Content area
Aims
To evaluate the learning outcomes of an IPE program for nursing students in relation to theoretical knowledge, interprofessional collaborative practice competency and nursing core competency and their learning experiences.
BackgroundSimulation-based interprofessional education (IPE) is an effective method for developing students’ collaborative skills. Nursing students have limited opportunities to learn with healthcare professionals.
DesignThis was a convergent mixed-methods study.
MethodsThe quantitative component used a quasi-experimental design. The experimental group (IPE group) participated in an IPE program with an acute chest pain model in an Emergency Medicine and Nursing course. The learning outcomes were evaluated using a knowledge test, IPE collaborative competence assessment tool and nursing core competence instrument. The qualitative component comprised written reflections and interviews with students on their learning experiences.
ResultsAmong the 117 participants, IPE group showed significantly higher scores on the knowledge test (B = 1.93, p = .001), interprofessional education collaborative competency (B = 0.31, p = .001) and nursing core competence (B = 0.25, p = .027) than the control group. The qualitative interviews with 14 students identified the following themes of learning experiences: enhancement of effective communication within healthcare teams; integration of knowledge with clinical practice; familiarization with the professional roles of team members; strengthening decision-making skills; and the establishment of interprofessional collaborative care abilities.
ConclusionsThe learning outcomes of a simulation-based IPE program for nursing students demonstrated enhanced core competencies for interprofessional collaborative practice. Simulation-based IPE is a useful teaching method that should be actively promoted across healthcare disciplines.
As rapid advances in technology make emergency patient management more complex, the provision of optimal care increasingly depends on collaboration among healthcare team members. Yet, university-level curricula offer limited opportunities for interprofessional education (IPE) and emergency nursing courses rarely include IPE. Simulation-based IPE is recognized as an effective method for developing healthcare students’ collaborative skills ( Chen et al., 2022; Lee et al., 2024; Saragih et al., 2023). Although it has been recommended as a teaching strategy for clinical practice in undergraduate nursing education ( Gunaldo et al., 2021; Mohammed et al., 2021; Oerther et al., 2023), few studies have explored its application in emergency nursing education. The present study addressed this gap in understanding how such training supports interprofessional collaboration in high-acuity clinical environments.
2 Background2.1 Simulation-based interprofessional education
Collaboration among healthcare professionals demonstrably improves the quality of patient care and patient outcomes ( He et al., 2024). In the emergency department (ED) environment, IPE has been identified as an effective method for developing the skills needed for collaboration within multidisciplinary teams ( Ericson et al., 2017). IPE involves participants collaboratively learning to interact, understand and communicate across professions ( World Health Organization, 2010). Such shared learning experiences and open dialogue across disciplines have been shown to enhance students’ competencies and foster a patient-centered, team-based approach to care ( Mohammed, et al., 2021), thereby preparing students for effective patient care in clinical settings ( Caronia and Saglietti, 2018; Chew et al., 2019). In relation to simulation-based IPE, a systematic review of 39 studies confirmed its effectiveness in promoting interdisciplinary collaboration in medicine, nursing and healthcare ( Macías Inzunza et al., 2020). Reported benefits include improved understanding of professional roles, enhanced teamwork, better communication, fewer medical errors and improved learning retention ( Görücü et al., 2024; Saragih et al., 2024).
2.2 Interprofessional collaborative practiceInterprofessional collaborative care is now a global priority in nursing education ( Interprofessional Education Collaborative, 2023). It involves ongoing teamwork among professionals from diverse backgrounds to address complex healthcare challenges ( Morgan et al., 2015). The Interprofessional Education Collaborative outlines four core competencies essential for collaborative practice: values and ethics, roles and responsibilities, interprofessional communication and teamwork ( Interprofessional Education Collaborative, 2023). Values and ethics focus on working with team members to maintain shared values, ethical behavior and mutual respect. Roles and responsibilities refer to the contributions of individual team members’ profession-specific knowledge to addressing patients’ outcomes. Interprofessional communication highlights respectful, responsive and compassionate dialogue. Teamwork competency involves applying collaborative values and scientific principles to adapt roles within healthcare teams. These core competencies serve as guidelines for IPE in healthcare, shaping and directing its initiatives in IPE and collaborative practice.
2.3 AimsThe aim of this study was to evaluate the impact of IPE teaching on nursing students’ theoretical knowledge, nursing core competency and interprofessional collaborative practice competency in relation to caring for patients with acute chest pain in the ED. We also aimed to examine students’ learning experiences of engaging with an IPE program.
