Content uploaded by Bojan N. Joksimovic
Author content
All content in this area was uploaded by Bojan N. Joksimovic on Jan 11, 2018
Content may be subject to copyright.
145
Copyright © 2017 by the Academy of Sciences and Arts of Bosnia and Herzegovina.
e eects of interprofessional diabetes education on the
knowledge of medical, dentistry and nursing students
Maja Račić1, Bojan N. Joksimović2, Smiljka Cicmil3, Srebrenka Kusmuk1, Nedeljka
Ivković3, Natalija Hadživuković4, Milan Kulić2, Biljana Mijović1, Mirjana Mirić5,
Vedrana R. Joksimović1, Milena Dubravac1
Original article
Acta Medica Academica 2017;46(2):145-154
DOI: 10.5644/ama2006-124.199
Introduction
Each profession has distinct profession-
based behavior, viewpoint, and values, even
before commencing undergraduate training
(1, 2). Prior work has found entrenched in-
group ratings of academic ability and pro-
fessional competence among students across
10 professional and social care programs
surveyed at the outset of their training; rst-
year nursing, pharmacy, and medical stu-
dents all perceive themselves as more “car-
ing” than members of the other disciplines
(3, 4). Such health-professional stereotypes
can adversely impact teamwork and, ulti-
mately, patient care (5, 6).
1Department of Primary Health Care
and Public Health, Faculty of Medicine
Foča, University of East Sarajevo, Bosnia
and Herzegovina, 2Department of Basic
sciences, Faculty of Medicine Foča
University of East Sarajevo, Bosnia
and Herzegovina, 3Department of Oral
Rehabilitation, Faculty of Medicine Foča
University of East Sarajevo, Bosnia and
Herzegovina, 4Department of Nursing,
Faculty of Medicine Foča, University of
East Sarajevo, Bosnia and Herzegovina
5Department of Pathological Physiology
Medical Faculty of the University in
Pristina with temporary seat in Kosovska
Mitrovica, Kosovo, Serbia
Correspondence:
joksimovic_bojan@yahoo.com
Tel.: +387 65 373 507
Fax.: + 387 58 210 007
Received: 31 August 2017
Accepted: 30 November 2017
Key words: Interprofessional education
Diabetes mellitus Professional role.
Objectives. Interprofessional teamwork is best attained through edu-
cation that promotes mutual trust and eective communication. e
primary aim of the study was to evaluate the impact of interprofes-
sional learning on knowledge about diabetes. Methods. e cross-sec-
tional study included students of medicine, dentistry and nursing at
the Faculty of Medicine Foča, Bosnia and Herzegovina. e students
were randomly allocated into one of two groups. Group 1 attended an
interprofessional course on diabetes while group 2 was divided into
three subgroups and each of the subgroups attended an uniprofes-
sional diabetes course. e measuring instrument used in the course
in order to assess the participants’ knowledge about diabetic care was
a test containing multiple-choice questions about diabetes. e Inter-
professional Questionnaire was used to explore the attitudes, views,
values and beliefs of students regarding interprofessional education
(IPE). Results. No statistically signicant dierence in total score on
the test was found between the groups at baseline, but at follow-up
the dierence was highly statistically signicant (F=10.87; p=0.002).
e students from Group 1 had better results (21.82 points), compared
to Group 2 (18.77 points). e statistically signicant dierence was
observed in mean values (t=-3.997; p=0.001), between Groups 1 and
2; the students from Group 1 obtained 20.42 points, which is consid-
ered to indicate a respectively positive self-assessment of communi-
cation and teamwork skills. However, Group 2 indicated a negative
self-assessment of communication and teamwork skills. Conclusion.
e ndings suggest that IPE activities may provide health profession
students with valuable collaborative learning opportunities.
146
Acta Medica Academica 2017;46:145-154
West et al. (7) concluded that clear pro-
fessional roles are essential, and that team
members could benet from a comprehen-
sive understanding of both their own pro-
fessional role and the professional roles of
their colleagues. Damour and Oansen (8)
concluded that educational eorts should
be introduced early in the curriculum, prior
to the developing of professional identities
and the formation of stereotypes. Saroo et
al. (9) argued that successful interprofes-
sional training should take advantage of the
students’ psycho-sociological determinants,
such as professional role behavior, hierar-
chy, and power relations. According to the
Centre for the Advancement of Interprofes-
sional Education (CAIPE), interprofessional
learning involves “educators and learners
from 2 or more health professions and their
foundational disciplines who jointly create
and foster a collaborative learning environ-
ment. e goal of these eorts is to develop
knowledge, skills and attitudes that result in
interprofessional team behaviors and com-
petence” (10, 11).
