a critical review of evaluations of interprofessional education

We’re fighting to restore access to 500,000+ books in court this week. Join us!

Internet Archive Audio

a critical review of evaluations of interprofessional education

This Just In
Grateful Dead
Old Time Radio
78 RPMs and Cylinder Recordings
Audio Books & Poetry
Computers, Technology and Science
Music, Arts & Culture
News & Public Affairs
Spirituality & Religion
Radio News Archive

Flickr Commons
Occupy Wall Street Flickr
NASA Images
Solar System Collection
Ames Research Center

All Software
Old School Emulation
MS-DOS Games
Historical Software
Classic PC Games
Software Library
Kodi Archive and Support File
Vintage Software
CD-ROM Software
CD-ROM Software Library
Software Sites
Tucows Software Library
Shareware CD-ROMs
Software Capsules Compilation
CD-ROM Images
ZX Spectrum
DOOM Level CD

Smithsonian Libraries
FEDLINK (US)
Lincoln Collection
American Libraries
Canadian Libraries
Universal Library
Project Gutenberg
Children's Library
Biodiversity Heritage Library
Books by Language
Additional Collections

Prelinger Archives
Democracy Now!
Occupy Wall Street
TV NSA Clip Library
Animation & Cartoons
Arts & Music
Computers & Technology
Cultural & Academic Films
Ephemeral Films
Sports Videos
Videogame Videos
Youth Media

Search the history of over 866 billion web pages on the Internet.

Mobile Apps

Wayback Machine (iOS)
Wayback Machine (Android)

Browser Extensions

Archive-it subscription.

Explore the Collections
Build Collections

Save Page Now

Capture a web page as it appears now for use as a trusted citation in the future.

Please enter a valid web address

Donate Donate icon An illustration of a heart shape

A critical review of evaluations of interprofessional education

Bookreader item preview, share or embed this item, flag this item for.

Graphic Violence
Explicit Sexual Content
Hate Speech
Misinformation/Disinformation
Marketing/Phishing/Advertising
Misleading/Inaccurate/Missing Metadata

plus-circle Add Review comment Reviews

12 Previews

DOWNLOAD OPTIONS

No suitable files to display here.

PDF access not available for this item.

IN COLLECTIONS

Uploaded by station64.cebu on June 13, 2022

SIMILAR ITEMS (based on metadata)

Browse by Year
Browse by Research Area
Browse by Faculty
Browse by Kingston Author

Due to planned repository maintenance on Tuesday the 6th of November between 9am and 2pm, the repository may experience brief outages, and the users will not be able to deposit new items.

We apologise for any inconvenience caused.

A critical review of evaluations of interprofessional education

Freeth, Della , Hammick, Marilyn , Koppel, Ivan , Reeves, Scott and Barr, Hugh (2002) A critical review of evaluations of interprofessional education. (Other) London, UK : LTSN Health Sciences and Practice. 63 p. (Occasional Paper, no. 2) ISBN 095424401X

Official URL:
Item Type:	Monograph (Other)
Additional Information:	This review was commissioned by the Learning and Teaching Support Network Health Sciences and Practice from the Interprofessional Education Joint Evaluation Team and published in May 2002.
Research Area:
Faculty, School or Research Centre:
Series Name:	Occasional Paper
Date Deposited:	06 Sep 2007
Last Modified:	13 Sep 2022 10:19
URI:

Actions (Repository Editors)

Item Control Page

Technical report

A critical review of evaluations of interprofessional education

Freeth, D., Hammick, M., Koppel, I., Reeves, S. and Barr, H. 2002. A critical review of evaluations of interprofessional education. London, UK Higher Education Academy, Health Sciences and Practice Network. https://doi.org/OccasionalPaperNo2

Publication dates
Title	A critical review of evaluations of interprofessional education
Authors	, , , and
Type	Technical report
Year	2002
Publisher	Higher Education Academy, Health Sciences and Practice Network
Place of publication	London, UK
	2002
Web address (URL)
Digital Object Identifier (DOI)

Related outputs

An anatomy of continuing interprofessional education Barr, H. 2009. An anatomy of continuing interprofessional education. Journal of Continuing Education in the Health Professions. 29 (3), pp. 147-150. https://doi.org/10.1002/chp.20027

Social work in collaboration with other professions Barr, H., Goosey, D. and Webb, M. 2008. Social work in collaboration with other professions. in: Davies, M. (ed.) The Blackwell companion to social work. 3rd ed. Oxford Blackwell.

Interprofessional education: the fourth focus Barr, H. 2007. Interprofessional education: the fourth focus. Journal of Interprofessional Care. 21 (Supplement 2), pp. 40-50. https://doi.org/10.1080/13561820701515335

Interprofessional education in essence Barr, H. 2007. Interprofessional education in essence. in: Ayers, S., Baum, A., McManus, C., Newman, S., Wallston, K., Weinman, J. and West, R. (ed.) Cambridge handbook of psychology, health and medicine. 2nd edition Cambridge, UK Cambridge University Press.

Mainstreaming interprofessional education in the United Kingdom: a position paper Barr, H. and Ross, F. 2006. Mainstreaming interprofessional education in the United Kingdom: a position paper. Journal of Interprofessional Care. 20 (2), pp. 96-104. https://doi.org/10.1080/13561820600649771

Evaluating interprofessional education: a self-help guide Freeth, D., Reeves, S., Koppel, I., Hammick, M. and Barr, H. 2005. Evaluating interprofessional education: a self-help guide. London, UK Higher Education Academy Learning and Teaching Support Network for Health Sciences and Practice. https://doi.org/Occasionalpaperno5

Multiprofessional/interprofessional education Barr, H. 2005. Multiprofessional/interprofessional education. in: Dent, J.A. and Harden, R.M. (ed.) A practical guide for medical teachers. 2nd edition Edinburgh, UK Elsevier.

Interprofessional education: today, yesterday and tomorrow: a review. Revised edition June 2005 Barr, H. 2005. Interprofessional education: today, yesterday and tomorrow: a review. Revised edition June 2005. London, UK Higher Education Academy, Health Sciences and Practice Network. https://doi.org/OccasionalPaperNo1

Six of the best Barr, H. 2005. Six of the best. Journal of Interprofessional Care. 19 (1), pp. 1-2. https://doi.org/10.1080/13561820400024068

Evaluating teamwork Barr, H. 2005. Evaluating teamwork. Journal of Interprofessional Care. 19 (2), pp. 81-82. https://doi.org/10.1080/13561820500062893

Canada as a case study Barr, H. 2005. Canada as a case study. Journal of Interprofessional Care. 19 (Suppl 1), pp. 5-7. https://doi.org/10.1080/13561820500081562

Interprofessional education: a decade of developments in Oula and beyond Barr, H. 2004. Interprofessional education: a decade of developments in Oula and beyond. in: Alatolonen, T. (ed.) Treveytta ja Hyvintvointia Naoaoaoiiilta Paivantaasaajalle Ouly, Finland Kalevaprint Oy.

Unpacking interprofessional education Barr, H. 2003. Unpacking interprofessional education. in: Leathard, A. (ed.) Interprofessional collaboration: from policy to practice in health and social care Hove, UK Brunner-Routledge.

Interprofessional issues in work-based learning Barr, H. 2003. Interprofessional issues in work-based learning. in: Burton, J. and Jackson, N. (ed.) Work-based learning in primary care Abingdon, UK Radcliffe Medical Press.

Evaluating interprofessional education Barr, H. 2003. Evaluating interprofessional education. in: Carlisle, C. (ed.) Interprofessional education: an agenda for healthcare professionals Salisbury, UK Quay Books. pp. 167

Twelve tips for undertaking a systematic review Reeves, S., Koppel, I., Barr, H., Freeth, D. and Hammick, M. 2002. Twelve tips for undertaking a systematic review. Medical Teacher. 24 (4), pp. 358-363. https://doi.org/10.1080/01421590220145707

Systematic reviews of evaluations of interprofessional education: results and work in progress Hammick, M., Barr, H., Freeth, D., Koppel, I. and Reeves, S. 2002. Systematic reviews of evaluations of interprofessional education: results and work in progress. Journal of Interprofessional Care. 16 (1), pp. 80-84. https://doi.org/10.1080/13561820220104195

Interprofessional education: selected case studies Barr, H. and Goosey, D. 2002. Interprofessional education: selected case studies. Commissioned by the Department of Health from the UK Centre for the Advancement of Interprofessional Education (CAIPE).

Social work in collaboration with other professions Barr, H. 2002. Social work in collaboration with other professions. in: Davies, M. (ed.) The Blackwell companion to social work. 2nd edition Oxford, UK Oxford University Press. pp. 266-272

Interprofessional education: today, yesterday and tomorrow: a review, 2002 Barr, H. 2002. Interprofessional education: today, yesterday and tomorrow: a review, 2002. London, UK Higher Education Academy, Health Sciences and Practice Network. https://doi.org/OccasionalPaperNo1

Establishing a systematic approach to evaluating the effectiveness of interprofessional education Issues in Interdisciplinary Care Koppel, I., Barr, H., Reeves, S., Freeth, D. and Hammick, M. 2001. Establishing a systematic approach to evaluating the effectiveness of interprofessional education Issues in Interdisciplinary Care. Issues in Interdisciplinary Care. 3 (1), pp. 41-49.

Interprofessional education: effects on professional practice and health care outcomes (Cochrane Review) Zwarenstein, M., Reeves, S., Barr, H., Hammick, M., Koppel, I. and Atkins, J. 2000. Interprofessional education: effects on professional practice and health care outcomes (Cochrane Review). Cochrane Database of Systematic Reviews. 3. https://doi.org/10.1002/14651858.CD002213

A systematic review of interprofessional education Zwarenstein, M., Atkins, J., Barr, H., Hammick, M., Koppel, I. and Reeves, S. 1999. A systematic review of interprofessional education. Journal of Interprofessional Care. 13 (4), pp. 417-424.

Permalink - https://westminsterresearch.westminster.ac.uk/item/93wx8/a-critical-review-of-evaluations-of-interprofessional-education

Usage statistics

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Publications
Account settings
My Bibliography
Collections
Citation manager

Save citation to file

Email citation, add to collections.

Create a new collection
Add to an existing collection

Add to My Bibliography

Your saved search, create a file for external citation management software, your rss feed.

Search in PubMed
Search in NLM Catalog
Add to Search

Interprofessional Education and Practice Guide No. 3: Evaluating interprofessional education

Affiliation.

1 Centre for Health and Social Care Research, Kingston University & St George's University of London , London , UK .
PMID: 25671416
DOI: 10.3109/13561820.2014.1003637

We have witnessed an ongoing increase in the publication of evaluation work aimed at measuring the processes and outcomes related to a range of interprofessional education (IPE) activities and initiatives. Systematic reviews of IPE have, however, suggested that while the quality of evaluation studies is improving, there continues to be a number of empirical weaknesses with this work. In an effort to enhance the quality of IPE evaluation studies, this guide provides a series of ideas and suggestions about how to undertake a robust evaluation of an IPE event. The guide presents a series of key lessons for colleagues to help them undertake a good quality IPE evaluation, covering a range of methodological, practical and ethical issues. These include: the formation of evaluation questions, use of evaluation models and theoretical perspectives, advice about the selection of qualitative, quantitative and mixed methods evaluation designs, managing evaluation resources, and ideas about disseminating evaluation results to the broader IPE community. It is anticipated that this guide will assist IPE colleagues in undertaking high-quality evaluation in order to provide valuable evidence for different stakeholders, and also help inform the scholarly knowledge for the interprofessional field.

Keywords: Evaluation; interprofessional education; interprofessional learning; mixed methods; qualitative methods; quantitative methods.

PubMed Disclaimer

Related information

Cited in Books

LinkOut - more resources

Full text sources.

Taylor & Francis

Citation Manager

NCBI Literature Resources

MeSH PMC Bookshelf Disclaimer

The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.

The implementation of interprofessional education: a scoping review

Open access
Published: 10 June 2022
Volume 28 , pages 243–277, ( 2023 )

Cite this article

You have full access to this open access article

Fiona Bogossian ORCID: orcid.org/0000-0001-9909-5852 1 , 2 , 3 ,
Karen New 3 , 4 ,
Kendall George 1 ,
Nigel Barr 1 ,
Natalie Dodd 1 , 2 , 3 , 5 ,
Anita L. Hamilton 3 ,
Gregory Nash 6 ,
Nicole Masters 3 ,
Fiona Pelly 3 ,
Carol Reid 1 ,
Rebekah Shakhovskoy 2 , 3 , 7 &
Jane Taylor 3

10k Accesses

24 Citations

5 Altmetric

Explore all metrics

Introduction

Implementation of interprofessional education (IPE) is recognised as challenging, and well-designed programs can have differing levels of success depending on implementation quality. The aim of this review was to summarise the evidence for implementation of IPE, and identify challenges and key lessons to guide faculty in IPE implementation.

Five stage scoping review of methodological characteristics, implementation components, challenges and key lessons in primary studies in IPE. Thematic analysis using a framework of micro (teaching), meso (institutional), and macro (systemic) level education factors was used to synthesise challenges and key lessons.

Twenty-seven primary studies were included in this review. Studies were predominantly descriptive in design and implementation components inconsistently reported. IPE was mostly integrated into curricula, optional, involved group learning, and used combinations of interactive and didactic approaches. Micro level implementation factors (socialisation issues, learning context, and faculty development), meso level implementation factors (leadership and resources, administrative processes), and macro level implementation factors (education system, government policies, social and cultural values) were extrapolated. Sustainability was identified as an additional factor in IPE implementation.

Lack of complete detailed reporting limits evidence of IPE implementation, however, this review highlighted challenges and yielded key lessons to guide faculty in the implementation of IPE.

Potentialities and limitations of Interprofessional Education during graduation: a systematic review and thematic synthesis of qualitative studies

Exploring experiential learning within interprofessional practice education initiatives for pre-licensure healthcare students: a scoping review

Sociomaterial perspective as applied in interprofessional education and collaborative practice: a scoping review

Avoid common mistakes on your manuscript.

Interprofessional education (IPE) is key to the development of a collaborative practice-ready workforce. Interprofessional education promotes collaboration as participants review relationships between their professions, enhance mutual understanding and explore ways to combine their expertise towards improving delivery of service, patient safety and quality of care (World Health Organization, 2010a ). The benefits of IPE and interprofessional collaborative practice (IPCP) are widely reported in the literature and include; role clarification, improved team functioning, enhanced conflict resolution and collaborative leadership, access to and coordination of care, appropriate use of specialist clinical resources, provision of optimal care, improved health care outcomes, reduced adverse consequences, reduced duplication of services, overcoming gaps in service provision, greater health worker productivity, inter-sectoral efficiency and community cohesion (Gilbert, 2018a , b ; World Health Organization, 2010a ).

The actions required to support IPE and IPCP are well described at a system level for health policy makers, but can be difficult concepts to explain, understand and implement (World Health Organization, 2010b ). Implementation of IPE has been described as extremely challenging because of a deficit of quality methodological studies and staff resources (Lewy, 2010 ). However, examining implementation is important because a well-designed program can have differing levels of success depending on implementation quality (Gagnon et al., 2015 ). Unexpected outcomes, small effect sizes or inconsistent findings may not be related to the program design, but rather to poor program implementation (Caldwell et al., 2008 ).

As highlighted in the WHO Framework for Action on Interprofessional Education and Collaborative Practice, those responsible for implementing IPE should be competent and have expertise consistent with the nature of the planned IPE (World Health Organization, 2010b ). However, many faculty (i.e., all health professional staff who have teaching roles) (Freeth et al., 2005 ) who have responsibility for implementing IPE need development to move beyond single professional approaches to implement learning experiences that are truly interprofessional (Ryland et al., 2017 ). While the importance of faculty development in IPE has been highlighted for many years (Freeth et al., 2005 ; Steinert, 2005 ) there is little evidence-based literature available to guide faculty development in IPE (Silver & Leslie, 2017 ), on the key knowledge and skills to implement IPE (Anderson et al., 2009 ). Consequently, the aim of this paper is to summarise the evidence for implementation of IPE and identify challenges and key lessons to guide faculty in IPE implementation.

To address the aim, scoping review methodology was chosen to enable a systematic search of the literature not restricted by study design (Cooper et al., 2019 ) and appropriate to explore the extent of evidence for IPE implementation. We did not register a review protocol. As a first step, we developed an operational definition of implementation as the activation of a specified set of planned and intentional activities of an intervention. The Interprofessional Curriculum Renewal Consortium Australia ( 2014 ) proposed a Teaching and Learning Decision Making which identifies “delivery” components and descriptors which were adopted as components and descriptors of implementation. These include curriculum (course, unit, activity), dimension (embedded/integrated or discrete/freestanding, mandatory or optional, implicit or explicit, individual or group learning, common or comparative learning, interactive or didactic learning), duration (hours, days, weeks, years), location (on campus, off campus), mode (face-to-face, online, blended), timing (synchronous, asynchronous), and teaching (individual, co-teaching, team teaching).

