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A Longitudinal Study of Interprofessional Education Experiences among Health Professional Graduates

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Title: A Longitudinal Study of Interprofessional Education Experiences among Health Professional Graduates
Language: English
Authors: S. Price (ORCID 0000-0002-5535-6624), L. Van Dam, M. Sim, C. Andrews, J. Gilbert, K. Lackie, J. Almost, N. Kennie-Kaulbach, E. Sutton, H. Khalili
Source: Advances in Health Sciences Education. 2025 30(3):735-754.
Availability: Springer. Available from: Springer Nature. One New York Plaza, Suite 4600, New York, NY 10004. Tel: 800-777-4643; Tel: 212-460-1500; Fax: 212-460-1700; e-mail: customerservice@springernature.com; Web site: https://link.springer.com/
Peer Reviewed: Y
Page Count: 20
Publication Date: 2025
Document Type: Journal Articles
Reports - Research
Education Level: Higher Education
Postsecondary Education
Descriptors: Interprofessional Relationship, Allied Health Personnel, College Graduates, Professional Identity, Foreign Countries, Socialization, Cooperation, Educational Experience
Geographic Terms: Canada
DOI: 10.1007/s10459-024-10374-8
ISSN: 1382-4996
1573-1677
Abstract: Effective teamwork and collaboration among health professionals is a well-recognized strategy toward enhancing patient outcomes. However, there is a lack of understanding on how to best prepare health professionals for collaborative practice. The aim of this research is to gain a better understanding of how graduates of five health professions (dentistry, medicine, nursing, pharmacy, physiotherapy) perceive and experience interprofessional education for collaborative practice (IPECP) throughout their health professions journey, with a focus on transition to practice. This longitudinal study employed an interpretive, narrative methodology to understand interprofessional identity development of 24 individuals who had recently graduated from a health professions program (dentistry, medicine, nursing, pharmacy, physiotherapy) at a Canadian university. Participant experiences were analyzed using narrative analysis. Participants' narratives provided insight into the context, factors and curricular experiences needed for interprofessional identity development and preparedness for collaborative practice. Participants identified the importance of socialization and connection with others, collaborative role models and exposure to collaborative experiences and settings for interprofessional practice. Participants expressed some dissatisfaction with their earliest IPECP experiences and most valued their exposure to 'real-life' practice examples and clinical scenarios. Participants desired more authentic experiences of interprofessional collaboration during their programs. Improving health professionals' interprofessional socialization and collaborative experiences within IPECP is critical to improving patient outcomes. Study findings can inform future curricula and IPECP strategies that create conditions to enhance collaborative practice and ensure the preparedness of a future health workforce with a strong collaborative identity.
Abstractor: As Provided
Entry Date: 2025
Accession Number: EJ1484723
Database: ERIC
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  Value: <anid>AN0185469545;oak01jun.25;2025Jun02.02:37;v2.2.500</anid> <title id="AN0185469545-1">A longitudinal study of interprofessional education experiences among health professional graduates </title> <p>Effective teamwork and collaboration among health professionals is a well-recognized strategy toward enhancing patient outcomes. However, there is a lack of understanding on how to best prepare health professionals for collaborative practice. The aim of this research is to gain a better understanding of how graduates of five health professions (dentistry, medicine, nursing, pharmacy, physiotherapy) perceive and experience interprofessional education for collaborative practice (IPECP) throughout their health professions journey, with a focus on transition to practice. This longitudinal study employed an interpretive, narrative methodology to understand interprofessional identity development of 24 individuals who had recently graduated from a health professions program (dentistry, medicine, nursing, pharmacy, physiotherapy) at a Canadian university. Participant experiences were analyzed using narrative analysis. Participants' narratives provided insight into the context, factors and curricular experiences needed for interprofessional identity development and preparedness for collaborative practice. Participants identified the importance of socialization and connection with others, collaborative role models and exposure to collaborative experiences and settings for interprofessional practice. Participants expressed some dissatisfaction with their earliest IPECP experiences and most valued their exposure to 'real-life' practice examples and clinical scenarios. Participants desired more authentic experiences of interprofessional collaboration during their programs. Improving health professionals' interprofessional socialization and collaborative experiences within IPECP is critical to improving patient outcomes. Study findings can inform future curricula and IPECP strategies that create conditions to enhance collaborative practice and ensure the preparedness of a future health workforce with a strong collaborative identity.</p> <p>Keywords: Professional socialization; Interprofessional education; Collaborative practice; Health professional students; Medical and Health Sciences Public Health and Health Services Psychology and Cognitive Sciences Psychology</p> <p>Supplementary Information The online version contains supplementary material available at https://doi.org/10.1007/s10459-024-10374-8.</p> <hd id="AN0185469545-2">Introduction</hd> <p>In today's complex healthcare environments, effective interprofessional teamwork is essential to enhance the quality and safety of care and health outcomes for patients (Reeves et al., [<reflink idref="bib37" id="ref1">37</reflink>], [<reflink idref="bib38" id="ref2">38</reflink>]; Sangaleti et al., [<reflink idref="bib40" id="ref3">40</reflink>]; World Health Organization [WHO], [<reflink idref="bib45" id="ref4">45</reflink>]). Contemporary health system transformation necessitates the integration of new models of care delivery and/or expanded scopes of health professional practice that values effective collaboration among diverse health professionals (Reeves et al., [<reflink idref="bib38" id="ref5">38</reflink>]; Sangaleti et al., [<reflink idref="bib40" id="ref6">40</reflink>]). Interprofessional collaborative practice (IPC) is enacted when health professionals with differing disciplinary backgrounds come together to use their collective and complementary skills and knowledge to coordinate quality care and management of patients, families, and communities across diverse settings (WHO, [<reflink idref="bib45" id="ref7">45</reflink>]). IPC is identified as improving access to care for populations, creating safer, more effective health systems, and mitigating stress and burnout amongst health care workers (World Health Professions Alliance [WHPA] [<reflink idref="bib46" id="ref8">46</reflink>]). Interprofessional education (IPE) is defined as "occasions when members or students of two or more professions learn about, with and from each other, to improve collaboration, and the quality of care and services" (Centre for the Advancement of Interprofessional Education [CAIPE], [<reflink idref="bib8" id="ref9">8</reflink>]). The WHO recognizes IPE as an integral component of health professions education and interprofessional education for collaborative practice (IPECP) include initiatives that enable developing students' skills and knowledge to collaborative across disciplines and which support effective interprofessional teams and optimal patient care in practice (CAIPE, [<reflink idref="bib8" id="ref10">8</reflink>]; WHO, [<reflink idref="bib45" id="ref11">45</reflink>]).