interprofessional working in health and social care essay

Interprofessional Working for Health and Social Care

• © 1997
• John Øvretveit (Professor of Health Policy and Management, and Director of the Nordic Quality Network) 0 ,
• Peter Mathias (Director of the Joint Awarding Bodies) ,
• Tony Thompson (Director of Practice Development) 2

Nordic School of Public Health, Gothenburg, Sweden

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Ashworth Centre, Ashworth Hospital, Liverpool, UK

Part of the book series: Community Health Care Series (CHCS)

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Table of contents (11 chapters)

Front matter, introduction.

• John Øvretveit, Peter Mathias, Tony Thompson

How to Describe Interprofessional Working

John Øvretveit

Planning and Managing Interprofessional Working and Teams

Evaluating interprofessional working — a case example of a community mental health team, how patient power and client participation affects relations between professions, preparation for interprofessional work: trends in education, training and the structure of qualifications in the united kingdom.

• Peter Mathias, Tony Thompson

Preparation for Interprofessional Work: Holism, Integration and the Purpose of Training and Education

• Peter Mathias, Ruth Prime, Tony Thompson

The Development of Shared Learning: Conspiracy or Constructive Development?

• Jenny Weinstein

The Functional Map of Health and Social Care

• Lindsay Mitchell, Margaret Coats

Interprofessional Collaboration: Problems and Prospects

• Simon Biggs

The World Health Organisation and European Union: Occupational, Vocational and Health Initiatives and their Implications for Cooperation Amongst the Professions

• Tony Thompson, Peter Mathias

Back Matter

• Integration
• participation
• social work

About this book

Editors and affiliations.

Tony Thompson

About the editors

Bibliographic information.

Book Title : Interprofessional Working for Health and Social Care

Editors : John Øvretveit, Peter Mathias, Tony Thompson

Series Title : Community Health Care Series

DOI : https://doi.org/10.1007/978-1-349-13873-9

Publisher : Red Globe Press London

eBook Packages : Medicine , Medicine (R0)

Copyright Information : Macmillan Publishers Limited 1997

Edition Number : 1

Number of Pages : XIII, 248

Additional Information : Previously published under the imprint Palgrave

Topics : Nursing

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Rights, Risks and Responsibilities: Interprofessional Working in Health and Social Care

• Article contents
• Figures & tables
• Supplementary Data

Barbara Tisdall, Rights, Risks and Responsibilities: Interprofessional Working in Health and Social Care, The British Journal of Social Work , Volume 42, Issue 8, December 2012, Pages 1634–1635, https://doi.org/10.1093/bjsw/bcs182

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This publication grapples with the dilemmas inherent in the attempts by health and social care practitioners to promote service users' rights while also managing and minimising risk. The complexities involved are considered within the context of interprofessional practice, and a real strength of this book is that the contributors come from a diverse range of health and social care professional backgrounds. In addition, contributors from these different professional backgrounds have co-written several chapters, and the result is quite a unique collaborative perspective regarding rights, risks and responsibilities. The challenges and case studies presented throughout the text encourage the reader to evaluate the potential impact of their own values, knowledge and power on their attempts to balance rights and risks, while maintaining a focus on their own particular responsibilities.

The content is divided into two parts, with Part I focusing on theoretical concepts and constructs relating to responsibilities, rights and risks, and Part II considering the application of theory to specific areas of practice.

In Chapter 1, Peter Ellis begins by proposing some definitions of rights and responsibilities, and introduces the reader to some of the ethical debates relating to the provision of health and social care. In Chapter 3, Adrian Adams explores in some detail the effect of the shifts in ideology over the past century, from individual responsibility for welfare to collective responsibility and more recently back once again to individual responsibility, and the impact of this on contemporary definitions of risk.

Part II begins with Georgina Koubel and Cheryl Yardley providing a competent analysis of the unenviable territory that health and social care professionals have to navigate as they try to uphold service users' rights and promote choice, alongside managing or minimising any risks evident. The authors' use of pertinent case studies makes this complex dimension of practice particularly accessible, and encourages the reader to consider the potential effect of different perceptions of risk and vulnerability.

Chapter 8 provides a compelling account of the need for collaborative interprofessional practice in relation to safeguarding children. Jane Greaves and Cheryl Yardley lead by example in this chapter as professionals from different backgrounds who have collaborated in order to deliver shared safeguarding training for social workers undertaking Post-Qualifying training and nurses undertaking specialist Public Health Nursing training. In addition to highlighting tools, such as the Common Assessment Framework, which were introduced to improve interprofessional communication, the authors discuss the challenges that have accompanied successive initiatives aimed at improving outcomes for children. The case for interprofessional education as a means of enhancing professionals' understanding of each others' roles is put forward, echoing previous authors' views about both the benefits and the challenges inherent in shared learning ( Sharland et al. , 2007 ; Carpenter and Dickinson, 2008 ). There is some consideration given to how different professionals within the safeguarding arena may be viewed by service users, with social workers more likely to be associated with surveillance and monitoring roles, whereas health workers may be perceived as less threatening. Readers may also wish to refer to Ruch and Murray (2011) for an account of their research which explored professional roles in integrated children's services.

In Chapter 9, Jane Arnott and Georgina Koubel provide a useful analysis of the similarities and differences between several interprofessional roles associated with community care—namely those of care manager, case manager and community matron, highlighting the complexity of care/case management. They reinforce the importance of collaborative practice based on a sound understanding of the roles and responsibilities of all professionals involved. Factors that may hinder effective collaborative practice are explored in Chapters 8 (Jane Greaves and Cheryl Yardley) and 10 (Hazel Colyer), in addition to strategies to overcome barriers and enhance interprofessional working.

The themes of rights, risks and responsibilities within the context of interprofessional practice are evident throughout this publication and the recurrence of particular aspects in different contributions adds to the overall coherence of this edited text. The introduction and conclusion make for stimulating reading and again compliment the coherence of the text. This book contains a wealth of knowledge relevant for both students and practitioners working in health and social care settings.

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Leadership in interprofessional health and social care teams: a literature review

Leadership in Health Services

ISSN : 1751-1879

Article publication date: 15 March 2018

Issue publication date: 20 September 2018

The purpose of this study is to review evidence on the nature of effective leadership in interprofessional health and social care teams.

Design/methodology/approach

A critical review and thematic synthesis of research literature conducted using systematic methods to identify and construct a framework to explain the available evidence about leadership in interprofessional health and social care teams.

Twenty-eight papers were reviewed and contributed to the framework for interprofessional leadership. Twelve themes emerged from the literature, the themes were: facilitate shared leadership; transformation and change; personal qualities; goal alignment; creativity and innovation; communication; team-building; leadership clarity; direction setting; external liaison; skill mix and diversity; clinical and contextual expertise. The discussion includes some comparative analysis with theories and themes in team management and team leadership.

Originality/value

This research identifies some of the characteristics of effective leadership of interprofessional health and social care teams. By capturing and synthesising the literature, it is clear that effective interprofessional health and social care team leadership requires a unique blend of knowledge and skills that support innovation and improvement. Further research is required to deepen the understanding of the degree to which team leadership results in better outcomes for both patients and teams.

• Collaboration
• Health care
• Interprofessional
• Multiprofessional

Smith, T. , Fowler-Davis, S. , Nancarrow, S. , Ariss, S.M.B. and Enderby, P. (2018), "Leadership in interprofessional health and social care teams: a literature review", Leadership in Health Services , Vol. 31 No. 4, pp. 452-467. https://doi.org/10.1108/LHS-06-2016-0026

Emerald Publishing Limited

Copyright © 2018, Tony Smith, Sally Fowler-Davis, Susan Nancarrow, Steven Mark Brian Ariss and Pam Enderby

Published by Emerald Publishing Limited. This article is published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence may be seen at http://creativecommons.org/licences/by/4.0/legalcode

This paper reports on the results of a critical literature review ( Grant and Booth, 2009 ) that aimed to evaluate the evidence and to present an analysis of leadership in interprofessional teams in health and social care organisations.

Concerns over leadership in the UK National Health Service (NHS) first became an area of focus in the late 1980s when professional management was introduced ( Mackie, 1987 ). When the labour government came to power in 1997, leadership capacity was recognised as a critical factor in the reform agenda; to modernise the NHS ( Goodwin, 2000 ). The Department of Health set up a National Centre for Leadership in 2001 as part of the NHS Modernisation Agency and this led to a plethora of leadership initiatives commissioned by NHS organisations that included public health ( McAreavey et al. (2001) , a range of leadership frameworks ( Bolden et al. , 2003 ) and competency frameworks ( Bolden et al. , 2006 ). For nearly two decades, leadership development has been a priority within health care but less attention has been given to the effectiveness of leadership on the outcomes of teams. Reports on health service failures at an organisational level have further regularly identified poor leadership as a contributory factor in criminally negligent care ( Keogh, 2013 ; Francis, 2013 ; Berwick, 2013 ).

The Kings Fund (2011) has consistently calls for replacement of heroic leadership models which focus on the development individuals in favour of an increased focus on shared/collective leadership models and extension of leadership development efforts to all levels. The continuing erosion of professional divisions in intermediate care and particularly community services has been driven in part by the ambition to create integrated services has enabled health and social care professions to increasingly work together around discrete stages of patient pathways ( Ovretveit, 1997 ; Pollard et al. , 2005 , Means et al. , 2003 ).