3 Methods3.1 Research design
This study used a convergent mixed methods design that combines qualitative and quantitative data to gain a comprehensive, in-depth understanding of the research question ( Creswell and Plano Clark, 2011; Nair and Prem, 2020). This design was chosen because it combines the strengths of both methods. The quantitative component used a quasi-experimental research design. The experimental group (IPE group) participated in an IPE program with an acute chest pain model in an Emergency Medicine and Nursing course, while the control group underwent traditional teaching with group case discussions. Matching or stratification was not used in group assignment due to constraints in course scheduling and the similarity in students’ background. Students were allocated to the IPE or control group based on the section of the course where they were enrolled. Learning outcomes regarding theoretical knowledge of managing patients with acute chest pain, interprofessional collaborative care ability and nursing core competencies were compared between the two groups. The qualitative component of the study involved written reflections and semi-structured interviews with students on their learning experiences with and perceptions of IPE.
3.2 Setting and samplesThe study was conducted at a university in Taiwan, which graduates 1000 Bachelor of Science in Nursing students annually. The participants were fourth-year students who took the elective Emergency Medicine and Nursing course. The research team divided the classes into the IPE and control groups. The inclusion criteria were nursing students who were: (1) enrolled in the Emergency Medicine and Nursing course; and (2) willing to participate. The exclusion criterion was inability to attend the simulation-based IPE classes, which were scheduled in the evening.
Sample size estimation was performed using G*Power version 3.1 ( Faul et al., 2007), with a medium effect size (f =.25), α = .05, power = .8 and correlation = .5. The total sample size calculated for the two groups and two measurements was 98. In the qualitative component, the inclusion criteria were students who participated in IPE and agreed to be interviewed. The number of participants for the interviews was determined by data saturation, which was defined as the point at which no new information emerged.
3.3 Research instruments3.3.1 IPE lesson plan: caring for patients with acute chest pain in an ED
The research team developed a simulation-based IPE lesson plan for patients with acute chest pain in the ED. The characteristics of patients included high urgency and a life-threatening condition. As an IPE lesson plan in the Emergency Medicine and Nursing course, it aimed to enhance students’ collaborative skills in team care. The plan was structured around a core of contextualized knowledge, attitude and skills (CCKAS), as recommended by Chou (2011) (Appendix A). It focused on patients with acute chest pain visiting the ED in relation to four episodes: ED triage; emergency care for acute coronary syndrome; cardiac catheterization; and the management of life-threatening arrhythmia. Each episode lasted approximately 10 min. Three clinical experts—a physician, a senior nurse and a nurse practitioner—reviewed and revised the IPE lesson plan to ensure that it aligned with the collaborative care process in the ED.
3.3.2 Chest pain knowledge written testThe research team developed a theoretical knowledge written test based on learning objectives and the content of the acute chest pain module. The test focused on the assessment and management of patients with acute coronary syndrome in the ED based on the Acute Cardiac Life Support protocol. It consisted of 20 short answer questions for a maximum score of 20 points. The written test was provided to students before (pre-test) and after (post-test) the acute chest pain module.
3.3.3 Interprofessional education collaborative (IPEC) competency Self-Assessment toolThe IPEC Competency Self-Assessment Tool was designed by Lockeman et al. (2016) to assess healthcare students’ competencies for the collaborative practice program. It consists of 16 items with 2 factors—interprofessional interactions and interprofessional values—and uses a 5-point Likert scale (1 = strongly disagree and 5 = strongly agree) to assess students’ perceptions of their ability to engage in interprofessional collaborative practice. The tool was administered before and after the chest pain lesson. Cronbach’s alpha was.955, which indicated good reliability.
3.3.4 Nursing core competence instrumentThe Nursing Department at the participating university developed a Nursing Core Competence Instrument for the Bachelor of Nursing program. This instrument is based on the eight core competencies identified by the Taiwan Nursing Education Accreditation Council: critical thinking, clinical nursing skills, foundational biomedical science, communication and collaboration, compassion, ethical literacy, accountability and lifelong learning ( Chen, 2010). To evaluate the effect of the nursing curriculum on the students’ competencies, a 10-item questionnaire was created, using a 5-point Likert scale (1 = strongly disagree and 5 = strongly agree). This instrument assesses students’ perceptions of their nursing competencies before and after learning and it was administered before and after the chest pain lesson. Cronbach’s alpha was.932, which indicated good reliability.
