Identification of barriers and facilitators of successful interprofessional education (IPE) – a scoping umbrella review / Identifizierung der Einflussfaktoren für die interprofessionelle Ausbildung (IPE) – ein Umbrella Scoping Review

≥ two different health professions

Students/trainees from the health professions

Trained health professionals

Only one health profession

Health professions where the clients are not human, such as veterinarians

Persons before the start of training or studies (pre-study internship)

IPP^**

Readiness for IPE/IPP with RIPLS^***

Empirical studies

Reviews without systematic literature search

(0) age and gender [5, 8]

(+) younger students [5]

(0) (previous) experiences [3, 5, 9]

(−) own role uncertainty [3, 8, 9]

(−) lack of knowledge about each other profession [1, 3, 5, 8]

(−) focus on professional knowledge [9]

(+) enthusiasm and motivation [8, 9]

(−) students thought it was time-wasting [8]

(−) reserved style [9]

(−) lack of respect [1, 3]

(−) feeling threatened [9]

(−) fear about loss of professional identity [8, 9]

(−) distrust [3, 9]

(+) respect and interest in IPE [5, 9]

(−) monoprofessional self-identity [1, 9]

(−) role and professional identity uncertainty [8, 9]

(−) arrogant and aggressive behaviour [9]

(−) professional stereotypes [5, 8, 9]

(−) lack of clear expectations [8, 9]

(−) status [9]

(0) age and gender [5, 8]

(0) number of professions and group size [4, 5, 9]

(0) mismatch in age, profession, and differences in experiences [5, 8]

(−) lack of diversity in small learning groups [9]

(−) different levels of learning [9]

(−) differences in workload [3]

(−) differences in the knowledge base [3, 8]

(−) different learning needs [8]

(−) differences in experiences [3, 8]

(−) different learning styles [1, 8]

(−) different professional jargons [8]

(+) clear IPE goals [3]

(−) unclear or irrelevant IPE goals [3]

(−) profession-specific goals in combination with IPE goals [9]

(+) common values for IPE [8]

(+) effective communication [8];

open communication style [9]

(+) make joint decisions in agreement [6] (+) urgency [9]

(−) unfamiliarity [9]

(−) lack of active engagement in team tasks [9]

(−) lack of conflict resolution strategies [3]

(+) own role clarity [8, 9]

(+) equal status [9]

(+) team identity; being part of a ‘supra-identity’ [2]

(−) different role expectations [8, 9]

(−) medical profession is usually perceived as dominant to other professions [8]

(−) focusing on one’s own profession [8, 9]

(−) professional stereotyping [5, 8, 9]

(+) building interprofessional relationships/time to socialize [3, 9]

(+) use of informal learning [5, 9]

(+) trust and collegiality [9]

(−) the more professionals are specialized, the more difficulties are to collaborate [8]

(−) professional tribalism [8. 9]

(−) status/power differentials [5, 8, 9]

(−) not valuing others’ opinions [9]

(−) conflicts or tensions between learners [8]

(+) competent educators [2, 5, 8, 9, 10]

(+) knowledge of each other’s roles [6]

(−) inadequate faculty development specific to IPE [3, 9, 10]

(−) inability to fully understand the IPE concept and its inherent value [1] (−) limited knowledge and skills [4, 8]

(−) lack of clarity on (learning) goals [4]

(+) enthusiasm, humour, and empathy [6]

(−) lack of respect; lack of interest [8]

(−) sense of academic elitism [8] (+) valuing diversity [10]

(+) active engagement with other profession [9]

(+) educating style: not just ‘imparting knowledge’ [8, 9]

(−) educating style that corresponds to professional traditions [8, 9].

(−) condescension and defensiveness [8]

(−) lack of preparations [5, 8]

(−) unfamiliarity with teaching different professions [8]

(−) time inadequacy [8]

(+) patient-centred models [2, 3, 8]

(+) team-based approaches [2. 4, 7, 9]

(+) self-directed learning [9]

(+) experiential-based learning through clinical or community practice and placements [2, 3, 7, 9]

(+) teambuilding activities [2, 3, 7, 9]

(+) team skills training [9]

(+) training in team communication skills [9]

(+) combining learning methods [2, 7]

(−) employing a single learning method [7]

(−) compiling case studies for students [7, 8]

(−) silo approach [8]

(+) creating a climate of safety and confidence among learners [5] (+) safe and supportive learning environment [2, 9]

(+) creating a motivational environment, providing incentives [2]

(+) diversity of educators; co-facilitation [2, 5, 9] (+) providing effective instruction [6]

(+) debriefing [4, 5, 6]

(+) feedback [6]