</p> <p>Professional socialization, along with interprofessional socialization, is a key component for IPECP and involves the process of developing a professional identity and gaining a deeper understanding of the beliefs, responsibilities, attitudes, and social norms of a professional role (Davis, [<reflink idref="bib10" id="ref12">10</reflink>]). Professional socialization impacts individuals' perceptions and behaviours related to professional roles and identity, that could facilitate, or hinder, interprofessional relationships (Khalili et al., [<reflink idref="bib24" id="ref13">24</reflink>]; Reeves et al., [<reflink idref="bib37" id="ref14">37</reflink>], [<reflink idref="bib38" id="ref15">38</reflink>]; Reeves et al., [<reflink idref="bib37" id="ref16">37</reflink>], [<reflink idref="bib38" id="ref17">38</reflink>]). Interprofessional socialization (IPS) experiences between health professionals, on the other hand, can not only improve individuals' interprofessional knowledge, skills, values and behaviours, but also enhance their knowledge of their own professional role in relation to the larger team in a way that values their unique and complementary contributions to patient care without encouraging opposition to one another (Dolan & Nowell, [<reflink idref="bib11" id="ref18">11</reflink>]; Khalili, et al., [<reflink idref="bib23" id="ref19">23</reflink>]). IPS is significant to effective collaboration across the health professions as it promotes development of a dual (professional and interprofessional) identity (Khalili & Orchard, [<reflink idref="bib21" id="ref20">21</reflink>]; Khalili & Price, [<reflink idref="bib22" id="ref21">22</reflink>]). Interprofessional socialization experiences within health professions pre-licensure IPE can promote students' development of an interprofessional identity, where through consistent exposure to others, individuals are better able to recategorize themselves on a level of sameness with others that promotes social closeness, trust and inclusive group formation (Prasch et al., [<reflink idref="bib33" id="ref22">33</reflink>]). IPS supports dual identity formation and a sense of belonging to both professional and interprofessional groups which favours collaboration in practice and improved quality of care and services (Khalili & Orchard, [<reflink idref="bib21" id="ref23">21</reflink>]; Khalili & Price, [<reflink idref="bib22" id="ref24">22</reflink>]).</p> <hd id="AN0185469545-3">Background</hd> <p>Even though strong interprofessional relations have been highlighted as an essential principle to providing effective care and creating healthy work environments, there continues to be barriers in cultivating a collaborative culture amongst health professionals (Khalili, [<reflink idref="bib20" id="ref25">20</reflink>]; Khalili et al., [<reflink idref="bib24" id="ref26">24</reflink>]). Current approaches by which health professional students are socialized within their education programs, are identified as reinforcing development of a profession-specific (uni-professional) identity that impedes collaboration between professionals and teams in practice (Chen et al., [<reflink idref="bib9" id="ref27">9</reflink>]; Reeves et al., [<reflink idref="bib37" id="ref28">37</reflink>], [<reflink idref="bib38" id="ref29">38</reflink>]). IPE is an intervention that is increasingly integrated in health professions education to enhance collaboration and IPECP experiences for students- including practice simulation, case-study activities and clinical experiences, are well-documented as valuable learning opportunities for students to be exposed to, and develop skills for collaborative practice. (Grace, [<reflink idref="bib15" id="ref30">15</reflink>]; O'Leary et al., [<reflink idref="bib29" id="ref31">29</reflink>]; Reeves et al., [<reflink idref="bib36" id="ref32">36</reflink>]). However, the literature available has also noted that long-term impacts of IPECP exposure on students' professional development and preparedness for IPC are not well understood and few studies have explored the benefits of extended and immersive IPECP experiences (Grace [<reflink idref="bib15" id="ref33">15</reflink>]; Nagel et al., [<reflink idref="bib27" id="ref34">27</reflink>]; Powers et al., [<reflink idref="bib32" id="ref35">32</reflink>]). Investigating the contexts in which professional socialization occurs will provide a greater understanding of how health professions students develop a professional (or uni-professional) identity throughout their programs and their ability (or lack of) to begin processes of developing the skills, attitudes and behaviours of an interprofessional practitioner.</p> <p>Few studies have explored processes of professional socialization among diverse health professions throughout their prelicensure education and into professional practice. There is also limited understanding of how current IPECP experiences and IPE curricula within pre-licensure education inform students' perceptions and expectations of interprofessional practice. In addition, research focusing on processes of professional socialization during students' education have been predominantly quantitative and scholars have consistently recognized the need for more qualitative approaches (McGuire et al., [<reflink idref="bib26" id="ref36">26</reflink>]; Tong et al., [<reflink idref="bib43" id="ref37">43</reflink>]). Methodologically rigorous qualitative analyzes are needed to better understand processes of professional and interprofessional socialization within pre-licensure health professions education and the implications of students' IPECP experiences for IPC upon program completion.</p> <hd id="AN0185469545-4">Research aim</hd> <p>The aim of this research was to gain an understanding of how IPECP experiences during pre-licensure education for health professional students (dentistry, medicine, pharmacy, physiotherapy and nursing) impacted their interprofessional socialization and readiness for collaborative practice upon program completion and entry to practice. This study reports on student reflections of their IPECP curriculum at two time points; time of graduation and within the first few years of their professional practice (final follow-up). This study is part of a larger longitudinal study exploring professional socialization and IPECP experiences of all five of these health professions (Harman et al., [<reflink idref="bib17" id="ref38">17</reflink>]; Kennie-Kaulbach et al., [<reflink idref="bib19" id="ref39">19</reflink>]; Price et al., [<reflink idref="bib34" id="ref40">34</reflink>], [<reflink idref="bib35" id="ref41">35</reflink>]). Description of the IPECP curriculum for all professional programs and student perceptions of IPECP and professional socialization early in their pre-licensure education have been previously reported (Price et al., [<reflink idref="bib34" id="ref42">34</reflink>], [<reflink idref="bib35" id="ref43">35</reflink>]). This paper satisfies a need for IPECP research that follows healthcare students' longitudinally throughout their programs and into practice. Moreover, this this paper contributes to a gap in the literature focusing on understanding best practices for IPECP programming in pre-licensure health professions education, including how professional socialization within IPECP impacts perceptions and expectations of collaboration across health professions and influences their early experiences working in collaborative practice settings.</p> <hd id="AN0185469545-5">Methods</hd> <p>This study employed an interpretive, narrative methodology to understand the experiences and evolving self-identities of health professional students at the time of graduation and within their early professional practice experiences (Polkinghorne, [<reflink idref="bib31" id="ref44">31</reflink>]). This narrative inquiry was guided by the philosophical and theoretical tenets of interpretivism, hermeneutics, and narrative identity theory (Polkinghorne, [<reflink idref="bib30" id="ref45">30</reflink>], [<reflink idref="bib31" id="ref46">31</reflink>]; Ricoeur, [<reflink idref="bib39" id="ref47">39</reflink>]). Narrative identity theory is built upon the premise that individuals' stories are the "primary scheme by means of which human existence is rendered meaningful" (Polkinghorne, [<reflink idref="bib30" id="ref48">30</reflink>], p. 11). Narrative research is an interpretive approach that is not a mere retelling or description of an individual's story, but rather a dynamic process of interpretation that alters and contributes to meaning making (Polkinghorne, [<reflink idref="bib30" id="ref49">30</reflink>]). Narrative is often acknowledged as a method for data collection, analysis, and a representational form for findings. However, narrative is also recognized as a theoretical approach to understanding the meaning of human experience by drawing events and actions together and noting the contributions that they make to a particular outcome. As such, narrative approaches are well suited to explore professional identity development and provides a robust framework for understanding individual, developmental, social, and organizational factors that influence one's professional identity (Singer, [<reflink idref="bib42" id="ref50">42</reflink>]). Narrative inquiry was used in this study to understand how socialization experiences within pre-licensure health professions IPECP contribute to professional and interprofessional identity formation and individuals' perceptions and expectations of IPC upon program completion and within their early practice experiences. Ethics approval was obtained from the Health Sciences Research Ethics Board at Dalhousie University (REB #: 2014-3416). Attention was given to not only influential events and experiences but also to the ways in which individuals organize these influences within their story and narrate their professional identity in relation to interprofessional practice.