The merit of mandatory interprofessional education for pre-health professionalstudents

Abstract

Background: Since the World Health Organization identified interprofessional education (IPE) as an important component of primary health care in 1978, health sciences educators continue to debate when it might be best to introduce IPE into the academic training of health professionals. While IPE continues to be offered at increasingly early stages in students’ professional development, few if any IPE initiatives have targeted undergraduate pre-health professional students who are likely to enter health professional programs.

Objectives: To design, execute and evaluate the effectiveness of a mandatory IPE initiative targeting students in their first year of a general undergraduate health science education.

Methods: An integrated exercise was created to introduce students to eight health professions and the underlying concepts of interprofessionalism through self-directed independent research, problem-based learning and collaborative group discussions. A two-part questionnaire was developed using a seven point Likert scale to assess the participants’ perceived changes in knowledge, interests, and attitudes.

Results: A total of 161 students (99.4%) completed both instruments. Pre and post-exercise responses (n = 161) indicated meaningful improvements in students’ knowledge on the specific roles of different health professionals (p < 0.001), knowledge on the value of interprofessionalism (p < 0.001), interests in pursuing the various health professions as future careers (p = 0.075), and attitudes towards IPE (p < 0.001). Post-exercise data also revealed that students acquired valuable knowledge and gained a strong interest in learning more about the various health professions as a result of this exercise.

Conclusions: Participation in this short, one-time IPE exercise resulted in profound changes in attitudes, interests, and knowledge amongst participating students. Based on these changes, mandatory IPE for pre-health professional students is merited but additional research on this topic is necessary.

Introduction

Recently there has been an explosion of interest in interprofessional practice by governments and academic institutions around the world. Research suggests that interprofessional collaboration – a patient-centred, team-based approach to health care delivery that synergistically maximizes the strengths and skills of each contributing health professional – may lead to improved patient care (Kohn et al. 2000; Barr 2002; West et al. 2006) and increased employment satisfaction amongst increasingly fatigued health professionals (McGrath 1991), yet additional evidence of efficacy is certainly required (Zwarenstein et al. 2000). The need for collaborative care has nonetheless been recognized (Barr et al. 1999; Brandon & Knapp 1999; Finch 2000), and interprofessional education (IPE) has been shown to work best in promoting this goal (Hammick 2000). Various IPE initiatives have been developed and implemented for pre-licensure health professional students and post-licensure professionals, and IPE researchers continue to focus on evaluating the effectiveness of the programs.

Table

Practice points
•Educators must address the existence of harmful stereotypes that are held by students even prior to their matriculation in health professional studies.
•Prior professional knowledge is not necessary for IPE to be effective.
•Even a one-time, short duration exercise may allow for meaningful, positive changes in knowledge, interests, and attitudes.
•Merit exists to offer mandatory IPE for pre-health professional students.
•Additional research must be conducted to determine whether mandatory IPE for pre-health professional students is cost-effective and realistic.

One of the greatest controversies still facing health sciences educators is when to introduce IPE into the academic training of health professionals. According to Barr (2002), conventional wisdom had once held that IPE was best offered only after licensure when participants’ professional identities were secure and when they had experiences to share. Freeth et al. (2002) seemed to confirm the implementation of this notion when she reported that less than thirty percent of studies were based on pre-licensure students with most focused on practicing health professionals.

Historical evidence, however, shows a trend towards offering IPE at increasingly earlier stages in students’ professional development. Almost twenty years ago, Areskog (1988) recommended that IPE be instituted early in the undergraduate education of health professionals. The General Medical Council (1993) in the United Kingdom made a similar statement five years later, and both Carpenter (1995) and Parsell et al. (1998) subsequently recommended earlier and sustained IPE as a way to ensure that the positive effects of this training would not be lost. Finally, Horder (1995) suggested that the early adoption of an IPE curriculum may prevent negative attitudes and stereotypes amongst health professional students that would otherwise develop during the course of their studies.