In addition to components of implementation, there are education factors which can influence the outcomes of IPE implementation and thus affect the health professional learner’s capacity to reach the goal of becoming an interprofessional collaborative practitioner. The Interprofessional Education for Collaborative Patient-Centred Practice (IECPCP) Framework proposed by D’amour and Oandasan ( 2005 ) provides a structure to categorise and understand education factors. The framework categorises education factors as micro or teaching factors (learner and educator professional and cultural beliefs and attitudes, learning context, faculty development), meso or institutional factors (leadership and resources, administrative processes), and macro or systemic factors (education system accreditation and institutional structures, social and cultural values that influence professional and cultural beliefs and attitudes). Combining the components of IPE implementation with the factors that influence outcomes was important to answer the research questions below.

The method for this scoping review followed the stages recommended by Arksey and O’Malley ( 2005 ) and Levac et al. ( 2010 ). The PRISMA Extension for Scoping Reviews (PRISMA-ScR) (Tricco et al., 2018 ) was selected to guide the reporting of this review.

Identifying the research question

The research questions for this review were: (1) What are the methodological characteristics and implementation components reported in primary IPE studies? and (2) What are the challenges and key lessons for faculty to consider when implementing IPE?

Identifying relevant studies

A Senior Librarian managed the search of Scopus, Web of Science, ERIC (Education Resources Information Center), PsycInfo, CINAHL (EBSCOHost) and the Cochrane Library databases in collaboration with the project team. The key words ‘interprofessional education’, ‘interprofessional learning’ and ‘interprofessional collaboration’ were searched in title, abstract and keywords of articles. Filters applied to searches included human participants, English language, and publication date between 2010 and 2019. The full electronic preliminary search strategy is provided below.

Database	SCOPUS	Web of Science	ERIC	PsychInfo	CINAHL	Cochrane Reviews
Date coverage	2010 to 2019
Date of search	16/05/2019
Limits	Language: English Document type: Original research and Review Subject areas: health topics
Search query (keywords)	“interprofessional education” OR “inter-professional education” OR “interdisciplinary education” OR “inter-disciplinary education” OR “interprofessional learning” OR “inter-professional learning
Number of hits	393	150	5	53	4	2

The search was subsequently refined to terms ‘interprofessional assessment’ OR ‘interprofessional design’ OR ‘interprofessional implementation’ OR ‘interprofessional evaluation’. Peer-reviewed original research and reviews, regardless of methodological approach were eligible for inclusion. Theses and grey literature (technical reports, government papers, conference proceedings) were excluded.

Study selection

The results were collated in Endnote 7 (2013) by the Senior Librarian, who removed duplicates which, in turn, were checked by one team member (KN). Then two members (KN and FB) screened titles and abstracts independently for potential eligibility which included reporting on IPE design, implementation, assessment, and/or evaluation involving learners from two or more professions, where at least one of the professions was from a list of 25 regulated and self-regulated professional groups in Australia. Disciplines included were Chinese medicine, chiropractic, counselling, dietetics, dentistry, exercise physiology, Indigenous or First Nations’ health, medical imaging, medicine, midwifery, nursing, nutrition, occupational therapy, optometry, osteopathy, paramedicine, pastoral care, pharmacy, physiotherapy, podiatry, psychology, public health, physician assistant, social work, and speech therapy. Screening results were compared, and non-agreement resolved though discussion.

Following the retrieval of the full texts for papers identified as potentially eligible, six pairs of team members (NB-KG; AH-NM; GN-JT; FP-RS; CR-ND; FB-KN) were assigned a portion of the papers to determine the focus of the paper and which component/s of IPE were addressed; design, implementation, assessment and/or evaluation. One of two team members (KN, FB) arbitrated disagreements or uncertainty between paired team members. The papers deemed eligible were organised under each of the four domains by one team member (KN), and papers identified for the implementation domain that reported on primary studies progressed to the data charting stage for this review.

Charting the data

For this stage, three team members (NB, KG, FB) were assigned to systematically review each paper identified for this domain, confirm its inclusion, and chart implementation data based on the components previously identified. Data not explicitly reported were extrapolated where possible. Each paper was then re-assessed by FB and KN, ensuring components that contributed to IPE implementation were captured, and key lessons and challenges reported by the authors of the individual papers were charted.

Collating, summarising and reporting the results

Data relating to the components of implementation were mapped and summarised (Chelimsky, 1989 ; Stemler, 2001 ; Tashakkori & Teddlie, 2010 ) and data relating to challenges and key lessons were compared for points of consistency through an interactive process of describing, classifying and connecting information. To summarise the challenges and key lessons for faculty implementing IPE, thematic analysis of the textual data using the education factors of the IPECPCP framework (D’amour & Oandasan, 2005 ) was undertaken by one author (FB). The analysis was then independently checked by one other researcher (KN) and then collaboratively summarised.

A total of 27 papers met the inclusion criteria and were confirmed for inclusion in this review (Fig. 1 ).

PRISMA flow diagram for the paper selection process

Characteristics of included studies

The characteristics of included studies are presented in Table 1 . Studies were undertaken in the United States of America (USA) (n = 15), Canada (n = 6), United Kingdom (UK) (n = 3), Australia & New Zealand (Lapkin et al., 2012 ), Belgium (n = 1), and Sweden (n = 1).

Most of the studies were descriptive in design and 17 were classified as case reports, three cross sectional, and one mixed methods study. Analytical observational designs included two cohort studies, one pilot study and pre and post-test design elements were included in three case reports. There were no experimental or quasi-experimental studies.

Included studies largely reported directly on the implementation of IPE programs or activities directed to health profession learners. Four studies reported indirectly on components of program implementation by drawing on analysis of faculty discussions during debrief sessions (Di Prospero & Shimji-Hewitt, 2011 ), facilitation of faculty members from different institutions and professions in development of IPE (Evans et al., 2011 ), strategies that fostered IPE faculty development (Grymonpre, 2016 ), and a survey to determine the extent, scope, barriers and facilitators to IPE use (Lapkin et al., 2012 ).

Implementation components of included studies

The implementation components of IPE were variously reported (or could be inferred) across the included studies, with timing and teaching components the least frequently reported. Curriculum components were universally reported and varied from a university-wide course (Packard et al., 2018 ) to courses, modules or activities—some of which occurred during placement.

The dimension components were inconsistently reported. Only eight studies reported whether the activities were discrete or integrated into curricula, with two studies identified as having discrete IPE, four as having integrated IPE, and two studies having both.

More frequently reported was whether IPE was implemented as mandatory or optional, with five studies reporting mandatory, six studies reporting optional, a further six studies reporting both possibilities for all learner groups, and two studies reporting that IPE was mandatory for some learner groups and optional for others. In their cross-sectional survey of 31 Universities, Lapkin and colleagues ( 2012 ) reported that 69% of programs reported mandatory IPE and made the distinction between optional IPE with academic credit (12%) and extracurricular without academic credit (19%).

None of the included studies reported nor could it be inferred as to whether the IPE was implemented implicitly for learners or made explicit during activities. Likewise, none of the studies reported on common or comparative learning across the professions. Group learning was reported in seven studies, and a combination of individual and group learning was reported in three studies. No studies reported individual learning. Implementation of IPE using interactive methods were reported in three studies and didactic methods in one study. Six studies reported using both methods.

Most of the studies reported on implementation duration, which varied from short 45-minute sessions to week/s, semester or year-long and whole of programme durations. However, six studies did not report on duration, nor could this be inferred (Table 1 ). The location of IPE implementation was on campus in 11 studies, off campus in three studies and both on and off campus in six studies.

The mode of IPE implementation was predominantly face-to-face (n = 12), or blended (n = 7). Two studies reported using either face-to-face or blended modes and four using online mode only. Lapkin and colleagues ( 2012 ) reported face-to-face (46%), blended and distance (28%), and online (22%) in their cross-sectional survey.

The timing of IPE implementation was identified as synchronous in nine studies, asynchronous in three studies or as both in three studies. The remaining studies did not report on timing of implementation.

IPE was implemented using individual teaching in three studies, co-teaching in seven studies and team teaching in a further eight studies. When co-teaching and team teaching were implemented, teachers’ professions were representative of the learner professions, with medicine, nursing and therapies being the most frequently reported. Two studies reported varied teaching implementation.

Challenges and key lessons in included studies

Interprofessional education implementation challenges and key lessons were extracted from the text of the included studies and mapped against the themes of micro (teaching), meso (institutional) and macro (systemic) level factors (D’amour & Oandasan, 2005 ). Factors that fell outside this framework were identified as ‘other’.

Micro level

Three teaching factors were identified in the included studies that could affect the learners’ capacity to become a competent collaborative practitioner namely, socialisation issues, learning context, and faculty development.

Socialisation issues (professional and cultural beliefs and attitudes that develop among health professionals) of learners and educators were identified as challenges in eight studies. Being unreceptive to learning from other professionals (Acquavita et al., 2014 ), professional silos (Packard et al., 2018 ), learners’ perceptions of unequal status and role identification (Dando et al., 2012 ), negative stereotyping and misperceptions (Acquavita et al., 2014 ; Michalec et al., 2017 ), insufficient professional identity formation in learners (Michalec et al., 2017 ) and professional lack of awareness of similarities and differences in thinking (Gummesson et al., 2018 ) were identified as professional culture challenges. Additionally, there was scepticism and lack of buy in to IPE from others including learners (Di Prospero & Shimji-Hewitt, 2011 ) and learner resistance (Lapkin et al., 2012 ) which challenged learner engagement with IPE.

Key lessons— Socialisation issues .

There is a need to acknowledge and address socialisation issues: hierarchical barriers and stereotyping (Di Prospero & Shimji-Hewitt, 2011 ; Grymonpre, 2016 ), differences across disciplines (Evans, et al., 2011 ), status differences (Deutschlander et al., 2012 ), and convey that IPE is equally as important as clinical topics (Djukic et al., 2012 ).

Learning context which reflects the ‘who, what, where and when’ of IPE (D’amour & Oandasan, 2005 ) also presented challenges to implementation. In terms of ‘who’ is involved in IPE, learner considerations were variability in student numbers and mix from different professions (Dando et al., 2012 ), disparity in health professions students clinical experiences (Kaplan et al., 2015 ) and learning needs (VanKuiken et al., 2016 ). Faculty challenges included the variability in appointment of preceptors across professions (Dean et al., 2014 ).

Key lessons— Learning context .

Key lessons— Learning context - Who.

Managing group diversity is important (Welsh, 2012 ) however the focus should be on a cohesive approach and developing understanding between disciplines when common elements are being taught (Masters et al., 2013 ).

Learners should be included more in, or perhaps lead the debrief sessions to promote their engagement in the interprofessional team approach (Lapkin et al., 2012 ).

Interprofessional educator teams and collaborative practice teams are needed in both classroom and clinical settings (Acquavita et al., 2014 ) and should role model interprofessional team collaboration and communication (Shaw-Battista et al., 2015 ).

Interprofessional faculty team members must respect and accommodate different levels of confidence, experience and enthusiasm for teaching and mentoring learners from different professions (Dean et al., 2014 ).

Interprofessional mentoring in existing placement courses is highly successful (Deutschlander et al., 2012 ) and involving the patient as mentor can enhance IPE experience (Michalec et al., 2017 ).

With respect to the ‘what’ of IPE challenges, faculty considerations included shifting the focus of learning from knowledge and tasks to IPE competencies such as teamwork and communication (Lapkin et al., 2012 ) while meeting each discipline’s IPE requirements (Packard et al., 2018 ). During implementation of ‘what’ is being taught, not all activities were as collaborative as intended (Packard et al., 2018 ) and the gap between what was planned by faculty and what was experienced by learners may require increased attention to factors that impede learner engagement.

Key lessons— Learning context - What.

Small group learning enables the development of interprofessional collaborative practice competencies in communication, teamwork, problem solving, independent responsibility for learning, sharing information and respect for others (Cusack & O’Donoghue, 2012 ), and is more effective than large group discussion (Tartavoulle et al., 2016 ).

Adult learning principles should be applied to integrate practice experiences, knowledge acquisition, reflection (Deutschlander et al., 2012 ) in interprofessional discussion (Kaplan et al., 2015 ) and to link small group sessions to relevant course content and professional clinical practice (Di Prospero & Shimji-Hewitt, 2011 ).

Those in the early stages of IPE, should consider innovative pedagogies (such as IPE Passports) complemented by clear strategy for successful implementation (Packard et al., 2018 ).

Authentic scenarios (Krystallidou et al., 2018 ) and case studies of patients which highlight different treatment needs, discipline involvement, collaborative interaction and reflection (Vanderzalm et al., 2013 ) that have flexibility in scenario timelines to reflect clinical decision making (Watts et al., 2014 ) should be used but may need to be modified during implementation depending on disciplines, experience and learning objectives (Shaw-Battista et al., 2015 ).

Formal education and structured activities in IPE are necessary (Tartavoulle et al., 2016 ) and both formal and informal opportunities should be implemented to assist direct learner engagement (Michalec et al., 2017 ).

Learners with little clinical experience will require knowledge of interprofessional collaborative practice, whereas learners with clinical experience will require more interprofessional skills development (VanKuiken et al., 2016 ).

Learners need to understand each other’s professional language in order to improve communication (Grant et al., 2011 ) and should be encouraged to consider how they might use each other’s professional skills (Grymonpre, 2016 ).

Challenges which reflected ‘where’ in terms of learning context did not specifically relate to whether the learning took place in the academic institution or the hospital environment, in the classroom, on clinical placement or in the virtual environment. However, the challenges included the implementation of authentic experiences such as real-time, multi-patient simulations involving multiple professions (Watts et al., 2014 ), the provision of physical space for teamwork, and a respectful learning and working environment (Dean et al., 2014 ).

Key lessons— Learning context - Where.

Authentic, multi-professional learning environments (whether in clinical settings, training wards or in realistic simulation environments) are critical to enhance the preparation of learners in roles (Galbraith et al., 2014 ) and provide opportunities for reflection and debrief (Cusack & O’Donoghue, 2012 ).

Asynchronous, modular, web-based, on-line learning can be beneficial (Lapkin et al., 2012 ) and overcome the lack of physical space (Djukic et al., 2012 ) but they may not support opportunities for interprofessional conversation and exchange of ideas (Kaplan et al., 2015 ) or lend themselves to shared experiences.

Curriculum implementation considerations illustrated the ‘when’ of IPE and included the impact of elective (Dean et al., 2014 ) and optional activities on participation (Deutschlander et al., 2012 ; Shaw-Battista et al., 2015 ) and building new ideas and concepts into curricula full of uni-professional content (Reis et al., 2015 ).

Key lessons— Learning context - When.

Interprofessional education requires a unique type of curriculum, with defined curriculum structures that facilitate and promote interaction and group learning between disciplines (Acquavita et al., 2014 ), and provide for demonstrable evidence of collaboration with importance placed on the value of learning with and from each other (Cusack & O’Donoghue, 2012 ).

An induction programme (Dando et al., 2012 ) or orientation sessions should be implemented for learners to understand goals, activities, and participation (Deutschlander et al., 2012 ), develop a set of rules around group role expectations (Di Prospero & Shimji-Hewitt, 2011 ), address the roles of each profession (Kaplan et al., 2015 ), and the impact of interprofessional collaborative practice on health care system and patient outcomes (Di Prospero & Shimji-Hewitt, 2011 ).

Rich interprofessional learning experiences require pre-brief discussion to create a supportive learning environment (Shaw-Battista et al., 2015 ) and facilitate discussion in the classroom (Kaplan et al., 2015 ).

The timing of interprofessional experiences in the curricula needs careful consideration about whether learners have early or later exposure or, whether exposure is early and continuous (Lapkin et al., 2012 ).

Mandatory intra-curricular interprofessional experiences will support attendance and group participation (Cusack & O’Donoghue, 2012 ) while optional or elective extra-curricular experiences are self-selected and participants are motivated and interested (Tartavoulle et al., 2016 ).

Curriculum implementation should address how to support students who go off track, manage end of semester reporting, non-attendance and, unprofessional behaviour (Packard et al., 2018 ).

Faculty development represents the final micro factors. It addresses the need to learn how to facilitate IPE and to recognise ones’ own professional beliefs and attitudes about collaboration (D’amour & Oandasan, 2005 ) and is also revealed as challenges in the included studies. To optimise the success of IPE, expert facilitation and facilitator support and training are required (Di Prospero & Shimji-Hewitt, 2011 ) to cultivate buy-in and create a critical mass of faculty who understand IPE. However, dedicated IPE faculty with formal training is not a common practice (Dean et al., 2014 ). Lack of faculty time, sufficient interested faculty (C Evans, H et al., 2011 ), lack of faculty flexibility and, willingness to work with each other (Grant et al., 2011 ) were identified as challenges in the included studies.

Key lessons— Faculty development .

Faculty development and competence in IPE is critical to successful implementation (Acquavita et al., 2014 ) and faculty from each profession need to be involved in the team for implementation (Kaplan et al., 2015 ).

A theoretical framework should be used to guide desired learning outcomes for faculty development (Grymonpre, 2016 ).

Faculty development requires formalised training to enable faculty to develop a shared understanding of IPE, be prepared to address issues faced including managing tensions, hierarchal barriers and cultural tensions and be attuned to the dynamics of interprofessional learning (Di Prospero & Shimji-Hewitt, 2011 ).