The formation of interprofessional teams has brought the issue of leadership to the fore with the challenge of enabling sometimes large teams of different professionals and differently skilled workers to coordinate their efforts and work more closely together than was traditionally the case. This integration agenda is not straightforward, however, as it fundamentally contradicts many of the fundamental tenets of professionalism ( Reeves et al. , 2010 ), with health-care leaders sharing responsibility across services, for the delivery and outcomes of care.

Thylefors et al. (2005) developed a useful taxonomy to understand the level of integration of work practices in health-care teams consisting of a range of professions/disciplines.

“Multiprofessional” teams have no focus on collective working. Professionals treat the patient independently, without the input of other team members. This model represents the customary form of health-care delivery in which doctors traditionally took responsibility for coordinating independent contributions to the care of patients.

Interprofessional working encapsulates the core notion of teamworking, where outputs are measured and based on the collective effort of team members working with the patient. Effective care is accomplished through the interactive efforts of health-care workers, with some responsibilities shared, requiring collective planning and decision-making ( Day, 1981 ; Sicotte et al. , 2002 ).

A study of the effects of multiprofessional and interprofessional team approaches on teamwork; and team effectiveness for rehabilitation teams, found that interprofessional teams showed significantly better results for nearly all aspects of teamwork and team effectiveness measured ( Korner, 2010 ).

This paper presents a review of leadership in interprofessional health and social care teams, seeking to identify elements that are characteristic of and/or associated with higher performance and achieving better patient outcomes.

Critical review is undertaken as a method for enabling new conceptual insights by seeking to embody existing or derive new theory from existing literature ( Torraco, 2016 ). A potential difficulty with the approach is that the evaluation of contribution is dependent on the type of evidence. In management literature, publications about the topic may be small in quantity, of poor quality, and/or inconsistent in terms of both the application of methods and epistemology ( Tranfield et al. , 2003 ).

In addition, systematic reviews in management literature need to relate directly to the context of health and social care ( Easterby-Smith et al. , 2008 ) to be considered the best evidence available, even though these may not be rigorous experimental studies of the type normally conducted within the medical sciences and may even propose theory where no empirical evidence exists.

Review questions/objectives

The specific aim of the review was to describe facets of leadership within interprofessional health and social care teams and generate a thematic framework that explains and develops conceptual understanding of that role.

research and grey literature on interprofessional team leadership in health and social care, to appraise any key theoretical constructs and tested variables; and

research and grey literature relating to interprofessional health and social care team working, commenting on interprofessional team leadership.

The search strategy was designed to access peer-reviewed, published studies for the period 1994–2015. This time period was determined as significant, based on the policy context i.e. Department of Health had begun to focus increasingly only patient pathways and interprofessional working to improve patient care (NHS Plan 2000 – www.nhshistory.net/nhsplan.pdf ) and at the end of the period, the Five Year Forward View ( NHS England, 2014 ) outlined and consolidated the ambition to commission and provide integrated health care with significant focus on the leadership of new services and ways of working ( Ham and Murray, 2015 ) .

Cochrane database of systematic reviews;

Health management information consortium;

NHS Confederation;

Department of Health;

King’s Fund; and

University of Sheffield, STAR library database.

A search using all identified relevant keywords and index terms (see Table I ) was then undertaken across all included databases. Hand searching included reference lists of all identified reports and articles, which were screened to identify additional studies and relevant texts in the grey literature referring to interprofessional team leadership in health services. The search was then extended to include any identifiable reference to “team-working” and interdisciplinary, which were broader than interprofessional, to identify any mention of team leadership in a health context. An additional reason for the extension was in recognition of unqualified or non-professional staff who are part of the teams caring for and treating patients. Finally, the search terms identified a range of team and service outcome metrics that refer to the process of care and the impact of care typically using outcomes of service/team rather than health status or health outcome.

Table I below outlines the key search terms and Table II provides the terms used for the additional focus on potential outcomes of team leadership within the care context.

Inclusion and exclusion criteria

The critical review aims to develop an evidence-based theoretical understanding of interprofessional team leadership, including conceptual models for practice. It is based on empirical findings or narrative examples from practice, described and/or evaluated. Selection began with an initial screening of the papers by title and abstract using the specific decision rules to identify relevant papers. A set of decision criteria were developed; to identify relevant papers that would distinguish between leadership theories in health care and those particularly referring to interprofessional teams. The initial categories related to main methodology i.e. empirical study, qualitative research, or a narrative study, or systematic review. This method sorted papers and enabled authors to select key papers related to the review objectives and enhanced decisions about which papers to include or exclude ( Paterson et al. , 2001 ). Further selection identified any papers including reference or outcomes achieved through interprofessional team leadership in health and social care. As there were few papers specifically on this topic, the search was extended to include papers on interprofessional teamwork, again allowing leadership to become the emerging narrative within publications on health care team practice. Owing to the dearth of literature on inter* (professional, disciplinary) team leadership publications discussing primary or secondary research on interdisciplinary team leadership, or interdisciplinary team working were included. Papers that had no apparent evidence base were excluded from the review and these included opinion pieces and editorials with particular views of a single author.

A mixed methods quality appraisal tool was then used to evaluate the selected empirical studies and this was also adapted and applied to the descriptions of teams and clinical practice context. Table III includes the quality assessment criteria used for the study. Evaluations of leadership or team outcomes and processes were included and the content re-viewed for satisfactory description and relevant content.

Data extraction and synthesis

Data extraction was undertaken manually using an excel spreadsheet designed for the purpose of categorising findings. Papers were read and re-read as full text and emergent ideas were identified with key ideas and theories recognised and noted. The Ritchie and Spencer (1994) “Framework” approach was adopted to code the data and further analysis was undertaken using the findings from the selected reports (grey literature). This approach was chosen, because it was both rigorous and permitted the analysis of original data but was also open to adaptation and change; allowing methodical treatment of all similar units of analysis and some case comparisons. Principally it was adopted as a means of synthesis that allowed full review of the located data ( Ritchie and Spencer, 1994 ). Following the coding of papers and data extraction into categories a number of preliminary themes were developed. These formed the basis of the framework that could then be used to create some broader, higher order themes and additional data were included, based on agreement with other authors. The framework was continually modified as a deeper understanding of the data was developed, as new data were coded and new themes emerged. The synthesis was completed when all data had been incorporated and items checked to ensure that the framework permitted a robust “container” for the data and permitted a more conceptual analysis of interprofessional leadership.

Searches for Interprofessional Team (working and) Leadership identified a total of 634 texts and after supplementing these searches with relevant papers identified in the interprofessional teamworking literature review and back-chaining through reference lists, 1,419 papers were identified as being of possible interest. All papers contained a combination of the key words used in the search from published literature between 1994 to 2015.

Following full text screening, categorisation by methods to exclude opinion pieces and critical appraisal a total of twenty-eight papers were selected. These were deemed to provide an analysis of outcomes from team leadership and proposed conceptual frameworks of IpTL or discussed elements of IpTL in-depth.

consciously involve team members in, decision-making and delegate responsibilities appropriately ( Day, 1981 ; McCallin, 1999 ; Wilson, 2001 ; Ovretveit, 1997 ; Mickan and Rodger, 2000 ; McCallin, 2003 , Institute-for-innovation-and-improvement, 2010, Sicotte et al ., 2002 ; West et al ., 2003 );

empower team members ( McCray, 2003 );

develop and maintain non-hierarchical structures ( Ovretveit, 1997 ; Krueger, 1987 );

provide information the team requires ( Mickan and Rodger, 2000 );

work to create agreement ( Mickan and Rodger, 2000 ); and

coach colleagues in shared leadership ( McCallin, 2003 ; Maister, 1993 ).

create a climate where staff are challenged, supported, motivated and rewarded ( West et al ., 2003 );

respond to change flexibly ( Suter et al ., 2007 );

facilitate or act as a catalyst for practice change ( Willumsen, 2006 );

act as a role model ( Pollard et al ., 2005 ; West et al ., 2014 ); and

inspire other team members ( West et al ., 2003 ).

enthusiasm ( Pollard et al ., 2005 );

commitment ( Abreu, 1997 );

empathy ( McCray, 2003 ); and

knowledge of people ( Suter et al ., 2007 ).

ensure the team has articulated a clear and inspiring vision of its work ( Lyubovnikova et al ., 2015 );

assure productivity and goals are in line with the organisation ( Leathard and Cook, 2004 );

protect regular time for the team to review its performance ( Lyubovnikova et al ., 2015 ); and

provide feedback about important issues ( Mickan and Rodger, 2000 ; Leathard and Cook, 2004 ).

establish a productive balance of harmony and debate to ensure creativity ( Leathard and Cook, 2004 );

develop innovations and new practice models ( Suter et al ., 2007 ); and

ensure effective leadership and team work processes ( West et al ., 2003 ).

maintain clear communication channels and facilitate interaction processes ( Ovretveit, 1997 ; Suter et al ., 2007 ; Willumsen, 2006 ; Blewett et al ., 2010 );

listen to, support and trust team members ( Mickan and Rodger, 2000 ; Leathard and Cook, 2004 );

initiate constructive debates and share their own ideas ( Mickan and Rodger, 2000 ; Lyubovnikova et al ., 2015 ); and

manage conflict and maintain a productive balance between harmony and healthy debate ( Mickan and Rodger, 2000 ; McCray, 2003 ).

set expectations for working together ( Suter et al ., 2007 );

create a climate of mutual respect ( Ovretveit, 1997 ; Leathard and Cook, 2004 );

ensure cohesion ( Willumsen, 2006 );

develop the interpersonal skills of the team ( Ovretveit, 1997 );

ensure the contextual socialisation of new/inexperienced team members ( McCray, 2003 );

promote interprofessional collaboration ( Suter et al ., 2007 ; McCallin, 2003 ; Branowicki et al ., 2001 ); and

facilitate group reflection on practice ( McCallin, 1999 ; Branowicki et al ., 2001 ).