</p> <hd id="AN0185469545-6">Participants and study setting</hd> <p>This study included a convenience sample of 24 individuals from the longitudinal study of pre-licensure health professions students. Individuals who had previously consented and participated in interviews early in their pre-licensure education (<emph>n</emph> = 49), were contacted via email with an invitation to participate in a follow-up interview at the time of their program graduation. Fifteen individuals from programs in dentistry (n = 1), pharmacy (n = 1), physiotherapy (n = 4), or medicine (n = 9) consented to participate in interviews at this time. A final invitation was sent by email to participants two years post-graduation (four years post-graduation for physiotherapy), and 24 individuals from dentistry (n = 2), pharmacy (n = 3), physiotherapy (n = 6), medicine (n = 8) and nursing (n = 5) consented to a final follow-up interview. Participants' program and interview timelines are provided (Table 1). Fourteen of the participants completed interviews at both timepoints.</p> <p>Table 1 Description of health professions programs and interview timelines</p> <p> <ephtml> <table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="2"><p>Professional program</p></th><th align="left" colspan="2"><p>Interviews</p></th></tr><tr><th align="left"><p>Graduation (2017/2019)</p></th><th align="left"><p>Final follow-up (2021)</p></th></tr></thead><tbody><tr><td align="left"><p>Dentistry </p></td><td char="." align="char"><p>N = 1</p></td><td char="." align="char"><p>N = 2</p></td></tr><tr><td align="left"><p>Nursing </p></td><td char="." align="char"><p>N = 0</p></td><td char="." align="char"><p>N = 5</p></td></tr><tr><td align="left"><p>Medicine</p></td><td char="." align="char"><p>N = 9</p></td><td char="." align="char"><p>N = 8</p></td></tr><tr><td align="left"><p>Physiotherapy<sup>a</sup></p></td><td char="." align="char"><p>N = 4</p></td><td char="." align="char"><p>N = 6</p></td></tr><tr><td align="left"><p>Pharmacy</p></td><td char="." align="char"><p>N = 1</p></td><td char="." align="char"><p>N = 3</p></td></tr></tbody></table> </ephtml> </p> <p> <sups>a</sups>Two-year program for physiotherapy students versus four-year programs (dentistry, nursing, medicine, and pharmacy)</p> <p>All individuals were graduates of a large public university in Canada and began their studies in the fall of 2015. These five health professions were chosen as they represent the largest cohort of health professional students at the study setting, are all direct care providers, and have evolving and overlapping scopes of practice. Further, as part of the university curriculum, these health professions students were required to participate in mandatory IPECP curriculum (Price et al., [<reflink idref="bib35" id="ref51">35</reflink>]).</p> <p>No nurses responded to interview requests at the time of their graduation, therefore data for this cohort at this timepoint is missing. Reasons for participant attrition at the time of graduation and final follow-up included workload impact of the COVID-19 pandemic, scheduling conflicts, or inability to be contacted. Only one participant declined continued participation due to pandemic response burnout. Demographic information was not collected from participants.</p> <hd id="AN0185469545-7">Data collection</hd> <p>We employed one-on-one semi structured interviews consistent with narrative research (Polkinghorne, [<reflink idref="bib30" id="ref52">30</reflink>]). Following informed consent, interviews were conducted at the time of graduation: in 2017 for the two-year physiotherapy program and in 2019 for the remaining 4-year programs. Participants from the longitudinal study were contacted again a few years later (2021), early into their professional practice careers, and invited to participate in a final follow-up interview. Interviews ranged from 30 to 80 min, with a median interview time of 50 min. A postdoctoral fellow (MS) conducted the interviews using semi-structured interview guides. (Supp1) Interviews were conducted in-person and virtually depending on participant preference and in accordance with public health measures related to COVID-19 (2021 interviews). Interview questions at graduation related to student experiences of IPECP and their expectations and perceptions of interprofessional collaboration and preparedness for collaborative practice as they transitioned to professional practice. Interview questions at final follow-up related to reflections on IPECP curricular experiences during pre-licensure education and impacts on interprofessional socialization and collaboration in their first few years of practice. All interviews were audio-recorded, transcribed, de-identified and assigned a numeric code to organize the data. All participants were assigned a pseudonym for use of their quotes in this manuscript.</p> <hd id="AN0185469545-8">Data analysis</hd> <p>Data analysis was guided by Beiter's narrative analysis framework (Beiter, [<reflink idref="bib3" id="ref53">3</reflink>]) and Polkinghorne's theory of narrative configuration and emplotment (Polkinghorne, [<reflink idref="bib30" id="ref54">30</reflink>]). The term "theme" within the context of interpretive, narrative inquiry does not necessarily represent something stated repeatedly but instead reflects an understanding or significance. Interviews were analyzed simultaneously across all health professional programs and transcripts from the graduation timepoint were examined at the time of data collection for thematic characterizations and the identification of plots, subplots, characters, settings, and tensive points. Upon completion of final-follow up interviews 2-years later, transcripts from this timepoint were subject to identical processes of analysis and thematic characterization. Transcribed data and identified themes from both timepoints were then reviewed and analyzed together in order to create a meaningful, synthesized narrative account of participants' stories of professional socialization and interprofessional experiences. Initial coding and themes were developed by the Research Assistant, a PhD in Health candidate, and then validated by the Principal Investigator and other core members of the research team at both timepoints.</p> <hd id="AN0185469545-9">Investigator positionality</hd> <p>All authors in this study hold backgrounds as practicing health professionals, health educators and researchers in Canada and the USA, with representation from all 5 cohorts of health professional programs included in the research. Collectively, the authors have extensive experience in qualitative research and have intimate knowledge of, and hold professional designations, of the health professions represented in this study. The Principal Investigator (SP) is a registered nurse, Professor (School of Nursing) and a well-published expert in the field of interprofessional education and interprofessional socialization within the health professions. All authors contributed to the analysis and interpretation of the study findings, promoting rigour in the results.</p> <hd id="AN0185469545-10">Findings</hd> <p>Using narrative structure, the narratives of health professions graduates' revealed major plots and subplots of their IPECP and pre-licensure program experiences and their significance to developing an interprofessional identity. Narrative emplotment draws attention to characters, events, situations, and settings narrated by participants and identified as influential for their interprofessional socialization experiences during pre-licensure education. Processes of emplotment are also sensitive to the timing of events within IPECP that enabled health professions students' development of collaborative skills, attitudes and behaviours and perceived readiness for interprofessional practice. Across participant narratives, two major plotlines for developing an interprofessional identity included a need for establishing meaningful connections with others and authentic experiences observing and participating in collaboration with others.</p> <hd id="AN0185469545-11">Establishing early & meaningful interprofessional connections</hd> <p>Within the participant narratives, the understanding of self as "collaborative practitioner" and "team member" often centered on knowing the others who were part of the team. Establishing peer relationships with other health professional students during pre-licensure education was a central part of their professional development. An important subplot was that exposure to diverse peers during education were formative and meaningful socialization experiences that provided a foundation upon which to build future collaborative relationships. Having the opportunity to connect and get to know about one another as people (formally and informally) helped to deconstruct some of the misperceptions and stereotypes they had about other health professions. In addition, several participants reflected that socialization opportunities helped to balance historical hierarchies, which enabled the building of rapport and enhanced communication. Tim (medicine) shared:</p> <p> <emph>[Socializing] kind of broke down barriers. Because med students just tend to hang out with med students, nursing students hang out with nursing students, respiratory therapists hang out with respiratory therapists. Getting to know people from other programs was a great way to break down some of the barriers that exist between multiple professions.