Ongoing faculty development (Shaw-Battista et al., 2015 ) using regular team meetings, student free time (Dean et al., 2014 ) and joint faculty debrief sessions are valuable to facilitate faculty learning, team development (Grant et al., 2011 ) and role development (Di Prospero & Shimji-Hewitt, 2011 ).

Interprofessional facilitation guides (with key points for discussion and debrief) are needed to support new faculty (Di Prospero & Shimji-Hewitt, 2011 ).

Faculty need role models (Acquavita et al., 2014 ) who demonstrate collaboration by modelling interprofessional behaviour, respectful cooperation and valuing of input from others (Masters et al., 2013 ).

Institutional factors of leadership and resources as well as administrative processes impact the implementation of IPE regardless of whether it is conducted in the academic or hospital environment (D’amour & Oandasan, 2005 ).

Leadership and resources refer to administrators having the power to advance IPE by providing resources and champions to support the vision (D’amour & Oandasan, 2005 ), and was described by one study as balancing buy in with infrastructure to ensure quality IPE experiences (Packard et al., 2018 ). Leadership included lack of institutional (Lapkin et al., 2012 ) and higher-level support (Packard et al., 2018 ) and was linked to the engagement of clinical leaders and management (Vanderzalm et al., 2013 ) and of other faculty who were not leading the IPE activities (Packard et al., 2018 ).

Resources were highlighted in the included studies and challenges related to limitations (Djukic et al., 2012 ), availability (Grant et al., 2011 ), the appropriateness of teaching and learning resources (Lapkin et al., 2012 ), and funding (Lapkin et al., 2012 ; Reis et al., 2015 ) were recognised. Implementation of IPE activities was identified as having impact on resources. Placements were resource intensive (Dando et al., 2012 ), multi-patient simulation required a large number of staff (Watts et al., 2014 ) and large scale technology mediated IPE required significant financial resources and staff with expertise in educational technology and instructional design (Djukic et al., 2012 ). Activities including curriculum revision, planning, and implementing IPE also required staff time (Shaw-Battista et al., 2015 ). In the environment of a large health care facility, site facilitation, coordination, and management of resources (Vanderzalm et al., 2013 ) also posed challenges.

Key lessons— Leadership and resources .

To support IPE implementation strong committed leadership (Dean et al., 2014 ) with a clear strategy, thoughtful approach, and measured responses to potential challenges are needed (Packard et al., 2018 ).

Transformational leadership which engages both faculty and staff as core champions and leverages early adopters is important to successful implementation (Packard et al., 2018 ).

Pre-implementation steps include creating a shared vision, developing resources, identifying clear roles and securing financial support (VanKuiken et al., 2016 ).

Administrative processes refer to methods for implementing initiatives including logistical decisions and financial incentives (D’amour & Oandasan, 2005 ). In terms of logistics, timing was identified as a challenge (Acquavita et al., 2014 ) in response to clinical placement variation (Dean et al., 2014 ) as a result of diversity in curricula timing where content and learning experiences occur (Masters et al., 2013 ) and a lack of time for interaction (Reis et al., 2015 ). This was distinct from issues with timetabling (Cusack & O’Donoghue, 2012 ; Grant et al., 2011 ) and scheduling (Masters et al., 2013 ; Packard et al., 2018 ) relating to students being from different professions (Dando et al., 2012 ) with different schedules (C Evans, H et al., 2011 ) and at varied levels (Shaw-Battista et al., 2015 ) merging curricula with fixed schedules (Kaplan et al., 2015 ) and arranging meetings with team members and mentors (Michalec et al., 2017 ; VanKuiken et al., 2016 ).

Location also posed challenges in blending students who are full-time, on campus with those working clinically and studying part-time (VanKuiken et al., 2016 ) and in relation to the coordination of activities in different locations and community logistics (C Evans, H et al., 2011 ). Providing participation experiences for large numbers of students (Galbraith et al., 2014 ) or when student numbers in one profession exceeds all other groups (VanKuiken et al., 2016 ), was also challenging. Technology issues were also identified as costly and time consuming in one study (Reis et al., 2015 ). None of the included studies reported on financial incentives.

Key lessons— Administrative processes .

Logistical challenges are threats to IPE implementation and managing these requires regular meetings of directors, faculty, supporting staff and instructional designers (Packard et al., 2018 ).

Engaging administrators is critical (VanKuiken et al., 2016 ) to successful implementation.

Macro level

The macro or systemic factors which can influence the implementation of IPE are threefold. Firstly, the education system which includes accreditation and institutional structures, secondly government policies on education, health and social services and finally social and cultural values that influence professional beliefs and attitudes. Education system factors identified in the included studies were institutional policies (Lapkin et al., 2012 ), rigid program requirements (Acquavita et al., 2014 ), burdensome institutional approval for new courses (Deutschlander et al., 2012 ), obtaining course approval across academic units and allocating course credits (C Evans, H et al., 2011 ). The downstream impact of government policies is reflected in different accreditation standards (Packard et al., 2018 ), legislative requirements (Lapkin et al., 2012 ), and regulatory and credentialing requirements (VanKuiken et al., 2016 ) for each profession. Social and cultural factors included hidden power structures (Grymonpre, 2016 ) and role perceptions. Clinical leaders and managers expressed that interprofessional roles and functions fell outside busy front-line positions (Vanderzalm et al., 2013 ).

Key lessons— systemic factors .

Institutional policies for academic credit for participation in IPE initiatives, should be established and embedded in curricula (Grant et al., 2011 ) to support effective implementation of IPE.

Enhancement opportunities that do not require onerous institutional, large scale faculty review and approval (Deutschlander et al., 2012 ) should be considered as an IPE implementation approach.

Partnerships within and between academia and health care delivery organisations are important (Grymonpre, 2016 ) to implementation of IPE.

High level institutional support (Cusack & O’Donoghue, 2012 ; Djukic et al., 2012 ) that includes strong collaborative culture (Dean et al., 2014 ) and demonstrates that person-centred and professional perspectives are mutually important (Gummesson et al., 2018 ).

Other factors.

Sustainability of implementation emerged as a consideration in several studies (Deutschlander et al., 2012 ; Grant et al., 2011 ; VanKuiken et al., 2016 ) whether related to lack of administrative infrastructure (C Evans, H et al., 2011 ) or the absence of additional funding (Kaplan et al., 2015 ) and in the case of the latter, that replicability of IPE implementation is also limited (Reis et al., 2015 ). Identification, engagement (Packard et al., 2018 ) and alignment (Grymonpre, 2016 ) of supportive stakeholders in implementation activities (Shaw-Battista et al., 2015 ) was also viewed as critical to sustainability.

Key lessons— Other factors .

Organisational change theory and diffusion of innovation theory should be employed as part of implementation (Packard et al., 2018 ).

The use of a framework can help illustrate the changes required both within and between the educational and practice domains at micro, meso and macro levels (Grymonpre, 2016 ).

Achieving harmonisation between all stakeholders is important to achieve scalable and sustainable program implementation (Grymonpre, 2016 ).

This review sought to identify the methodological characteristics, implementation components of primary studies of IPE, and the challenges and key lessons for faculty to consider when implementing IPE. Twenty-seven primary studies met the criteria for inclusion in this review. The included studies were predominantly from North America, Canada and the UK which is aligned with locations of international IPE leaders and practitioners as well as scholarship and activity in IPE.

In response to the first research question, what are the methodological characteristics and implementation components reported in the primary IPE studies? , the review found that study designs were mostly descriptive, case reports and the preponderance of this level of evidence is broadly in keeping with the popularity of this method in education research (Grauer, 2012 ). Some studies may have been conducted as pilot projects (although not necessarily identified as such) for IPE initiatives with the intention of scaling up if successful (Burns & Schuller, 2007 ). The reliance on case reports may also reflect educational research more broadly, which typically has low levels of investment and a deficit of experimental designs (Burns & Schuller, 2007 ).

Aligned with the purposes of this review, case reports may be more likely to contain rich description (Kyburz-Graber, 2004 ) of the implementation components of IPE activities. However, the components of implementation were variously and inconsistently reported across all included studies. No one study reported all the implementation components and in particular timing and teaching components of implementation were infrequently reported. However, all studies reported the curriculum level of IPE implementation which is essential to interpretation given that the implications for the degree of organisational change required varies according to the level of delivery (The Interprofessional Curriculum Renewal Consortium Australia, 2014 ).

In terms of implementation components, IPE was most commonly integrated into curricula, was optional, involved group learning, and used combinations of interactive and didactic approaches. Integration has been associated with higher-level educational outcomes (Prast et al., 2016 ), however, guidance on methods for effective integration is sparse (Thistlethwaite & Moran, 2010 ). The finding that integration was more frequent in the reviewed studies differs from those of an Australian national survey in which the majority of IPE activities were discrete (The Interprofessional Curriculum Renewal Consortium Australia, 2014 ).

Most of the included studies implemented optional activities and this may influence learner perceptions that these are not as important as mandatory experiences, and result in reduced learner engagement (Reeves, 2012 ; The Interprofessional Curriculum Renewal Consortium Australia, 2014 ). Optional activities can provide positive learning experiences but this implementation is associated with lower uptake (The Interprofessional Curriculum Renewal Consortium Australia, 2014 ). Whereas implementing a combination of both mandatory and optional learning activities, as was evident in three of the included studies, has the potential to result in perceived high status of the IPE program, offer flexibility in scheduling extra-curricular activities (Reeves, 2012 ), and provide interested learners with leadership development opportunities.

Group or collective learning (The Interprofessional Curriculum Renewal Consortium Australia, 2014 ) was most commonly reported followed by both group and individual learning. This reflects the use of small group processes in IPE and highlights the need to address issues related to group balance, size and stability (Oandasan & Reeves, 2005 ). Interactive learning or a combination of interactive and didactic learning were most common in the included studies consistent with the assertion that effective IPE generally utilises interactive learning in small groups with didactic methods used sparingly (The Interprofessional Curriculum Renewal Consortium Australia, 2014 ).

None of the studies reported whether IPE was explicit or implicit or whether it was implemented to highlight commonalities or make comparisons across professions, perhaps because these are more nuanced approaches in implementing IPE. However, because implicit IPE occurs in an unplanned, uncontrolled, and unpredictable fashion (The Interprofessional Curriculum Renewal Consortium Australia, 2014 ), the purposeful implementation of IPE with explicit learning outcomes is important to report. As the primary goal of IPE is to teach collaborative practice (Oandasan & Reeves, 2005 ), what is taught should include both commonalities, i.e. collaborative competencies, as well as comparisons, i.e. recognition of one’s own and others’ roles.

The implementation of IPE varied in duration and the length of the activity had significant impact on shaping the experience and resource implications (The Interprofessional Curriculum Renewal Consortium Australia, 2014 ). IPE was most commonly implemented on campus. The type of setting can influence the motivation of learners and whether they see the relevance of IPE to practice (Oandasan & Reeves, 2005 ). Ideally on-campus activities should be supported by deliberate opportunities for IPE in clinical placement (Lapkin et al., 2013 ) or in simulated clinical environments.

The predominant mode of delivery was face-to-face and synchronous with fewer studies implementing IPE online and asynchronously. Online mode for IPE is becoming more prevalent (Evans et al., 2019 ) and with the rapid transition to online learning in response to the COVID-19 pandemic it is likely that there will be even greater use of online mode to implement IPE. The most frequent issues identified in the student experience of online learning during COVID were difficulties with IT issues, variation in staff expertise in its use, inadequate academic interaction, lack of engagement, and insufficient peer interaction (Martin, 2020 ) all of which can threaten the integrity of IPE experiences.

Online modalities have been identified as a means of overcoming the logistical challenges in implementation of IPE, however there are also challenges in implementing IPE in an online format specifically, the logistics of coordination, time factors, expectations of those involved in online learning, and the need to incorporate social presence (Myers & O’Brien, 2015 ). Studies suggest that online learning in IPE can yield similar outcomes to face-to-face learning, for example, in communication skills (Lempicki & Holland, 2018 ) and there is some guidance about implementation in the literature (Ellaway & Masters, 2008 ) but there are gaps in the evidence about the efficacy of online IPE and its timing.

Group teaching models (co-teaching or team teaching) were most frequent in this review, which is unsurprising given that shared learning and teaching are integral to IPE. Whether IPE is implemented by individual, or group teaching, models may be a logistical and resource decision given that group teaching time is more intensive and costlier than individual teaching. However, co-teaching and team teaching are positively evaluated by learners and are collaborative processes, that provide the opportunity to role model collaborative behaviours (Crow & Smith, 2003 ) and have implications for professional socialisation and team formation (Oandasan & Reeves, 2005 ). Explicit reporting about the characteristics of the team and their roles in teaching may provide stronger evidence to guide implementation of group teaching.

In order to respond to the second research question, what are the challenges and key lessons for faculty to consider when implementing IPE ? these were categorised as micro, meso and macro level factors. Professional and cultural beliefs of learners and educators were pervasive in the included studies and notably problems presented by professional culture may be the most significant barriers to overcome (Acquavita et al., 2014 ). Challenges identified across and in, the micro, and meso levels were consistent with the World Health Organization (WHO) mechanisms that shape IPE at the practice level (World Health Organization, 2010b ). Those challenges relating to learning context were consistent with curricular mechanisms of program content, attendance, learning methods, shared objectives while contextual learning and faculty development reflected the educator mechanism of staff training. Likewise, leadership and resources (champions, institutional and managerial support) and administrative processes (logistics and scheduling) were also aligned with the WHO identified mechanisms that support IPE. Sustainability and supportive stakeholders emerged as additional themes, both of which are recognised as critical to successful implementation of IPE (World Health Organization, 2010b ).

Summary of key findings

Overall, the lack of complete and detailed reporting about implementation of IPE limits the ability to compare the efficacy of implementation approaches, the utility of studies to inform practice, to be replicated in other settings and to contribute to the advancement of IPE scholarship. However, the included studies highlighted micro, meso and macro challenges and yielded key lessons to guide faculty in the implementation of IPE.

Strengths and limitations

The findings of this review should be considered in light of strengths and potential limitations. This review has focused on implementation of IPE as differentiated from design, assessment and evaluation of IPE. Although we acknowledge that these four domains are interconnected, the scope of this review means that broader assertions cannot be made about whether implementation components are effective or deliver demonstrable benefit to learners.

Although scoping reviews are not required to be comprehensive, our approach demonstrates procedural and methodological rigour. The systematic search was developed in conjunction with a Senior Librarian, with independent screening at title and abstract before paired multi professional teams assessed the eligibility of included studies. Despite this, it is possible that relevant studies have been missed. Because we did not screen papers based on the inclusion of design, implementation, assessment and/or evaluation in the title or abstract our review resulted in more comprehensive approach to the inclusion of papers than is typical in a review.

For the purposes of this review, publication in peer reviewed journals was a proxy for quality and we did not conduct quality assessment on the included studies or exclude studies based on quality. This was important in order to elucidate the methodological characteristics and extent to which implementation components are reported in peer reviewed publications. Identification of components of implementation for data charting was guided by using the delivery components of the decision-making tree proposed by a consortium of leaders in the field (The Interprofessional Curriculum Renewal Consortium Australia, 2014 ). However, where components were not explicitly stated we needed to make inferences based on the information provided in the studies. Thematic analysis of the text of studies was undertaken to identify challenges and key lessons using the IPECPCP framework (D’amour & Oandasan, 2005 ) and additional emergent themes were not excluded. Recognising the importance of stakeholder involvement as a way to enhance the usefulness of synthesised research evidence (Pollock et al., 2018 ) the wider project, of which this review forms a component, has been informed by an international panel of experts in interprofessional education.

Future research

The findings of this review suggest that further research could inform a structured approach for reporting of implementation of IPE studies. This review provides guidance for faculty in implementation of IPE, further research could validate these key lessons. While beyond the scope of this review, the examination of implementation outcomes i.e. acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, penetration and sustainability (Lengnick-Hall et al., 2022 ) warrants further examination in relation to the implementation of IPE.

Conclusions

This scoping review has responded to the deficit of quality methodological studies and staff resources for IPE implementation. Summarising the evidence for implementation IPE has highlighted the lack of complete and detailed reporting for implementation of IPE. The challenges in implementation of IPE should not be underestimated. Raising awareness of these and providing guidance to faculty through key lessons may contribute to improving IPE implementation quality and the level of success of IPE programs.

Acquavita, S. P., Lewis, M. A., Aparicio, E., & Pecukonis, E. (2014). Student perspectives on interprofessional education and experiences (Review). Journal of Allied Health , 43 (2), e31–e36.

Google Scholar

Anderson, E. S., Cox, D., & Thorpe, L. N. (2009). Preparation of educators involved in interprofessional education. Journal of Interprofessional Care , 23 (1), 81–94. https://doi.org/10.1080/13561820802565106 .

Article Google Scholar

Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology , 8 (1), 19–32. https://doi.org/10.1080/1364557032000119616 .

Burns, T., & Schuller, T. (2007). The evidence agenda. In Evidence in education: Linking research and policy (pp. 15–32). Paris: OECD Publishing.