ensure clarity of leadership ( Nancarrow et al ., 2009 ; West et al ., 2003 ); and

combine strong leadership and high involvement ( Rosen and Callaly, 2005 ).

coordinate tasks ( Mickan and Rodger, 2000 );

manage processes ( Maister, 1993 );

ensure work is allocated work equally ( Pollard et al ., 2005 ); and

set clear tasks ( Ross et al ., 2000 ).

represent the team externally ( Irizarry et al ., 1993 );

ensure necessary resources ( Maister, 1993 );

develop strategies for promoting the work of the team ( Irizarry et al ., 1993 );

demonstrate effectiveness through data collection and evaluation ( Irizarry et al ., 1993 );

ensure the team understands its customers and can exploit new opportunities ( Willumsen, 2006 ); and

develop networks and linkages( Pollard et al ., 2005 ).

recruit externally and develop internally ( Ross et al ., 2000 );

ensure regular supervision and PDR ( Burton et al ., 2009 ); and

assure access to relevant training ( Burton et al ., 2009 ).

high levels of professional expertise ( Maister, 1993 ; Irizarry et al ., 1993 ; Branowicki et al ., 2001 );

demonstrate in-depth understanding of the organisation ( Branowicki et al ., 2001 ) and current development programmes ( West et al ., 2014 );

balance focus between the needs of the patient, organisation and team ( Branowicki et al ., 2001 );

facilitate understanding of context and ensure all perspectives are taken into account ( Abreu, 1997 ); and

knowledge of the professional role of others ( MacDonald et al ., 2010 ).

Facilitate shared leadership

For interprofessional teams to work effectively, each team member must accept responsibility as a member-leader stepping in and out of the leadership role when their professional expertise, particular knowledge of a client, or the situation comes to the fore ( McCallin, 1999 ; Wilson, 2001 ).

This process requires a formal leader who has overall responsibility for the performance of the team, but consciously shares the leadership function facilitating joint decision-making and delegates leadership roles ( Day, 1981 ; Sicotte et al ., 2002 ; Ovretveit, 1997 ; Mickan and Rodger, 2000 ; McCallin, 2003 , Institute-for-innovation-and-improvement 2010, West et al ., 2003 ).

The key mechanism for achieving this is empowerment ( McCray, 2003 ). The leader actively works to develop/maintain non-hierarchical, democratic structures ( Ovretveit, 1997 ; Krueger, 1987 ). They coach team members ( Maister, 1993 ) to develop the skills required ( McCallin, 2003 ) share their ideas, work to create agreement and supply information the team requires ( Mickan and Rodger, 2000 ).

Transformation and change

Transformational leadership is important ( McCray, 2003 ; Irizarry et al ., 1993 ). The IpTL acts as a role model in line with their espoused values ( Pollard et al ., 2005 ; West et al. , 2014 ) to create a climate in which staff are inspired ( West et al. , 2003 ) challenged, supported, motivated and rewarded ( Irizarry et al. , 1993 ); respond to change in a flexible way ( Suter et al. , 2007 ); and facilitate or act as a catalyst for practice change ( Willumsen, 2006 ).

Personal qualities

The IpTL must be able to show enthusiasm ( Pollard et al. , 2005 ), commitment ( Abreu, 1997 ), the ability to empathise ( McCray, 2003 ) and knowledge of people ( Suter et al. , 2007 ).

Goal alignment

The IpTL works to influence the direction and climate of the group to ensure goal alignment with the organisation and productivity ( Leathard and Cook, 2004 ). They do this by ensuring the team has articulated a clear and inspiring vision of its work, creating regular times when it can review it’s performance ( Lyubovnikova et al. , 2015 ) providing feedback to highlight important issues ( Mickan and Rodger, 2000 ; Leathard and Cook, 2004 ).

Creativity and innovation

A productive balance of harmony and debate is vital to ensure creativity ( Leathard and Cook, 2004 ) and development of innovations and new practice models ( Suter et al. , 2007 ). However, teamwork processes and team leadership have been found to consistently predict team innovation ( West et al. , 2003 ).

Communication

The leader must facilitate the interaction processes and develop/sustain clear communication channels in the team ( Ovretveit, 1997 ; Suter et al. , 2007 ; Willumsen, 2006 ; Blewett et al. , 2010 ). They do this by initiating constructive debates and modelling their own ideas ( Mickan and Rodger, 2000 ; Lyubovnikova et al. , 2015 ) and supporting, listening to and trusting team members ( Mickan and Rodger, 2000 ; Leathard and Cook, 2004 ).

The leader must also manage conflict, ensuring a productive balance between harmony and healthy debate ( Mickan and Rodger, 2000 ; McCray, 2003 ).

Team-building

Teamwork is not a naturally occurring phenomenon ( Lyubovnikova et al. , 2015 ). The team leader must therefore invest time in team-building, `setting expectations for working together ( Suter et al. , 2007 ) and creating a climate of mutual respect ( Ovretveit, 1997 ; Leathard and Cook, 2004 ). They work to ensure cohesion ( Willumsen, 2006 ), developing the interpersonal skills of the team ( Ovretveit, 1997 ) promoting interprofessional collaboration through group reflection ( McCallin, 1999 ; Branowicki et al. , 2001 ) on practice and ensuring contextual socialisation of new or inexperienced team members ( McCray, 2003 ).

Collaboration is promoted by allowing enough time for discussion and reflection on practice and encouraging staff to interact with those outside their profession ( Suter et al. , 2007 ; McCallin, 2003 ; Branowicki et al. , 2001 ).

Leadership clarity

In spite of growing support for shared/collaborative/collective leadership models there is evidence to suggest that interprofessional teams need an overall team leader to operate effectively ( McCallin, 2003 ).

A 2009 study found that teams with a specific team leader had higher levels of staff satisfaction than teams where the leadership role was split ( Nancarrow et al. , 2009 ). Clarity of leadership is associated with clear team objectives, high levels of participation, commitment to excellence and support for innovation ( West et al. , 2003 ). Primary health-care team members rated their effectiveness more highly when they had strong leadership and high involvement amongst team members ( Rosen and Callaly, 2005 ).

Direction setting

The leader ensures that the team retains a focus on its priorities and goals and that individual team members maintain the correct focus ( Mickan and Rodger, 2000 ). They work to manage team processes ( Maister, 1993 ) including setting clear tasks ( Ross et al. , 2000 ) coordinating work ( Mickan and Rodger, 2000 ) and ensuring equitable allocation ( Pollard et al. , 2005 ).

External liaison

The team leader must exercise external responsibility for the team ( Irizarry et al. , 1993 ) ensuring that it is represented and gains the resources it requires ( Maister, 1993 ). This requires: promoting the work of the team ( Irizarry et al. , 1993 ) the ability to develop networks and linkages ( Pollard et al. , 2005 ) demonstrating effectiveness through data collection and evaluation ( Irizarry et al. , 1993 ) and adopting a marketing orientation to ensure the team understands its clients and can exploit new opportunities ( Willumsen, 2006 ).

Skill mix and diversity

The team leader’s role is to ensure that the team contains the right skill mix and diversity to achieve its goals and tasks. This involves both external recruitment and internal development ( Ross et al. , 2000 ) with regular supervision, annual performance reviews and access to relevant training important factors ( Burton et al. , 2009 ).

Clinical and contextual expertise

Professionals will only be accepted into IpTL roles if they prove their professional expertise ( Maister, 1993 ; Irizarry et al. , 1993 ; Branowicki et al. , 2001 ). Knowledge of the professional role of others is also a key competency ( MacDonald et al. , 2010 ). Within this, it is important that the team leader balances focus between the needs of the patient, organisation and team ( Branowicki et al. , 2001 ). Understanding of the organisation’s mission, structure, economics, politics ( Branowicki et al. , 2001 ) and current development programmes ( West et al. , 2014 ) together with a sound historical perspective, are also important to facilitate understanding of context and ensure all perspectives are taken into account ( Abreu, 1997 ).

Discussion and conclusions

An IpTL framework in health care has been synthesised from the available published evidence and has been presented as a range of particular competencies that can be compared to the general management literature related to team management and leadership.

Many factors associated with better team leadership within management literature can also be seen in the IpTL framework. Both bodies of literature include a focus on: achieving organisational goals, managing performance, managing external relationships (boundary spanning activities) and demonstrating technical expertise ( Larssen and LaFasto, 1989 ; Hackman, 1989 ; Stanniforth and West, 1995 ; LaFasto and Larssen, 2002 ; Hayes, 2002 ; Hackman, 2002 ; Katzenbach and Smith, 2003 ; Shackleton, 1995 ; Stoker, 2008 ; Burke et al. , 2006 ; Stoker, 2008 ).

In contrast, the IpTL framework specifically highlights a leadership function for the team and the review demonstrates that as well as maintaining the managerial function an interprofessional team requires a person who can promote transformation and change and support creativity and innovation as key elements of their role. Significantly, a meta-analysis by Burke et al. (2006) shows that transformational leadership behaviours, (often linked to change and innovation) can have a potent effect within teams. West et al. (2003) also found that teamwork and team leadership processes consistently predict innovation.