Dierent studies noted that the students
are not suciently exposed to interprofes-
sional teamwork during their clinical training
(12, 13). Aase et al. (14) found that theoretical
lectures on interprofessional teamwork were
not followed-up in clinical training, espe-
cially in nursing schools. Medical schools ex-
posed their students to more interprofession-
al education (IPE), but, still they are not very
compliant with the WHO recommendations,
calling for strengthening interprofessional
teamwork in educational programs (14). e
reasons for this are partly because of faculty
and students’ attitudes (15).
On the other hand, diversity in the im-
plementation of IPE has made it dicult
to determine best practice models, optimal
IPE delivery model or reliable measurement
tools (16, 17). Examples of reliable measure-
ment tools to measure IPE are Interdisci-
plinary Education Perception Scale (IEPS)
and University of the West of England En-
try Level Interprofessional Questionnaire
(UWE-ELIQ) (18). It has been suggested
that IPE courses should have dened the
core competences as their curricular com-
ponents (19). A comprehensive assessment
of those competences is needed for eec-
tive medical and health care education
programs. A clear dierentiation between
the identication of essential components
(knowledge, skills, and attitudes) and of cri-
teria to assess the behavioral performance of
health care workers is crucial, as in the per-
formance criteria several components are
integrated or used in combination (20).
Numerous studies of the eectiveness on
interprofessional education compared IPE
to education in which the same professions
were learning independently from each oth-
er (21, 22). e analyses suggested that IPE
seemed to be more eective in relation to re-
action and learning, with much less evidence
of impact on behavior and results. Based on
the ndings from other studies evaluating
the use of interprofessional education, the
sta of Medical School Eastern Sarajevo
decided to conduct an interprofessional
course on diabetes. e lecturers focused on
four interprofessional competency domains
outlined by the Interprofessional Education
Collaborative: ethics, roles and responsibili-
ties, communication and teamwork.
e primary aim of the study was to eval-
uate the impact of interprofessional learning
on knowledge about diabetes, the roles, and
responsibilities of other health professions.
e secondary aim was to analyze the at-
titudes, views, values and beliefs of health
profession students who are learning togeth-
er, regarding IPE, compared to the students
who are learning independently from each
other.
147
Methods
Data collection and participant
characteristics
e cross-sectional study was conducted
during the winter semester at the Faculty
of Medicine, University of East Sarajevo,
Bosnia and Herzegovina, in January 2017.
Participants were all students enrolled in
sixth-year of medicine (29 students), h-
year of dentistry (21 student) and third-year
of nursing (16 students), as the teaching cur-
ricula for these years and study programs in-
tegrated obligatory lectures in diabetes. e
list with students’ names, provided by the
Student Administrative Service, was torn
into separate strips. e strips were put in a
hat and were mixed. Each name was pulled
out and put into one of two groups alter-
nately. Group 1 attended interprofessional
course on diabetes. Group 2 was divided
into three subgroups: medical, dental and
nursing.
Intervention design
e interprofessional diabetes course was
designed to provide students with in-depth
knowledge of diabetes mellitus. e course
was a one-day mandatory class and consisted
of four blocks. Block 1 focused didactically
on the therapeutic management of Type 1
and Type 2 Diabetes, blood glucose moni-
toring, patient education and evidence-base
for diabetes care and decision making in
interprofessional practice. Block 2 didactics
focused on the ethics, roles, responsibilities
and scope of medical, dental and nursing
practices, and introduced the characteris-
tics of an eective team. Block 3 analyzed
government strategies for diabetes and ex-
amined their benets for practice within
an interprofessional context and evaluated
the physical, psycho-social and cultural
impact of diabetes on the patient and fam-
ily. e last block focused on a paper-based
case scenario in which a newly established
patient with diabetes was presented. e
scenario incorporated the history provided
by family practitioner. Students included in
IPE were placed in eight mixed-profession
teams, consisting of 3-4 medicine, 2-3 den-
tistry and 2 nursing students that remained
together throughout the whole course.