</emph> </p> <p>Developing friendships with other health professional students during their professional programs also enabled participants to gain respect for, and a greater understanding of, other professions and their roles. As Kim (pharmacy) described,<emph>By having really good friends who are almost all physicians now, I find it very comfortable to talk to doctors. And IPECP activities helped a little bit with that, but it's more that I have really good friends who are doctors.</emph></p> <p>Establishing authentic connections with other health professions students early in their programs, was also narrated as a critical timepoint for participants in their professional development. Participants identified that having peers in other health programs at the beginning, and throughout their pre-licensure education were important supports as they navigated their programs and learned their professional role. Narratives also emphasized how having friendships and connections with others helped mitigate feelings of being overwhelmed as they prepared for transition into professional practice. Maria (medicine) explained:<emph>As much as I felt unprepared a lot of times, I never felt alone. And I was really comforted in the fact that other people were also doing this dance, and also felt like they were in over their heads.</emph></p> <p>Several participants also narrated that the friendships they formed with others health professions students during their pre-licensure education allowed them to feel more confident having to approach other health professions in their future practice. Christina (physiotherapy) reflected:<emph>Once you're out in practice and you're all graduating around the same time you might run into each other and, you know, you would already have that connection</emph></p> <p>For some participants, the importance of fostering connections with other health professions students was not fully revealed until they transitioned into professional practice. For Shelley (dentistry), seeing patients with diverse health needs that extended beyond her professional scope allowed her to better appreciate the importance of the relationships she had made during her professional program and within her IPECP experiences. She reflected,<emph>I saw the potential there. Like sometimes you'll learn stuff and you'll take it with a grain of salt. But then when you get out into practice, you're like, "Oh, I really wish I had so-and-so's number from the time we were in IPECP together.</emph></p> <p>Amy (nursing) reflected that her socialization experiences during her time in pre-licensure IPECP contributed to more effective interprofessional collaboration experiences in practice.<emph>When you are in high acuity situations and you are depending on the people standing next to you to understand your words and understand your body language, and to just work effectively as a team in a really highly charged situation, it helps to have some team building. I think informal socialization is part of that team building.</emph></p> <p>Across narratives, participants solidified the value of informal relationships with peers, considering them vital for developing understanding, trust and respect for other health professionals and health professions. In the timeline of students' interprofessional identity development, early socialization, and opportunities to connect with others is identified as a necessary precursor to interprofessional collaboration in practice.</p> <hd id="AN0185469545-12">Authentic experiences of collaboration: a collaborative web</hd> <p>Another key plotline for students to learn and develop skills for collaborative practice were opportunities to witness and experience interprofessional role models for collaboration. Participant narratives characterized professional mentors during their pre-licensure and IPECP experiences as standout characters for role modelling and learning collaborative behaviours. Faculty members, instructors and clinical clerks, who positively modelled collaborative practice during students' IPECP and clinical practice experiences were described to significantly influence the characteristics and traits adopted by participants. Participants believed that mentors who were role models for interprofessional practice were important characters that supported their own development as interprofessional care providers. Witnessing collaborative team members in practice provided a template for future interprofessional interactions. As Ted (medicine) described,<emph>I think a lot of it is about role modelling...And a lot of what they have to say, especially in those pre-clerkship years, will imprint on you in terms of how you view professional interactions</emph></p> <p>Several participants also spoke to the impact of seeing and experiencing interprofessional role models for what they desired their future professional practice experiences to look like. Joni (nursing) shared how positive role modelling of collaborative practice that she experienced on a clinical rotation as a student was a deciding factor for her nursing career path.<emph>I've been on [hospital unit] since I was student. During my final placement is when I noticed how well everyone worked together, and it was very supportive. A very friendly environment to learn in.</emph></p> <p>In addition to exposure to role models, firsthand accounts of collaborative practice were narrated as some of the most profound learning experiences. The narrative climax for participants' interprofessional identity development was identified as exposure to authentic experiences and settings of collaborative practice. Participants narratives described the best form of IPECP to be opportunities to observe and participate in 'real world' practice alongside others health professionals.</p> <p>Simulation activities during pre-licensure IPECP were described as important opportunities for students' to be introduced to interprofessional settings and collaboration in 'real time'. Participating in simulations that mimicked 'real' clinical experience were identified as valuable opportunities to understand diverse roles and responsibilities. For Robert, simulated case scenarios from his IPECP experiences in his physiotherapy program resonated in his present work as a physiotherapist,<emph>We had an OSCE that involved working as a team with medicine students, a pharmacist, a nurse, and an occupational therapist. There were several stations and each of us took on a particular role. each station was to highlight our role in that situation. I think that was probably the best (IPECP experience). Because I remember thinking back to it, and I didn't realize pharmacists knew so much about medication, and they knew about different conditions and what kind of medications blended together. At that time, if a patient would come in with a question about their medication, I always say "go talk to your doctor". I gained a better idea of their scope and their knowledge-base, it was an eye-opener.</emph></p> <p>The clinical practice environment was often identified as a primary setting that exposed participants to other health professionals, role models and authentic opportunities to learn with, from, and about one another. Clinical practice experiences were narrated as key events that allowed health professions students to become 'a part' of the collaborative web of professionals in practice. As several participants narrated,<emph>I think the best experience I had was all through my clerkship experiences....working as part of multidisciplinary teams in various settings in the hospital. Being part of those teams myself, interacting with people and observing how my colleagues, like peer residents, staff, would interact. I think that was honestly the strongest component in my education, was that experiential piece when I actually got to my clerkship. (Lee, Medicine)</emph></p> <p>Participants also believed that more of these experiences are needed within pre-licensure education to better understand and value the scopes and roles of other professionals:<emph>I don't know what I thought nurse practitioners did, but I'd never seen one... having them in subspecialties like cardiology and neurology was really different. I liked working with them a lot. They were really good. (Medicine, Alex)</emph><emph>I got to interact with so many different professions in the hospital that I had always... I knew they existed...but I've never spent enough time with them to get a great sense of their role. I learned so much practical information about how I will better interact with allied health professionals as a family doctor. (Medicine, Maria)</emph></p> <p>In addition to promoting interprofessional understanding, clinical placements within interprofessional settings enhanced the participants' understanding of their own professional role:<emph>Placements were definitely the things that molded you into who you are as a physiotherapist or your interests as a physiotherapist because you're actually doing it, you're in there seeing like what it's like to do, getting a little bit of taste for it (Physiotherapy, Alice).