Caldwell, L., Younker, A., Wegner, L., Patrick, M., Vergnani, T., Smith, E., et al. (2008). Understanding leisure-related program effects by using process data in the healthwise south africa project. Journal of Park and Recreation Administration , 26 (2), 146–162. https://doi.org/10.1901/jaba.2008.26-146 .

Chelimsky, E. (1989). Content analysis: A methodology for structuring and analyzing written material . United States General Accounting Office.

Cooper, S., Cant, R., Kelly, M., Levett-Jones, T., McKenna, L., et al. (2019). An evidence-based checklist for improving scoping review quality. Clinical Nursing Research . https://doi.org/10.1177/1054773819846024 .

Crow, J., & Smith, L. (2003). Using co-teaching as a means of facilitating interprofessional collaboration in health and social care. Journal of Interprofessional Care , 17 (1), 45–55. https://doi.org/10.1080/1356182021000044139 .

Cusack, T., & O’Donoghue, G. (2012). The introduction of an interprofessional education module: Students’ perceptions (Review). Quality in Primary Care , 20 (3), 231–238.

Dando, N., D’Avray, L., Colman, J., Hoy, A., & Todd, J. (2012). Evaluation of an interprofessional practice placement in a UK in-patient palliative care unit (Review). Palliative Medicine , 26 (2), 178–184. https://doi.org/10.1177/0269216311400479 .

Dean, H. J., MacDonald, L., Alessi-Severini, S., Halipchuk, J. A. C., Sellers, E. A. C., et al. (2014). Elements and enablers for interprofessional education clinical placements in diabetes teams (Review). Canadian Journal of Diabetes , 38 (4), 273–278. https://doi.org/10.1016/j.jcjd.2014.02.024 .

Di Prospero, L., & Shimji-Hewitt, S. (2011). Learning is in the facilitation: Faculty perspectives with facilitated teaching and learning-recommendations from informal discussions. Journal of Allied Health , 40 (4), e61–e65.

Deutschlander, S., Suter, E., & Lait, J. (2012). Models in interprofessional education: The IP enhancement approach as effective alternative (Review). Work (Reading, MA) , 41 (3), 253–260. https://doi.org/10.3233/WOR-2012-1293 .

Djukic, M., Fulmer, T., Adams, J. G., Lee, S., & Triola, M. M. (2012). NYU3T: Teaching, technology, teamwork. A model for interprofessional education scalability and sustainability (Review). Nursing Clinics of North America , 47 (3), 333–346. https://doi.org/10.1016/j.cnur.2012.05.003 .

D’amour, D., & Oandasan, I. (2005). Interprofessionality as the field of interprofessional practice and interprofessional education: An emerging concept (Review). Journal of Interprofessional Care , 19 (S1), 8–20. https://doi.org/10.1080/13561820500081604 .

Ellaway, R., & Masters, K. (2008). AMEE Guide 32: e-Learning in medical education—Part 1: Learning, teaching and assessment. Medical Teacher , 30 (5), 455–473. https://doi.org/10.1080/01421590802108331 .

Evans, C., Cashman, H., Page, S. B., D., A, & Garr, D., R (2011). Model approaches for advancing interprofessional prevention education (Review). American Journal of Preventive Medicine , 40 (2), 245–260. https://doi.org/10.1016/j.amepre.2010.10.014 .

Evans, S. M., Ward, C., & Reeves, S. (2019). Online interprofessional education facilitation: A scoping review. Medical Teacher , 41 (2), 215–222. https://doi.org/10.1080/0142159X.2018.1460656 .

Freeth, D., Hammick, M., Reeves, S., Koppel, I., & Barr, H. (2005). Effective interprofessional education: development, delivery, and evaluation . Blackwell Publishing.

Gagnon, R. J., Franz, N. K., Garst, B. A., & Bumpus, M. F. (2015). Factors impacting program delivery: The Importance of implementation research in extension . Retrieved: Iowa State University Digital Repository.

Galbraith, A., Harder, N., Macomber, C. A., Roe, E., & Roethlisberger, K. S. (2014). Design and implementation of an interprofessional death notification simulation (Review). Clinical Simulation in Nursing , 10 (2), e95–e102. https://doi.org/10.1016/j.ecns.2013.08.003 .

Gilbert, J. (2018a, 31st August 2018). Building the organisational and educational conditions to support the development of IPE and IPCP—National and international perspectives . Paper presented at the Securing an interprofessional future for Australian health professional education and practice, University of Technology, Sydney.

Gilbert, J. (2018b, 30th August 2018). Enhancing patient safety—The relationship between IPE/IPCP and patient safety . Paper presented at the Securing an interprofessional future for Australian health professional education and practice, University of Technology, Sydney.

Grant, L., McKay, L. K., Rogers, L. G., Wiesenthal, S., Cherney, S. L., et al. (2011). An interprofessional education initiative between students of dental hygiene and bachelor of science in nursing. Canadian Journal of Dental Hygiene , 45 (1), 36–44.

Grauer, K. (2012). A case for case study research in education. In S. Klein, R. (Ed.), Action research methods: Plain and simple (pp. 69–79). New York: Palgrave Macmillian.

Chapter Google Scholar

Grymonpre, R. E. (2016). Faculty development in interprofessional education (IPE): Reflections from an IPE coordinator (Review). Journal of Taibah University Medical Sciences , 11 (6), 510–519. https://doi.org/10.1016/j.jtumed.2016.10.006 .

Gummesson, C., Sunden, A., & Fex, A. (2018). Clinical reasoning as a conceptual framework for interprofessional learning: A literature review and a case study (Review). Physical Therapy Reviews , 23 (1), 29–34. https://doi.org/10.1080/10833196.2018.1450327 .

Kaplan, R., Shaw-Battista, J., & Stotland, N. E. (2015). Incorporating nurse-midwifery students into graduate medical education: Lessons learned in interprofessional education (Review). Journal of Midwifery and Women’s Health , 60 (6), 718–726. https://doi.org/10.1111/jmwh.12315 .

Krystallidou, D., Van De Walle, C., Deveugele, M., Dougali, E., Mertens, F., et al. (2018). Training “doctor-minded” interpreters and “interpreter-minded” doctors: The benefits of collaborative practice in interpreter training (Review). Interpreting , 20 (1), 126–144. https://doi.org/10.1075/intp.00005.kry .

Kyburz-Graber, R. (2004). Does case-study methodology lack rigour? The need for quality criteria for sound case-study research, as illustrated by a recent case in secondary and higher education. Environmental Education Research , 10 (1), 53–65. https://doi.org/10.1080/1350462032000173706 .

Lapkin, S., Levett-Jones, T., & Gilligan, C. (2012). A cross-sectional survey examining the extent to which interprofessional education is used to teach nursing, pharmacy and medical students in Australian and New Zealand Universities (Review). Journal of Interprofessional Care , 26 (5), 390–396. https://doi.org/10.3109/13561820.2012.690009 .

Lapkin, S., Levett-Jones, T., & Gilligan, C. (2013). A systematic review of the effectiveness of interprofessional education in health professional programs. Nurse Education Today , 33 (2), 90–102. https://doi.org/10.1016/j.nedt.2011.11.006 .

Lempicki, K. A., & Holland, C. S. (2018). Web-based versus face-to-face interprofessional team encounters with standardized patients. Currents in Pharmacy Teaching and Learning , 10 (3), 344–351. https://doi.org/10.1016/j.cptl.2017.11.014 .

Lengnick-Hall, R., Gerke, D. R., Proctor, E. K., Bunger, A. C., Phillips, R. J., et al. (2022). Six practical recommendations for improved implementation outcomes reporting. Implementation Science , 17 (1), 16. https://doi.org/10.1186/s13012-021-01183-3 .

Levac, D., Colquhoun, H., & O’Brien, K. K. (2010). Scoping studies: Advancing the methodology. Implementation Science: IS , 5 (1), 69–69. https://doi.org/10.1186/1748-5908-5-69 .

Lewy, L. (2010). The complexities of interprofessional learning/working: Has the agenda lost its way? Health Education Journal , 69 (1), 4–14. https://doi.org/10.1177/0017896910363299 .

Martin, L. (2020). Foundations for good practice: The student experience of online learning in australian higher education during the COVID-19 Pandemic . Australian Government Tertiary Education Quality and Standards Agency. https://eric.ed.gov/?id=ED610395 . Accessed 8 Nov 2021.

Masters, C., O’Toole Baker, V., & Jodon, H. (2013). Multidisciplinary, team-based learning: The simulated interdisciplinary to multidisciplinary progressive-level education (SIMPLE©) approach (Review). Clinical Simulation in Nursing , 9 (5), e171–e178. https://doi.org/10.1016/j.ecns.2011.11.007 .

Mendel, S., Curtis, D., & Page, J. C. (2015). Interprofessional podiatric surgical simulation a pilot study. Journal of the American Podiatric Medical Association , 105 (4), 331–337. https://doi.org/10.7547/13-164.1 .

Michalec, B., Giordano, C., Pugh, B., Arenson, C., & Speakman, E. (2017). Health professions students’ perceptions of their IPE program: Potential barriers to student engagement with IPE goals. Journal of Allied Health , 46 (1), 10–20.

Myers, C. T., & O’Brien, S. P. (2015). Teaching interprofessional collaboration: Using online education across institutions. Occupational Therapy in Health Care , 29 (2), 178–185. https://doi.org/10.3109/07380577.2015.1017789 .

Oandasan, I., & Reeves, S. (2005). Key elements for interprofessional education. Part 1: The learner, the educator and the learning context. Journal of Interprofessional Care , 19 (S1), 21–38. https://doi.org/10.1080/13561820500083550 .

Packard, K., Doll, J., Beran-Shepler, K., Stewart, N. H., & Maio, A. (2018). Design and implementation of the interprofessional education passport curriculum in a multi-campus university with distance learners (Review). Medical Science Educator , 28 (4), 749–755. https://doi.org/10.1007/s40670-018-0589-3 .

Pollock, A., Campbell, P., Struthers, C., Synnot, A., Nunn, J., et al. (2018). Stakeholder involvement in systematic reviews: A scoping review. Systematic Reviews , 7 (1), 208. https://doi.org/10.1186/s13643-018-0852-0 .

Prast, J., Herlache-Pretzer, E., Frederick, A., & Gafni-Lachter, L. (2016). Practical strategies for integrating interprofessional education and collaboration into the curriculum. Occupational Therapy in Health Care , 30 (2), 166–174. https://doi.org/10.3109/07380577.2015.1107196 .

Reeves, S. (2012). The rise and rise of interprofessional competence. Journal of Interprofessional Care , 26 (4), 253–255. https://doi.org/10.3109/13561820.2012.695542 .

Reis, P. J., Faser, K., & Davis, M. (2015). A framework for web-based interprofessional education for midwifery and medical students (Review). Journal of Midwifery and Women’s Health , 60 (6), 713–717. https://doi.org/10.1111/jmwh.12331 .

Ryland, H., Akers, E., Gowland, E., & Malik, N. (2017). How do we develop health educators for the future using an interprofessional approach? Journal of Interprofessional Care , 31 (1), 5–7. https://doi.org/10.1080/13561820.2016.1246433 .

Shaw-Battista, J., Belew, C., Anderson, D., & van Schaik, S. (2015). Successes and challenges of interprofessional physiologic birth and obstetric emergency simulations in a nurse-midwifery education program (Review). Journal of Midwifery and Women’s Health , 60 (6), 735–743. https://doi.org/10.1111/jmwh.12393 .

Silver, I. L., & Leslie, K. (2017). Faculty development for continuing interprofessional education and collaborative practice. The Journal of Continuing Education in the Health Professions , 37 (4), 262–267. https://doi.org/10.1097/CEH.0000000000000178 .

Steinert, Y. (2005). Learning together to teach together: Interprofessional education and faculty development. Journal of Interprofessional Care , 19 (S1), 60–75. https://doi.org/10.1080/13561820500081778 .

Stemler, S. (2001). An overview of content analysis. Practical Assessment Research & Evaluation , 7 (17), 1–6.

Tartavoulle, T. M., English, R., Gunaldo, T. P., Garbee, D., Mercante, D. E., et al. (2016). Using the IDEA framework in an interprofessional didactic elective course to facilitate positive changes in the roles and responsibility competency (Review). Journal of Interprofessional Education and Practice , 2 , 21–24. https://doi.org/10.1016/j.xjep.2016.03.003 .

Tashakkori, A., & Teddlie, C. (2010). Sage handbook of mixed methods in social & behavioral research . Thousand Oaks: SAGE Publications.

Book Google Scholar

The Interprofessional Curriculum Renewal Consortium Australia. (2014). Curriculum Renewal for interprofessional education in health . Centre for Research in Learning and Change, University of Technology Sydney. https://nexusipe-resource-exchange.s3-us-west-2.amazonaws.com/AustralianIPECurriculumRenewal_2014.pdf .

Thistlethwaite, J., & Moran, M. (2010). Learning outcomes for interprofessional education (IPE): Literature review and synthesis. Journal of Interprofessional Care , 24 (5), 503–513. https://doi.org/10.3109/13561820.2010.483366 .

Topping, D. (2015). An interprofessional education Russian cultural competence course: Implementation and follow-up perspectives. Journal of Interprofessional Care , 29 (5), 501–503. https://doi.org/10.3109/13561820.2015.1012582 .

Tricco, A. C., Lillie, E., Zarin, W., O’Brien, K. K., Colquhoun, H., et al. (2018). PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Annals Of Internal Medicine , 169 (7), 467–473. https://doi.org/10.7326/M18-0850 .

VanKuiken, D. M., Schaefer, J. K., Flaum Hall, M., & Browne, F. R. (2016). Integrating interprofessional education into the curriculum: Challenges and solutions for a university without a medical center (Review). Journal of Interprofessional Education and Practice , 2 , 5–11. https://doi.org/10.1016/j.xjep.2015.12.002 .

Vanderzalm, J., Hall, M. D., McFarlane, L. A., Rutherford, L., & Patterson, S. K. (2013). Fostering interprofessional learning in a rehabilitation setting: Development of an interprofessional clinical learning unit (Review). Rehabilitation Nursing , 38 (4), 178–185.

Watts, P., Langston, S. B., Brown, M., Prince, C., Belle, A., et al. (2014). Interprofessional education: A multi-patient, team-based intensive care unit simulation (Review). Clinical Simulation in Nursing , 10 (10), 521–528. https://doi.org/10.1016/j.ecns.2014.05.004 .

Welsh, J. (2012). Overcoming language barriers when teaching interprofessional groups (Review). Emergency Nurse , 20 (6), 33–36. https://doi.org/10.7748/en2012.10.20.6.33.c9345 .

World Health Organization. (2010a). ‘Framework for action on interprofessional education & collaborative practice’ Health Professions Networks Nursing & Midwifery Human Resources for Health . Geneva: World Health Organization. http://whqlibdoc.who.int/hq/2010/WHO_HRH_HPN_10.3_eng.pdf .

World Health Organization 18. (WHO/HRH/HPN/10.3.). (2010b). ‘Framework for action on interprofessional education and collaborative practice’ . Geneva World Health Organization. http://whqlibdoc.who.int/hq/2010/WHO_HRH_HPN .

Download references

Acknowledgements

The authors gratefully acknowledge the valuable expert contributions of Mr Roger Carter, University of the Sunshine Coast Senior Librarian to the design and conduct of the literature search which underpins the larger project.

Open Access funding enabled and organized by CAUL and its Member Institutions. This work was partially funded by a 2019 University of the Sunshine Coast, Commissioned Learning and Teaching Program Grant.

Author information

Authors and affiliations.

School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Australia

Fiona Bogossian, Kendall George, Nigel Barr, Natalie Dodd & Carol Reid

Sunshine Coast Health Institute, 6 Doherty Street, Birtinya, QLD, 4575, Australia

Fiona Bogossian, Natalie Dodd & Rebekah Shakhovskoy

School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, Australia

Fiona Bogossian, Karen New, Natalie Dodd, Anita L. Hamilton, Nicole Masters, Fiona Pelly, Rebekah Shakhovskoy & Jane Taylor

Consultant, Healthcare Evidence and Research, Brisbane, Australia

School of Medicine and Dentistry, Griffith University, Sunshine Coast, Birtinya, Australia

Natalie Dodd

School of Preparation Pathways, University of the Sunshine Coast, Sippy Downs, Australia

Gregory Nash

Sunshine Coast Hospital and Health Service, Birtinya, Australia

Rebekah Shakhovskoy

You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fiona Bogossian .

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ .

Reprints and permissions

About this article

Bogossian, F., New, K., George, K. et al. The implementation of interprofessional education: a scoping review. Adv in Health Sci Educ 28 , 243–277 (2023). https://doi.org/10.1007/s10459-022-10128-4

Download citation

Received : 13 March 2022

Accepted : 08 May 2022

Published : 10 June 2022

Issue Date : March 2023

DOI : https://doi.org/10.1007/s10459-022-10128-4

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Collaboration
Implementation
Interprofessional education
Interprofessional practice
Find a journal
Publish with us
Track your research

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Publications
Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

Advanced Search
Journal List
Am J Pharm Educ
v.70(3); 2006 Jun 15

Evaluation of Evidence for Interprofessional Education

Tami l. remington.