Empowerment appears as a primary focus in the generic team leadership literature as a mechanism for collaboration, but the focus in the IpTL literature is more on shared, collaborative or more recently collective ( West et al. , 2014 ) leadership. Conceptually these factors are distinct, but in the ways they are described appear to have more similarities. The IpTL literature talks more about shared, collective and collaborative leadership, particularly in relationship to professionals within the teams. However, there is a paradox in that there is good evidence that clarity of leadership ( West et al. , 2003 ; Nancarrow et al. , 2009 ) also appears to be important. Other commentators clarify, that shared leadership in IpT’s is facilitated by the team leader ( Krueger, 1987 ; Maister, 1993 ). It may be that shared or collective leadership are more palatable concept to professionals than empowerment as they lend more status to professional expertise and accommodate autonomy rather than challenge it.

The IpTL framework overtly mentions team building as a key activity of the team leader and the wider literature on team leadership also refers to the fact that it takes effort to develop a team ( Stanniforth and West, 1995 ; Hackman, 2002 ; Katzenbach and Smith, 2003 ). In the IpT literature, teamwork is still often an ideal that health and social care organisations are working to attain and a level of complexity is apparently which is to do with ensuring the correct mix and level of skills in the team. The IpTL literature focuses on developing the dynamics within the team as a whole and increasing integrated professional practice, with less attention paid to setting priorities and managing performance.

The literature review also raised some general questions about IpT’s. There is consensus in teamwork literature that teams become less effective as they become larger. However, Nancarrow et al. (2009) found that larger interprofessional care teams providing intermediate and community care for older people produced better patient outcomes, in spite of less satisfaction amongst team members and higher intention to leave. It is not clear from these results whether there is a limit to this relationship, where the economies of scale and enhanced workforce flexibility delivered by larger services, becomes offset by the impact on teamworking? In a further study ( Nancarrow et al. , 2013 ) comments on the difference between assumed shared decision-making and shared power across professions and the reality; perhaps alluding to the challenges of working across a large multi-professional context.

A second issue is that whilst many of the services that took part in this particular study were called teams, it is unclear how many operate as teams in practice. As already discussed, “team” is a term almost ubiquitously applied to work groups. Certainly, the size and structure of teams in this study are often outside the parameters put forward in the literature on teams. A final issue is the term interprofessional. There are increasing numbers of none professionally qualified staff in health care IpT’s, however their role and function in the literature on interprofessional teamworking and leadership is totally absent. We would therefore propose that that interdisciplinary is a more suitable term to use as it is broader and inclusive of all team members.

What is different about IpTL in health care appears to be the unique context in which it is applied. The multiprofessional nature of the workforce in health, the public service setting, their function and the contexts that they operate within, make the dynamics in health care IpT’s differ from the dynamics of teams in other settings. This difference seems to be highlighted by West et al. (2014) who advocate collective, distributed leadership practices for the NHS as a whole that resonate closely with the findings of this review.

Further, the literature does indicate that there are some elements of leadership practice, which may be particularly effective in interprofessional team settings. Perhaps the key issue highlighted is the fact that the operational workforce within health and social care is predominantly multi-professional in nature. Increasingly these professionals, together with other disciplines, are working together in a more integrated fashion. The creation of IpT’s has therefore created a unique leadership context. Whereas traditionally professions would be functionally led (i.e. doctors by doctors, nurses by nurses) by a professional with recognised expertise, in IpT’s, this functional leadership divisions are impossible to sustain. The leader can at most be only from one profession or discipline and therefore cannot therefore demonstrate greater professional expertise in other professions. This makes IpT leadership more demanding as the team leader, needs to find a way of leading a diverse professional workforce, without being able rely on professional credibility as a locus of authority. Further, the IpTL needs to be able to find ways to persuade an interprofessional group, to give up some professional autonomy, to integrate their practices and operate as a team.

This critical literature review examines how leaders of interprofessional teams are functioning and the synthesis identifies a framework of factors that contribute to good leadership practice. With a continuing paucity of empirical research data on IpTL, there is still much that is unknown about the IpTL process.

Key search terms for IpTL

Key search terms for outcomes of IpTL

Quality assessment criteria

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Further reading

Department-Of-Health ( 2000 ), The NHS Plan: A Plan for Investment, a Plan for Reform , HMSO , London .

Kings Fund ( 2016 ).

Sorrels-Jones , J. ( 1997 ), “ The challenge of making it real: interdisciplinary practice in a seamless organization ”, Nursing Administration Quarterly , Vol. 21 No. 2 , p. 20 .

Corresponding author

About the authors.

Dr Tony Smith is a Senior Lecturer, in Leadership and Organisation Development, at the Centre for Leadership in Health and Social Care, Sheffield Hallam University and has conducted research related to leadership in health and social care teams.

Dr Sally Fowler-Davis is a Clinical Academic Researcher in the Centre for Health and Social Care Research, Sheffield Hallam University and Clinical Research Development Officer for the Combined Community and Acute Care Group at Sheffield Teaching Hospitals.

Susan Nancarrow is a Professor of Health Sciences and Chair of Academic Board at Southern Cross University, Australia. Susan is a Health Services Researcher with a particular interest in health workforce development.

Dr Steven Mark Brian Ariss is a Research Fellow at the School of Health and Related Research, University of Sheffield, UK.

Pam Enderby is a Professor Emeritus of Community Rehabilitation in the School of Health and Related Research University of Sheffield. She is a Speech and Language Therapist and has worked clinically and conducted research related to intermediate care.

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Interprofessional Identity in Health and Social Care: Analysis and Synthesis of the Assumptions and Conceptions in the Literature

Affiliations.

• 1 Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium.
• 2 Research Group Interprofessional Collaboration in Education, Research and Practice (IPC-ERP), Ghent University, 9000 Ghent, Belgium.
• 3 Department of Educational Studies, Ghent University, 9000 Ghent, Belgium.
• 4 Department of Experimental-Clinical and Health Psychology, Ghent University, 9000 Ghent, Belgium.
• PMID: 36429519
• PMCID: PMC9690615
• DOI: 10.3390/ijerph192214799

Interprofessional identity (IPI) development is considered essential in reducing incongruency and improving interprofessional collaboration. However, noticeable differences in conceptualizations are being put forward in the literature, hindering interpretation of research findings and translation into practice. Therefore, a Concept Analysis and Critical Interpretative Synthesis of empirical research articles were conducted to explore the assumptions and conceptions of IPI. Independent literature screening by two researchers led to the inclusion and extraction of 39 out of 1334 articles. Through critical analysis, higher order themes were constructed and translated to a synthesizing argument and a conceptual framework depicting what constitutes IPI (attributes), the boundary conditions (antecedents) and the outcomes (consequences) of its development. The attributes refer to both IPI's structural properties and the core beliefs indicative of an interprofessional orientation. The antecedents inform us on the importance of IPI-fitting constructivist learning environments and intergroup leadership in enabling its development. This development may lead to several consequences with regard to professional wellbeing, team effectiveness and the quintuple aim. Given the educational orientation of this study, ways for facilitating and assessing the development of IPI among learners across the professional continuum have been proposed, although empirical research is needed to further validate links and mediating and moderating variables.

Keywords: collaborative practice; continuous professional development; curriculum; healthcare; interprofessional collaboration; interprofessional education; interprofessional identity; welfare.

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• v.148(4); 2015 Jul

Interprofessional collaboration in health care

I mproved health care collaboration has been cited as a key strategy for health care reform. 1 , 2 Collaboration in health care has been shown to improve patient outcomes such as reducing preventable adverse drug reactions, 3 , 4 decreasing morbidity and mortality rates 5 , 6 and optimizing medication dosages. 7 Teamwork has also been shown to provide benefits to health care providers, including reducing extra work 4 and increasing job satisfaction. 8 As a fourth-year pharmacy student at the University of Saskatchewan (BB), I have noticed this shift becoming increasingly evident in our education, with the incorporation of interprofessional-based learning activities and relocation to a recently built health sciences building.

Having played competitive hockey for about 15 years, I have been on both highly successful teams that went on to win championships, as well as teams that were unable to function effectively. What was it about these teams that contributed to our successes or failures? Moreover, can these lessons be extrapolated to health care teams?

Characteristics have been identified in both sports and health care that may influence team success. 2 , 9 Examples include accountability, communication, leadership, discipline, coordination, having a clear purpose and having a strategy in place. While a cooking recipe may consist of many ingredients (some perhaps to add flavour; others for consistency), a few ingredients will always remain essential. Reflecting on my experiences as an athlete and as a pharmacy student, 5 key ingredients seem necessary for success in a collaborative team ( Table 1 ).

Five essential ingredients for team success

Role clarity

We have all seen examples of teams that consist of members who are extremely talented and yet do not function effectively. Conversely, some teams that are considered to lack skill succeed where others fail. In a successful team, every single participant is relied on to execute his or her unique role. For instance, in the game of hockey, there are goal scorers, defensemen, “grinders” and goalies. If a hockey team is composed of only goal scorers, the other aspects of the game will be ignored and the team will have weaknesses. Teams in health care consist of diagnosticians, prescribers, medication experts and members who tend to the ongoing daily needs of the patient. Each expert adds a specific value, creating a collective synergy so that patient needs can be most effectively met. 10 While role clarity is essential, team members need to be comfortable with some “overlap” of skills. Sometimes doing what is in the best interests of the patient most efficiently will require team members to step outside their traditional professional role. A defenseman, for instance, will take a shot at an open net should the opportunity arise.