3.3.5 IPE written learning reflectionThe IPE written learning reflection developed by the research team comprised two parts. The first part collected participants’ personal information from both groups, such as gender, age and prior experience with simulations and IPE. In the second part, which was only completed by the IPE group, participants described their learning experiences, focusing on four core competencies—values/ethics for interprofessional practice, roles/responsibilities, interprofessional communication and teams and teamwork—and their overall reflections. This reflection was written within one week following the chest pain lesson.
3.3.6 IPE interview outlineA semi-structured interview guide (Appendix B) was used to conduct face-to-face interviews with students to explore their learning experiences with IPE.
3.4 Ethical considerationsThis study was approved by the Institutional Review Board (IRB No: 202102176A3C501) and conducted with the consent of the participating university. In the first week of the course, a researcher attended class meetings to explain the study and recruit participants. The students were informed about the study’s purpose, methods and procedures and were assured that participation was voluntary and anonymous and that they could withdraw at any time without penalty or effect on their academic results. All participants provided written informed consent.
3.5 IPE procedures3.5.1 IPE preparation stage
Before the IPE simulation, fifth-year or higher medical students with clinical experience were recruited to act as emergency physicians. A researcher briefed them on study procedures, lesson plans and patient data and provided guidance for leading discussions. The simulation lab was transformed into an ED setting with patient models, equipment and trained standardized patients. The facilitators received structured training before simulation. They were responsible for guiding students through the simulation scenarios, promoting interprofessional communication and facilitating team discussions. The training focused on interprofessional teamwork, including communication, role, decision-making and problem-solving. Facilitators documented these elements during the sessions and their observations were used in debriefings to provide feedback.
3.5.2 IPE implementation stageThe acute chest pain module spanned 4 h over 2 weeks, including 2 h of lectures and 2 h of simulation activities. Nursing students were divided into four teams, each paired with a medical student. After introducing the IPE process, students discussed a case for 30 min, then drew lots to complete one of four assigned episodes. Roles such as primary nurse and documentation were assigned; others observed and recorded the process for reflection. Each simulation lasted 10 min, followed by a 30-minute debriefing.
3.5.3 IPE evaluation stageIPE learning was evaluated via a questionnaire and a written knowledge test, which focused on students’ assessment and management of patients with acute chest pain in the ED, the performance of each group member in IPE activities and students’ reflections on participating in IPE learning.
3.6 Data collectionIn the quantitative part of the study, the participants completed a knowledge test and questionnaire before and after the chest pain module. In the qualitative part of the study, students in the IPE group submitted written reflections after the IPE simulation. The participants in the IPE group were then invited to face-to-face interviews, which were recorded and transcribed verbatim, with recordings and transcripts reviewed by the researcher. The study was conducted from 1 August 2022–31 July 2023. The protocol for the study process and data collection is shown in Appendix C.
3.7 Data analysisQuantitative data were analyzed using IBM SPSS Statistics 22.0. Descriptive statistics (frequencies and percentages) and inferential statistics (chi-square test, paired t-test, independent sample t-test and generalized estimating equations [GEE]) were used to compare the groups. To avoid bias in the research findings due to differences in baseline data, the GEE model was used to compare the changes in the two study groups during the study period and to understand the outcomes after the IPE intervention. Statistical significance was set at p < 0.05.
Qualitative data were analyzed using content analysis. The trustworthiness of the findings was assessed using Lincoln and Guba’s (1985) criteria of credibility, transferability, dependability and confirmability. Credibility was achieved by providing verbatim extracts from participants’ accounts. Transferability was enabled by providing detailed descriptions of the research context and process. Dependability was ensured via clear descriptions of the study design and methods of data collection and analysis. Confirmability was achieved by documenting the interviewer’s thoughts and emotions and establishing an audit trail. Original data, including interview notes and analyses, were digitally stored for future theory development.
Data analysis followed Onwuegbuzie and Teddlie’s (2003) mixed methods framework for integrating qualitative and quantitative data. This framework contains seven steps: (1) data reduction; (2) data display; (3) data transformation; (4) data correlation; (5) data consolidation; (6) data comparison; and (7) data integration. During reduction, the quantitative and qualitative findings were simplified. Quantitative data were presented in tables, and qualitative data were shown visually. In the transformation stage, quantitative results were narrated, and qualitative themes were described. The data were then consolidated, compared for alignment or discrepancies and integrated into cohesive results.
4 ResultsThe study results are presented in four parts: quantitative results; student feedback on IPE; qualitative results in relation to IPE learning experiences; and integrated qualitative and quantitative results.