Recent evidence suggests that such negative stereotypes exist amongst students even prior to beginning their professional education. According to Tunstall-Pedoe et al. (2003) and Cooper et al. (2005), students begin internalizing professional values upon matriculation, which may contribute to the various barriers experienced when practicing or learning within an interprofessional setting. Indeed, Rudland & Mires (2005) showed that first year medical students held negative stereotypes of their nursing colleagues even in the first week of classes. Leaviss (2000) and Herzberg (1999) also argued for the early implementation of IPE before such stereotypes would influence student attitudes towards collaborative practice, and Parsell et al. (1998) showed that students themselves believed that including IPE early in the first year of undergraduate education was necessary for the same reason. While the evidence for the effectiveness of IPE at an early stage in a student's professional development remains unclear (Byrne 1991; Van der Horst et al. 1995; Zwarenstein et al. 2000), Harden (1998) and Salvatori & Solomon (2005) suggest that students at any level may benefit from such training. In fact, Horsburgh et al. (2001) showed that even health professional students in their first year of studies believed that IPE was beneficial for them and would result in better care for their patients. Therefore, the notion of instituting mandatory IPE for students prior to their matriculation in a health professional program may simply be the next logical progression and intervention for IPE.

The education systems of Canada and the United States, for example, would allow for such an IPE curricula at the university level due to the widespread demand by many health professional schools for the completion of an undergraduate degree (e.g., B.A., B.Sc., B.H.Sc.) prior to acceptance by a health professional program. As such, three or four years of pre-health professional studies (e.g., pre-medical studies) are often undertaken by students who wish to pursue those health professions that require a prior undergraduate degree (e.g., medicine, chiropractic, physiotherapy). Special programs have consequently been established to prepare students for a professional education and expose them to the various areas of a health sciences education. For example, the Bachelor of Health Sciences (Honours) Program at McMaster University is such a program where students are introduced to the study of health from biological, behavioural, and population-based perspectives. Emphasis is placed on independent research, teamwork, critical thinking and communication skills which are seen as important to success in health professional studies or graduate work in the medical sciences. Overwhelming evidence exists to support that these students are likely to become health professionals. In fact, data collected by McMaster University reveals that approximately 75% of graduating students enter health professional programs, with approximately 60–65% of graduates choosing to enter medical school (n = 280).

Since the World Health Organization identified IPE as an important component of primary health care in 1978 (WHO 1978) and issued its technical report on this subject in 1988 (WHO 1988), few if any mandatory IPE initiatives have targeted pre-health professional students who are more than likely to enter health professional programs. In fact, while a significant body of research has discussed the best time to introduce IPE, there is a dearth of research examining the potential effectiveness and overall merit of IPE targeting students prior to entry into a professional health faculty.

Inspired by the belief that prior specialized knowledge is not necessary for the development of many of the skills that IPE is intended to foster (e.g., communication and teamwork skills), the McMaster University Interprofessional Student Council developed and executed an IPE exercise aimed at introducing the roles and responsibilities of various health professions along with the concept of interprofessional collaboration to first year Bachelor of Health Sciences (BHSc) students. This study seeks to analyze the effectiveness of this mandatory IPE exercise that was offered on 20 October 2005 as an integrated component of the introductory health sciences curriculum and to determine whether merit exists for the expansion of such programming for pre-health professional students in the future.

Methods

Program design

An exercise was created to introduce first year BHSc students to eight arbitrarily chosen health professions (chiropractor, nurse, nurse practitioner, occupational therapist, pharmacist, physician, physiotherapist, and social worker) and the underlying concepts of interprofessionalism through self-directed independent research, problem-based learning, and collaborative group discussions. Inspired by Dalhousie University's Interprofessional Learning Modules (Johnston & Banks 2000), the program consisted of three components that were conducted in groups of approximately eight students: (1) an introduction to the roles and responsibilities of each health profession; (2) a stereotypes exercise highlighting preconceived notions regarding each health profession; and (3) a detailed examination and structured discussion of one of three randomly assigned patient case studies. At the conclusion, three or four groups joined together and participated in a teaching assistant-led discussion on key themes in interprofessionalism and IPE.

As the participants were pre-health professional students with no prior professional knowledge or training, the challenge was to develop the requisite knowledge within the groups. This unique challenge was overcome by randomly assigning each student one of the eight health professions three weeks prior to the exercise with instructions to conduct self-directed independent research on their assigned profession. Each student was given a list of sixteen guiding topics to assist in their research and was advised that they would be acting as an “ambassador” for their assigned profession during group discussions.

