculty resistance to the change, (31), diverse teaching styles (32) and administrative hurdles (33). Some of these barriers can be overcome by regular faculty development programs (34) and by developing a curricular framework including representations from all medical and health sciences faculties (35).