</emph><emph>I've always found my hospital placements the biggest eye-opener in terms of what pharmacists can do and how much we can collaborate with other people. In hospital, you are part of a team from 8:30am straight through to 4:30pm. You deal with another health professional probably every hour (Pharmacy, Kai)</emph></p> <p>Further, experiential learning within authentic clinical environments allowed participants to see others working within their roles, which enabled a greater appreciation for the knowledge and skills of other health professionals. For example, James (medicine) noted:<emph>Before I was in medicine, I assumed that the knowledge of nurses and all other allied healthcare professionals was less or something, or that docs were the final person you went to see about health problems. But now I think I realize it's a lot more just of a web. And I've learned a lot from [other professionals].</emph></p> <hd id="AN0185469545-13">'Setting' the stage for collaboration: space and time</hd> <p>A key subplot for forming meaningful connections with other professionals and developing an interprofessional identity was the opportunity for interaction within shared practice settings. The participants emphasized that sharing a physical space with other professionals presented an opportunity for learning roles, responsibilities, and working collaboratively. Participants further described that any environment where health professionals were in proximity to one another in practice (e.g., hospital setting, rounds, lunchrooms, shared lounges/break rooms, study spaces) afforded important opportunities for socialization.</p> <p>As Benjamin (dentistry) reflected, a potential strategy for health profession faculties to enhance interprofessional learning would be to create spaces that can be shared among the professional programs:<emph>I think trying to integrate the programs a little bit more. Instead of secluding themselves. I mean part of that seclusion is also physical, if you think about it, because all the buildings are separate from each other.</emph></p> <p>Several participants agreed that proximity to other health professionals enabled a 'team' culture and provided an opportunity for enhanced understanding between professionals in providing patient care. Proximity to others was narrated to be important both in pre-licensure IPECP and in extension to participants' early professional practice experiences. For Amy, establishing interprofessional connections in the workplace was critical to her successful transition to practice. She also described how learning to work as part of an interprofessional team was enhanced by her proximity to other professionals in her practice setting. As she shared:<emph>There's going to be situations even once you get out of your preceptorship, out of your first year, or second year, that you're still not going to know what to do. But you're never alone. If you stick your head out of a room, someone is there. The doctors are there, the nurses are there, we have cleaners, medics, clerks.. we're very much connected.</emph></p> <p>Reflecting on his pre-licensure and professional practice experiences, Benjamin also emphasized the importance of having interprofessional practice settings to the provision of patient care. Within the context of the COVID-19 pandemic, he described a meaningful scene where he learned the value of working alongside other professionals,<emph>The vaccination campaign, was literally collaborative work...it didn't matter what your rank was, it didn't matter what your specialty was, we all worked as a team. We were all there with one purpose-it was myself, and a couple of general dentists, a couple of general physicians and we were all working together, were all respectful toward each other, and we all learned from each other. You know, there's things that I taught them about injection techniques; things that they taught me about injection techniques.</emph></p> <p>In addition to the importance of setting within the participant narratives, temporality, and the timing of IPECP events to be vital for staging the development of an interprofessional identity. Specifically, the timing of IPECP curriculum and opportunities for connection were found to enhance or hinder students' understanding of professionals' roles, responsibilities, and collaborative practice. A tensive point identified by participants including physiotherapy student, Taryn, was that the focus of some IPECP activities were introduced too early in their professional program. This left Taryn, and several others feeling frustrated with IPECP events and disillusioned with their significance to their professional development and practice:<emph>They pair us up with OTs in our first year and I mean, neither of us really had an idea what our whole scope could be, or what we could really do. It was really frustrating because you wanted to learn about the other profession but they didn't know anything about the profession...</emph></p> <p>As Taryn's quote highlights, the context of the IPECP matters in terms of the appropriateness of timing. For example, it is difficult to have curriculum focus on understanding others' scopes of practice before students themselves understand their own scope of practice. Taryn further described the difficulty of having IPECP events with learners at different timing/stages of their education.<emph>The IPECP event that we did with everyone - with all the health professions, I think that was only useful because the OT and the PTs-we were 2nd years. We already had a pretty decent understanding of what we needed to accomplish. We had 1st year nursing students with us, and I was like 'well they don't know anything, they want a year's worth of education in one class'. They were just wee babies.</emph></p> <p>The narratives of participants reveal that development of an interprofessional identity is contingent on attention to both the timing and sequencing of IPECP events.</p> <p>Overall, participants' IPECP experiences during their pre-licensure education presented a juxtaposition– they recognized its importance and value but were at times dissatisfied with their experiences. Students believed that IPECP needed to be prioritized from the beginning of their program, be more authentic, and focus on experiential learning. Exposure to collaborative role models and settings, and the timing of these experiences, can impact students' perceptions of interprofessional practice and influence their desire to practice collaboratively. Reflecting on her pre-licensure experiences, Laura (medicine) narrated the positive impact of experiencing authentic interprofessional collaboration on her future practice:<emph>I can't imagine why I wouldn't have kept chasing that experience.</emph></p> <hd id="AN0185469545-14">Intentionality & integration matters—IPECP is more than ticking boxes</hd> <p>The participant narratives highlighted their appreciation for IPECP experiences, describing them an integral component of their early socialization, ongoing identity development and future collaborative practice. However, the narratives dually revealed tensive points that challenged the merit of their collaboration experiences. Framed as an antagonist for developing an interprofessional identity, was what health professions' graduates perceived as inauthentic and 'tickbox' IPECP experiences.</p> <p>Participants narrated that IPECP events often did not provide authentic scenarios that allowed them to connect as a team or to understand their interprofessional role. Many participants narrated a desire for increased opportunities to learn with, from and about one another within the contexts and settings that reflect real-world practice. The participants noted that merely brining diverse groups of health professionals together in a course did not equate to interprofessional education. As Candace (pharmacy) reflected,<emph>We did a project in first year where we just talked to a person who had a chronic condition about their experiences in the health care system. So those were good to get to know other people around us. But we really didn't have the opportunity to function as health care providers. Like practice as functioning health care providers in those roles. It was more of just a group activity, really.</emph></p> <p>For others, the structure and formality of IPECP events during their pre-licensure education were viewed as serving a "tick a box" for program credits which left students "jaded" about interprofessional collaboration in general. As Ted (medicine) described:<emph>I guess for me it's just when it's being treated as a tick box. 