While some members within a team or collaborative relationship may take on more of a leadership role, everyone must be enabled to contribute. Why would some commit to making sacrifices for the betterment of a team if they felt their role was insignificant? Individual contributions need to be valued and not underplayed. Yet, for maximum performance, the focus needs to be on “team success.” The old saying “Win as a team and lose as a team” holds true in health care as well. Thus, a team filled with members who know their individual roles, put personal egos aside and feel appreciated increases the likelihood of team success and individual job satisfaction. 11

Trust and confidence

Trust, one of the most important elements of a successful team, is difficult to gain yet easy to lose. Developing trust takes time and a lot of personal contact. This may be a challenge in some health care settings due to logistical barriers such as rotating staff schedules, which contributes to constantly changing teams. If teams have the opportunity to work together daily, the development of confidence within the team is naturally facilitated.

Having just completed my Structured Practical Experience Program (SPEP) rotation at the Saskatchewan Transplant Program, I had the opportunity to work with an effectively functioning team of pharmacists, physicians and nurses. The health care practitioners in this setting are hired by the transplant program and work together exclusively. The pharmacists and nurses partially attribute their team success to the fact that they share an office and work so closely with one another. Proximity and contact have led to an atmosphere where trust has been built rather than lost. Exposure to other health care disciplines and the opportunity to work collaboratively have been shown to facilitate awareness and appreciation for interprofessional roles. 12 It is more likely that members of health care teams will develop a mutual trust if they are aware of other professions’ roles and witness their capabilities firsthand. 13 In addition, evidence shows that implementing interprofessional education (IPE) earlier in health care curriculums can positively influence students’ perception of teamwork. 14 Efforts to incorporate IPE into students’ education should therefore be encouraged, with the goal of fostering future collaborative practice.

To develop team trust, it is essential that members are confident in their own abilities. It is noteworthy that the athletes I have played hockey with who have gone on to win championships and compete at the highest level (the National Hockey League) have radiated individual confidence, which in turn facilitated team confidence. When faced with pressure situations, the team remained confident because we trusted each other and had spent countless hours together improving our skills and forming good habits throughout the season. This was evident in the transplant program, which deals with complex patients and high-stress situations when organs for transplant become available. Trust and confidence in one another there kept the pandemonium in check, similar to being down a goal with 30 seconds left on the clock.

The ability to overcome adversity

At some point, all teams will be faced with adversity. In an athlete’s world, this could be a turnover in basketball or the referee making a bad call during a football game. Adversity and challenges are part of health care delivery, whether it be complex patients or dealing with staff shortages. It is during these difficult situations that collaboration becomes even more essential, and it is in the face of adversity that the team’s true integrity is revealed. When teams are faced with adversity, the tendency can be to pass blame and begin to question the system, management or leadership. Challenges require every member to remain committed to the ultimate goal, which in the case of health care is patient care. Since adversity is something that every team in any setting will inevitably encounter, it is imperative that health care providers working collaboratively become adept at dealing with it effectively.

The ability to overcome personal differences

It is not always possible to get along with every team member, but how those differences in opinions are handled is what truly matters. When I played hockey in Medicine Hat, there were arguments between team members on a daily basis, and it was not uncommon for teammates to fight during practice. Despite these disagreements, the players had the ability to move past their differences and focus on the common goal. Team diversity should be viewed as a strength; it can bring about different viewpoints, facilitate innovation and problem solving 15 and have the potential to result in amazing outcomes. 16 The key is for everyone to work towards a common goal and have a shared vision on how to achieve it.

Collective leadership

Collective leadership takes pressure off any one individual and disperses it throughout the group. During my time in Medicine Hat, I was fortunate to be coached by the current coach of the Vancouver Canucks, Wilbrod Desjardins. He was a true believer that each person is only as good as the people they are surrounded by. Rather than relying exclusively on the team captain, a leadership group consisting of 8 players would convene regularly to discuss team issues. This group approach helped to engage more individuals and facilitated “buy-in” from the rest of the team. The value of collective leadership has been noted in both sports teams and health care. 17 , 18 In fact, collaborative leadership has been recognized as 1 of the 6 competency domains for interprofessional education 19 and has been given a priority for student learning in this capacity.

In sports, winning is obviously more gratifying than losing, and reflecting on my hockey career, the years we ended up winning championships were the most enjoyable. I believe that our successes during these years resulted because we had discovered a winning recipe for functioning effectively as a team: while each person played a unique and fundamental role, we practised collective leadership. We had built trust and confidence in our teammates, and we learned to put personal differences aside and overcome adversity. These factors were also evident within the interdisciplinary team at the Saskatchewan Transplant Program. Judging from their patient successes, it leads me to believe that these 5 ingredients are essential in health teams as well.

To conclude, the importance of interprofessional teamwork in health care has been consistently highlighted. To increase the likelihood of team success, the value of selecting individuals capable of embodying these core characteristics should not be overlooked. ■

At the time of writing, Brennan Bosch was a fourth-year pharmacy student at the University of Saskatchewan who was completing a Structured Practice Experience Program (SPEP) rotation at the Saskatchewan Transplant Program, under the supervision of Dr. Mansell. Brennan played competitive hockey for over 15 years, and his accomplishments include a Western Hockey League championship in 2006-07 with the Medicine Hat Tigers and the 2011-12 Canada West hockey title with the University of Saskatchewan Huskies.

Author Contributions: B. Bosch wrote the initial draft of the manuscript and H. Mansell performed the revisions. Both authors contributed to the theme and ideas.

Declaration of Conflicting Interests: The authors declared no potential conflict of interest with respect to the research, authorship and/or publication of this article.

Funding: The authors received no financial support for the research, authorship and/or publication of this article.

• Open access
• Published: 26 April 2024

Interprofessional socialization of first-year medical and midwifery students: effects of an ultra-brief anatomy training

• Dana Bostedt 1 ,
• Ebrar Hümeyra Dogan 1 ,
• Sina Chole Benker 1 ,
• Maret Antje Rasmus 1 ,
• Emily Eisner 1 ,
• Nadine Lana Simon 1 ,
• Martina Schmitz 2 ,
• Markus Missler 3 &
• Dogus Darici 3  

BMC Medical Education volume  24 , Article number:  464 ( 2024 ) Cite this article

Metrics details

Interprofessionalism is considered a key component in modern health profession education. Nevertheless, there remains ongoing debate about when and where to introduce interprofessional trainings in the curriculum. We identified anatomy, a subject commonly shared among health professionals, as a practical choice for initiating early intergroup-contact between first-year medical and midwifery students. Our study examined the effects of a four-hour block course in anatomy on interprofessional socialization and valuing, as well as long-term effects on intergroup contact.

Based on different concepts and theories of learning, we implemented 12 interprofessional learning stations. Several measures were taken to foster group cohesion: (1) self-directed working in interprofessional tandems on authentic obstetric tasks, (2) competing with other tandems, (3) creating positive interdependencies during task completion, and (4) allowing room for networking. In a pre-post design with a three-month follow-up, we assessed the outcomes of this ultra-brief training with qualitative essays and quantitative scales.

After training, both groups improved in interprofessionalism scores with strong effect sizes, mean difference in ISVS-21 = 0.303 [95% CI: 0.120, 0.487], P  < .001, η² = 0.171, while the scales measuring uniprofessional identity were unaffected, mean difference in MCPIS = 0.033 [95% CI: -0.236, 0.249], P  = .789. A follow-up indicated that these positive short-term effects on the ISVS-21 scale diminished after 12 weeks to baseline levels, yet, positive intergroup contact was still reported. The qualitative findings revealed that, at this initial stage of their professional identity development, both medical and midwifery students considered interprofessionalism, teamwork and social competencies to be of importance for their future careers.

This study advocates for an early implementation of interprofessional learning objectives in anatomical curricula. Young health profession students are receptive to interprofessional collaboration at this initial stage of their professional identity and derive strong advantages from a concise training approach. Yet, maintaining these gains over time may require ongoing support and reinforcement, such as through longitudinal curricula. We believe that an interprofessional socialization at an early stage can help break down barriers, and help to avoid conflicts that may arise during traditional monoprofessional curricula.

Peer Review reports

Interprofessional education (IPE) is a learning approach in which two or more professions “ learn with, from, and about each other to improve collaboration in patient care ” (WHO 2010). Some of the IPE goals are to exchange ideas on a personal level, bring together distributed knowledge, and harness the benefits of different specializations [ 1 , 2 , 3 ]. By fostering interprofessional communication and teamwork, IPE has been shown to break hierarchical structures [ 2 ], reduce stereotypes in health professions education [ 3 ], and ultimately improve patient care and job satisfaction [ 4 ].

Despite the chances IPE offers, there is still an ongoing debate on when and where to implement IPE into existing health profession curricula. One administrative and logistical challenge of IPE is that aligning schedules involves coordinating with multiple faculties, finding common time slots, and ensuring that students can participate without disrupting their core learning objectives. Nonetheless, proponents argue that early implementation of IPE, despite the scarcity of available time slots, is favorable. Thus, implementing IPE in undergraduate health profession curricula may promote early interprofessional socialization between various professions and effectively counteract stereotypes between them [ 2 ].

To address this feature of IPE, we identified anatomy as a feasible subject to enable early intergroup contact between undergraduate, first-year medical and midwifery students [ 5 , 6 , 7 , 8 , 9 , 10 ]. Following socio-constructivist principles of learning [ 1 ], which sees individual knowledge as socially constructed, we designed and implemented an interprofessional block training. We put effort to embody these principles through (a) the emphasis on collaborative learning and problem-solving activities among students in interprofessional tandems, (b) through authentic and contextual learning stations within real-world healthcare scenarios, and (c) through facilitating reflection and networking events.