Aer each didactic block, team members
met to discuss personal values, teamwork,
leadership, consensus building and the abil-
ity to identify and achieve joint goals in
care for patients related to presented topic.
Vision of team-working, decision making
processes, shared responsibility for team ac-
tions, own role and the roles of others, role
boundaries, team skills and knowledge were
explored. At the end of course, each team
reviewed the activities that occurred at the
process of interprofessional learning.
e course content for group 2 was iden-
tical except for the interprofessional group
work. Students received the same learning
experience, but interaction with students of
dierent health profession was lacking. Di-
dactic blocks were handled by three faculty
members, with background in family medi-
cine, parodontology and nursing.
e measuring instruments
e measuring instrument used during the
course to assess the participants’ knowledge
about diabetic care was a test containing
multiple-choice questions about diabetes.
e multiple-choice test contained 20 ques-
tions, divided into two scales, about diabetic
patient care, with each question carrying
between 1 to 4 points, and with the total
score being 33. e rst subscale consisted
of 13 questions about the general knowledge
about diabetes (denition, diagnosis, screen-
ing, self-control, complication, treatment
and care for diabetic patients). To explore
if IPE contributes to nursing and medicine
students’ knowledge regarding oral health in
Maja Račić et al.: Eect of interprofessional education on students
148
Acta Medica Academica 2017;46:145-154
diabetic patients, the second subscale con-
sisted of 10 questions was also included. e
test was distributed at the beginning of the
course, and aer completion of the course.
e large amphitheater was provided to al-
low students to sit in every third seat and ev-
ery second row. e students were assigned
to specic seat, and seating arrangement was
changed for follow-up test. To prevent cheat-
ing, mobile phone signals were blocked.
Prior to the test, the principal researcher
presented student behavior rules. e stu-
dents were instructed to conduct themselves
honestly. ey were not permitted to ask the
questions of invigilators (except in the case
of ambiguities) or to copy someone else’s an-
swers. Four invigilators practiced constant
observation, watching the students all the
time. Test-taking time was 30 minutes long.
To explore the attitudes, views, values,
and beliefs of study participants regarding
IPE, the Interprofessional Questionnaire,
based on the University of the West of Eng-
land Entry Level Interprofessional Ques-
tionnaire (UWE-ELIQ) (23) was used. e
Questionnaire included 33 multiple- choices
questions, divided into 4 scales: interprofes-
sional learning, communication and team-
work scale, interprofessional interaction and
interprofessional relationships. e answers
were rated according to Likert-type scale.
e Interprofessional Learning Scale
assessed attitudes towards learning in an
interprofessional setting, whilst the In-
terprofessional Interaction scale analyzed
perceptions of other interprofessional col-
leagues and interactions. e perceptions of
students’ own relationships with colleagues
were evaluated with the Interprofessional
relationships scale. e answers were scored
from 1 (strongly agree) to 5 (strongly dis-
agree), the neutral point being included.
e scores for these three scales were pre-
determined for the questionnaire, indicat-
ing positive (8 to 20 points), neutral (21 to
27 points) or negative (28 to 40 points) at-
titudes or perception.
e Communication and Teamwork
Scale provided self-assessment of skills. e
statements were scored from 1 (strongly
agree) to 4 (strongly disagree). Positive self-
assessment was dened as meeting expec-
tation, and unsatisfactory communication/
teamwork skills were transmitted to nega-
tive self-assessment. e minimum score
was 8, maximum 32. e score from 8–20
represented positive, 21–25 neutral, and
26–32 negative self-assessment of skills. e
reliability analysis was conducted by calcu-
lating a Cronbach’s alpha coecient and its
value of 0.724 was found to be satisfactory.
Ethical considerations
e study is conducted with the approval of
the Ethical Committee of theMedical Fac-
ulty of Foča, University of East Sarajevo,
Bosnia and Herzegovina.
Statistical analysis
Statistical analyses were carried out using
SPSS 20 (SPSS Inc., Chicago, IL, USA). e
p values of less than 0.05 were considered as
statistically signicant. Data were described
using percentages, mean values, standard
deviations, and frequency distributions. e
Paired-Samples T test was used to compare
mean values before and aer intervention
on students. ANOVA with repeated mea-
sures was used to show possible statistically
signicant dierences between study pro-
grams and groups of students at baseline
and at follow up. e independent t-test was
used to show statistically signicant dier-
ences between study programs and groups
of students in mean values of the Interpro-
fessional Questionnaire. To determine cor-
relations between the knowledge of students
and the IPE Questionnaire answers, we used
Pearson’s coecient for correlations.