4.1 Quantitative resultsA total of 119 participants were recruited. Two participants in the IPE group withdrew due to absences during implementation phase, which resulted in 117 who completed the study (52 in the IPE group and 65 in the control group), with an attrition rate of 1.38 %. Data previously collected from those who withdrew were excluded from analysis. Most (88.9 %) of the participants were women aged 20–25 years (99.1 %). While 91.5 % of the participants had previous simulation learning experience, 75.2 % had not participated in interprofessional simulations. There was no significant difference in interprofessional simulation experience between the two groups ( Table 1).
4.1.1 Theoretical knowledgeThe mean score on the knowledge test in the IPE group after the chest pain module was 12.52 (standard deviation [SD] = 3.10), which was significantly higher than that in the pre-test (T = −11.13, p < .001). Comparisons of the theoretical knowledge score differences from pre-test to post-test between the two groups showed that the IPE group significantly outperformed the control group (pre-test T = 4.85, p < .001; post-test T = 7.21, p < .001) ( Table 2). GEE analysis showed the score changes from pre-test to post-test in each group were compared with evaluate the effectiveness of IPE teaching. The IPE group had significantly better knowledge outcomes than the control group (B = 1.93, p = .001, Table 3).
4.1.2 IPEC competencyThe mean score for IPEC competency in the IPE group was significantly higher (3.91, SD =.52) in the post-test than in the pre-test (4.49, SD =.44) (T = −7.52, p < .001, Table 2). A further comparison of the pre-test and post-test scores between the two groups showed that the control group had significantly higher pre-test scores (T = −5.21, p < .001) and post-test scores (T = −2.08, p = .040) than the IPE group. GEE analysis showed that the interdisciplinary collaboration scores in the IPE group were significantly higher than those in the control group (B =.31, p = .001, Table 3). In the interaction and values subscales, the IPE group scored higher than the control group (B =.36, p = .001; B =.25, p = .003, respectively).
4.1.3 Nursing core competenciesAll the participants’ nursing core competency scores were significantly higher in the post-test than in the pre-test ( Table 2). After the IPE intervention, the IPE group had significantly higher core competency scores than the control group (B =.25, p = .027, Table 3).
4.2 IPE written learning reflection resultsA total of 52 students completed the written reflection. The results are presented below in relation to the overall learning experiences of participating in the simulation-based IPE, followed by a focus on the four core competencies.
4.2.1 Overall IPE learning reflectionThe participants gave positive feedback on the simulation-based IPE and appreciated the unique experience of learning with medical students. They reported that the simulation was a realistic and effective learning experience. Through IPE, they gained a broader perspective, identified gaps in clinical care abilities and recognized the need to improve their knowledge and skills in emergency patient care to enhance clinical competence. Some examples of feedback are as follows:
IPE47: This simulation exercise was more interesting than any previous one. It was the most immersive and effective learning experience I’ve had so far.
IPE35: I gained a lot of valuable professional insight from medical students, which prompted me to think about problems from different perspectives and broaden my knowledge base.
4.2.2 Learning reflection on values and ethics for interprofessional practiceThrough IPE, nursing students gained a stronger appreciation for professional values such as respect, inclusiveness and teamwork. They shifted from viewing healthcare as hierarchical to embracing interprofessional dialogue and collaboration. This experience helped them recognize the value of each professional’s perspective in patient care. Reflections showed that IPE fosters open-mindedness and mutual respect—key qualities for effective teamwork and ethical practice. The findings are reflected in the following feedback:
IPE37: There was professional discussion rather than just following orders.
IPE52: When professionals from different fields collaborate, everyone may have different points of view … I learned how to respect and embrace these different ideas and management, finding common ground in collaboration to achieve the best patient care.
4.2.3 Learning reflection on the roles and responsibilities for interprofessional practiceThe participants reported that effective interprofessional practice requires nurses to have a range of abilities in addition to basic nursing knowledge and skills. They must also possess ethical awareness, have the capacity for critical thinking, teamwork and lifelong learning and understand the roles and responsibilities of different professionals. The students’ feedback included the following:
IPE26: I believe that besides having general clinical care skills and basic medical knowledge to assess the patient’s condition, nurses also need ethical awareness, critical thinking, teamwork and a sense of responsibility in their work. Lifelong learning is also crucial.
IPE39: The role of nurses involves discussing treatment plans with physicians. During the simulation, I observed the responsibilities of doctors, nurses and leaders.
4.2.4 Learning reflection on communication for interprofessional practiceThe students gained a deeper understanding of how communication is essential to promoting effective teamwork, solving patients’ issues efficiently and ultimately delivering high-quality care. They recognized that in high-pressure scenarios, such as emergencies, clear and coordinated communication in the team becomes even more critical. Some examples of their feedback are as follows:
IPE31: Communication within the team is crucial during emergencies and this is something we need to learn well.