In a mixed-methods approach, we explored the short- and long-term effects of this novel training on interprofessional socialization and valuing, as well as interprofessional identity and intergroup contact. We conclude by evaluating the challenges and merits of this new approach and derive recommendations for future curriculum planners.

Theoretical introduction into related constructs and IPE theories

Interprofessional socialization and valuing.

According to Arnold et al. (2020) [ 11 ], health professionals usually go through monoprofessional socialization during their training period. As a result, professionals work side by side, but not necessarily with each other, in their daily professional lives. Thus, interprofessional socialization is necessary not only to ensure better communication but also to prevent the isolation of professional groups [ 3 , 12 ]. This enables students to build a dual, professional and interprofessional, identity. Khalili et al. (2013) [ 13 ] suggest a three-stage process when transforming from an uniprofessional identity to a dual professional and interprofessional identity, (1) breaking down barriers, (2) interprofessional tole learning and interprofessional collaboration, and (3) dual identity development. We argue that an early exposure to IPE may break down barriers because it helps to shape perceptions and attitudes before monoprofessional identities become deeply ingrained.

Interprofessional identity (IPI)

Through effective interprofessional socialization, students are likely to develop an interprofessional identity. IPI can be understood as a sense of belonging in one’s own professional group to an interprofessional community [ 13 , 14 ]. IPI assists students in expanding their monoprofessional perspective of practice to encompass a wider interprofessional viewpoint that appreciates the contributions of other professions to client care [ 3 , 15 , 16 ]. Education focusing solely on uniprofessional identity formation bears the risk of dis-integrating one’s own profession from interprofessional elements [ 2 ]. At the same time, interprofessional and professional identities are intertwined and influence each other [ 3 ]. The establishment of a strong IPI is thought to be particularly beneficial because it increases efficiency and appreciation within the team [ 12 ].

Intergroup contact

Interprofessional socialization is reinforced by intergroup contact [ 13 ]. The contact hypothesis [ 17 ] suggests that bringing together different groups can effectively reduce prejudice between the group members. Constant intergroup contact may contribute to an interprofessional identity as different groups get to know each other better, build relationships, and become more positive about working together [ 2 ]. Feeling a sense of belonging to a group is a significant requirement in the professional realm and appears essential for cultivating a positive work environment. When extended to an interprofessional setting, fostering a favorable disposition toward interprofessionalism becomes possible [ 3 ].

The current study made a concerted effort to integrate these theoretical underpinnings into both the overall design of the training and the specific setup of the training stations, as detailed in the methods section.

Research questions and hypotheses

We asked whether an ultra-brief interprofessional training in anatomy (i.e., a four-hour block) may be sufficient to promote key elements of interprofessionalism. Specifically, we hypothesized that an ultra-brief anatomy training would have H1: positive effects on interprofessional valuing and socialization, and H2: intergroup contact (primary outcomes). We further hypothesized that these effects would be measurable H3: directly after training, and, with the anticipation that the positive effects of this training would persist beyond the classroom setting through ongoing intergroup contact, H4: three months after training (secondary outcomes). Finally, we explored professional and interprofessional identity formation in medical and midwifery students and conclude with practical implications for future curriculum design.

Materials and methods

A pre-post interventional study with a three-month follow-up was conducted at the University of Münster, Germany, during the winter term of 2022/2023. The study protocol was deemed not to require formal medical ethics approval. Study participation was voluntary, and informed consent was received from all participants. Data generated or analyzed during the study can be requested from the corresponding author.

Overview of the medical curriculum

The medical program at the University of Münster is a six-year curriculum that combines theoretical university teaching with practical training in hospitals. The final exam is the state medical examination, which is divided into two sections after 4 and 10 semesters of studying. The four-semester preclinical section focuses on fundamental knowledge of the human body and the natural sciences. Students attend lectures, seminars and practical courses in biology, chemistry, physics, biochemistry, physiology and anatomy. Sociology and psychology subjects teach the theoretical foundations of the doctor-patient relationship and communication. The preclinical section concludes with the preliminary exam. The clinical section of the curriculum consists of topic-based subject modules and block practical courses that introduce students to different medical specialties. Complementary courses cover communication skills, ethics, and the doctor-patient relationship. The clinical section concludes with the second medical license examination, the final clinical year, and the third medical license examination.

Overview of the midwifery curriculum

The Midwifery Bachelor of Science program at the University of Münster is a dual, primarily professionally qualifying program that combines practical professional training with university teaching and academic education. The standard period of study is 8 semesters with a volume of 240 ECTS (European Credit Transfer and Accumulation System) points. The curriculum is structured to provide knowledge and skills (in various aspects) from the physiological basics to norm variants to pathology around pregnancy, birth and the first time as a family. In the first semesters, students acquire evidence-based midwifery knowledge and skills in the areas of the physiology of pregnancy, childbirth, and the postpartum period, as well as in the physiological development of the newborn and infant. After that, students learn about pathological conditions in these areas. Important practical skills and hand movements are practiced in the practical exercises at the “study hospital”. In addition, the teaching of scientific work, communication skills, midwifery and health care research, as well as ethics and professional policy round out the acquisition of competencies in the profession of midwifery.

Bringing together anatomy for medical and midwifery students

Both, medical and midwifery students study anatomy in their first year. Medical students have mandatory anatomy lessons, four hours weekly in the first term, 7.7 h in the second, and 8.3 h in the third term. The anatomical curriculum proceeds as follows: The first semester covers general anatomy and embryology through theoretical introductions. The second semester includes seminars and practical instructions, focusing on macroscopic anatomy and a full dissection course. In the third semester, students delve into histology and neuroanatomy, concluding with a four-day anatomy and imaging block course. To complete the anatomy course, students must pass written and oral exams.

Midwifery students, in the first semester, integrate anatomy into their curriculum through a module called ‘basic sciences,’ dedicating four hours weekly. The anatomy coursework emphasizes general embryology and the reproductive system. This teaching approach includes histology, sonoanatomy, and in-depth gross anatomy sessions using prosections, i.e. using prepared cadavers to demonstrate anatomical structures. The primary goal is to equip students with proficiency in medical terminology and the ability to connect their anatomical knowledge to physiological processes in the human body. At the semester’s end, students undergo assessment via a written and an oral exam.

The design of an ultra-brief interprofessional training in anatomy

After a brief welcome and an overview of the upcoming four-hour interprofessional training, midwifery science and medical students formed self-selected groups of two or three, consisting of students from both professions (Fig.  1 ). The “selection” was based on openness and a positive first impression, with no specific order or pattern. To strengthen the interprofessional identity, the tandems gave themselves their own names and competed with each other against the other tandems.

The 18 interprofessional tandems were divided into two large groups. One group went through six theoretical stations covering hormones and diagnoses, while the other group completed six tasks related to body donations and various models in the dissection room. After their initial stations, they swapped places, resulting in each tandem experiencing a total of twelve stations, each lasting 15 min. In these interprofessional tandems, students mastered anatomical case studies, played “hormone memory”, solved tests on body donations, discussed embryology topics, and assessed spermiograms under microscopes. The use of authentic healthcare scenarios aligns with socio-constructivst theories that advocate for learning in context. Students managed task distribution and documentation themselves. Afterward, there was a joint meal, providing an opportunity to connect, network and reflect on their shared experiences in the medical field to create intergroup contact. Additionally, several students proposed the creation of a shared WhatsApp group to stay in touch. Participation in the group was optional, yet all students chose to engage with this platform for exchange to establish long-term intergroup contact.

Flowchart of the ultra-brief interprofessional training in anatomy

Details on the interprofessional training stations

The different interprofessional training stations required students to exchange and discuss skills and knowledge across various areas of anatomy, patient care and medical fundamentals (Fig.  2 ). Students from both disciplines actively built new knowledge to complete tasks. Learning did not occur through the institute lecturers’ teaching, as their role was to merely oversee and moderate the learning stations. Due to differing curricula, either the midwifery or the medical students’ knowledge levels could determine success in specific tasks. Their clinical and academic responsibilities could be demonstrated to the other profession without any bias. Both parties were able to score equally within the tandem, fostering equitable learning. For instance, midwifery students had limited exposure to dissection rooms, while medical students regularly dissected cadavers. This experience helped medical students alleviate the midwives’ apprehension regarding body donations and instill the necessary respectful ethical behavior.

In the dissection room, ethical work with body donors in interprofessional teams was a primary focus. For instance, station nine concentrated on fetal relics in a cadaver, such as the ligamentum teres hepatis and ductus arteriosus. Students acquired knowledge in an authentic learning environment, termed “situated learning”. This approach enabled students to visualize structures and engage in discussions within their interprofessional tandems. Station seven challenged participants to memorize and identify muscles and structures on 3D pelvic floor models, emphasizing joint documentation as part of interprofessional collaboration. Station ten tasked students with drawing and labeling the anatomical differences between female and male pelvic floors, employing the “learning with drawing” strategy. Furthermore, the students were challenged to create a document that encouraged discussion and agreement within interprofessional tandems. Station eleven tested embryological knowledge by having students identify structures on embryonic models of the 7th, 15th and 25th development days. Station twelve required tandems to name sex differences in male and female pelvic construction using male and female skeletons. Both, station eleven and twelve, employed “situated learning”, prompting students to exchange their individual skills and knowledge to reach a common conclusion.

Theoretical learning stations compelled participants to collaborate in solving tasks through knowledge exchange, discussion and evaluation. For example, in station one, students applied female reproductive system anatomy to address an ectopic pregnancy case. Station six involved comparing and evaluating healthy and unhealthy sperms, also utilizing “situated learning”. Station two fostered mutual appreciation for each other’s expertise by requiring tandems to create a fictional conversation to accompany and educate a woman after childbirth.