149
Results
e study included 66 undergraduate stu-
dents divided in two groups, rst, interprofes-
sional (Group 1) and second, uniprofessional
(Group 2). Mean ±SD age in study popula-
tion was 23.1±2.8 years, and 57.6% of partici-
pants were female. Majority of respondents in
both groups study medicine (44.2%), 31.8%
dentistry and 25.8% nursing school. e sta-
tistically signicant dierences between base-
line and follow-up knowledge about diabetes
(t=−8.166; p=0.001) and impact of diabetes
on oral health were found (Table 1).
Gradient improvement of knowledge
was detected in both groups, but at follow-
up, the scores were signicantly higher
among interprofessional group of students
(Table 2).
Table 3 shows the comparisons of mean
values of test scores between the students of
medicine, nursing and dentistry. Although
baseline and follow up general knowledge on
diabetes were the greatest among medicine,
and oral health among dentistry students,
signicant dierences in total score at fol-
low-up were not found (F=0.179, p=0.836).
e Communication and Teamwork
scale was used to evaluate students’ commu-
nication and teamwork skills. Self-assess-
ment of skills in interprofessional group was
positive, and in uniprofessional group nega-
tive (t=−3.997; p=0.001). e perceptions of
students’ own relationships were positive in
both groups, conversely, attitudes towards
learning in an interprofessional setting and
perceptions of interprofessional interac-
tions were positive in group 1 and neutral in
group 2 (Table 4).
Dentistry students reported positive self-
assessment of communication and team-
work skills (20.38 points), compared to
medical (26.03 points) and nursing students
(27.23 points), whose self-assessment was
neutral and negative, respectively (t=-3.270;
p=0.005). e attitude of medicine students
Table 1 Comparisons of test score mean values before and after the course
Test score Mean values (± SD) of test scores t - test p
Baseline Follow up
Subscale 1 5.83 (2.47) 9.13 (3.80) -8.166 0.001
Subscale 2 7.54 (2.03) 11.34 (2.78) -11.317 0.001
Total score 13.37 (2.76) 20.39 (4.30) -12.510 0.001
Table 2 Comparisons of the test score mean values between interprofessional and uniprofessional groups at
baseline and at follow up
Test score Mean values (± SD) of test scores t - test p
Group 1 Group 2
Subscale 1
Baseline 6.11 (2.31) 5.51 (2.64) 0.246 0.622
Follow up 10.31 (3.66) 7.80 (3.54) 7.04 0.010
Subscale 2
Baseline 7.08 (1.54) 8.06 (2.39) 7.25 0.009
Follow up 11.68 (1.23) 10.96 (3.85) 4.26 0.043
Total score
Baseline 13.20 (2.51) 13.58 (3.05) 1.77 0.188
Follow up 21.82 (4.54) 18.77 (3.41) 10.87 0.002
Maja Račić et al.: Eect of interprofessional education on students
150
Acta Medica Academica 2017;46:145-154
Table 3 Comparisons of the test scores mean values according to the study programs at baseline and at follow up
Test score Mean values (± SD) of test scores F p
Medical students Dentistry students Nursing students
Subscale 1
Baseline 7.64 (1.70) 3.28 (1.67) 6.00 (1.45) 23.22 0.001
Follow up 11.21 (2.42) 5.95 (3.90) 9.64 (2.89) 5.073 0.009
Subscale 2
Baseline 7.57 (1.16) 9.09 (1.84) 5.58 (1.73) 15.10 0.001
Follow up 10.32 (2.40) 14 (1.76) 9.76 (1.04) 15.48 0.001
Total score
Baseline 15.21 (2.25) 12.38 (2.51) 11.58 (2.00) 14.57 0.001
Follow up 21.32 (4.75) 19.95 (3.72) 19.41 (4.12) 0.179 0.836
F=Variation between sample means, ANOVA.