IPE43: By discussing cases together, we communicated with doctors, exchanged knowledge and provided more comprehensive care to the patients.
4.2.5 Learning reflection on teams and teamwork for interprofessional practiceThrough their interprofessional experience, the participants gained valuable insight into the requirements for effective teamwork. They understood the true meaning and importance of collaboration across different professions. Working closely with medical students helped foster stronger team relationships. This collaboration not only enhanced participants’ understanding of patients in the ED but also enabled them to contribute to high-quality patient care. Examples of this feedback are as follows:
IPE39: I came to understand what ‘medical teamwork’ truly means.
IPE43: Collaborating with medical students to care for patients and discussing cases allowed us to learn from each other and gain a more comprehensive understanding of the case from different perspectives.
4.3 Qualitative interview resultsA total of 14 female students aged 20–22 years were interviewed. Analysis of the data identified four key themes in relation to their learning experiences with IPE: enhancement of effective communication within interprofessional teams; integration of theoretical knowledge with clinical practice; familiarization with the professional roles of team members; and strengthened clinical decision-making abilities. The core theory is that IPE teaching helps establish interprofessional collaborative practice capabilities, enabling the provision of comprehensive healthcare services to patients ( Fig. 1).
4.3.1 Theme one: IPE learning enhances effective communication within the healthcare teamThrough IPE learning, nursing and medical students had the opportunity to engage in dialogue. During discussions of situational cases, everyone shared their thoughts and exchanged knowledge. They learned how to communicate with professionals from other fields, respect and embrace different values and collaborate to improve patient care. For example:
P7: Everyone actually thinks differently about the same issue … When I meet different people, I think about how to cooperate and communicate with the team to handle things better. I think this is great because both sides can complement each other.
P12: During the process, we communicated with the doctors and exchanged what we had learned … I learned how to respect and embrace different values, find common ground in collaboration and provide better care for the patient.
4.3.2 Theme two: IPE learning integrates theoretical knowledge with clinical practiceLearning with medical students encouraged participants to reassess their approaches and recognize gaps in their knowledge. They realized the need to strengthen their clinical foundation to care for emergency patients. Collaboration broadened their perspective on ED care and improved their ability to apply theory in diverse clinical scenarios. This experience highlighted the value of integrating theory with practice, enhancing their confidence and preparedness for real-world healthcare settings:
P2: This helps me use what I’ve learned more flexibly because different situations require different approaches to provide appropriate treatment based on the patient’s symptoms in the ED.
P8: The medical students worked together with us in applying theory to the patients for clinical assessment and management.
4.3.3 Theme three: IPE learning enables familiarization with the professional roles of healthcare team membersBefore learning with medical students, participants viewed doctors as intimidating and avoided interaction. Through interprofessional collaboration, they found doctors more approachable and realized that nurses can actively engage in discussions, share assessments and advocate for patients. They also recognized the valuable contributions nurses make to patient care through professional insight and recommendations:
P3: I now understand more clearly why doctors do what they do, their thought processes and what their work involves … now, I can understand different perspectives and learn about the roles of different responsibilities.
P13: This (IPE) really made me deeply understand the importance of teamwork. Every member plays an important role and no one can be missing. Only then can each individual’s value be fully realized.
4.3.4 Theme four: IPE learning strengthens clinical decision-making skillsStudents noted that the interprofessional simulation more closely reflected the real ED environment than past nursing-only experiences. It helped them grasp the urgency of emergency care and the importance of timely, accurate decisions. Discussions with medical students revealed clinical reasoning processes, enhancing their holistic thinking, problem-solving and adaptability for future practice:
P2: The interprofessional simulation created that atmosphere. Because it’s the frontline, you have to make quick and accurate judgments.
P10: Knowing doctors’ thoughts helped us understand how to act if we encounter similar cases in the hospital. In the simulation, we improved our adaptability and problem-solving skills, which we can apply to clinical situations in the future.
4.3.5 Core theme: IPE learning for establishing interprofessional collaborative care abilitiesThrough IPE, the participants gained an understanding that healthcare relies on effective communication and collaboration among professional teams and that each profession provides unique knowledge and skills associated with clinical practice, all of which are essential for delivering high-quality patient care. The participants recognized the distinct and important contributions of each role and understood that engaging in collaborative care could lead to better health outcomes. By working with team members, the participants expressed they were able to provide patients more comprehensive care in the ED and that IPE learning enhanced their capacity for interprofessional collaboration in patient care ( Fig. 1).