1 College of Pharmacy, The University of Michigan

Mariko A. Foulk

2 Turner Geriatric Clinic, Social Work Department, University of Michigan Health System

Brent C. Williams

3 Medical School, The University of Michigan

Based on recommendations from numerous organizations, educators in healthcare disciplines are implementing interprofessional training programs. Our objective was to summarize relevant literature in a way that would be most useful to clinican educators. Studies involving educational interventions in health professions to enhance learner-based outcomes relevant to the provision of interprofessional care were identified. We sought prospective, controlled trials in which at least 2 health care disciplines were represented, and 1 of which was medicine. Thirteen reports met the criteria for inclusion. Interventions varied widely in design and intensity, but generally included both didactic and clinical components and lasted several weeks or longer. Most studies used pretest/posttest controls and observed positive effects on learners' attitudes and knowledge. Combined clinical and didactic experiences may produce short-term improvements in learners' knowledge and attitudes about interprofessional care. Future research should employ control groups and validated, behaviorally oriented outcome measures whenever possible.

INTRODUCTION

In its report entitled Crossing the Quality Chasm , the Institute of Medicine calls for radical realignment of the health care system to enhance its quality, safety, patient-centeredness, timeliness, efficiency, and equity. 1 A subsequent summit of educators of health care professionals concluded that to achieve this vision, all health care professionals should be trained to function in interprofessional teams. 2 Enhanced education for health professionals in interprofessional care has also been endorsed by leading government and philanthropic organizations in the United States, including the Institute of Medicine 3 and the Pew Charitable Foundation. 4 Consistent with these trends, the American Society of Health-System Pharmacists, 5 American Association of Colleges of Pharmacy, 6 American Association of Medical Colleges (AAMC), 7 and the Accreditation Committee for Graduate Medical Education (ACGME) 8 recommend training to enhance pharmacists' and physicians' ability to work in interprofessional teams and to communicate effectively with healthcare professionals from other disciplines.

Programs to enhance interprofessional health care education have been in place in the United States for up to 30 years, and some have included pharmacy. Examples include the Department of Veterans Affairs' Interprofessional Team Training and Development (ITT&D) and Primary Care in Internal Medicine (PRIME) programs, 3 , 9 and the Partnerships for Quality Education (PQE) Collaborative Interprofessional Team Education (CITE) programs. 10 In geriatrics, interprofessional education has received particular emphasis, for example, in a 1995 white paper from the Health Resources and Services Administration (HRSA) of the Department of Health and Human Services (DHHS), 11 and through training programs including HRSA-sponsored Geriatrics Education Centers, 3 , 12 and the John A. Hartford Foundation Geriatrics Interdisciplinary Team Training (GITT) initiative. 13

Despite endorsement by government, philanthropic, and educational organizations, interprofessional education is limited in most health care curricula in the United States. Experts recommend that such training be integrated into health care curricula in a gradual and graduated fashion, and that educational models including multiple health care disciplines integrate didactic instruction with clinical learning. 9 However, educators are challenged to integrate interprofessional education into current clinical training environments. Barriers to interprofessional education include differences between disciplines in history and culture, academic schedules, professional identity, accountability and clinical responsibility, and expectations of professional education. 14 Barriers pertaining to educational systems also exist, 15 such as availability of interprofessional education and educational content, including understanding professional roles and group skills. 15

Optimal curricula in interprofessional education would be designed to affect learner behavior in clinical settings in ways demonstrated to improve patient outcomes, or to improve processes of care that improve patient outcomes. Evidence is scarce, however, on interprofessional care models most likely to improve patient outcomes or processes of care. One recent federal report examining interprofessional care identified 6 literature reviews examining its effectiveness. The reviews found few well-controlled studies and mixed results. The report concluded “there is…evidence, primarily in hospital settings and mainly with older populations, that conscious team approaches to care delivery can result in improvements in a range of outcomes. As a group, however, the studies have a number of serious limitations…As a result, the impact of the overall quality of such efforts on outcomes cannot be assessed.” 16

A recent comprehensive literature review by the Cochrane Effective Practice and Organization of Care Group that sought to summarize results from studies examining the effects of interprofessional education on health care processes or outcomes found no studies of adequate quality for inclusion. 17 In contrast, a commissioned systematic review of interprofessional education produced by many of the same authors applied more liberal criteria and described a large number of studies broadly related to interprofessional education. 18 - 21 Many of the studies describe interesting observations and innovative programs in interprofessional education but do not include objective measures and/or control groups, and are therefore of limited or unclear generalizability. A narrower search strategy that excludes descriptive reports, uncontrolled studies, and those with a lack of objective or validated measures could yield a body of evidence that more clearly identifies educational interventions that are useful for interprofessional education.

The objective of this review was to summarize the wide-ranging literature on interprofessional education in a way that would be most useful to clinician educators involved with, or considering, designing interprofessional education programs. Specifically, recognizing that there is currently little evidence that interprofessional education influences health care processes or outcomes, 17 we wished to address the question, what educational interventions for health professions trainees are likely to enhance learner-based outcomes (knowledge, skills, and behavior) relevant to the provision of interprofessional care?

Interprofessional care was defined as joint assessment and/or management of patients by health professionals from more than one discipline (eg, medicine, nursing, pharmacy, social work) closely linked in time and space, and is distinct from consultative or multidisciplinary models of care, or those where responsibility for patient care is delegated from one profession (usually a physician) to another (eg, pharmacist, nurse practitioner). Interprofessional education intervention was defined as a planned experience for learners from more than one discipline that includes direct instruction (eg, didactics, seminars, workshops) and/or a clinical experience in interprofessional care. Proficiency was defined as learner attitudes, knowledge, skills, or behavior directly relevant to interprofessional care.

Criteria for Study Inclusion

We sought to include prospective, controlled trials. Other methodologies were excluded as inadequate to quantify effect sizes or to establish causality between measured effects and education interventions applied. All types of educational, training, and teaching models were included. Suitable controls included parallel controls (participants were similar to experimental trainees, but received the “usual” intervention) with or without randomization, or pre-/post- controls (trainees were evaluated before and after the educational intervention). The intervention must have been described in sufficient detail to allow it to be reproduced in other settings, even if additional information, such as details on teaching methods or educational content, might be required.

We included educational models in which at least 2 health care disciplines were represented, 1 of which was medicine. Studies not involving medical learners were excluded because those teams are different from teams with medical learners; this limitation was necessary to keep our research question focused and the sampling of studies more homogenous. In addition, there is a large and growing need to involve physicians in interdisciplinary teams because the current standard model of care is physician-directed. Studies enrolling physicians from more than one specialty but no professionals from other health care disciplines were also excluded. Subjects enrolled in the studies could be health care undergraduate, graduate, or postgraduate students, or practicing clinicians.

Studies were required to report objective measurement of learners' attitudes, knowledge, skills, or behaviors. Studies that reported only learners' self-assessed improvements in attitudes, knowledge, skills, or behavior were excluded, since self-assessment is only weakly related to objective measures of performance. 22 Measurement of learner outcomes could be through written or observer-based assessments. Validation of measurement methods was not a requirement.

Search Strategy and Methods of Review

We searched the following electronic databases: PubMed, CINAHL, Psych-Info, ERIC, EMBASE, TRIP, TIMELIT, and Cochrane Collaboration. Initial searches on PubMed were conducted for English-language studies through September 2003 using the terms (interdisciplinary OR interprofessional) AND (education OR training), restricted to human subjects. Searches of the remaining databases were carried out in an iterative fashion in consultation with a reference librarian using terms common among relevant references. Because of ambiguity in terminology used in these types of studies (interprofessional, interdisciplinary, multidisciplinary), we intentionally kept our search strategy broad to avoid exclusion of relevant studies. Reference sections of relevant articles and of previous reviews related to interprofessional education were also searched for potentially relevant studies.

All titles were initially scanned by one reviewer (B.W., T.R., or M.F.). Abstracts from articles whose titles were potentially relevant to the inclusion criteria were reviewed. Full-text manuscripts were obtained for articles that met our inclusion criteria or could not be excluded with the information available. Articles selected for inclusion by the primary reviewer were reviewed by at least 1 other author. All 3 authors reviewed specific articles about which the primary reviewer had questions. Final decisions for inclusion or exclusion were made by consensus.

Our search strategy produced a total of 8,903 titles, many of which were identified in more than one database. Of these, the full-text version of 209 articles was obtained for detailed review. Nineteen articles were identified by at least 1 reviewer as meeting the criteria for inclusion. On inspection by the second reviewer, 6 of these were subsequently excluded, resulting in 13 articles included in the final review (Table (Table1 1 ). 23 - 35 Two studies from the same group employed the same intervention and evaluation methods to medical and social work students, and medical and nursing students, respectively. 27 , 28 Two other studies did not report results but were included to provide a more complete description of study designs, interventions, and measurement methods. 31 , 34

Prospective,Controlled Studies of Educational Interventions for Enhancing Proficiencies Relevant to Interprofessional Care

An external file that holds a picture, illustration, etc.
Object name is ajpe66tbl1.jpg

The majority of articles not included but related to interprofessional education were conceptual in nature, descriptions of qualitative factors felt relevant to interprofessional education, or descriptions of educational programs without control groups or objective learner-based outcome measures.

The selected studies were published over a period of 24 years and were conducted in inpatient, 23 - 25 , 33 , 35 rural ambulatory, 29 - 31 , 33 , 34 residential retirement facility, 32 or academic ambulatory 26 settings. There was a wide variety of health care disciplines represented in the interprofessional teams of the trials. By definition, medical trainees were involved in all studies. Nursing was represented often, 23 , 25 , 26 , 28 - 35 with smaller numbers of trainees from other disciplines, including pharmacy, 29 , 33 social work, 23 , 26 , 27 , 29 - 32 psychology, 26 physical therapy, 23 , 29 , 32 , 34 occupational therapy, 23 nutrition, 29 , 32 dentistry, 23 , 32 speech therapy, 32 pastoral care, 32 health administration, 23 , 30 , 32 public health, 31 and health education. 30 Most of these trainees were health professions students; only 2 trials included practicing clinicians as study subjects. 26 , 35

Duration and intensity of the educational programs and types of learners involved varied widely. While some were discrete experiences, 27 , 28 , 32 , 35 others were weeks or months long and were set in actual clinical practices. 23 - 26 , 29 - 31 , 33 , 34 Many included didactic educational experiences about participating on teams. 23 , 27 , 28 , 31 , 32 Despite most interventions being conducted as part of educational curricula for health professions students, participation in the studies was often voluntary. Most studies employed a pre-test/post-test design to measure and compare their chosen outcomes. 23 - 34 Only 3 trials used a parallel group comparison 23 , 30 , 35 and only 1 of these employed random assignment of teams to an active or control group. 35

The interventions chosen for the 13 trials were mainly a combination of didactic instruction with clinical training. 23 - 25 , 30 , 32 , 34 , 35 Two studies from the same research group utilized an intervention consisting of didactic instruction only, including a fictitious case for students to evaluate and report on. 27 , 28 Three trials apparently consisted only of clinical interventions. 26 , 29 , 33

A total of 4 studies used previously developed questionnaires to measure outcomes. 23 , 24 , 29 , 35 One other study incorporated an existing questionnaire at the end of the reported study. 31 No study that used previously developed questionnaires described or mentioned the validity or reliability of the instrument based on previous work. Five studies developed their own questionnaires and described some of their features (eg, number of items, response scales). 25 , 30 , 32 , 33 , 35 Of these 5, 2 studies reported measurements of survey reliability or validity. 32 , 35 The instruments used in the remaining 4 studies 26 , 28 , 34 were not described.

Study results were largely positive (Table (Table1). 1 ). Outcomes examined included measures of attitudes, knowledge, and behaviors/skills. Eleven studies examined the effect of their intervention on attitudes of the trainees. The attitudes assessed were those toward other disciplines, 23 , 27 - 29 , 34 their own discipline, 34 health care teams, 31 , 32 interprofessional team training, 30 , 33 roles on health care teams, 33 roles of health care disciplines in the care of geriatric patients, 25 experience in a rural setting, 30 , 33 and aging. 24 The dimensions of knowledge assessed included aging, 24 , 32 other disciplines' skills and roles, 27 , 28 interprofessional care, 34 geriatrics, 26 and quality improvement methods. 35 Behaviors and skills were assessed through observer 23 or self-report, 31 , 35 and included communication skills, 23 group interactions, 35 team skills, 31 and problem-solving. 35

Studies were too few and too small to allow inferences relating different types or duration of intervention, or learner type, to learner outcomes.

From a large body of literature related to interprofessional education in the health professions, we identified only a few studies examining the effects of interprofessional education on learner-based outcomes that included control groups and objective outcome measures. Previous reviews of interprofessional education and/or its effects have been less focused on identifying studies that assess learner-based outcomes 15 , 17 , 18 , 36 or included a wider range of study design and methods. 15 , 18 , 36 Criteria for studies in this review were chosen to identify studies of most immediate and practical relevance to educators involved in or considering designing interprofessional education activities.

The relative lack of information to guide educators in designing interventions to improve interprofessional education has been recognized. For example, a general review of interprofessional education and teamwork identified medical education system and educational content issues as important to interprofessional education and teamwork, but did not find specific studies identifying effects of educational interventions on learner outcomes. 15 Another review concluded that application of research results outside the cultural conditions and contextual determinants in which they were generated is not recommended because of effects of local socio-political forces, and called for more process-oriented research. 36 A recent review concluded that the evidence supporting interprofessional education is in need of more qualitative studies. 18

Implications for Education

Results of this review indicate that interprofessional education is likely to improve learners' short-term knowledge and attitudes, but there is little direct evidence for persistent improvement or behavioral change among learners. Although few studies of methodologically high quality were found, nearly uniformly positive results were seen across the 13 studies, especially with respect to knowledge and attitudes. Only a few outcome measures were found to be unchanged (attitudes toward other professions, 27 attitudes on working in rural practice 33 ) or variable (attitudes toward working with other professions, 23 role of nurses, 25 knowledge of other disciplines' attitudes, skills and roles, 28 perceptions of roles 33 ), and no learner outcome measures were negatively affected by the interventions studied. While some of the findings may be due to lack of sensitivity of measurement instruments or control group selection, the uniformity of the results provides some basis for continued implementation of education directed at skills and behaviors relevant to interprofessional care.

The highly variable features of program design imply that effective training programs for participating in interprofessional teams can be developed for a variety of trainees across a range of clinical settings. This is especially important because pharmacy was represented in only a small number of studies. 29 , 33 Although data are too limited to draw definitive conclusions about elements of training programs that might predict or preclude success, 3 features of the programs included in our review may be highlighted for instructors involved in educational interventions for interprofessional care. First, nearly all the educational interventions in the 13 studies included explicit attention to “non-clinical skills,” including communication, group, and conflict-resolution skills, as has been recommended by experts. 15 Second, most of the educational interventions employed a combination of didactic and clinical instruction. 23 - 25 , 30 - 32 , 34 , 35 Third, some of the interventions used in these studies were “nontraditional” in that service-learning models 23 , 29 - 31 , 33 , 34 or interprofessional problem-based learning strategies 23 , 25 , 28 - 31 , 33 - 35 were employed. Experts have cautioned, however, that carrying out these types of educational programs requires selection of motivated and skilled faculty members or additional faculty training in nontraditional teaching methods. 15

Implications for Research

Research of high methodological quality on outcomes of interprofessional education would be of significant value in planning and implementing curricula in interprofessional care. This is especially true in light of the substantial time, training, and costs associated with interprofessional education and the paucity of clinical evidence for improved outcomes associated with interprofessional care. Two main design issues confronting researchers in interprofessional education are the selection of meaningful control groups and outcome measures. Identifying comparison learners is particularly challenging in interprofessional education and may not be practical in most clinical and educational settings since the ideal comparison learner would be exposed to the same discipline-specific clinical training during the same period as trainees in interprofessional care, but without explicit training in interprofessional care. Use of reliable, valid methods to measure learner knowledge, attitudes, skills, and behavior is essential to establishing the role of interprofessional education in health professions' education. Sixty-six assessment instruments designed to measure team performance have been reviewed elsewhere and may be useful in measuring outcomes of educational interventions. 37 There was a trend toward improved measurement methods over time among the studies reviewed. Studies published after 1995 emphasized assessment of knowledge, attitudes, skills, and behavior relevant to functioning on interprofessional teams, contrasting the emphasis on measuring attitudes toward and knowledge of geriatrics and roles of different disciplines from earlier studies. Fortunately, recent progress has been made in developing reliable, valid, outcome measures in interprofessional education. 37

Study Limitations

The main limitation of our study is that some studies may not have been identified due to the diverse literature and terminology related to interprofessional care. It is unlikely, however, that key studies of high methodological rigor that could potentially affect the overall conclusions of our review were overlooked. Limiting our review to studies involving medical learners may have restricted the external validity of the study somewhat in that conclusions drawn from this body of evidence may not be extrapolated to interprofessional teams without medical learners.

Overall, there is little evidence from controlled trials related to interprofessional teams to guide rapidly changing educational models and clinical practice. Programs that incorporate clinical training combined with explicit training on the processes of interprofessional care can produce changes in attitudes, knowledge, skills, and behaviors of clinicians. It is too early to discern elements of training programs that appear to be particularly successful. Future research in this area should consist of prospective, controlled trials with objective measurement of outcomes related to short- and long-term learner behaviors, processes of care, and patient-based outcomes.