Table 4 Comparisons of mean values of Interprofessional Questionnaire in three study programs
Groups
of students
Interprofessional Questionnaire scales
CETS ILS IIS IRRS
Mean (SD) Mean (SD) Mean (SD) Mean (SD)
Group 1 20.42 (5.12) 18.77 (9.58) 20.25 (5.72) 16.65 (7.17)
Group 2 28.06 (7.88) 21.54 (8.84) 22.67 (4.74) 18.45 (7.81)
t - test/p -3.997 / 0.001 -1,128 / 0.226 -1.857 / 0.068 -0.972 / 0.335
Medical 26.03 (8.01) 22.96 (9,97) 21.60 (5.46) 18.85 (7.90)
Dentistry 20.38 (3.82) 18.47 (5.92) 20.04 (4.37) 16.71 (4.86)
Nursing 27.23 (7,28) 17.29 (10.72) 22.7 (6.33) 16.41 (7.59)
t - test/p 3.270 / 0.005 1.982 / 0.058 1.115 / 0.271 1.019 / 0.314
CETS=Communication, Ethics and Teamwork scale; ILS=Interprofessional Learning scale; IIS=Interprofessional Interaction Scale;
IRRS=Interprofessional Roles and Responsibilities Scale.
Table 5 Correlation between students’ knowledge and Interprofessional Questionnaire scales
Test score
Interprofessional Questionnaire Scales
CETS ILS IIS IRRS
r / p r / p r / p r / p
Subscale 1 0.084 / 0.501 0.013 / 0.919 0.030 / 0.813 -0.047 / 0.705
Subscale 2 -0.673 /0.001 -0.284 / 0.021 -0.397 / 0.001 -0.247 / 0.046
Total score -0.327 /0.007 -.137 / 0.274 -0.189 / 0.128 -0.175 / 0.159
CETS= Communication, Ethics and Teamwork scale; ILS=Interprofessional Learning scale; IIS=Interprofessional Interaction Scale;
IRRS=Interprofessional Roles and Responsibilities Scale; r=correlation coecient.
related to inteprofessional learning was neu-
tral contrary to (22.96) positive attitudes
of dentistry (18.47) and nursing students
(17.29). All three groups had a positive per-
ception about interprofessional interaction
and their own interprofessional relation-
ships. However, statistical signicant dier-
ences in attitudes and perceptions by study
program and intervention were not found.
e correlation between test subscales and
Interprofessional Questionnaire’ scales are
shown in Table 5.
151
Anecdotal comments included Group 1
students remarking how much more in-
formed they were now about the role of
health care of professions other than their
own, and that there should be more of such
learning and teaching activities organized
during undergraduate studies
Discussion
To evaluate the health profession students’
skills, perception and attitudes regarding
IPE, the course on diabetes was carried out.
e current study showed that health pro-
fession students who participated in IPE
course had greater overall knowledge of
diabetes as well as more positive assessment
of their communication and teamwork skill
compared to the students involved in uni-
professional course. e ndings are in line
with other studies showing the inuence of
bringing dierent health professions togeth-
er to learn on achieving better results and
interprofessional collaboration (23-25).
e literature suggests that implemen-
tation of IPE into undergraduate curricula
could increase the likelihood of future physi-
cians, nurses and dentists engaging in a com-
municative and team member behavior that
promotes and improves the model of multi-
disciplinary, patient-centered care. Helping
students form, and successfully integrate,
their professional selves into their multiple
identities is a fundamental of medical edu-
cation (26, 27). Albeit the most students in
IPE group rated their communication and
teamwork skills positively, a signicant dif-
ference was found between self-assessed
skills of dierent health profession students.
Nursing students had more negative opin-
ion compared with neutral self-assessment
of medicine and positive view of dentistry
students. e quantity of structured inter-
personal learning experiences was but few
at Faculty of Medicine Foča, and this was
the rst course in the medicine, nursing and
dentistry undergraduate curricula address-
ing IPE. As curricula are traditional, under-
standing of others health professions’ roles
is limited, nurses being seen as proximate,
caring aids to physicians, physicians as main
care providers for diabetic patients, and
dentists as a profession taking care of oral
health only. Available data indicate that col-
laboration readiness and specically higher
levels of condence in personal skills could
be improved by engaging all health profes-
sion students in IPE (27, 28). IPE sustains
augmented condence relating to students’
skills and positive attitudes toward interpro-
fessional roles and responsibilities (29).