4.4 Integration of quantitative and qualitative resultsTable 4 shows the results of the seven-step analysis of the quantitative and qualitative data. IPE provided the participants with opportunities to learn with other professions. The IPE simulation of patients with acute chest pain in the ED helped the participants understand the real clinical environment and the importance of interprofessional collaboration. Through collaborative patient care, the participants increased their knowledge, attitudes and skills. IPE enhanced emergency care knowledge, fostered respect for other professions, familiarized students with team roles and encouraged self-reflection. Overall, the results indicate that IPE improves communication, teamwork and clinical decision-making, bridges theory and practice and builds a foundation for collaborative care.
5 DiscussionA unique aspect of this study is that we applied a mixed-methods approach to obtain three different types of learning outcomes. Findings demonstrated the effectiveness of simulation-based IPE in enhancing students’ learning experiences. The IPE group showed significantly higher theoretical knowledge scores in managing ED patients compared with the control group. This aligns with recent meta-analyses reporting that IPE improves students’ knowledge acquisition, retention and application ( Saragih et al., 2024; Guraya and Barr, 2018; Murdoch et al., 2017), supporting the value of IPE in nursing education.
Our qualitative findings showed that IPE helped nursing students integrate theoretical knowledge with clinical practice. Engaging with medical students allowed them to exchange ideas, identify knowledge gaps and better understand how to apply theory in patient care. Previous studies support these outcomes. IPE fosters interdisciplinary thinking not achievable through single-discipline education ( Garwood et al., 2022; Saragih et al., 2024). Sanko et al. (2020) found that IPE helped students recognize gaps in knowledge and skills. Sulaiman et al. (2021) reported positive experiences with cross-disciplinary collaboration to enhance clinical understanding. These findings align with the results of our study.
The IPE group showed significantly higher scores in team interactions and professional values related to collaborative care than the control group. Although over 90 % of students had experience with simulation-based learning, 88 % had never participated in IPE. Reflections indicated that students developed the four IPEC core competencies (Interprofessional Education Collaborative, 2011), distinguishing this experience from non-IPE simulations. IPE promoted mutual learning, enhanced understanding of roles and strengthened professional identity. It also reduced stereotypes and improved teamwork ( Rodrigues da Silva Noll Gonçalves et al., 2021). Previous studies confirm that IPE enhances collaboration, professional confidence and trust, leading to improved patient-centered care and better outcomes ( Abusabeib et al., 2024; Saragih et al., 2024; Sulaiman et al., 2021). However, our results differ from those of Herge et al. (2015), who reported no significant change in students’ attitudes after IPE training. This inconsistency may be context related. We suggest that our outcomes of significant gains in interprofessional competencies, teamwork and clinical decision-making might be attributable, in part at least, to the use of high-fidelity simulation and realistic scenarios. In the context of a scenario involving ED patients with acute chest pain, our findings indicate that IPE can bridge theory and practice, enhance collaboration and strengthen clinical skills for students. Further research is needed to explore its impact across different settings and teaching designs.
Our qualitative results showed that simulation-based IPE improved students’ communication within the healthcare team, familiarized them with professional roles and enhanced clinical decision-making. These aspects were interconnected and fostered interprofessional collaborative care abilities. These findings are consistent with those from qualitative studies in Australia, Hong Kong, the Netherlands, Taiwan and the USA, which indicate that IPE learning experiences improved interprofessional communication ( Rossler and Kimble, 2016). IPE simulation-based teaching has also been shown to improve knowledge of others’ roles and responsibilities ( Chen et al., 2022; He, et al., 2024; Lanning et al., 2021; Teuwen et al., 2022), improve interprofessional communication ( Chen et al., 2022; Lanning et al., 2021; Teuwen et al., 2022) and strengthen team interactions and collaborative care skills ( Rossler and Kimble, 2016).
In this study, the IPE group demonstrated significantly higher nursing core competency scores than the control group. A review of 11 studies highlighted teamwork and interprofessional collaboration as key benefits of IPE (Rodrigues da Silva Noll Gonçalves et al., 2021). Sulaiman et al. (2021) also found that IPE fosters diverse problem-solving and joint decision-making. Our findings align with this, showing that IPE enhances the application of theoretical knowledge, critical thinking, communication and teamwork. However, Saragih et al. (2024) reported no significant improvement in teamwork, possibly due to a small sample size. While simulation-based IPE is considered effective and feasible for nursing curricula ( Macías Inzunza et al., 2020), further research is needed to explore its impact on specific nursing core competencies.