ACKNOWLEDGMENT

Preparation of this manuscript was funded by the Robert Wood Johnson Foundation through Partnerships for Quality Education.

CAIPE Strategy 2022-2027 launched • VIEW

Barr, H., Freeth,D., Hammick, M., Koppel, I. & Reeves, S. (2000) Evaluations of interprofessional education

This Review was commissioned by the British Educational Research Association (BERA) and is being published by the United Kingdom Centre for the Advancement of Interprofessional Education (CAIPE) (see Appendices 1 & 2).

It is addressed primarily to CAIPE members interested in the evaluation of interprofessional education in health and social care, but also to BERA members interested in the evaluation of a interprofessional education in other fields in the context of research into professional education as whole. We look forward to working with colleagues in BERA and CAIPE to refine and improve ways to monitor and evaluate interprofessional education and to secure a firmer evidence base to inform future developments.

The Review focuses upon evaluations of interprofessional education in health and social care in the United Kingdom (UK). BERA is picking up implications for other professions travelling similar roads towards collaboration in learning and practice as educational programmes are integrated.

Download “Barr-H.-FreethD.-Hammick-M.-Koppel-I.-Reeves-S.-2000-Evaluations-of-interprofessional-education.pdf”

DOI: 10.59915/jes.2024.si1.2
Corpus ID: 271320855

Exploring Interprofessional Education in Higher Education Institutions: A South African Case Study

Zijing Hu , R. Venketsamy
Published in Journal of education studies 1 June 2024

19 References

Implementing japanese lesson study as a professional development tool in south africa, teacher’s experience of support in teaching number sense in the early grades, interprofessional education and collaboration: strategies for implementation, simulation as an effective strategy for interprofessional education, breaking down silos: teaching for equity, diversity, and inclusion across disciplines, interprofessional health education to improve collaboration in the south african context: a realist review, outcome indicators on interprofessional collaboration interventions for elderly, interprofessional teamwork and team interventions in chronic care: a systematic review, an interprofessional education panel on development, implementation, and assessment strategies, interprofessional learning and rural paramedic care., related papers.

Showing 1 through 3 of 0 Related Papers

Open access
Published: 30 July 2024

Escape room design in training crew resource management in acute care: a scoping review

Gerald J. Jaspers 3 ,
Simone Borsci 1 , 2 ,
Johannes G. van der Hoeven 3 ,
Wietske Kuijer-Siebelink 4 , 5 &
Joris Lemson 3

BMC Medical Education volume 24 , Article number: 819 ( 2024 ) Cite this article

Metrics details

Effective teamwork is crucial to providing safe and high-quality patient care, especially in acute care. Crew Resource Management (CRM) principles are often used for training teamwork in these situations, with escape rooms forming a promising new tool. However, little is known about escape room design characteristics and their effect on learning outcomes. We investigated the current status of design characteristics and their effect on learning outcomes for escape room-based CRM/teamwork training for acute care professionals. We also aimed to identify gaps in literature to guide further research.

Multiple databases were searched for studies describing the design and effect of escape rooms aimed training CRM/teamwork in acute care professionals and in situations that share characteristics. A standardized process was used for screening and selection. An evidence table that included study characteristics, design characteristics and effect of the escape room on learning outcomes was used to extract data. Learning outcomes were graded according to IPE expanded typology of Kirkpatrick’s levels of learning outcome and Medical Education Research Study Quality Instrument (MERSQI) scores were calculated to assess methodology.

Fourteen studies were included. Common design characteristics were a team size of 4–6 participants, a 40-minute time limit, linear puzzle organization and use of briefing and structured debriefing. Information on alignment was only available in five studies and reporting on several other educational and escape room design characteristics was low. Twelve studies evaluated the effect of the escape room on teamwork: nine evaluated reaction (Kirkpatrick level 1; n = 9), two evaluated learning (Kirkpatrick level 2) and one evaluated both. Overall effect on teamwork was overtly positive, with little difference between studies. Together with a mean MERSQI score of 7.0, this precluded connecting specific design characteristics to the effect on learning outcomes.

Conclusions

There is insufficient evidence if and how design characteristics affect learning outcomes in escape rooms aimed at training CRM/teamwork in acute care professionals. Alignment of teamwork with learning goals is insufficiently reported. More complete reporting of escape rooms aimed at training CRM/teamwork in acute care professionals is needed, with a research focus on maximizing learning potential through design.

Peer Review reports

Effective teamwork is crucial to providing safe and high-quality patient care, especially in acute care settings where stakes are high and time-sensitive decisions and actions are required. In the past two decades, there has been a growing interest in training teamwork in these settings and its effectiveness [ 1 , 2 ]. Crew (or Crisis) Resource Management (CRM) principles are frequently used for structuring, improving and training teamwork and communication in these settings [ 1 ]. CRM identifies factors in, and threats to effective teamwork and offers tools to improve teamwork and communication and prevent error. Substantial evidence shows that training improves CRM skills in health care professionals on multiple learning outcome levels and might lead to safer care [ 3 ]. To achieve these outcomes effective training is necessary [ 3 , 4 , 5 , 6 , 7 ]. CRM training varies considerably and can include a wide range of interventions, like lectures, table-top games, simulation, etc. [ 4 ]. Practice-based interventions, like simulation, are often included in CRM training. CRM skills are trained by applying in simulation and this was found to be more effective than other instructional methods [ 8 , 9 , 10 ].

Other practice-based interventions might also be able to fulfill this role. A new, innovative and practice-based training tool in CRM/teamwork training is the use of escape rooms. Escape rooms are, as defined by Nicholson [ 11 ] ‘live-action team-based games where players discover clues, solve puzzles, and accomplish tasks in one or more rooms in order to accomplish a specific goal (usually escaping from the room) in a limited amount of time’. They offer great potential for teamwork training in acute care as they are, by definition, time-limited team-based activities that both force and facilitate teamwork, with the need to coordinate tasks and communicate [ 11 ]. Their use in healthcare, as well as in education in general, has increased significantly in recent years [ 12 , 13 ]. The high learning potential is also reflected in that they are often enjoyed by participants and, albeit limited, in healthcare students have shown an increase in skills, knowledge, and attitudes [ 12 ].

Educational intervention design characteristics may affect learning outcomes. Several considerations have been proposed for the design requirement for developing educational escape rooms in healthcare settings in general [ 14 , 15 ] and also for teamwork [ 16 ], but such considerations are often based on theory and practice experience, and not on a synthesis of the available evidence. There seems to be consensus that alignment of the learning goals with the escape room is an important requirement. Recent reviews in escape rooms in healthcare students [ 12 ] and higher education (including medical escape rooms) [ 17 ] underscores this, but also identify a lack of evidence on the impact design characteristics have on learning outcomes [ 12 ]. Little to no guidelines are available regarding how escape rooms that aim at improving CRM/teamwork for the acute care setting should be designed, or how to maximize learning outcomes through design in this setting. Therefore, the question driving our review was: what are the design requirements that should be taken into account in the design of such escape rooms.

In the present study, we aim to identify common design characteristics, relate these to learning outcomes and thereby identifying a set of evidence-based design requirements for escape rooms to train CRM/teamwork in acute care. To achieve these goals, we performed a scoping review of the literature regarding design characteristics and their effect on learning outcomes in escape rooms used for crew resource management and/or teamwork training for healthcare professionals in acute care settings.

Research questions

To guide the development of physical escape rooms aimed at improving crew resource management/teamwork in healthcare personnel in acute care settings, the present review investigated the answer to the following questions:

Which common design characteristics can be derived from peer-reviewed literature?

What common design characteristics can be derived from similar situations:

Escape rooms assessing students instead of healthcare personnel.

Virtual escape rooms instead of physical escape rooms.

Escape rooms used for training CRM in situations with similar characteristics to acute care: time-limited, high stakes, high-pressure, high safety (i.e., aviation, military, etc.)

When connecting design characteristics to learning outcomes, which design requirements can be identified that maximize learning outcomes?

What are the major gaps in the evidence on design requirements for optimizing learning outcomes?

To best meet these broad objectives, and analyze a range of different study designs, we used a scoping review design. The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols extension for scoping reviews (PRISMA-ScR) [ 18 , 19 ].

Eligibility criteria

Inclusion criteria were drafted to match the primary aim: studies describing the design of physical escape rooms to train crew resource management in healthcare professionals working in acute care . As CRM is about teamwork, all studies on escape rooms aimed at teamwork, or related terms were included. Escape rooms can have other learning goals (i.e., knowledge or skills) besides teamwork that influences design. To be included, training CRM/teamwork had to be one of the main aims. If studies had a different focus than describing design, they were included if sufficient detail on design was provided. This was defined as at least a puzzle scheme and description of the puzzle organization.

To enrich the data, we also looked at studies describing escape rooms in situations that share characteristics. To balance between precision on the one hand, and not miss relevant publications on the other, studies that differed on one aspect of the primary aim were included. This was defined as studies describing acute care escape rooms, but only fulfilling 2 of the 3 other criteria: (i) virtual instead of a physical escape room; (ii) students instead of healthcare professionals; (iii) Settings with similar characteristics to acute care: time-limited, high stakes, high-pressure, high safety (for example aviation, military). These studies were grouped as ‘virtual’, ‘students’, and ‘setting’ and are mentioned throughout the review as such.

Only studies that were full-text, empirical and published in a peer-reviewed journal were included. There was no limitation on study type or design (i.e. qualitative, qualitative) but we excluded letters to the editor, conference papers/abstract, etc. because of insufficient detail. Finally, we included studies that did not describe design, but measured effectiveness/evaluation of an escape room of which the design was described in an included article. These studies were used for the analysis of the effect of the design criteria on learning outcomes.

Databases and search strategy

For full information on the selection of databases and the search strategy, we refer to additional file 1 . An extensive range of databases were searched (CINAHL, EMBASE, ERIC, MEDLINE (PubMed), PsycINFO, Scopus, and Web of Science). To cross-check no relevant articles were missed, three additional sources were used: (1) Forward and backward citation tracking of articles eligible for inclusion, (2) Elicit [ 20 ] (an AI tool that uses language models to find relevant papers), (3) Google Scholar [ 21 ].

The search strategy was drafted by one author (GJ) and iteratively refined through team discussion. A librarian, experienced in systematic searches, evaluated and further refined the search strategy.

The search focused on two keywords: escape room and Crew Resource Management/teamwork. Both keywords were maximally broadened. For escape room, we added all alternative and related terms. For crew resource management/teamwork, we also included related and alternative terms. Additionally, we added CRM-elements like situational awareness, communication, leadership, task allocation, and decision-making. Databases were checked for relevant MeSH (or equivalent) terms and additionally, all terms were used in a title, abstract, and keyword search. No language restrictions were applied, but the search was limited to studies published after the year 2000, as the first well-documented escape room was not described until 2007 [ 11 ]. The search was completed in June 2023. Results were imported into EndNote (EndNote™, version 20, Clavirate, Philadelphia, U.S.). After removing duplicates the results were exported to Rayyan [ 22 ] for screening.

Title and abstract of all articles were independently screened for eligibility by two authors (GJ and JL). Any discrepancies were solved through discussion. In the second stage, two authors (GJ and JL) screened the full texts of all included articles against the eligibility criteria; any discrepancies were resolved in discussion with a third author (SB).

Data items and charting process

Using an iterative process, a set of data items to extract was defined. First three categories were determined in which to categorize and structure the data and reporting:

Study characteristics.

Educational and escape room design characteristics.

Effect on learning.

Specific data extraction items in these categories were identified through studying reviews and frameworks: educational escape room design [ 14 , 15 , 16 , 17 , 23 , 24 , 25 , 26 ], healthcare CRM training/simulation [ 4 , 27 , 28 ], and interprofessional education [ 29 ]. All authors critically reviewed the data-items, added or deleted items and through iterative discussion, a final selection was made. In Additional file 2 the full list of data-items can be found as column headings.

In ‘study characteristics’, data were collected on subjects, setting and aim of the study and escape room and was used to provide an overview of the included studies. In the ‘educational and escape room design characteristics’, data that guided the design were extracted. Alignment of learning goals with the escape room is considered essential in design [ 16 , 17 ]. We used this data item to extract data on explicit information how alignment was achieved. However, all design characteristics relate to alignment. These separate characteristics were identified using the process mentioned above. For example, for the educational underpinning items like learning theory and CRM/teamwork model, briefing and debriefing technique were extracted. As teams in acute care often consist of members with different roles and from different backgrounds, the interprofessional educational (IPE) characteristics [ 29 ] interdependence (the need for a contribution from the expertise of all team-members [ 29 ]) and embodiment (also called immersion; the feeling of being immersed in a situation that feels authentic and that is similar to working in their profession) were included. Also data on the escape room design characteristics were extracted, such as team size, puzzle organization (open, linear/sequential, path-based, pyramid or complex (for more info and graphical representation see reference [ 11 ]) and facilitator role.

In the ‘effect on learning’ category, data were collected on the effect of the escape room on teamwork. To define design requirements, this data was used link the design characteristics to their effect on learning outcomes. As our focus is on CRM/teamwork, only data on the effect of the escape room on teamwork were extracted and data on, for example, knowledge or skills was not extracted. The level of the evaluation on the effect on CRM/teamwork was determined using Reeves’ [ 30 ] IPE expanded typology of Kirkpatrick’s [ 31 ] classic model of the levels of learning outcomes: reaction (level 1); modification of attitudes/perceptions (level 2a); acquisition of knowledge/skills (level 2b); behavioral change (level 3); outcome on a patient or organizational level (level 4).

To appraise the methodological quality of the teamwork evaluation, Medical Education Research Study Quality Instrument (MERSQI) scores were calculated [ 32 ]. As this was used to qualitatively assess the strength of the link between design characteristics and their effect, MERSQI scores were not calculated for the whole study, but only for the assessment of the effect on CRM/teamwork. The MERSQI [ 32 ] is considered a useful and reliable tool for appraising the methodological quality of medical education research with good interrater reliability [ 33 ]. The MERSQI has 6 domains (10 items) from study design to study outcome. Each domain has a maximum of 3 points that can be scored, and totals range from 5 up to 18 points. The 6 domains allow interpretation to focus on normative domain-specific scores, rather than on overall scores [ 33 ] and to better identify specific gaps in methodology. To maximize the available data, all studies were included in the analysis of effect and no cut-off scores were used to exclude studies based on their MERSQI score. The MERSQI scores were calculated by the first author (GJ). Additionally, three authors (JL, SB and WK) independently calculated a MERSQI score for 1 of the studies to check scoring quality and consistency. In case of doubt on the scoring in the other studies, this was solved by discussion in the full team of authors.

An Excel (Microsoft ® Excel ® for Microsoft 365 MSO, Redmond, Washington, U.S) data charting form was developed for data extraction and calculating MERSQI scores. The form was evaluated for consistency and completeness by extracting data from 3 included articles by 1 author (GJ), with double-checking by all other authors. After final amendments, 1 author (GJ) extracted the data.

Synthesis of results

The three previously mentioned categories (study characteristics - educational and escape room design characteristics – effect on learning) were used as headings to summarize data. Data from studies in the virtual, student and setting group were included in the analyses and synthesis of the data was used to answer the research questions.

Selection of sources of evidence

In Fig. 1 a PRISMA flowchart [ 19 ] depicts the search results and screening process. Fourteen studies were included in the analysis, of which four were included in the ‘student’ group and two in the ‘virtual’, group. No studies were found for the ‘settings’ group. Of the fourteen studies, twelve described the design of an escape room. While the other two studies (both in the ‘student’ group) were evaluation studies of one of the escape rooms in the ‘student’ group.

PRISMA flowchart of screening process [ 19 ]. *before the full text screening studies were divided into the different strands. If during full-text screening a study better fitted into one of the other strands, the study was transferred there

Qualitative Synthesis

The full data extraction form, including all extracted data can be found in the Additional file 2 . The overall characteristics of the included studies are presented in Table 1 . The two studies that only evaluated the effect of the escape room are displayed in relation with the study describing the escape room design (ID 10 A-B [ 34 , 35 ]). In the 11 studies that evaluated the escape room, 419 participants were included (mean 45). In 50% of the studies ( n = 6/12) the escape room was aimed at teamwork in Emergency Medicine. Aims of both the studies and the escape rooms differed significantly. Excluding both evaluation studies, two-third of the studies ( n = 8/12) primarily described design [ 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ], while the others [ 44 , 45 , 46 , 47 ] had evaluation as their primary aim. Teamwork was not the sole aim of all escape rooms, as eight studies also aimed at knowledge and/or skills. This heterogeneity complicated the extraction of design criteria, their underpinning and relating them to their effect on CRM/teamwork.