(+) shared reflection for learners [3, 5, 6, 9]

(+) high quality of facilitation [5, 9]

(−) lack of adequate supervision/support [8]

(+) learning in a non-threatening environment [2]

(+) learning at their own time; asynchronous aspect [2, 5]

(+) faculty development programs [1, 5, 8, 10]

(+) educational theory linked to supporting collaborative social learning [5]

(−) IPE teaching through lectures [9]

(−) teacher who just transmits knowledge [9]

(−) sub-optimal IPE – teaching that not represent clinical settings [2]

(+) stimulating collaboration and teamwork [9] (+) face to face small group learning activities [9] (+) learn about roles [9]

(+) panel discussion with IP team practitioners [9]

(+) support for IPE matched to clinical reality [9]

(+) involvement of (simulation) patients in IPE lessons [9]

(+) participate in case scenarios in small groups [2]

(+) self-efficacy and understanding of others’ professional role [9]

(+) value in the discussions during the simulation [4] (+) increased team learning [4]

(+) improved interprofessional communication [2, 9]

(+) building positive relationships [2]

(+) benefit of being an observing participant [4]

(−) lack of simulation knowledge [4]

(−) lack of faculty expertise in technology [4]

(+) real cases [9]

(+) scenarios as learning material for discussion [7]

(+) problem-based learning [9]

(+) complete root cause analysis and develop recommendations [9]

(+) authenticity of the context [9]

(+) real cases for clinical practice [7]

(+) identify the roles of other professions [9]

(+) promoted interaction in a non-threatening environment [2] (+) created a lasting impression [3]

(−) lack of adequate supervision/support [8]

(+) external / internal funding [1, 5]

(−) different funding and competition [1, 8]

(−) lack of financial incentives [1, 5, 8]

(−) successfully sustain IPE activities within normal budgets [5]

(−) differential salaries [8]

(+) flexible schedule; spread over time [2]

(−) lack of allocation of time resources [3, 5, 8, 9]

(−) different timetables and complex schedules [1, 3, 8]

(−) varying program calendars [1, 8]

(−) lack of time for implementation of IPE [1, 3. 5, 8]

(+) well-resourced rooms [2, 8]

(+) physical space designated for simulation [2, 4]

(−) lack of classroom space [3, 5, 8]

(−) logistics of the location [8]

(−) equipment issues [5]

(+) regular planning and discussion between facilitators [5]

(+) remuneration for IPE faculty training [2]

(+) providing online resources for faculty training [8]

(−) limited faculty resources [8]

(−) high workloads placed upon staff by management [1, 8]

(−) poor attendance of medical staff [8]

(−) require more staff [8]

(+) support through management and leaders [1, 2, 5]

(+) shared interprofessional vision by staff [1]

(−) lack of (conceptual) support from management [2, 5, 8]

(−) limited availability of staff development programs [1, 8]

(+) well integrated with the curricula [2, 8, 9]

(+) longitudinal, structured setting/curriculum of IPE [2, 3, 7, 9]

(+) referral to a specific standard/framework of competence for IPE [4, 7]

(−) various accreditation demands [1, 8]

(−) integrating IPE into curriculum of different institutions [3, 8]

(−) no underlying principles of competency framework [8]

(−) predominantly siloed, content-heavy monoprofessional curricula [1, 3, 8, 9]

(+) structured IPE programmes [2]

(+) development of appropriate organisational structures [1]

(+) flexibility (interprofessional e-learning the asynchronous aspect) [5]

(−) contrasting systems and teaching processes [8]

(−) lack of central planning [8]

(−) clashes with profession-specific learning activities [5]

(−) coordinating students and teachers from different units [8]

(−) large number of students [5, 6, 8]

(0) different conceptualizations of IPE (top-down vs. student centered IPE) [8]

(0) selection of appropriate level of study among students [8]

(+) face to face small group learning activities [9]

(+) combining learning methods [2, 7]

(+) providing electronic resources such as cases or simulations [8]

(−) complexity of the learning topic [7]

(−) difficulty meeting needs of all disciplines [4]

(−) adaption to learners needs [5]

(−) dissonance between stated faculty values and educational practice [3, 9]

(−) lack of access, structure or continuity to (interprofessional) placements [3, 8]

(+) collaboration and shared commitment of stakeholders [1]

(+) wearing a uniform [9]

(−) difference in personal objectives of the involved educators [4]

(−) high learning load [8]

(−) lack of enough time [1, 2, 3, 5, 8, 9]

(+) providing standardized assessment tools [8]

(+) progress of IPE and the positive results [8]

(−) lack of assessment [4, 8, 9]