This study supports previous findings that IPE enhances decision-making, knowledge and clinical skills ( Herge et al., 2015). Implementing IPE poses challenges, including limited space, funding, equipment, curriculum planning and scheduling ( Herge et al., 2015; Macías Inzunza et al., 2020; Mohammed et al., 2021). Effective IPE should avoid content overload, unclear objectives and unnecessary competition. It must align with learning goals, integrate across curricula and connect to clinical practice ( Sulaiman et al., 2021). Collaboration among governments, universities and healthcare institutions is essential to ensure adequate support and resources for developing interprofessional teamwork skills.
A key strength of this study is its mixed methods design to assess the effectiveness of an IPE program. However, several limitations exist. The study was conducted at a single university without a medical school, making it difficult to recruit medical students and coordinate schedules. Results may not be generalizable to all nursing students. Additionally, students from other healthcare disciplines were not included. This study’s use of a quasi-experimental design without random assignment may also introduce selection bias, limiting the ability to infer causality.
6 ConclusionThis study suggests that IPE helps nursing students build professional identity, understand diverse roles and respect other disciplines. Communication enhances collaboration, coordination and problem-solving while fostering self-awareness and professional growth. We recommend integrating IPE into core nursing curricula to promote collaborative learning. Simulation-based IPE can strengthen teamwork skills. Governments and institutions should allocate resources to reduce barriers and support faculty participation. Future research should involve diverse healthcare students and track interprofessional competency development during clinical transitions. Despite implementation challenges, IPE remains an effective and innovative teaching strategy that deserves wider adoption in healthcare education.
CRediT authorship contribution statementHui (Grace) Xu: Writing – review & editing, Writing – original draft. Chin-Yen Han: Writing – review & editing, Writing – original draft, Supervision, Methodology, Formal analysis, Conceptualization. Li-Chin Chen: Writing – review & editing, Writing – original draft, Methodology. Wen Chang: Writing – review & editing, Writing – original draft, Project administration, Investigation, Funding acquisition, Formal analysis, Data curation, Conceptualization.
Informed consent statementInformed consent was obtained from all subjects involved in the study.
Funding statementThis research was funded by the Ministry of Education (grant number PMN1110214).
Institutional review board statementThe study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board of Chang Gung Medical Foundation (IRB approved number No: 202102176A3C501).
Declaration of Competing InterestThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Appendix A Supporting informationSupplementary data associated with this article can be found in the online version at doi:10.1016/j.nepr.2025.104424.
Appendix A Supplementary materialSupplementary material
| Items | Number
n (%) | Groups | χ 2 | p value | |
| IPE group
( n (%) | Control group
( n (%) | ||||
| Gender | 5.002 | .025 * | |||
| Male | 13 (11.1) | 2 (3.8) | 11 (16.9) | ||
| Female | 104 (88.9) | 50 (96.2) | 54 (83.1) | ||
| Age (years) | 1.628 | .443 | |||
| | 116(99.1) | 52(100.0) | 64(98.5) | ||
| | 1(0.9) | 0(0.0) | 1(1.5) | ||
| Scenario simulation learning experience | 5.599 | .018 * | |||
| No | 10 (8.5) | 8 (15.4) | 2 (3.1) | ||
| Yes | 107 (91.5) | 44 (84.6) | 63 (96.9) | ||
| IPE simulation learning experience | .229 | .632 | |||
| No | 88(75.2) | 38(73.1) | 50(76.9) | ||
| Yes | 29(24.8) | 14(26.9) | 15(23.1) | ||
| simulation as a nurse practitioner | .000 | 1.000 | |||
| No | 54(46.2) | 24(46.2) | 30(46.2) | ||
| Yes | 63(53.8) | 28(53.8) | 35(53.8) | ||
| Variable | Pre-test | Post-test | T | p value | Cohen’s
| |
| Mean (SD) | Mean (SD) | |||||