Dierences in attitudes toward inter-
professional learning, roles and interaction
were not found among the students partici-
pating in IPE and non-IPE course. However,
the students exposed to IPE were more fa-
vorably inclined towards interprofessional
learning in addition to dentistry and nursing
students generally, what corroborates previ-
ous studies (30). ey held counteractive
opinions about interprofessional interac-
tion. In agreement with prior research (31,
32) all students reported improvement in
understanding the roles of other health pro-
fessionals in the patient care and challenges
of learning in interprofessional teams as this
was the rst time for all students, regardless
the study program and intervention, to have
the opportunity to attend lectures presented
by the professors with dierent expertise.
An improvement in diabetes knowledge
level was identied among all three profes-
sions, medical, dentistry and nursing. ere
was a statistically signicant dierence in
baseline knowledge. As expected, medi-
cal students had the highest score in gen-
eral knowledge and dentistry students in
oral health due to the previous training in
the specic areas. Observing the subscales
responses, the scores per group notably in-
creased with the ratio between the profes-
sions being stable, but the dierence in to-
Maja Račić et al.: Eect of interprofessional education on students
152
Acta Medica Academica 2017;46:145-154
tal scores by study program was not found.
Both interventions included contents new
to students, involving multidisciplinary
clinical scenario that might have allowed
increased understanding of diabetes and its
oral-systemic connections (33). IPE course
particularly strengthened the knowledge of
the nursing students who started with low
scores. Sequential with the ndings of oth-
ers, the authors of the current study believe
it is possible that integrating IPE learning
activities into undergraduate health profes-
sion curricula, within the context of a rel-
evant topic like diabetes management, may
augment students’ learning abilities and
improve their collaboration related compe-
tences (29, 34, 35).
Creating the IPE courses requires coop-
eration from deans, administrators and fac-
ulty members. Curricula in each discipline
should oer sucient opportunities for
students to rst interact, both formally and
informally, with their own members, and to
explore and even challenge accepted frame-
works of established roles (36, 37).
Limitations of the study
e current study has several limitations.
e ndings could be specic to University
of East Sarajevo and didactic approach of
the faculty, which was not necessarily the
same as at the other faculties of medicine
in Bosnia and Herzegovina. Knowledge,
attitudes and perception were assessed at
one point in time. e study was based on
the self-assessment, therefore subjectivity
and accountability need be considered. Al-
though this study demonstrates promising
ndings, it is preliminary, so replication of
the study longitudinally, throughout study
years, analyzing the comparison of a change
in attitudes, and including the higher num-
ber of participants should be set up at same
and other faculties of medicine in the coun-
try. Future research is needed to examine
whether IPE could result in a breakdown
of negative stereotypes over time and if so,
what type of IPE intervention would be the
most eective.
Conclusion
e ndings suggest that interprofessional
education activities may provide health pro-
fession students with valuable collaborative
learning opportunities in addition to im-
proving specic clinical knowledge, level of
condence in own skills and positive attitude
conducive to collaboration with other health
professionals. In order to prepare the health
professional students for interprofessional
collaborative practice following graduation,
dierent IPE interventions are needed. Fur-
ther longitudinal, multi-site studies explor-
ing the impact of interprofessional learning
on knowledge, attitudes and perceptions of
students are requisite.
What is already known on this topic
Interprofessional teamwork is best attained through educa-
tion that promotes mutual trust and eective communication.
According to the Centre for the Advancement of Interprofes-
sional Education (CAIPE), interprofessional learning involves
educators and learners from 2 or more health professions and
their foundational disciplines who jointly create and foster a
collaborative learning environment. e goal of these eorts is
to develop knowledge, skills and attitudes that result in inter-
professional team behaviors and competence. Health profes-
sionals as team members could benet from a comprehensive
understanding of both their own professional role and the pro-
fessional roles of their colleagues.
What this study adds
Interprofessional education activities may provide health pro-
fession students with valuable collaborative learning opportu-
nities in addition to improving specic clinical knowledge, level
of condence in own skills and positive attitude conducive to
collaboration with other health professionals. In this line, we
evaluated impact of interprofessional learning on knowledge
about diabetes among medical, dentistry and nursing students.
We also explored the attitudes, views, values and beliefs of stu-
dents regarding interprofessional education.