Example of the “Interprofessional Learning Station” six. A  The goal was to differentiate between healthy and unhealthy sperms based on various criteria (i.e., concentration, morphology, etc.) within a certain time limit. Medical and midwifery students both had to assess the specimen under the microscope in pairs, exchange information, and document their findings on the worksheet. B  The interprofessional learning objective was to conduct a joint documentation as part of an interprofessional collaboration, while the anatomical learning objective was to differentiate and evaluate healthy and unhealthy sperms

Study participants

The participating students were recruited through regular courses in the medical and midwifery science degree programs. The idea of the project was very well received. According to the students’ feedback, only scheduling difficulties prevented some students from participating.

Measurements

Interprofessional socialization and valuing scale (isvs).

The Interprofessional Socialization and Valuing Scale (ISVS) was developed by King et al. (2010) [ 18 ] to evaluate the beliefs, behaviors, and attitudes that underlie interprofessional socialization and collaborative practice in health care settings. The scale is closely related to the extended professional identity scale of Reinders et al. (2020) [ 19 ]. The ISVS is a 24-item self-report measure with a 7-point scale used to assess the extent of the shift towards collaborative care in health care settings [ 20 ]. A sample item was: “I have a better appreciation for using a common language across the health professionals in a team”. Three subscales can be identified: The ability to work with others, as well as value and comfort of working with others. The reliability of the scale was deemed adequate (Cronbach’s α  = 0.67).

Maclead clark professional identity scale (MCPIS)

In order to control for socially desirable response behavior (i.e., the tendency of the students to adjust their answers to the perceived expectations of the study), we used a second scale, which measured a closely related but nevertheless different construct. For this purpose, we used the MCPIS, which we assumed to be a subordinate dimension of interprofessional identity [ 19 ]. The MCPIS is a validated instrument developed for the measurement of the professional identity of health and social care students from different professions. This scale was first developed by Adams and colleagues (2006) [ 1 ] for the measurement of PI in first-year students before the beginning of their training. We used the professional identity subscale of the questionnaire, which consists of 9 items measured on a five-point Likert scale. A sample item was: “I feel like I am a member of this profession.” The reliability of the scale was deemed adequate (Cronbach’s α  = 0.73).

Qualitative essays and content analysis

For methodological triangulation purposes and to avoid a common-method bias, we adapted the professional identity formation essay by Kalet et al. (2017) [ 21 ]. The 9 free-text items addressed mainly mono professional identity, e.g. with the sense of belonging to one’s own professional group, however, we specifically screened for answers related to inter professional identity, for example with regard to the perception of cooperation within the training. A sample item was: “What does being a member of the medical profession mean to you? How did you come to this understanding?”. The analysis was conducted using qualitative content analysis according to Mayring (2014) [ 21 ], and encompassed the following steps: developing a codebook, categorizing data, coding, ensuring reliability among raters via intraclass correlation coefficient (ICC) calculations, creating supracategories and quantifying qualitative data for comprehensive analysis.

For the evaluation of the free-text answers and to analyze the given content systematically, we operated with a category system, a codebook, that attempted to bundle the answers of the study participants into common categories. The utilization of the codebook allowed a more refined, focused and efficient analysis of the raw data in subsequent reads. After many iterations of the preliminary codebook, the final version was agreed upon by all four members of the research team. The iterative process of refining the codebook and the consensus among research team members ensured the validity of the categories used. In a similar inductive way, we assigned supracategories.

Subsequently, the same members independently read all the given answers again to assign the individual responses of the study participants to the defined categories. To evaluate the consistency among raters, we computed the Intraclass Correlation Coefficient (ICC) employing a two-way random effects model. The ICC for individual measures stood at 0.86, while the ICC for average measures reached 0.95, signifying good and excellent reliability, respectively (Koo and BPS). Finally, the frequencies of the responses received in each case were compared, and a relative frequency was calculated. This was done in order to be able to compare frequency distributions independently of the sample size. In this way, the qualitative answers could be quantified to enable a much more comprehensive analysis of a problem as well as to get a more comprehensive understanding.

A follow-up was conducted 12 weeks after the interprofessional training. The “long-term” effects of the training on IPI were evaluated using the same scales, i.e., ISVS and MCPIS, as well as intergroup contact-related items. We asked if they would participate in interprofessional trainings again and in what kind of situations they refer back to their training experience in their daily lives (“preparations for anatomy tests, internship, awareness of interprofessional communication when team working in the hospital”). In addition, we created an item ranging from 1 to 10 (1 =  no contact , 10 =  daily contact ) to assess the frequency of contact among students from different professions. Additionally, participants were asked to provide examples of places and platforms where they interact with each other to validate their responses.

Statistical analyses were conducted using the software SPSS v. 29.0.0.0 (IBM SPSS Statistics). As the MCPIS and ISVS scales were administered to participants before and after the intervention, the quantitative analysis pipeline for the provided results involved conducting an ANOVA with dependent samples, where time was considered a within-subject, and intervention (i.e., the training) a between-subject factor, to compare pre- and post-test scores on the scales. All statistics were performed under a significance value of alpha = 0.05, and the results are reported with a two-sided P -value. The statistical testing results were specified by an effect size with η 2  = 0.01 considered a small effect, η 2  = 0.06 a moderate effect, and η 2  = 0.14 a strong effect. For the comparison of frequency distributions, regardless of the sample size from both professions, the relative frequency for each profession was calculated (Table  1 ). This process of converting the qualitative answers into quantitative values aimed to provide a more objective evaluation and allowed a systematic and objective analysis of the collected qualitative data.

Participants

In total, 42 students were enrolled in this curriculum: 24 first-semester students of midwifery sciences and 18 s-semester students of medicine were recruited. A total of 15 (63%) out of the 24 eligible midwifery students answered the survey before the training, and 13 (54%) answered the survey immediately after the training. All 18 medical students (100%) answered the survey before the activity and 17 afterward (94%). Seven midwifery students (29%) and eight medical students (44%) participated in a follow-up 12 weeks after the training.

The majority of the participants in both professions identified themselves as female: 93% of the midwifery students identified themselves as female ( n  = 14), 7% as non-binary ( n  = 1). Among the medical students, 89% of the participants were female ( n  = 16), 11.1% male ( n  = 2). The median age of the midwifery students was 20.47 years ( SD  = 2.32, range =  18–28 years), the median age of the medical students was 20.50 years ( SD  = 1.25, range  = 19–24). Both groups did not significantly differ in age, 𝛘 2 (6) = 4.64, P  = .591. One student from each group of professions already had a completed professional education.

Exploring interprofessional identity prior to interprofessional training

Free-text responses before training were analyzed qualitatively to explore the (inter)professional identities of midwifery and medical students. Social competence, i.e., interprofessional teamwork and collaboration, emerged prominently as a career expectation in both personal (4.54% vs. 5.26%) and external career contexts (6.48% vs. 5.69%). Participants similarly placed great value on social competence when considering their professional role models, as evident in category H3 (6.48% vs. 6.83%). Interestingly, the lack of social competences, particularly working within interprofessional teams, were identified as potential sources of conflict for participants (7.13% vs. 5.41%). These findings point to the need for interprofessional training programs that specifically address the development of social competence and teamwork skills.

Short-term effects of an ultra-brief training on interprofessional socialization, valuing and professional identity

Before training, the ISVS score was lower for medical students (3.87 ± 0.33) than for midwifery students (4.10 ± 0.32). This number increased to 4.13 ± 0.3 resp. 4.43 ± 0.33 after the training (Fig.  3 b). The ISVS showed a significant improvement with a strong effect size for both medical and midwifery students, mean difference = 0.303, [95% CI: 0.120, 0.486], P  < .001, η² = 0.171. However, it was noticeable that midwifery students had slightly higher values for the MCPIS compared to medical students, 4.20 resp. 4.31 vs. 3.86 and 3.88, yet the results of the ANOVA showed no pre-post differences in MCPIS scores before and after the training, mean difference = 0.033, [95% CI: -0.236, 0.249], P  = .789 (Fig.  3 a). To conclude, the ultra-brief anatomy training fostered interprofessional socialization and valued both midwifery and medical students without affecting their uniprofessional identities.

Short-term effects of an ultra-brief (4-hour) interprofessional anatomy training on professional identity formation (MCPIS) ( A ) and interprofessional valuing (ISVS) of medical and midwifery students ( B ). * = P  < .01

Themes identified in free-text responses after training

Table  2 presents the analysis of free-text responses provided by participants after completing the interprofessional training program. These responses were coded into different themes, and the relative frequency of each theme was calculated, with a distinction made between midwifery and medical students’ perspectives. The analysis of free-text responses revealed a generally positive outlook on the interprofessional training, emphasizing the value of professional collaboration, personal growth, improved social relationships, and a more positive perspective on each other’s professions among participants from both midwifery and medical backgrounds. The professional and social dimensions of collaboration were frequently mentioned categories, and participants from both groups valued the harmonious and helpful interactions during the training. Notably, these responses revealed distinct differences between midwifery and medical students in their reflections on the training program. For example, while both groups recognized the social dimension of the training, a higher percentage of medical students (13.81%) expressed increased appreciation and respect for the other profession compared to midwifery students (5.33%).