| Knowledge | IPE | 7.73 (2.41) | 12.52 (3.10) | −11.13 | < .001 *** | |
| Control | 5.60 (2.30) | 8.46 (2.93) | −7.11 | < .001 *** | ||
| T value | 4.85 | 7.21 | ||||
| p value | < .001 *** | < .001 *** | ||||
| 0.61 | ||||||
| Core competencies | IPE | 4.08 (0.59) | 4.51 (0.47) | −4.14 | < .001 *** | |
| Control | 4.52 (0.43) | 4.68 (0.39) | −3.08 | .003 ** | ||
| T value | −4.41 | −2.24 | ||||
| p value | < .001 *** | .027 * | ||||
| 0.42 | ||||||
| IPCP | IPE | 3.91 (0.52) | 4.49 (0.44) | −7.52 | < .001 *** | |
| Control | 4.37 (0.42) | 4.65 (0.38) | −5.58 | < .001 *** | ||
| T value | −5.21 | −2.08 | ||||
| p value | < .001 *** | .040 * | ||||
| 0.63 | ||||||
| Interprofessional interactions | IPE | 3.74 (0.55) | 4.45 (0.47) | −8.04 | < .001 *** | |
| Control | 4.23 (0.51) | 4.59 (0.42) | −5.74 | < .001 *** | ||
| T value | −5.09 | −1.71 | ||||
| p value | < .01** | .091 * | ||||
| 0.62 | ||||||
| Interprofessional values | IPE | 4.08 (0.54) | 4.53 (0.45) | −6.28 | < .001 *** | |
| Control | 4.51 (0.42) | 4.71 (0.37) | −4.32 | < .001 *** | ||
| T value | −4.87 | −2.30 | ||||
| p value | < .001** | .024 * | ||||
| 0.55 |
| Study variable | Beta coefficient | Standard error | 95 % Wald confidence interval | p value | |||
| Knowledge | Intercept | 5.60 | .28 | 5.05 | to | 6.15 | < .001 *** |
| Study group (IPE vs. control) | 2.13 | .46 | 1.18 | to | 2.98 | < .001 *** | |
| Time point | |||||||
| Post-test vs. pre-test | 2.86 | .40 | 2.08 | to | 3.64 | < .001 *** | |
| Study group × time point | |||||||
| IPE × (post-test − pre-test) | 1.93 | .58 | .78 | to | 3.07 | .001 ** | |
| Core competencies | Intercept | 4.52 | .05 | 4.41 | to | 4.62 | < .001 *** |
| Study group (IPE vs. control) | −.43 | .10 | −.62 | to | −.24 | < .001 *** | |
| Time point | |||||||
| Post-test vs. pre-test | .17 | .05 | .06 | to | .27 | .002 ** | |
| Study group × time point | |||||||
| IPE × (post-test − pre-test) | .25 | .11 | .03 | to | .48 | .027
* | |
| IPCP | Intercept | 4.37 | .05 | 4.27 | to | 4.47 | < .001 *** |
| Study group (IPE vs. control) | −.46 | .09 | −.64 | to | −.29 | < .001 *** | |
| Time point | |||||||
| Post-test vs. pre-test | .28 | .05 | .18 | to | .38 | < .001 *** | |
| Study group × time point | |||||||
| IPE × (post-test − pre-test) | .31 | .09 | .13 | to | .48 | .001 ** | |
| Interprofessional interactions | Intercept | 4.23 | .06 | 4.11 | to | 4.36 | < .001 *** |
| Study group (IPE vs. control) | −.50 | .10 | −.69 | to | −.31 | < .001 *** | |
| Time point | |||||||
| Post-test vs. pre-test | .35 | .06 | .23 | to | .47 | < .001 *** | |
| Study group × time point | |||||||
| IPE × (post-test − pre-test) | .36 | .11 | .15 | to | .57 | .001 ** | |
| Interprofessional values | Intercept | 4.51 | .05 | 4.41 | to | 4.61 | < .001 *** |
| Study group (IPE vs. control) | −.43 | .09 | −.61 | to | −.25 | < .001 *** | |
| Time point | |||||||
| Post-test vs. pre-test | .20 | .05 | .11 | to | .29 | < .001 *** | |
| Study group × time point | |||||||
| IPE × (post-test − pre-test) | .25 | .09 | .09 | to | .42 | .003 ** | |
| Outcome | Quantitative | Qualitative | Integration | |
| Learning feedback | Interview | |||
| Knowledge | The IPE group had significantly better knowledge than the control group (p = .001) | Develops students’ logical thinking and problem-solving skills, deepens theoretical knowledge to address gaps, and enhances core competencies essential for collaborative care. | Five key themes:
| IPE offers nursing students the chance to learn collaboratively with other professions.
Simulation-based IPE introduces students to real clinical environments and allows them to recognize the value of collaborative care in interprofessional teams. This collaborative process enhances the following: |
| Core competencies | The IPE group had significantly improved core competencies compared with the control group (p = .027) | Promotes appreciation for the value, ethics, roles, and dynamics of interprofessional teamwork and communication. | ||
| IPEC | The IPE group had significantly improved IPEC compared with the control group (p = .001) | |||
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