Educational and escape room design characteristics

The underlying pedagogical or didactical principles and/or learning theories were only noted in four of the twelve studies. Specifically, Kutzin [ 38 ] provided an elaborate underpinning using interdisciplinary game theory for the development of his physical escape room aimed at teamwork. Rosenkrantz [ 39 ] Sanders [ 40 ] and Kutzin (virtual) [ 42 ] gave a short explanation for using the concept of edutainment in the development of their escape rooms. Four studies provided a theoretical CRM/teamwork framework with which the escape room was developed. Kutzin [ 38 ], Sanders [ 40 ] and Kutzin (virtual) [ 42 ] used the TeamSTEPPS framework and Rosenkrantz used the ‘Anesthesiologists Non-Technical Skills in Denmark (ANTSdk)’. Of the other eight studies, Turner [ 43 ] and Daniel [ 47 ] mentioned a number of non-technical skills like task-switching, leadership and shared mental model as a learning goal. The escape room learning goal of improving communication and/or teamwork was not further specified in all other studies.

Table 2 shows the summarized data that was extracted on escape room design. Full data on all studies can be found in Additional file 2 . Teams were given median 38 min (range 15–60) to escape. Teams ranged from 5 to 10 participants, with 4–6 being the most common team size (50%; n = 6/12); in three (25%) studies team size was not mentioned [ 36 , 37 , 40 ].

It is noteworthy that data on the alignment of the escape room with the teamwork learning objectives could only be extracted from five studies, with only Turner [ 43 ] providing specifics on each teamwork item. Alignment with skills and knowledge training was either explicitly stated and/or could be inferred from the puzzle theme or description (data not included). However, how the need for teamwork was ensured or facilitated was often not mentioned, other than that escape rooms were collaborative by nature.

With regard to the organization of the puzzles, the linear path (also called sequential) was most common ( n = 7/12), with 1 study combining the open and linear path [ 40 ].

Seven of the twelve studies noted a structured debriefing with the use of guidelines and known debriefing tools. Two studies did not mention whether debriefing was used and one study specifically mentions there was no debriefing. The two remaining studies mentioned a short debrief mainly aimed at the answers to the puzzles.

For interprofessional education we extracted data on the interdependence and embodiment (immersion). Interdependence was not specifically mentioned in the included studies. However, in four studies data were found that indicated some degree of interdependence. Sanders [ 40 ] mentioned presenting multiple puzzles at once, so different team members could be engaged and work simultaneously on different puzzles. Additionally, the team was led to certain points where they had to work together as a full team. The virtual escape room by Kutzin (virtual) [ 42 ] had several puzzles that ‘required participants to work on different screens with a need to communicate’. Additionally in the escape rooms developed by Podlog [ 44 ] and Gomez-Urquiza [ 46 ], the puzzle scheme allowed for participants to work on several puzzles simultaneously.

Details on immersion could be extracted from five studies and was often accomplished by using attributes and props that were also found in daily practice, and/or that were related to the escape room theme. Additionally darkening of the room was used by Rosenkrantz [ 39 ] and Sanders [ 40 ]. Sanders [ 40 ] and Abensur Vuillaume [ 36 ] mentioned using their escape room introduction to set the theme.

Escape rooms can be used as stand-alone activities, but are also often integrated into a course, curriculum, or used in combination with other teaching modalities. Three studies used the escape room as a stand-alone activity [ 37 , 39 , 46 ], two studies did not mention other teaching modalities [ 36 , 42 ], while the others used one or more other teaching modalities. Sanders, for example, used the escape room as part of an annual competition among pediatric Emergency Medicine faculty and fellows [ 40 ], while Kutzin [ 38 ] and Holland [ 45 ] used the escape room as part of an obligatory course. Morrell used a broad range of other teaching modalities: lectures, activities, case studies, videos, assigned readings, and simulation [ 41 ]. The escape room by Daniel had ALS simulations before and after the escape room [ 47 ]. Both Podlog [ 44 ] and Turner [ 43 ] tried to increase knowledge retention by giving a didactic summary and lecture respectively.

Effect on learning

Effectiveness was investigated in 13 studies. The data from Rosenkrantz [ 39 ] was split into acute care personnel and students as different methods were used to study the effect of their escape room in these 2 groups. See Table 1 for the measures used per study. Most studies ( n = 10) studied reaction (level 1) to the escape room using surveys ( n = 9), or informal feedback ( n = 1). Specific phrasing and number of questions differed, with 3 out of 9 survey studies not providing the specific questions [ 37 , 42 , 44 ]. In general participants were asked whether they enjoyed the escape room and thought it was effective in training teamwork.

Holland [ 45 ], besides using a survey, and both studies by Morrell [ 34 , 35 ] used focus group analysis to study modification of attitudes/perceptions (level 2a). Rosenkrantz [ 39 ], besides using a survey, rated videos of the fastest and slowest student group on the use of non-technical skills, which constituted studying acquisition of knowledge/skills (level 2b).

All the included studies showed a positive effect on teamwork of the escape room on the levels of effect they scored on. In the ten studies scoring Kirkpatrick level 1 > 80% of participants scored positive on enjoyment and engagement. Participants also generally felt that teamwork was trained by the escape room with mean Likert scores > 80% of the maximum, and teamwork and communication were often mentioned in response to open-ended questions directed at what participants felt they had learned. In the analysis on learning outcomes from focus groups (Kirkpatrick level 2a), teamwork also emerged as a theme in all 3 studies. Rosenkrantz [ 39 ] noted in the assessment of videos of students (Kirkpatrick level 2b) that time to finish the escape room was not related to whether there was a team leader. Video observers in the same study rated gathering information, exchanging information and reassessing decisions as the most used non-technical skills.

Additional file 3 shows the MERSQI scores of all the included studies. The median MERSQI score is 7.0 (range 6.0–12.0), which is lower than the mean of 9.6 in the original paper where MERSQI was first described [ 32 ]. Notably ‘validity evidence for evaluation instrument scores’ were rather low, with only 5 studies scoring 1.0 out of 3.0 points. This relates to the fact that researchers mostly used surveys that were developed for their study.

In this scoping review of fourteen studies addressing the design and effect of escape rooms used for training CRM/teamwork for healthcare professionals in acute care, we identified several commonly used design requirements, but noticed a lack of reporting on alignment and insufficient data to connect design requirements to learning outcomes. Below, these results are discussed per research question.

Design characteristics

Common design characteristics were derived from the whole group of included studies, given the small number of studies. Team size (4–6 participants) was in line with commonly used team sizes in healthcare and other fields [ 12 , 17 ]. The time limit of about 40 min was slightly shorter compared to the 60 min found in earlier reviews on escape rooms [ 12 , 17 ]. We found Puzzle organization most often to be linear, though complex and open puzzle organization were explicitly used to evoke teamwork. Some form of briefing and use of a facilitators (inside or outside the escape room) to moderate progress and provide hints were also used in all studies. Debriefing was often structured, coupling teamwork factors to what happened during the escape room and often relating this to the clinical situation. This suggests that debriefing was used to critically reflect on CRM/teamwork and promote learning. This parallels to simulation, where debriefing is considered a key factor in learning [ 48 ].

Little information was given on the alignment of the escape room with the teamwork learning goals. This may be due to the study types, which commonly focused on the effect of the escape room, instead of on how design moderated or optimized teamwork learning outcomes. However, even in those studies focused on design [ 36 , 39 , 40 , 41 ], little was reported on how design characteristics were used to achieve the desired teamwork learning outcomes. This was also reflected in the other data-items which were often not reported or could only be extracted indirectly.

Design characteristics and learning outcomes: deriving design requirements

In an attempt to connect design characteristics to their effect on learning outcomes, we reviewed the outcome measures and effect of the included escape rooms. These outcomes reflected the potential escape rooms yield for teamwork training, as reactions (level 1) to the escape room were overtly positive in all studies. This was further strengthened by the effects, be it in small numbers, seen on modification of attitudes/perceptions (level 2a) and studying acquisition of knowledge/skills (level 2b). However, looking at the quality of this evidence, there is no evidence on higher Kirkpatrick levels and study sizes are rather small. Additionally MERSQI scores on determining CRM/teamwork learning outcomes were rather low (median 7.0; mean 7.8), compared to for example the 9.6 mean in the original paper where MERSQI was first described [ 32 ]. Within the MERSQI the low ‘validity evidence for evaluation instrument scores’ further underscores the lack of valid effect measures. Combined with the considerable study heterogeneity, this precluded any conclusions on the effect design characteristics had on learning outcomes and the deriving of design requirements.

Gaps and looking forward

From our results we see 2 main gaps in the design of escape rooms aimed at CRM/teamwork in acute care professionals: (i) a lack of data on the effect of design requirements on learning outcome and (ii) a lack of (reporting on) alignment between learning goals and design of these escape rooms.

Escape rooms are collaborative by nature, with teams communicating and working on puzzles together. This suggests teamwork and attests to the potential escape rooms have. The overtly positive effects that were seen in the included studies confirmed this, and is in line with data from reviews covering a broad range of educational fields [ 17 , 24 ], including healthcare students [ 12 ]. In acute care this positive effect was also seen in two studies on the effect of a commercial escape room on teamwork [ 49 , 50 ]. Especially Valdes et al. [ 49 ], who showed that key CRM aspects improved in acute care simulation after participation in an escape room, attest to the potential escape rooms have for CRM/teamwork in acute care. However, which design characteristics maximize this potential remains unknown. None of the studies described or examined which characteristics were key in reaching the desired learning outcomes. As an example, we found the linear puzzle organization (in which one puzzle leads to the other) to be the most common. In their systematic review Veldkamp et al. [ 17 ], however stated that team-based medical escape rooms do not align well with a linear puzzle organization and suggested using other organizations. Whether different puzzle organizations really lead to higher learning outcomes, is debatable as they have not been compared directly. However, we do agree with their conclusion that studying the effect of different design characteristics on learning outcomes is necessary to maximize learning outcomes. A first step is systematic reporting on these design characteristics in all studies using escape rooms to train CRM/teamwork learning in healthcare. Reporting the data items we extracted, which are in line with a range of escape room development frameworks [ 14 , 15 , 16 ], would be a good way to start. Future research should not only focus on the effect escape rooms have, but also on the mechanisms by which this effect is reached, comparing different design characteristics and extracting which are pivotal and therefore should be considered as design requirements. By identifying these requirements, an evidence-based foundation can be laid for developing and executing these escape rooms.

The need for effective design requirements relates to the other major gap we identified: the need for better (reporting on) alignment between learning goals and escape room design. As is also acknowledged by others [ 16 , 51 ], we agree that better alignment should be sought, investigated and reported [ 17 ]. Cohen et al. [ 16 ] provide design considerations for escape rooms aimed at teamwork and advice using the Input-Moderator-Output-Input model by Ilgen [ 52 ] to identify and measure a variety of factors that best predict team outcomes and others advocate the use of Educational Design Research (EDR) [ 53 ]. Both could be used to initiate iterative cycles of individual puzzle or complete escape room development, leading not only to better reporting of alignment, but also to more effective design and the development of design requirements.

Strengths and limitations

Educational escape rooms are a relatively young and growing field. The fact that this field is young, translated into a limitation for our review. Only a relatively small number of studies with modest population size and limited methodological quality fitted our criteria. We therefore included studies on virtual acute care escape rooms and acute care escape rooms in students, which allowed us to enrich this dataset. By clearly marking these groups, it is easily deducible where the data came from.

Less than half of the studies had description of design as their primary aim, limiting the data that could be extracted. However, looking from an educational perspective, this review offers an excellent new starting point in the iterative cycle of development. A final limitation is that the search was conducted in June 2023 and research published since is not included.

Despite the above limitations, to our knowledge, the present study is the first to provide a comprehensive analysis of escape room design aimed at enhancing CRM/teamwork in acute care professionals.

In conclusion we found that escape rooms that aim at improving CRM/teamwork in acute care professionals often have 4–6 participants, a 40-minute time limit, linear puzzle organization, use briefing and a structured debriefing is considered important for learning. Reporting on alignment of CRM/teamwork learning goals and escape room design is insufficient and there is insufficient evidence on how and whether design characteristics optimize learning outcomes. There is a need for more complete reporting of future escape rooms aimed at training teamwork in acute care professionals and research on maximizing the learning potential of these escape rooms through design.

Data availability

All data generated or analyzed during this study are included in this published article and its supplementary information files (additional file 2).

Abbreviations

Advanced Life Support

Basic Life Support

Cardio-Pulmonary Resuscitation

Crew Resource Management

Electrocardiogram

Educational Design Research

Emergency Medicine

EMS Emergency Medical Services

Escape Room

Family Medicine

Intensive Care Unit

Medical Education Research Study Quality Instrument

Medical Students.

Nursing Students

Non-technical skills

Operating Room

Promoting Excellence and Reflective Learning in Simulation

Postpartum Hemorrhage

Buljac-Samardzic M, Doekhie KD, van Wijngaarden JDH. Interventions to improve team effectiveness within health care: a systematic review of the past decade. Hum Resour Health. 2020;18(1).

Hughes AM, Gregory ME, Joseph DL, Sonesh SC, Marlow SL, Lacerenza CN, et al. Saving lives: a meta-analysis of team training in healthcare. J Appl Psychol. 2016;101(9):1266–304.

Article Google Scholar

Buljac-Samardzic M, Dekker-van Doorn CM, Maynard MT. What do we really know about Crew Resource Management in Healthcare? An Umbrella Review on Crew Resource Management and its effectiveness. J Patient Saf. 2021;17(8):e929–58.

Gross B, Rusin L, Kiesewetter J, Zottmann JM, Fischer MR, Pruckner S, Zech A. Crew resource management training in healthcare: a systematic review of intervention design, training conditions and evaluation. Bmj Open. 2019;9(2):e025247.

O’Dea A, O’Connor P, Keogh I. A meta-analysis of the effectiveness of crew resource management training in acute care domains (90, pg 698, 2014). Postgrad Med J. 2014;90(1070):708.

Google Scholar

O’Connor P, Campbell J, Newon J, Melton J, Salas E, Wilson KA. Crew Resource Management Training effectiveness: a Meta-analysis and some critical needs. Int J Aviat Psychol. 2008;18(4):353–68.

Haerkens MH, Kox M, Lemson J, Houterman S, van der Hoeven JG, Pickkers P. Crew Resource Management in the Intensive Care Unit: a prospective 3-year cohort study. Acta Anaesthesiol Scand. 2015;59(10):1319–29.

Cook DA, Brydges R, Hamstra SJ, Zendejas B, Szostek JH, Wang AT, et al. Comparative effectiveness of technology-enhanced simulation versus other instructional methods: a systematic review and meta-analysis. Simul Healthc. 2012;7(5):308–20.

Cook DA, Hatala R, Brydges R, Zendejas B, Szostek JH, Wang AT, et al. Technology-enhanced simulation for health professions education: a systematic review and meta-analysis. JAMA. 2011;306(9):978–88.

Fung L, Boet S, Bould MD, Qosa H, Perrier L, Tricco A, et al. Impact of crisis resource management simulation-based training for interprofessional and interdisciplinary teams: a systematic review. J Interprof Care. 2015;29(5):433–44.

Nicholson S. Peeking behind the locked door: A survey of escape room facilities. 2015.

Quek LH, Tan AJQ, Sim MJJ, Ignacio J, Harder N, Lamb A, et al. Educational escape rooms for healthcare students: a systematic review. Nurse Educ Today. 2023;132:106004.

Lathwesen C, Belova N. Escape rooms in STEM teaching and learning-prospective field or declining Trend? A literature review. Educ Sci. 2021;11(6).

Dittman JM, Amendola MF, Ramraj R, Haynes S, Lange P. The COMET framework: a novel approach to design an escape room workshop for interprofessional objectives. J Interprof Care. 2022;36(1):161–4.

Doherty SM, Griggs AC, Lazzara EH, Keebler JR, Gewertz BL, Cohen TN. Planning an escape: considerations for the development of Applied escape rooms. Simulation & Gaming; 2023.

Cohen TN, Griggs AC, Keebler JR, Lazzara EH, Doherty SM, Kanji FF, Gewertz BL. Using escape rooms for conducting Team Research: understanding Development, considerations, and challenges. Simul Gaming. 2020;51(4):443–60.

Veldkamp A, van de Grint L, Knippels M, van Joolingen WR. Escape education: a systematic review on escape rooms in education. Educ Res Rev-Neth. 2020;31:17.

McGowan J, Straus S, Moher D, Langlois EV, O’Brien KK, Horsley T, et al. Reporting scoping reviews-PRISMA ScR extension. J Clin Epidemiol. 2020;123:177–9.

Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for scoping reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467–73.

Elicit. [Available from: https://elicit.com/.

Google S. [ https://scholar.google.com/ .

Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev-London. 2016;5.

Clarke S, Peel DJ, Arnab S, Morini L, Keegan H, Wood O. escapED: a Framework for creating Educational escape rooms and interactive games for Higher/Further education. Int J Serious Games. 2017;4(3):73–86.

Fotaris P, Mastoras T. Escape rooms for learning: a systematic review. Proc Eur Conf Game. 2019:235–43.

Veldkamp A, van de Grint L, Knippels MCPJ, van Joolingen WR. Escape education: a systematic review on escape rooms in education. Educ Res Rev-Neth. 2020;31.

Veldkamp A, Daemen J, Teekens S, Koelewijn S, Knippels MCPJ, van Joolingen WR. Escape boxes: bringing escape room experience into the classroom. Brit J Educ Technol. 2020;51(4):1220–39.