Authors’ contributions: Conception and design:
MR, BNJ, SC, SK, NI, NH, MK, BM, MM, VRJ and
MD; Acquisition, analysis and interpretation of data:
153
MR, BNJ, SC, SK, NI, NH, MK, BM, MM, VRJ and
MD; Draing the article: MR, BNJ, SC, SK, NI, NH,
MK, BM, MM, VRJ and MD; Revising it critically
for important intellectual content: MR, BNJ, SC, SK,
NI, NH, MK, BM, MM, VRJ and MD; Approved nal
version of the manuscript: MR, BNJ, SC, SK, NI, NH,
MK, BM, MM, VRJ and MD.
References
1. Rudland J, Mires GJ. Characteristics of doctors
and nurses as perceived by students entering med-
ical school: Implications for shared teaching. Med
Educ. 2005;39(5):448-55.
2. Harsburgh M, Perkins R, Coyle B, Degeling P.
e professional subcultures of students entering
medicine, nursing and pharmacy programmes. J
Interprof Care. 2006;20(4):425-31.
3. Hean S, Macleod Clark J, Adams K, Humphris D,
Lathlean J. Being seen by others as we see our-
selves: the congruence beteewn the ingroup and
outgroup perceptions of health and social care
students. Learn Health Soc Care. 2006;5(1):10-22.
4. Hawkes G, Nunney I, Lindqvist S. Caring for
attitudes as a means of caring for patients – im-
proving medical, pharmacy, and nursing student’s
attitudes to each other’s professions by engaging
them in interprofessional learning. Med Teach.
2013;35(7):1302-8.
5. Wilbur K, Kelly I. Interprofessional impressions
among nursing and pharmacy students: a quali-
tative study to inform interprofessional education
initiatives. BMC Med Edu. 2015;15:53.
6. Koel C, Burke KG, McGuinn K, Miltner RS. Inte-
gration of Quality and SafetyEducationfor Nurs-
es Into Practice: Academic-Practice Partnership’s
Role. Nurse Educ. 2017;42(5S Suppl 1):S49-S52.
7. West M, Markiowicsz L. Building Team-Based
Working. Cornwall: e British Society and
Blackwell Publishing Ltd; 2004.
8. D’Amour D, Oandasan I. Interprofessionality as
the eld of interprofessional practice and inter-
professional education: An emerging concept. J
Interprof Care. 2005;19 Suppl 1:8-20.
9. Sharma S, Boet S, Kitto S, Reeves S. Interprofes-
sional simulated learning: the need for ‘sociologi-
cal delity’. J Interprof Care. 2011;25(2):81-3.
10. Center for Advancement of Interprofessional
Education (CAIPE)[cited 2017 Oct 21]. Available
from: http://www.caipe.org.uk.
11. Buring SM, Bhushan A, Broeseker A, Conway S,
Duncan-Hewitt W,Hansen L, et al. Interprofes-
sional Education: Denitions, Student Compe-
tencies, and Guidelines for Implementation. Am
J Pharm Educ. 2009;73(4):59.
12. Bjorke G. Collaboration across professional
boundaries [in Norwegian]. HiO-Report No 1.
Oslo: Hogskolen i Oslo; 2009.
13. Almås S, Barr H. Common curricula in Norway:
Dierential implementation and dierential out-
comes in undergraduate health and social care
education. J Interprof Care. 2008;22(6):650-7.
14. Aase I, Aase K, Dieckmann P. Teaching interpro-
fessional teamwork in medical and nursing edu-
cation in Norway: A content analysis. J Interprof
Care. 2013;27(3):238-45.
15. Clark PG. Examining the interface between in-
terprofessional practice and education: Lessons
learned from Norway for promoting teamwork. J
Interprof Care. 2011;25(1):26-32.
16. istlethwaite J. Interprofessional education: A re-
view of context learning and the research agenda.
J Interprof Care. 2012;46(1):58-70.
17. Reeves S, Zwarenstein M, Goldmnn J, Barr
H, Freeth D, Koppel I, et al. e eectiveness
of interprofessional education: Key ndings
from a new systematic review. J Interprof Care.
2010;24(3):230-41.
18. Simko LC, Rhodes DC, McGinnis KA, Fiedor
J. Students’ perspectives on interprofessional
teamwork before and aer an interprofession-
al pain education course. Am J Pharm Educ.
2017;81(6):104.
19. Interprofessional Education Collaborative Expert
Panel. Core competencies for interprofessional
collaborative practice: report of an expert panel.