Questionnaire design

A two-part questionnaire was developed based on the Modified Kirkpatrick's Model of Educational Outcomes for IPE (Freeth et al. 2002) using a seven point Likert scale (strongly disagree = 1, moderately disagree = 2, slightly disagree = 3, neither agree nor disagree = 4, slightly agree = 5, moderately agree = 6, and strongly agree = 7) to assess the perceived effectiveness of the various exercise components and the knowledge and attitudinal changes in the students following this educational intervention. Student responses, pre and post-exercise, were solicited and analyzed for a number of key indicators, including: (1) acquisition of knowledge on the specific roles and responsibilities of different health professionals; (2) acquisition of knowledge on interprofessionalism; (3) interest in gaining additional information about certain health professions; (4) interest in pursuing the different health professions as future careers; and (5) attitudes towards interprofessional education and practice. The pre-exercise questionnaire consisted of thirty questions assessing the students’ knowledge, attitudes, and beliefs prior to the exercise, and the post-exercise questionnaire incorporated these thirty questions for comparison and added an additional forty-three questions soliciting responses on program design and knowledge acquisition. In an attempt to reduce patterned responses, some questions used negative wording but were coded appropriately for the analysis.

The pre-exercise questionnaire was distributed to students three weeks prior to the exercise and collected upon starting the exercise. The post-exercise questionnaire was completed by all participating students directly after the exercise's concluding discussion.

Results

In total, 162 BHSc students participated in this exercise with 161 of them completing both the pre and post-exercise questionnaire (99.4% response rate).

Statistical analysis

The questionnaire was found to be reliable with a Cronbach's alpha of 0.8946. While all statistical testing was conducted using the full range of responses provided by the seven point Likert scale, the data was also dichotomized into “agree” (strongly agree and moderately agree = 1) and “disagree” (slightly agree, neither agree nor disagree, slightly disagree, moderately disagree and strongly disagree = 0) for summary purposes. Data from the questionnaire was analysed by sub-section using a one-way within-subject repeated measures analysis of variance (ANOVA).

Acquisition of knowledge on the specific roles and responsibilities of different health professionals

Participants’ self-reported knowledge of the eight health professions’ specific roles and responsibilities was measured both pre and post-exercise. There was a significant increase in self-reported knowledge after the exercise (F(1, 1071) = 152.46, p < 0.001) with an additional 53% (7% to 60%) of students reporting post-exercise that their knowledge of the different professions was moderate or strong (see Table 1). In addition, there was a significant effect of profession (F(7, 1071)= 35.94, p < 0.001). A self-reported gain in valuable knowledge about the various health professions was also measured post-exercise with a mean response across professions of 5.49 out of 7. As can be seen in Table 2, over three quarters of students also reported that they acquired valuable knowledge on the eight health professions. Based on the finding of a significant effect of profession (F(7, 1085)= 6.797, p < 0.001), it is clear that the participating students treated the eight professions differently and saw meaningful distinctions between each question.

Table 1.  Self-reported knowledge of roles of health professions (pre and post-exercise)

Knowledge of health professionals’ roles and	Dichotomized data (1-5 vs 6-7)		Complete data (1-7)
responsibilities is strong:	% Agree (pre)	% Agree (post)	Mean (pre)	Mean (post)	ANOVA (pre/post)
Chiropractors	8%	29%	3.46	4.69	F(1, 1071) = 152.46 p < 0.001
Nurses	24%	53%	4.60	5.37
Nurse practitioners	16%	48%	3.53	5.04
Occupational therapists	18%	42%	3.59	4.97
Pharmacists	34%	62%	4.63	5.47
Physicians	58%	73%	5.36	5.83
Physiotherapists	24%	47%	4.20	5.14
Social Workers	25%	50%	4.09	5.15
All eight health professions	7%	60%	3.88	5.61
Mean	24%	52%	4.15	5.25

A significant effect of profession was also found (F (7, 1071) = 35.94, p < 0.001).

Table 2.  Self-reported gain in knowledge about health professions (post-exercise)

	Dichotomized (1-5 vs 6-7)	Complete data (1-7)
Gained valuable knowledge about:	% Agree (post)	Mean (post)	Standard Deviation
Chiropractors	48%	5.19	1.570
Nurses	63%	5.42	1.559
Nurse Practitioners	79%	6.02	.968
Occupational therapists	62%	5.61	1.279
Pharmacists	58%	5.40	1.594
Physicians	54%	5.26	1.568
Physiotherapists	61%	5.43	1.452
Social Workers	64%	5.61	1.391
All eight health professions	78%	6.09	.893
Roles of eight health professions	75%	5.94	.985
Anything	83%	6.25	.955
Mean (eight health professions)	61%	5.49	1.423
Mean	66%	5.66	1.292

A significant effect across profession was found (F (7, 1085) = 6.797, p < 0.001).