'oh, we have to do IPECP' so we'll do these things to tick the boxes. If that's the process then you just get students who are jaded....very busy....and this doesn't feel like a priority, and so students will sort of [dismiss] it and not treat it like a priority. So if it's not engaging, if it doesn't feel like you're really getting something out of it then people have a very negative attitude about it. And I'm convinced that that then corresponds to having a negative attitude about interprofessional practice in general.</emph></p> <p>Many participants also described that the ways in which IPC was discussed within the didactic settings of pre-licensure IPECP were ineffective at relating the true significance of collaboration. The characterization of IPECP experiences as unengaging and inauthentic was a major tensive point identified across narratives. Further, the inauthenticity of experiences was not directly apparent to participants until experiencing 'true' collaboration in practice. A key feature of narrative research is having the time for recall and reflexivity and the participants' appreciated the opportunity to reflect on the quality of their IPE curriculum. Participants like Benjamin (dentist) narrated opportunities to authentically 'live' collaboration in practice as the crescendo for overcoming obstacles in IPECP- such as poor design of team-based activities,-to truly learn and understand interprofessional collaboration.<emph>I mean they try to teach this to us, too. You know, they're like 'patient-centred care, patient-centred care, it's such a team effort.' But I didn't really understand the importance of it. I didn't realize when I was in school how important or how much it weighs. The whole idea of a collaborative team effort to provide care for the patient, I didn't realize how important that actually is. And I guess you could say in a way I didn't really understand the true meaning behind it.</emph></p> <p>Participants narrated that a more purposeful and meaningful integration of IPECP into the health professions' curriculum is needed. Moreover, they identified that IPECP needs to be presented as an essential component of their professional development and practice versus a curriculum requirement. Exposure to real clinical scenarios, collaborative role models, and experiential learning in simulation and practice were central plots and subplots revealing that meaningful IPECP takes place in practice settings—not in classrooms or didactic events. For participants, IPECP was a mandatory and formal term-based program module that provided students credit for participation ([blinded],2020). Health professional graduates narrated that this approach was inauthentic, and the time-limited structure resultingly failed to invoke impactful or transformational experiences for students' understanding of interprofessional collaboration or their role within a team.<emph>I think we only had to do five hours (of IPECP) in the run of the year. So not very much. My experiences were.. I would say somewhat indifferent. I think there was potential there, but maybe it wasn't memorable enough. (Shelley, dentistry).</emph></p> <p>Participants also reflected that despite participating in IPECP, they felt they had very little knowledge of other health professions and their scopes of practice. Many participants expressed a desire for more opportunities within pre-licensure programs to be exposed to the roles of others and how they may authentically interact and collaborate in practice. As identified in the narratives, there was a lack of regular and consistent exposure to other health professions' students and opportunities to solve 'real' patient issues together- whether it be in practice or simulation. Reflecting on his most impactful IPECP experiences, Ted (medicine) offered the following recommendation:<emph>I think you have to push to either do simulation-based tasks or potentially working with real patients. Either of those, I think those are the rich experiences where you actually can develop a little bit of a relationship and understanding. Particularly if you get to do it a couple of times as well.</emph></p> <p>Time-limited IPECP experiences were found to impede the participants' ability to make connections between collaboration in theory and collaborative practice.</p> <hd id="AN0185469545-15">Discussion/Implications</hd> <p>The longitudinal qualitative design of our study revealed important insights regarding interprofessional curriculum deemed useful by health professional students throughout their prelicensure years (Price et al., [<reflink idref="bib34" id="ref55">34</reflink>], [<reflink idref="bib35" id="ref56">35</reflink>]). By focusing on the experiences of students at their time of graduation and in their early years of professional practice in this study, we identified the valuable role that early and meaningful cross-professional connections and collaboration can have on interprofessional socialization and professional identity development. In addition, our findings draw attention to the gaps that IPECP continues to face in its integration and implementation in the academic setting and its implications for students' preparedness for collaborative practice as they transition into their professional roles.</p> <p>A key finding was that participants wanted more opportunities to make meaningful connections with other health professional students in the academic and clinical settings. Participants who developed informal relationships with others during their programs and continued to cultivate these relationships early in their professional practice reported that it helped to break down stereotypes and gain a greater understanding of diverse health professional roles. In addition, it helped to shape their identity as a collaborative health professional and promote self-confidence in their personal practice. Although participants desired these connections, the traditional structure of academic programs and the physical segregation of students on campus, often prevented this opportunity. Similar findings have been reported in other studies amongst health professions students (Carpenter & Dickinson, [<reflink idref="bib7" id="ref57">7</reflink>]; Gilligan et al., [<reflink idref="bib14" id="ref58">14</reflink>]; van Diggele et al., [<reflink idref="bib44" id="ref59">44</reflink>]), solidifying a need for academic health programs to review and restructure current educational settings in ways that promote opportunities for socialization and the breaking down of professional siloes.</p> <p>The narratives also identified that clinical and simulation experiences were important settings that exposed students to diverse health professionals and fostered role understanding. These findings are consistent with the stages of interprofessional socialization (Khalili et al., [<reflink idref="bib23" id="ref60">23</reflink>]) where eliminating barriers to IPS is essential in developing an interprofessional identity. Role learning, as the second stage of interprofessional socialization, is best occurred when interprofessional students are provided with the opportunity to observe and practice IPC/teamwork in action (Khalili & Orchard, [<reflink idref="bib21" id="ref61">21</reflink>]). While participants in our study shared an academic institution, facilitating engagement in shared IPECP experiences with other health professions, our findings support the need for hospitals and academic institutions to work together to create new opportunities for healthcare students across (uni-) professional colleges, universities and institutions to interact with other professions. This may require thoughtful consideration when choosing clinical placements especially for cohorts of students who are working in areas where teams are uni-professional in nature. In settings where interaction with diverse health professionals may be limited, there should be a deliberate attempt to ensure IPC competencies are met in other ways (i.e., simulation). In addition, participants reported that having mentors and role models who were collaborative and valued other health professionals positively influenced their view of IPC. Future IPECP experiences should involve intentionally pairing students with mentors who demonstrate strong leadership in IPC which could positively influence their perceptions, attitudes and desire to practice collaboratively. Existing evidence confirms the positive impact of mentoring activities within health education programs on students' professional development but underscores the need for early initiation of relationships and longitudinal exposure to role models to be successful (Jordan et al., [<reflink idref="bib18" id="ref62">18</reflink>]). Future iterations of IPECP curriculum should therefore seek to expose students' early on and continuously throughout their programs to collaborative role models. Future research is needed to explore the impact that longitudinal clinical mentorship in the health professional student placement environment can have on students' interprofessional identity development and perceptions of IPECP and IPC.