Comm IS. INACSL standards of best practice: Simulation(SM) Simulation Design. Clin Simul Nurs. 2016;12:S5–12.

Comm IS. INACSL standards of best practice: Simulation(SM) Simulation-enhanced Interprofessional Education (Sim-IPE). Clin Simul Nurs. 2016;12:S34–8.

Maddock B, Darzins P, Kent F. Realist review of interprofessional education for health care students: what works for whom and why. J Interprof Care. 2022.

Reeves S, Boet S, Zierler B, Kitto S. Interprofessional Education and Practice Guide 3: evaluating interprofessional education. J Interprof Care. 2015;29(4):305–12.

Kirkpatrick DL, Kirkpatrick J. Evaluating training programs: the four levels. Berrett. Berkley, USA: Koehler; 1998.

Reed DA, Cook DA, Beckman TJ, Levine RB, Kern DE, Wright SM. Association between funding and quality of published medical education research. JAMA. 2007;298(9):1002–9.

Cook DA, Reed DA. Appraising the quality of medical education research methods: the Medical Education Research Study Quality Instrument and the Newcastle-Ottawa Scale-Education. Acad Med. 2015;90(8):1067–76.

Morrell BLM, Eukel HN. Escape the generational gap: a Cardiovascular escape room for nursing education. J Nurs Educ. 2020;59(2):111–5.

Morrell BLM, Eukel HN, Santurri LE. Soft skills and implications for future professional practice: qualitative findings of a nursing education escape room. Nurse Educ Today. 2020;93.

Abensur Vuillaume L, Laudren G, Bosio A, Thévenot P, Pelaccia T, Chauvin A. A didactic escape game for Emergency Medicine aimed at learning to work as a team and making diagnoses: methodology for Game Development. JMIR Serious Games. 2021;9(3):e27291.

Borck JC, Meyer DDNPCAA, Gettrust LDNPA-BC, Novalija JC. Escape the OR: a novel teaching strategy to promote interprofessional learning and teamwork. Nurs Manag. 2022;53(2):28–35.

Kutzin JM. Escape the room: innovative approaches to Interprofessional Education. J Nurs Educ. 2019;58(8):474–80.

Rosenkrantz O, Jensen TW, Sarmasoglu S, Madsen S, Eberhard K, Ersboll AK, Dieckmann P. Priming healthcare students on the importance of non-technical skills in healthcare: how to setup a medical escape room game experience. Med Teach. 2019;41(11):1285–92.

Sanders JE, Kutzin J, Strother CG. Escape the Simulation Room. Simul Gaming. 2021;52(1):62–71.

Morrell B, Eukel HN. Shocking escape: a cardiac escape room for undergraduate nursing students. Simul Gaming. 2021;52(1):72–8.

Kutzin JM, Sanders JE, Strother CG. Transitioning escape rooms to a virtual environment. Simul Gaming. 2021;52(6):796–806.

Turner A, Tichter AM, Pillow MT. Let’s escape Didactics: virtual escape room as a didactic modality in Residency. J Educ Teach Emerg Med. 2021;6(2):Sg46–56.

Podlog M, Husain A, Greenstein J, Sanghvi S. Escape the trauma room. AEM Educ Train. 2020;4(2):158–60.

Holland T, Kuhnly JE, McKelvey M, Prast J, Walter L. Evaluation of a Postpartum Hemorrhage escape room: a Multisite Study. Simul Gaming. 2023:24.

Gomez-Urquiza JL, Requena-Palomares I, Gorjon-Peramato E, Gomez-Salgado J, Canadas-De La Fuente GA, Albendin-Garcia L. Emergency and critical care professionals’ opinion on escape room as a health sciences evaluation game: A cross-sectional descriptive study. Med (United States). 2022;101(25) (no pagination).

Daniel L, Valko J, McAtee TJ. Using an escape room modality to teach mock code essentials. J Contin Educ Nurs. 2021;52(3):118–22.

Cheng A, Eppich W, Grant V, Sherbino J, Zendejas B, Cook DA. Debriefing for technology-enhanced simulation: a systematic review and meta-analysis. Med Educ. 2014;48(7):657–66.

Valdes B, Mckay M, Sanko JS. The impact of an escape Room Simulation to improve nursing teamwork, Leadership and Communication skills: a Pilot Project. Simul Gaming. 2021;52(1):54–61.

Zhang XC, Lee H, Rodriguez C, Rudner J, Chan TM, Papanagnou D. Trapped as a Group, escape as a team: applying gamification to Incorporate Team-building skills through an ‘Escape room’ experience. Cureus. 2018;10(3):9.

Fotaris P, Mastoras T. Room2Educ8: a Framework for creating Educational escape rooms based on design thinking principles. Educ Sci. 2022;12(11).

Ilgen DR, Hollenbeck JR, Johnson M, Jundt D. Teams in organizations: from input-process-output models to IMOI models. Annu Rev Psychol. 2005;56:517–43.

Chen WC, Reeves TC. Twelve tips for conducting educational design research in medical education. Med Teach. 2020;42(9):980–6.

Download references

Acknowledgements

Not applicable.

Author information

Authors and affiliations.

Human Factors and Cognitive Ergonomics, Research Coordinator Human Factors-CODE team DSI institute & Faculty Behavioral, Management and Social Sciences (BMS), Data and Education (CODE) Group, University of Twente, Drienerlolaan 5, Cognition, Enschede, NB, 7522, The Netherlands

Simone Borsci

Department of Surgery and Cancer, NIHR London IVD, Imperial College of London, London, UK

Department of Intensive Care, Radboud University Medical Center, Geert Groote Plein Zuid 10, Nijmegen, 6525GA, The Netherlands

Gerald J. Jaspers, Johannes G. van der Hoeven & Joris Lemson

Research on Learning and Education, Radboudumc Health Academy, Radboud University Medical Center, Geert Groote Plein Zuid 10, Nijmegen, 6525GA, The Netherlands

Wietske Kuijer-Siebelink

School of Education, HAN University of Applied Sciences, Nijmegen, The Netherlands

You can also search for this author in PubMed Google Scholar

Contributions

G.J. designed the study-protocol, drafted the search, screened studies, extracted data and drafted the manuscript. S.B. and J.L. revised the study-protocol, checked screening of studies and data extraction and revised the manuscript. H.H. revised the manuscript. W.K. revised the study-protocol, checked data extraction and revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Gerald J. Jaspers .

Ethics declarations

Ethics approval and consent to participate, consent for publication, competing interests.

The authors declare no competing interests.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

12909_2024_5753_MOESM1_ESM.docx

Supplementary Material 1: Selection of databases and search strategy. Additional information on the selection of databases, the used additional resources and the full search strings for all databases.

12909_2024_5753_MOESM2_ESM.xlsx

Supplementary Material 2: Data extraction form. The full data extraction form (Table 1), including all data and data-items that were extracted (data-items are headings of the different columns). Calculated MERSQI score (Table 2).

12909_2024_5753_MOESM3_ESM.docx

Supplementary Material 3: Table with MERSQI scores. A Table with the full MERSQI scores, including scores on all separate items.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Jaspers, G., Borsci, S., van der Hoeven, J. et al. Escape room design in training crew resource management in acute care: a scoping review. BMC Med Educ 24 , 819 (2024). https://doi.org/10.1186/s12909-024-05753-z

Download citation

Received : 29 January 2024

Accepted : 08 July 2024

Published : 30 July 2024

DOI : https://doi.org/10.1186/s12909-024-05753-z

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Crisis resource management
Escape game
Puzzle room

BMC Medical Education

ISSN: 1472-6920

Submission enquiries: [email protected]
General enquiries: [email protected]

COMMENTS

A critical review of evaluations of interprofessional education
A Critical Review of. Evaluations of. Interprofessional Education. This review was comm issioned by the Learning and Teaching Support Network. Health Sciences and Practice from the ...
A critical review of evaluations of interprofessional education
"This review was commissioned by the Learning and Teaching Support Network Health Sciences and Practice from the Interprofessional Education Joint Evaluation Team and published in May 2002":- title page 63 pages : 30 cm
A Critical Review of Evaluations of Interprofessional Education
Journal of interprofessional care. 2020. TLDR. The review found very limited research for online interprofessional education related to chronic disease so it is not feasible to comment or draw conclusions in relation to its impact on interprofessional learning, student engagement in education or its impact in practice, services or health outcomes.
Evaluating interprofessional education: An important step to improving
The introduction of interprofessional education (IPE) into a professional curriculum requires thorough evaluation not only to guide educators concerning the quality of learning but also to report to professional bodies and influence policy.
The implementation of interprofessional education: a scoping review
Implementation of interprofessional education (IPE) is recognised as challenging, and well-designed programs can have differing levels of success depending on implementation quality. The aim of this review was to summarise the evidence for implementation of IPE, and identify challenges and key lessons to guide faculty in IPE implementation.
A systematic review and meta-analysis of outcomes of interprofessional
Interprofessional education (IPE) is an important teaching and learning model that involves two or more professions engaging or working together to improve the knowledge of healthcare students. However, the specific outcomes of IPE for healthcare students are unclear as only a few studies have reported them.
An Updated Synthesis of Review Evidence of Interprofessional Education
With continued growth and investment in interprofessional education (IPE) activities, there is a persistent need to understand the effect of IPE on learning, organizations, sys-tems, and patients. This paper presents an update of a pre-viously published synthesis of reviews. In doing so, it pro-vides a critical appraisal of the most recent evidence for the IPE review literature. Following a ...
[PDF] A best evidence systematic review of interprofessional education
In this way we sought to help shape future interprofessional education and maximize the potential for interprofessional learning to contribute to collaborative practice and better care. Objectives of the review: To identify and review the strongest evaluations of IPE.
A critical review of evaluations of interprofessional education
A critical review of evaluations of interprofessional education - Kingston University Research Repository
Twelve steps to evaluating interprofessional education
This paper sets out a step-by-step plan to help readers design, implement and disseminate evaluations of interprofessional education (IPE). We present the following twelve steps that are central to this process: formulating evaluation questions, agreeing on the evaluation approach, using evaluation frameworks, drawing upon evaluation expertise, reviewing the literature, selecting a methodology ...
Interprofessional education: tips for design and implementation
Interprofessional education (IPE) is a critical approach for preparing students to enter the health workforce, where teamwork and collaboration are important competencies. IPE has been promoted by a number of international health organisations, as part of a redesign of healthcare systems to promote interprofessional teamwork, to enhance the quality of patient care, and improve health outcomes ...
A best evidence systematic review of interprofessional education: BEME
This review identified, collated, analysed and synthesised the best available contemporary evidence from 21 of the strongest evaluations of IPE to inform the above proposition. In this way we sought to help shape future interprofessional education and maximize the potential for interprofessional learning to contribute to collaborative practice ...
The evidence base for interprofessional education within health
We will perform each task of screening, critical appraisal, data abstraction, and synthesis using at least two members of the review team. The review will enable an update and comprehensive understanding of the IPE evidence base to inform future IPE developments, delivery and evaluation across education and clinical settings.
A critical review of evaluations of interprofessional education
A critical review of evaluations of interprofessional education. London, UK Higher Education Academy, Health Sciences and Practice Network. https://doi.org/OccasionalPaperNo2
The evidence base and recommendations for interprofessional education
The evidence base and recommendations for interprofessional education in health and social care. The evidence base and recommendations for interprofessional education in health and social care. J Interprof Care. 2006 Jan;20 (1):75-8. doi: 10.1080/13561820600556182.
Potentialities and limitations of Interprofessional Education during
Interprofessional Education (IPE) is a promising alternative to deal with these changes, especially in courses in the health area. This systematic review was to explore the potentialities and limitations of IPE, from the perspective of undergraduate students, through a thematic synthesis of qualitative studies.
Assessment tools in pre‐licensure interprofessional education: A
Interprofessional education (IPE) aims to provide students with the opportunity to develop and demonstrate the team working behaviours and skills that will lead to positive patient outcomes. This systematic review aims to identify and critically appraise the assessment tools used after a pre-licensure IPE intervention and provide guidance on which tool to use according to the focus of the ...
Interprofessional Education and Practice Guide No. 3 ...
We have witnessed an ongoing increase in the publication of evaluation work aimed at measuring the processes and outcomes related to a range of interprofessional education (IPE) activities and initiatives. Systematic reviews of IPE have, however, suggested that while the quality of evaluation studie …
The implementation of interprofessional education: a scoping review
Introduction Implementation of interprofessional education (IPE) is recognised as challenging, and well-designed programs can have differing levels of success depending on implementation quality. The aim of this review was to summarise the evidence for implementation of IPE, and identify challenges and key lessons to guide faculty in IPE implementation. Methods Five stage scoping review of ...
Evaluation of Evidence for Interprofessional Education
Studies involving educational interventions in health professions to enhance learner-based outcomes relevant to the provision of interprofessional care were identified. We sought prospective, controlled trials in which at least 2 health care disciplines were represented, and 1 of which was medicine. Thirteen reports met the criteria for inclusion.
A critical interpretive synthesis of interprofessional education
Interprofessional practice can look quite different depending on a number of dynamics. Interprofessional education interventions may or may not orient toward this range of practice possibilities. This literature review explores: (1) how interprofessional education interventions relate to different kinds of interprofessional practice and (2) the range of interprofessional practices assumed by ...
PDF A Critical Review of Evaluations of Interprofessional Education
This 'critical review of evaluations of interprofessional education' is the second of a series of occasional papers commissioned by the Learning and Teaching Support Network (LTSN) Centre for ...
Barr, H., Freeth,D., Hammick, M., Koppel, I. & Reeves, S. (2000 ...
The Review focuses upon evaluations of interprofessional education in health and social care in the United Kingdom (UK). BERA is picking up implications for other professions travelling similar roads towards collaboration in learning and practice as educational programmes are integrated.
Full article: The development of a research-based interprofessional
The development of a research-based interprofessional communication behaviors repository in healthcare education: A systematic review Oona Janssens a Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium;b Department of Movement and Sports Sciences, Faculty of Medicine and Health ...
Exploring Interprofessional Education in Higher Education Institutions
A critical review of the literature in this area identifies gaps in which further research is required to further interprofessional learning (IPL) for paramedics and suggests IPL may help shape the emerging role of paramedics in rural settings where population size and other factors limit the availability of health professionals.
The Role of Interprofessional Education in Optimizing Laparoscopic
Background: This investigation evaluates the utility and benefits of integrating interprofessional education (IPE) into laparoscopic training, aiming to enrich medical education and skill acquisition methodologies. Methods: The study randomly allocated 36 participants of a 2023 laparoscopic training course into experimental and control groups, each comprising 18 individuals. The control group ...
Escape room design in training crew resource management in acute care
To appraise the methodological quality of the teamwork evaluation, Medical Education Research ... Maddock B, Darzins P, Kent F. Realist review of interprofessional education for health care students: what works for whom and why. ... Gomez-Salgado J, Canadas-De La Fuente GA, Albendin-Garcia L. Emergency and critical care professionals' opinion ...

Internet Archive Audio

Mobile Apps

Browser Extensions

Save Page Now

A critical review of evaluations of interprofessional education

plus-circle Add Review comment Reviews

DOWNLOAD OPTIONS

IN COLLECTIONS

SIMILAR ITEMS (based on metadata)

A critical review of evaluations of interprofessional education

Actions (Repository Editors)

A critical review of evaluations of interprofessional education

Related outputs

Usage statistics

Save citation to file

Add to My Bibliography

Interprofessional Education and Practice Guide No. 3: Evaluating interprofessional education

Similar articles

Related information

LinkOut - more resources

The implementation of interprofessional education: a scoping review

Cite this article

Introduction

Similar content being viewed by others

Potentialities and limitations of Interprofessional Education during graduation: a systematic review and thematic synthesis of qualitative studies

Exploring experiential learning within interprofessional practice education initiatives for pre-licensure healthcare students: a scoping review

Sociomaterial perspective as applied in interprofessional education and collaborative practice: a scoping review

Identifying the research question

Identifying relevant studies

Study selection

Charting the data

Collating, summarising and reporting the results

Characteristics of included studies

Implementation components of included studies

Challenges and key lessons in included studies

Micro level

Macro level

Summary of key findings

Strengths and limitations

Future research

Conclusions

Acknowledgements

Author information

Corresponding author

Additional information

Rights and permissions

About this article

Share this article

Evaluation of Evidence for Interprofessional Education

Mariko A. Foulk

Brent C. Williams

INTRODUCTION

Criteria for Study Inclusion

Search Strategy and Methods of Review

Implications for Education

Implications for Research

Study Limitations

ACKNOWLEDGMENT

Barr, H., Freeth,D., Hammick, M., Koppel, I. & Reeves, S. (2000) Evaluations of interprofessional education

Exploring Interprofessional Education in Higher Education Institutions: A South African Case Study

19 References

Escape room design in training crew resource management in acute care: a scoping review

Conclusions

Research questions

Eligibility criteria

Databases and search strategy

Data items and charting process

Synthesis of results

Selection of sources of evidence

Qualitative Synthesis

Educational and escape room design characteristics

Effect on learning

Design characteristics

Design characteristics and learning outcomes: deriving design requirements

Gaps and looking forward

Strengths and limitations

Data availability

Abbreviations

Acknowledgements

Author information