Acquisition of knowledge on interprofessionalism

Respondents’ self-reported knowledge on interprofessionalism was again measured before and after the exercise. The post-exercise scores were significantly higher than the pre-exercise scores across questions (F (1, 310) = 183.43, p < 0.001) and a significant effect of question was found (F(2, 310)= 35.42, p < 0.001). In fact, the vast majority of students reported moderate or strong knowledge on interprofessionalism following the exercise with 62% (14% vs 76%) more students understanding the potential benefits of interprofessionalism. See Table 3 for independent question means.

Table 3.  Self-reported gain in understanding about interprofessionalism (pre and post-exercise)

Understanding of the following aspects	Dichotomized data (1-5 vs 6-7)		Complete data (1-7)
of interprofessionalism is strong:	% Agree (pre)	% Agree (post)	Mean (pre)	Mean (post)	ANOVA (pre/post)
Potential benefits	14%	76%	3.97	5.84	F(1, 310) = 183.43, p < 0.001
Purpose of learning about it	34%	79%	4.76	6.09
Interprofessionalism in general	41%	80%	5.05	5.95
Mean	30%	78%	4.59	5.96

A significant effect of question was also found (F (2, 310) = 35.42, p < 0.001).

Interest in gaining additional information about certain health professions

The effect of this exercise on students’ interest in learning more about each health profession was also measured and a mean of 4.97 out of 7 was found across questions. A significant effect of question was found (F(7,1078) = 24.46, p < 0.001). Overall, 74% of participants responded that the exercise initiated a moderate or strong desire to learn more about health professionals with 68% indicating this interest for the medical profession. See Table 4 for a complete breakdown of student responses by health profession.

Table 4.  Interest in learning more about health professions (post-exercise)

	Dichotomized (1-5 vs 6-7)	Complete data (1-7)
Interest in learning more about health professions	% Agree (post)	Mean (post)	Standard Deviation
Chiropractors	27%	4.43	1.668
Nurses	24%	4.34	1.484
Nurse practitioners	35%	4.87	1.480
Occupational therapists	38%	4.70	1.533
Pharmacists	49%	5.14	1.487
Physicians	68%	5.87	1.279
Physiotherapists	42%	4.93	1.560
Social workers	24%	4.35	1.551
Health professionals in general	74%	6.12	1.051
Mean	42%	4.97	1.455

A significant effect of question was found (F (7,1078) = 24.46, p < 0.001).

Interest in pursuing the different health professions as future careers

The participating students’ interest in pursuing the eight health professions as future careers was also measured before and after the exercise without yielding a significant effect of time (F(1,1106) = 3.21, p = 0.075). However, a significant effect of question (F (7,1106) = 89.48, p < 0.001) was found. Interestingly, a smaller percentage of students expressed a moderate or strong interest in pursuing the following professions post-exercise: nursing (11% vs 7%), occupational therapy (14% vs 13%) and social work (8% vs 6%) (see Table 5). While any decrease in student interest for a particular profession warrants significant attention, such minimal decreases can only be expected after an exercise that was partly designed to expand and reinforce career choices. Such findings are within the expected range for this exercise and are not surprising in light of the goals of this exercise.

Table 5.  Interest in pursuing health professions as a future career (pre and post-exercise)

Interest in pursuing health	Dichotomized data (1-5 vs 6-7)		Complete data (1-7)
professions as future career	% Agree (pre)	% Agree (post)	Mean (pre)	Mean (post)	ANOVA (pre/post)
Chiropractors	9%	15%	2.99	3.19	F(1,1106) = 3.21, p = 0.075
Nurses	11%	7%	2.79	2.87
Nurse practitioners	9%	14%	2.80	3.32
Occupational therapists	14%	13%	3.41	3.33
Pharmacists	27%	34%	4.16	4.16
Physicians	73%	75%	5.86	5.88
Physiotherapists	19%	25%	3.81	4.00
Social workers	8%	6%	2.80	2.89
Health professional in general	80%	85%	6.22	6.43
Mean	28%	30%	3.87	3.64

A significant effect of question was also found (F (7,1106) = 89.48, p < 0.001).

Attitudes towards interprofessional education and practice

Students’ attitudes towards IPE and collaborative practice were very positive from the beginning and further improved after their first IPE experience. The post-exercise values were significantly higher than the pre-exercise values across questions (F(1,1224) = 8.99, p = 0.003) and a significant effect of question was found (F(8,1224) = 39.66, p < 0.001). See Table 6 for a full breakdown of the results.