</p> <p>Our study identified physical proximity amongst the health professions to be conducive to improving interprofessional communication, socialization opportunities and the elimination of perceived role hierarchies for new graduates in their first few years of professional practice. Within the academic setting, creating shared physical spaces that enable health professional students to be closer in proximity could provide students with greater opportunities for interaction. In addition, designing curriculum content to overlap, when possible, could promote relationship-building and collaboration amongst students from different health programs. It is important to acknowledge that merely providing students with shared spaces to interact may not create meaningful connections that challenge pre-existing stereotypes or beliefs (Kitto et al., [<reflink idref="bib25" id="ref63">25</reflink>]). However, creating shared spaces within and outside of IPECP activities can enhance opportunities for informal interaction amongst health professional students that may contribute to increased comfort practicing collaboratively in the future (Brewer et al., [<reflink idref="bib5" id="ref64">5</reflink>]).</p> <p>Our findings support the need for future IPECP initiatives to provide students with opportunities to make meaningful and authentic connections. Re-structuring existing IPECP initiatives to allow informal connections between diverse health professional students need to occur earlier in the program. In addition, initiatives that require interprofessional groups to come together multiple times could help to create lasting connections. The study by Powers et al. ([<reflink idref="bib32" id="ref65">32</reflink>]) investigated the perspectives of students participating in a longitudinal IPECP initiative (hotspotting) that focused on patient-centered, team-based care for individuals with complex medical and social needs. The study found that repeated interaction opportunities among students helped to create a safe learning environment that enabled participants to truly get to know each other and fostered communication. Our study builds upon these findings and further demonstrates that students derive greater learning about collaborative practice in the context of "real-life" scenarios that focus not just on a particular disease/condition but interprofessional approaches to patient-centred social care.</p> <p>Another key finding was that students were often dissatisfied with the lack of authenticity in the content and integration of IPE initiatives within their programs. Participants shared that IPE could feel inauthentic because case scenarios and activities often lacked intentional design and did not reflect the skill level or professional knowledge of all health professions students. As a result, some students came to view IPECP participation as a forced experience, only serving a as a mandatory tick-box of their program curriculum. This could leave students jaded about their experiences which was hinted at in a minority of our student narratives. There are various challenges that academic institutions face in integrating well-developed IPECP experiences, such as financial cost, increased time-commitment from academic personnel, lack of space and infrastructure, and challenges of arranging initiatives that are relevant for all students' and that fit their schedules (Bogossian et al., [<reflink idref="bib4" id="ref66">4</reflink>]; Fox et al., [<reflink idref="bib13" id="ref67">13</reflink>]; Schwarzbeck et al., [<reflink idref="bib41" id="ref68">41</reflink>]). Despite these challenges, our findings press that creating IPECP initiatives with intentionality and well-designed content is imperative, as there runs a risk of perpetuating stereotypes and power dynamics within the activity itself (Griffin et al., [<reflink idref="bib16" id="ref69">16</reflink>]). Poorly designed IPECP initiatives risk negatively influencing students' views of IPC altogether. Designing future IPECP initiatives that include content that is equally relevant for each health profession and enables students to work together in complimentary ways to learn about each other and achieve a common goal must be prioritized (Amerongen et al., [<reflink idref="bib2" id="ref70">2</reflink>]).</p> <p>Increasingly, IPECP research has been focused on exploring learning initiatives that are effective in developing competencies associated with IPC. In our study, participants preferred interactive IPECP initiatives that integrated experiential learning and simulation experiences. This is consistent with the current literature, with various studies reporting a preference for IPECP initiatives that are interactive, simulation-based, or practical as they tend to be more complex activities that provided opportunity for skill development (Aldriwesh et al., [<reflink idref="bib1" id="ref71">1</reflink>]; Cantaert et al., [<reflink idref="bib6" id="ref72">6</reflink>]). Designing more hands-on IPECP initiatives that are reality-based and relevant are recommended from our findings to enhance current IPECP curriculum and to more positively influence students' views of IPC and its value in the practice setting. Reliance on single, didactic format IPECP initiatives are reported as less impactful experiences as these learning activities failed to provide students the opportunity to collaborate and build relationships with students from other professions (Aldriwesh et al., [<reflink idref="bib1" id="ref73">1</reflink>]). Interactive IPECP events are ideal avenues by which to create psychologically safe learning environments for students to explore professional roles, misunderstanding and approaches to team-based care that can enhance collaboration in practice and effective IPC in the future. In addition, future iterations of the IPECP curriculum should ensure that students are at the same level in their programs, which could help to address issues of power imbalance. When psychological safety exists, individuals are respected for their competence and interpersonal risk-taking is supported, including speaking freely, asking for help, and engaging in constructive conflict without fear of retribution. (Edmonston & Lei, [<reflink idref="bib12" id="ref74">12</reflink>]; Newman et al., [<reflink idref="bib28" id="ref75">28</reflink>]) Developing IPECP experiences that better support socialization and respectful interaction between professions during their programs are needed to promote development of a dual (professional and interprofessional) identity.</p> <p>As the health care system continues to face unprecedented challenges, IPC will be foundational for providing safe, efficient, and quality care. Implementing changes within pre-licensure, academic settings that promote a culture of collaboration and expanding students' exposure to experiential learning within IPECP could influence students' perceptions of IPC upon graduation and their choice and readiness to pursue collaborative work environments. Re-designing IPECP opportunities to focus on improving teamwork and collaboration skills and expanding IPECP curriculum into more simulation and clinical/community settings, are strong recommendations from our findings to better prepare students to work in interprofessional teams.</p> <p>Our findings also highlight gaps that exist regarding current IPE curriculum and the impact of social connections on student's inter/professional socialization. Due to the varying ways in which IPECP is integrated in academic institutions, exploring the long-term impact of mandatory versus voluntary (including simulation and clinical/community experiences) is an area that requires further research. In addition, there is a need for a greater understanding of the long-term impacts of inter/professional socialization and dual identity development in pre-licensure years on health care professionals' perceptions of IPC and related outcomes.</p> <p>The authors acknowledge that a limitation to this study includes the loss of participants between timepoints and reliance on a convenience sampling of participants. As a result, it is acknowledged that some health professions are more represented in this study's findings. The absence of participant narratives from nursing at the time of graduation in particular, is a limitation to our understanding of the IPECP experience for this cohort at this time in their pre-licensure experience. Moreover, self-selection bias amongst participants is also a limitation as this may present an overly positive interpretation of students' IPECP experience. The impact of the COVID-19 pandemic on participant response rate and the early professional experiences of graduates cannot be negated in this study. Access to other health professions and viability of collaborative care experiences at this time is likely to have been affected by ongoing public health restrictions in Canada at the time of final follow-up. The authors maintain however that diligent attention to participant narratives, temporality and setting have been observed throughout this study to mitigate the impact of these limitations on the trustworthiness of the findings.