Long-term effects on interprofessional socialization and valuing

To assess the stability of the effect observed on interprofessional socialization and valuing, we re-examined a subgroup of students’ 12 weeks after the training (Fig.  4 ). Similarly, their results indicate an increase in ISVS values from 3.89 ( SD  = 0.17) and 4.13 ( SD  = 0.36) before training to 4.24 ( SD  = 0.28) and 4.44 ( SD  = 0.37) after training. However, 12 weeks after training, we observed a decline of the ISVS back to nearly baseline levels of 4.07 ( SD  = 0.44) and 4.08 ( SD  = 0.42). To conclude, the short-term effects observed after the training were not sustainable after 12 weeks.

Long-term effects of the ultra-brief interprofessional anatomy training on interprofessional valuing (ISVS) of medical and midwifery students

The intergroup contact rate for medical students was 2.63 (SD = 1.69), and 3.29 (SD = 2.63) for midwifery students. Common meeting places for both groups included the library (14.29%), university sports facilities (10%), the train station (10%), WhatsApp (14.29%), the cafeteria (42.86%), and university buildings (28.57%).

All participants expressed their willingness to attend the training again, highlighting the enjoyable nature of the experience, the opportunity to gain different perspectives, the ability to learn from one another, the establishment of new connections, preparation for their future careers, and the exchange of ideas. For instance, a medical student noted, “The exchange allowed us to have meaningful discussions and share common interests.” A midwifery student also pointed out that students from both disciplines experienced similar challenges in their education, and this training provided a valuable overview of topics they had already covered in class. This was exemplified by a midwifery student who said, “I realized that both professions encounter comparable difficulties, and we can support each other.”

Medical students expressed their intention to apply the training experience when studying for anatomy exams, during clinical internships, and in their interactions and teamwork within the hospital setting. Likewise, midwifery students found value in recalling their training experience during their daily duties in the hospital, exam preparations, and even in the cafeteria. As one midwifery student put it, “It helped me solidify my knowledge”. In conclusion, despite the quantitative data showing a decrease after 12 weeks, students reported positive outcomes in terms of intergroup interactions and their ability to apply these skills in clinical settings.

Although the importance of interprofessionalism in healthcare professions is recognized, the implementation of appropriate training formats remains a challenge for health profession curricula. The purpose of the current study was to investigate the potential of a theory-derived ultra-brief (i.e., 4 h) interprofessional training to promote key elements of interprofessionalism. The training showed strong effects on both professions in terms of interprofessional socialization and valuing (H1). The follow-up data indicated that these short-term effects did not remain stable over a period of three months (H3), yet positive intergroup contact was still evident (H2). Qualitative data suggested that the participants may have had transformative social experiences during their training, indicating a first step towards establishing an interprofessional identity. We believe that the results of this study provide an important contribution to the current discussion on the implementation of IPE curricula [ 22 ]. In the following, we evaluate our curriculum against the backdrop of existing literature, discuss potential strengths and weaknesses, and derive recommendations for future projects.

Bringing together members of different social groups is considered one of the most promising methods for improving relationships between these groups [ 23 ]. However, it is important to emphasize that intergroup contact between different groups per se does not guarantee an improvement in relations; it can also reinforce prejudices. The current ultra-brief interprofessional training, despite its brevity, demonstrated positive effects on medical and midwifery students. Importantly, the quantitative and qualitative data indicate that both professions benefited equally from the training format, and there were no indications of asymmetric interactions. Likewise, we observed no negative stress-inducing events associated with the training, which could have resulted in a negative perception of the other profession [ 1 ].

Of particular note is the strong effect size of the intervention on interprofessional socialization and valuing, with η² = 0.171 (Fig.  3 b). We attribute this effect particularly to incorporating several socio-constructivist learning theories into the curriculum design. For example, we placed considerable emphasis on the necessity of prior knowledge from both professions to successfully address the tasks. This positive interdependence , widely acknowledged in the literature as a critical foundation for successful collaboration [ 16 ], led to the inclusion of both tandem partners. In this way, the participants encountered each other on the same level, getting to know the respective team members on a personal level. Working collaboratively in the team allowed them to mutually support one another in different tasks while learning about the boundaries of their own profession. Concurrently, the competitive setting among the interprofessional tandems resulted in a shift in the identification subject from one’s own profession (“we as the medical students”) towards an interprofessional team (“we as an interprofessional tandem”) [ 24 ]. Together, we suggest that forthcoming curricula leverage the theoretical insights as a foundation when developing new educational formats.

Overall, we see early contact between professions as an excellent opportunity to break down barriers early on and establish a mutual understanding of roles. Following Khalili et al.‘s three-stage model [ 13 ], this early exchange could be an effective means of overcoming barriers and practicing interprofessional collaboration, ultimately leading to the formation of a dual identity. The early implementation of such training formats allows for the strengthening of identity-forming facets in a protected environment and a gradual approach to a new identity. This prevents the development of dysfunctional role perceptions and stereotypical notions about other professions in uniprofessional silos which constantly reinforce themselves when unsupervised and can lead to conflicts in future professional environments [ 22 ]. We also argue that it is more difficult and time-consuming to change an established dysfunctional identity later on than to support interprofessional socialization early on. However, the follow-up results warn against understanding such trainings as singular events, as the effects on interprofessional socialization seem to diminish over time. Therefore, we recommend anchoring such training formats in longitudinal curricula.

The current training was performed with medical and midwifery students, however, embedding such training formats in the core anatomy curriculum [ 25 ], in our experience, can be flexibly expanded to other health professions. Since most health professions begin their first semesters with anatomy lessons, both anatomical and interprofessional learning objectives can be cleverly combined. This not only avoids cutting valuable time from the anatomical core curriculum – a subject that has been heavily affected by curricular time reductions in recent years [ 26 ] – but also presents an excellent opportunity to allocate additional curricular time for interprofessional training formats. Additionally, we have found that the subject of Anatomy lends itself well to create various collaborative learning formats [ 27 ]. This includes, for example, working with body donors, which requires interaction between professions considering ethical principles, a core element of IPE [ 28 ]. Similarly, the vertical integration of clinical-obstetric content into anatomy is feasible and has allowed us to construct authentic cases that interprofessional tandems must tackle together. In our curriculum, this included clinical-anatomical cases on ectopic pregnancies or the examination of spermiograms using real microscopes (see Table  3 ). For future sessions, we plan to set up ultrasound devices and assign specific examination tasks to interprofessional tandems [ 29 ]. We believe that such authentic exercises will lower the threshold for future interprofessional collaboration, as the high authenticity of the stations results in socio-constructivist and situated learning [ 30 , 31 ]. Situated learning theory emphasizes authentic learning environments as particularly useful to promote effective collaboration and (inter)professional identity formation (“feeling like an interprofessional team solving a real task”) [ 2 , 3 ]. To further support students’ interprofessional identity, we plan to recruit the current study participants as interprofessional peer-teachers for future versions of this curriculum, who may serve as positive role models for interprofessional collaboration and communication.

Limitations

Several limitations must be acknowledged. First, all the instruments that were used in this study relied on the self-reported data of the students, which may have inflated correlations due to shared method variance, such as tendencies toward socially desirable responses or further responding tendencies. To estimate the extent of socially desirable responses, we used a closely related uniprofessional identity scale as a control construct. Still, further research may advance the implementation of behavior-oriented measures of interprofessional socialization, or IPI, even though there are only a few studies that consider the objective assessment of such measures. Second, study participation was voluntary, so participating students may not be representative of the whole cohort. Finally, we lost some participants in the follow-up, so the follow-up data must be interpreted cautiously as they represent only a subset of the study population.

“Working together has given me hope, that as the next generation of doctors and midwives, we can break the old hierarchy and work together as a functioning team.” In essence, this participant’s perspective not only acknowledges the transformative potential of an ultra-brief interprofessional training in anatomy but also advocates for a paradigm shift in educational approaches. By emphasizing the importance of teamwork and breaking down hierarchical structures early in the educational journey, we may cultivate a generation of healthcare professionals who are not only proficient in their respective fields, but also inherently collaborative and well-prepared to meet the complex challenges of modern healthcare.

Availability of data and materials

The datasets used and/or analyzed during the current study available from the corresponding author on reasonable request.

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Acknowledgements

Open Access funding enabled and organized by Projekt DEAL. This study received no official funding.

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Medical faculty, Universität Münster, 48149, Münster, Germany

Dana Bostedt, Ebrar Hümeyra Dogan, Sina Chole Benker, Maret Antje Rasmus, Emily Eisner & Nadine Lana Simon

Institut für Anatomie und Vaskuläre Biologie, Universität Münster, 48149, Münster, Germany

Martina Schmitz

Institut für Anatomie und Molekulare Neurobiologie, Universität Münster, Vesaliusweg 2-4, 48149, Münster, Germany

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DD and MM formulated the overarching research goals and aims. DD developed the methodology and conducted the formal analysis. DB, EHD, SCB, MAR, EE, NLS, and DD conducted the investigation process.DB, EHD, SCB, MAR, EE, NLS, and DD wrote the main manuscript text. DB, MAR, EE, DD, and SCB prepared the figures. DD, MS, and MM reviewed the manuscript.DD and DB revised the manuscript.DD supervised the research process. All authors have read and approved the manuscript.

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Correspondence to Dogus Darici .

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Bostedt, D., Dogan, E.H., Benker, S.C. et al. Interprofessional socialization of first-year medical and midwifery students: effects of an ultra-brief anatomy training. BMC Med Educ 24 , 464 (2024). https://doi.org/10.1186/s12909-024-05451-w

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Received : 30 November 2023

Accepted : 22 April 2024

Published : 26 April 2024

DOI : https://doi.org/10.1186/s12909-024-05451-w

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