Table 6.  Attitudes towards IPE and practice (pre and post-exercise)

	Dichotomized data (1-5 vs 6-7)		Complete data (1-7)
Attitudes towards interprofessionalism and IPE	% Agree (pre)	% Agree (post)	Mean (pre)	Mean (post)	ANOVA (pre/post)
Interprofessionalism is very important	75%	89%	6.11	6.45	F(1,1224) = 8.99, p = 0.003
Interprofessionalism is very beneficial for patients (r)	79%	86%	5.99	6.24
Interprofessionalism is very beneficial to professions	75%	80%	6.03	6.19
Learning about interprofessionalism is very important (r)	78%	83%	6.02	6.21
All health professional students should learn about interprofessionalism	75%	85%	6.06	6.30
All pre-health professional students should learn about interprofessionalism	66%	80%	5.78	6.20
All BHSc students at McMaster University should learn about interprofessionalism	70%	81%	5.87	6.18
As a result of this exercise, want to learn more about interprofessionalism	57%	64%	5.55	5.65
Interest in participating in additional IPE activities	43%	40%	5.17	5.07
Mean	69%	76%	5.84	6.05

A significant effect of question was also found (F(8,1224) = 39.66, p < 0.001).

It is important to note, however, that while more students post-exercise wanted to learn more about interprofessionalism (57% vs 64%), fewer were interested in participating in additional IPE activities (43% vs 40%). While this small decrease in interest for the latter may be in response to a few negative experiences, in light of contrary data and anecdotal evidence it is more likely to be the result of a concern that any future IPE activities would necessarily be mandatory and marked for grading purposes.

Discussion

This study presents self-reported changes in attitudes, interests and knowledge of first year pre-health professional students who participated in an IPE exercise. The evaluation tool examined the first three outcome measures for IPE as identified by Hammick (2000) – learners’ satisfaction with their experience, a modification of attitudes and perceptions, and the acquisition of knowledge – yet did not measure the latter three which include changes in behaviour, changes in organizational structure, and benefits to patients; all efforts to evaluate the final three measures was intentionally forgone as they do not yet apply to this particular student population which does not yet perform clinical duties. The collected data, nonetheless, shows that students reacted positively to their first IPE experience which may possibly be explained by the fact that harmful professional stereotypes had not yet developed.

This study is important as it is the first time that an IPE exercise has been implemented and evaluated for students before commencing a professional education. While a documented improvement in clinical practice would certainly be the ideal measured outcome to prove merit for mandatory IPE for pre-health professional students, no IPE study to date has been able to definitively measure its impact on patient care (Zwarenstein et al. 2000). Therefore, an evaluation of this IPE offering must be based on its ability to invoke changes in students’ knowledge, interests, and attitudes related to the future care of patients which all provide us with insight into their future career choices and willingness to learn and work with other health professions.

Benefits of IPE for pre-health professional students

In order for collaborative practice to succeed, IPE must be effectively utilized to change students’ attitudes from the traditional “silo” approach (Hall 2005) to a team-based mentality. Students must also develop an interest in learning about the roles and responsibilities of the many health professions, and knowledge must be acquired to enhance inter-professional understanding. Finally, emphasis must be placed on communication skills and reciprocal respect. This exercise, as merely a first attempt at IPE for pre-health professional students, has demonstrated the positive impact that IPE may have upon participating students. Improved attitudes, newly discovered interests, and the acquisition of relevant knowledge were all products of this innovative undertaking. Applied broadly, mandatory IPE for pre-health professional students may radically enhance the effectiveness of IPE by preparing students earlier for an interprofessional approach to patient care. Lacking a personal and intimate stake in “turf wars”, pre-health professional students may be better suited to embrace an interprofessional mentality and to gain respect for the many health professions as professional stereotypes may not yet have been ingrained. In fact, most participating students seem to agree as they strongly supported mandatory IPE for pre-health professional students (80%) at almost equal rates to mandatory IPE for health professional students (85%) (see Table 6).

Secondary benefits

In addition to the aforementioned benefits of IPE, value exists for pre-health professional students in other contexts that must also be recognized. For example, students learn to recognize personal boundaries and scopes of expertise while gaining an appreciation for different educational backgrounds and knowledge bases. IPE also offers students the opportunity to appreciate group-based learning and the importance of communication skills, while curriculum developers can strategically use it as an introduction to problem-based learning, case studies, and team-oriented environments. Finally, value exists in helping students make informed choices regarded their future careers in the health sciences. In fact, one participant posted a very positive unsolicited comment in a public internet forum that confirmed this finding (see Table 7).