</p> <hd id="AN0185469545-16">Conclusion</hd> <p>Contemporary health systems require health professional students that are prepared to effectively collaborate and work interprofessionally, yet IPECP continues to face challenges in its integration. Implementing well-designed IPECP initiatives that are interactive and relevant to all health professional students involved are needed to positively influence perceptions towards IPC. Increasing opportunities for social interaction- including shared physical spaces- among health professional students across various disciplines is warranted to begin to foster relationships that promote collaboration. The findings of this study can assist academic and health care institutions to better understand the inter/professional socialization experiences of health professional students at the time of graduation and to identify areas for IPECP curriculum reform that support the preparation of collaborative interprofessional team members in the future.</p> <hd id="AN0185469545-17">Acknowledgements</hd> <p>We would like to acknowledge the manuscript preparation support provided by Jeffrey Lebrun, RN, MN, Research Coordinator and Project Manager; Nicole Doria, PhD (c) and Research Assistant, Dalhousie University and Lindsay Tascona RN, MN Student and Research Assistant, Dalhousie University</p> <hd id="AN0185469545-18">Author contributions</hd> <p>Sheri Price was responsible for study conceptualization, funding acquisition, methodology and led data analysis, manuscript writing, review and editing. Data collection was performed by Meaghan Sim and first draft of the manuscript was written by Sheri Price and Lindsay Van Dam. All authors contributed to data analysis and interpretation findings, contributed to manuscript review and editing and read and approved the final manuscript.</p> <hd id="AN0185469545-19">Funding</hd> <p>The author(s) disclose receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Canadian Institutes of Health Research (CIHR)<emph>.</emph><bold>Grant #</bold> FRN 159480.</p> <hd id="AN0185469545-20">Data availability</hd> <p>The participants of this study did not give written consent for their data to be shared publicly, so due to the sensitive nature of the research supporting data is not available.</p> <hd id="AN0185469545-21">Declarations</hd> <p></p> <hd id="AN0185469545-22">Conflicts of Interest</hd> <p>The authors declare there is no conflict of interest.</p> <hd id="AN0185469545-23">Ethical approval</hd> <p>This study was approved by the Health Sciences Research Ethics Board, Dalhousie University (REB #:2014-3416). All participants provided written informed consent prior to enrollment in the study.</p> <hd id="AN0185469545-24">Supplementary Information</hd> <p>Below is the link to the electronic supplementary material.</p> <p>Graph: Supplementary file1 (PDF 101 KB)</p> <hd id="AN0185469545-25">Publisher's Note</hd> <p>Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.</p> <ref id="AN0185469545-26"> <title> References </title> <blist> <bibl id="bib1" idref="ref71" type="bt">1</bibl> <bibtext> Aldriwesh MG, Alyousif SM, Alharbi NS. Undergraduate-level teaching and learning approaches for interprofessional education in the health professions: A systematic review. BMC Medical Education. 2022; 22; 1: 13. 10.1186/s12909-021-03073-0</bibtext> </blist> <blist> <bibl id="bib2" idref="ref70" type="bt">2</bibl> <bibtext> Amerongen HM, LeGros TA, Cooley JH, Schloss EP, Theodorou A. 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  Data: A Longitudinal Study of Interprofessional Education Experiences among Health Professional Graduates
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  Data: <searchLink fieldCode="AR" term="%22S%2E+Price%22">S. Price</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0002-5535-6624">0000-0002-5535-6624</externalLink>)<br /><searchLink fieldCode="AR" term="%22L%2E+Van+Dam%22">L. Van Dam</searchLink><br /><searchLink fieldCode="AR" term="%22M%2E+Sim%22">M. Sim</searchLink><br /><searchLink fieldCode="AR" term="%22C%2E+Andrews%22">C. Andrews</searchLink><br /><searchLink fieldCode="AR" term="%22J%2E+Gilbert%22">J. Gilbert</searchLink><br /><searchLink fieldCode="AR" term="%22K%2E+Lackie%22">K. Lackie</searchLink><br /><searchLink fieldCode="AR" term="%22J%2E+Almost%22">J. Almost</searchLink><br /><searchLink fieldCode="AR" term="%22N%2E+Kennie-Kaulbach%22">N. Kennie-Kaulbach</searchLink><br /><searchLink fieldCode="AR" term="%22E%2E+Sutton%22">E. Sutton</searchLink><br /><searchLink fieldCode="AR" term="%22H%2E+Khalili%22">H. Khalili</searchLink>
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  Data: <searchLink fieldCode="SO" term="%22Advances+in+Health+Sciences+Education%22"><i>Advances in Health Sciences Education</i></searchLink>. 2025 30(3):735-754.
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  Data: Springer. Available from: Springer Nature. One New York Plaza, Suite 4600, New York, NY 10004. Tel: 800-777-4643; Tel: 212-460-1500; Fax: 212-460-1700; e-mail: customerservice@springernature.com; Web site: https://link.springer.com/
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  Data: 20
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  Data: 2025
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  Data: Journal Articles<br />Reports - Research
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  Data: <searchLink fieldCode="EL" term="%22Higher+Education%22">Higher Education</searchLink><br /><searchLink fieldCode="EL" term="%22Postsecondary+Education%22">Postsecondary Education</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Interprofessional+Relationship%22">Interprofessional Relationship</searchLink><br /><searchLink fieldCode="DE" term="%22Allied+Health+Personnel%22">Allied Health Personnel</searchLink><br /><searchLink fieldCode="DE" term="%22College+Graduates%22">College Graduates</searchLink><br /><searchLink fieldCode="DE" term="%22Professional+Identity%22">Professional Identity</searchLink><br /><searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink><br /><searchLink fieldCode="DE" term="%22Socialization%22">Socialization</searchLink><br /><searchLink fieldCode="DE" term="%22Cooperation%22">Cooperation</searchLink><br /><searchLink fieldCode="DE" term="%22Educational+Experience%22">Educational Experience</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Canada%22">Canada</searchLink>
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  Data: 10.1007/s10459-024-10374-8
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  Data: 1382-4996<br />1573-1677
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  Label: Abstract
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  Data: Effective teamwork and collaboration among health professionals is a well-recognized strategy toward enhancing patient outcomes. However, there is a lack of understanding on how to best prepare health professionals for collaborative practice. The aim of this research is to gain a better understanding of how graduates of five health professions (dentistry, medicine, nursing, pharmacy, physiotherapy) perceive and experience interprofessional education for collaborative practice (IPECP) throughout their health professions journey, with a focus on transition to practice. This longitudinal study employed an interpretive, narrative methodology to understand interprofessional identity development of 24 individuals who had recently graduated from a health professions program (dentistry, medicine, nursing, pharmacy, physiotherapy) at a Canadian university. Participant experiences were analyzed using narrative analysis. Participants' narratives provided insight into the context, factors and curricular experiences needed for interprofessional identity development and preparedness for collaborative practice. Participants identified the importance of socialization and connection with others, collaborative role models and exposure to collaborative experiences and settings for interprofessional practice. Participants expressed some dissatisfaction with their earliest IPECP experiences and most valued their exposure to 'real-life' practice examples and clinical scenarios. Participants desired more authentic experiences of interprofessional collaboration during their programs. Improving health professionals' interprofessional socialization and collaborative experiences within IPECP is critical to improving patient outcomes. Study findings can inform future curricula and IPECP strategies that create conditions to enhance collaborative practice and ensure the preparedness of a future health workforce with a strong collaborative identity.
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