Washington, DC: Interprofessional Education
Collaborative; 2011.
20. Vyt A. Interprofessional and transdisciplinary
teamwork in health care. Diabetes Metab Res Rev.
2008;24 Suppl 1:S106-9.
21. Vary PM, Lash J, Brown SS, Porter AG, Trinkle
D, Garber JS, et al. Collaborative Practice Educa-
tion: e Eect of an Interprofessional Teamwork
Course on Students’ Knowledge and Skills. Med
Sci Educ. 2013;23(Suppl 3):494-501.
22. Zwarenstein M, Reeves S, Perrier L. Eectiveness
of pre-licensure interprofessional education and
post-licensure collaborative interventions. J Inter-
prof Care. 2005;19 Suppl 1:148-65.
23. Freeth D, Reeves S, Koppel I, Hammick M, Barr
H. Evaluating interprofessional education: a self-
help guide. London: Higher Health Educational
Academy Health Science and Practice Network/
CAIPE; 2005.
24. McFadyen AK, Webster VS, Maclaren WM. e
test-retest reliability of a revised version of the
Maja Račić et al.: Eect of interprofessional education on students
154
Acta Medica Academica 2017;46:145-154
Readiness for Interprofessional Learning Scale
(RIPLS). J Interprof Care. 2006;20(6):633-9.
25. Evans JL, Henderson A, Johnson NW.Interpro-
fessional learning enhances knowledge of roles
but is less able to shi attitudes: a case
study from dental education. Eur J Dent Educ.
2012;16(4):239-45.
26. Pollard KC, Miers ME, Gilchrist M. Collaborative
learning for collaborative working? Initial nd-
ings from a longitudinal study of health and so-
cial care students. Health Soc Care Community.
2004;12(4):346-58.
27. Anderson ES, orpe LN.Early interprofessional
interactions: does student age matter? J Interprof
Care.2008;22(3):263-82.
28. Ruebling I,Pole D,Breitbach AP,Frager A,Ketten-
bach G,Westhus N,et al. A comparison of student
attitudes and perceptions before and aer an in-
troductory interprofessional education experi-
ence. J Interprof Care.2014;28(1):23-7.
29. Pollard KC, Miers ME. From students to profes-
sionals: results of a longitudinal study of attitudes
to pre-qualifying collaborative learning and work-
ing in health and social care in the United King-
dom.J Interprof Care.2008;22(4):399-416.
30. Gould K, Day KH, Barton AT. Changing stu-
dent attitudes through interaction: Findings
from an interprofessional workshop. J Interprof
Care.2017;31(4):540-2.
31. Reeves SA, Denault D, Huntington JT, Ogrinc G,
Southard DR, Vebell R. Learning to Overcome Hi-
erarchical Pressures to Achieve Safer Patient Care:
An Interprofessional Simulation for Nursing,
Medical, and Physician Assistant Students. Nurse
Educ. 2017;42(5S Suppl 1):S27-31.
32. Anders PL, Scherer YK, Hatton M, Antonson
D, Austin-Ketch T, Campbell-Heider N. Using
Standardized Patients to Teach Interprofessional
Competencies to Dental Students. J Dent Educ.
2016;80(1):65-72.
33. Darlow B, Coleman K, McKinlay E, Donovan S,
Beckingsale L, Gray B, et al. e positive impact
of interprofessional education: a controlled trial
to evaluate a programme for health professional
students. BMC Med Educ. 2015;15:98.
34. Goldie J. e formation of professional identity
in medical students: considerations for educators.
Med Teach. 2012;34(9):e641-8.
35. Pollard K, Miers ME, Gilchrist M. Second year
scepticism: pre-qualifying health and social care
students’ midpoint self-assessment, attitudes and
perceptions concerning interprofessional learning
and working. J Interprof Care. 2005;19(3):251-68.
36. Wilbur K, Hasnani-Samnani Z, Kelly I. Interpro-
fessional Education Activity Among Undergradu-
ate Nursing and Pharmacy Students in the Middle
East. Nurse Educ. 2015;40(4):163-4.
37. Luebbers EL, Dolansky MA, Vehovec A, Petty G.
Implementation and evaluation of a community-
based interprofessional learning activity. J Inter-
prof Care. 2017;31(1):91-7.