Table 7.  Unsolicited reflection on the IPE exercise by a participating student

“I really enjoyed the IPE (exercise) as I feel that I gained exposure to a vast array of health care fields … Activities such as this allow us to witness first hand the true diversity of the health care field and the numerous possibilities for career choices. The case study for example allowed us to relate to scenarios that occur in the real world everyday. I feel that personally, I gained new insight into fields I knew little about, something that is especially important for a student studying health sciences. For example, I had no idea about the difference between a nurse and nurse practitioner … I now see the importance of interprofessionalism in improving the health care system and feel that (exercises) such as this should continue in the future.”

Limitations of this study

The use of self-reports, particularly for sensitive matters such as knowledge acquisition, necessarily increases the chances of introducing social desirability bias into the measured results. While every possible action was taken to avoid and address this bias, it must nonetheless be considered when interpreting these results. However, it should be acknowledged that self-reports of attitudinal changes and knowledge acquisition reveal what students think are important regardless of whether responses tap into actual changes in attitudes and knowledge or a social desirability bias. Biased responses are presumably based on students' awareness and knowledge of what they think we want them to say, and thus any meaningful bias that may exist can serve as verification for a successful transfer of these values. Regardless, the impact of this bias must not be overestimated as participating students were rather blunt about not understanding the potential benefits of interprofessionalism pre-exercise (14%) which suggests that this bias was not pervasive. While the self-reported results were not objectively verified, it is nevertheless clear from this evaluation that students overall had a positive experience and that the program's objectives of knowledge acquisition and attitudinal changes were met.

The effectiveness of this IPE intervention is limited by its short duration as a one-time, short learning experience. Research conducted by Mu et al. (2004) suggests that a dose-response relationship exists for IPE whereby longer exposure produces increasingly positive outcomes. This limitation, however, would more adequately account for a tepid outcome as opposed to the overwhelmingly positive response that was afforded to this particular exercise. One of the most surprising findings of this study was that a minimal exercise had a major effect on students’ knowledge, interests, and attitudes, albeit the length of this effect was not studied.

While recent research on problem-based learning has shown that the use of a particular patient case study may have unique learning results (National Research Council 1999), such a hypothesis has not been applied to IPE or explored in this study. Understanding the extent of this case effect is important to understanding the effectiveness of this exercise and IPE in general as such learning has been inextricably tied to patient-centred, problem-based learning. Nonetheless, an in-depth examination of this phenomenon was beyond the scope of this study and thus no data was collected on patient case studies.

Parsell & Bligh's (1998) research reveals another limitation as it was argued that effective IPE requires secure professional identities, a quality that the participating students clearly lacked. However, it is our belief that a person's ability to understand the need to collaborate within and between health care teams does not require a fixed professional identity, nor does an appreciation for the roles and responsibilities of each health profession. In fact, entrenched profession identities may be responsible for the stereotypes and preconceived notions that inspired this study in the first place. While no effort was made to compare the effectiveness of IPE offered to health professional students and pre-health professional students, the merit of one is not dependent upon the failure of the other.

Conclusions

This study attempts to evaluate the merit of offering a mandatory IPE curriculum to pre-health professional students who are likely to enter health professional studies. The results from this particular exercise demonstrate a profound change in attitudes, interests, and knowledge amongst participating students which undoubtedly highlights the need for further examination and evaluation of this novel concept. Based on these changes, mandatory IPE for pre-health professional students is certainly merited, yet additional research must be conducted to determine its long-term effects and whether it is worth the significant human and financial resources necessary for its widespread implementation. Further research must also be undertaken to evaluate whether the early implementation of such IPE exercises demonstrate equally profound effects on students’ future career choices, their clinical practices, and their future patients’ health outcomes.

Details of contributions made by authors

Steven J. Hoffman designed the study, analysed the results, and wrote the paper. Del Harnish supervised the design of the study and the analysis of the results and contributed to the writing of the paper.

Additional information

Notes on contributors

Steven J. Hoffman

STEVEN J. HOFFMAN at the time of this study was student in the Bachelor of Health Sciences (Honours) Program at McMaster University and served as President of Canada's National Health Sciences Students’ Association. He now studies as a JD candidate at the University of Toronto Faculty of Law.

Del Harnish

DEL HARNISH is Assistant Dean of the Bachelor of Health Sciences (Honours) Program, Academic Director of the Centre for Leadership in Learning, and a Professor in the Department of Pathology and Molecular Medicine at McMaster University. He is a 3M Teaching Fellow and serves on McMaster University's Board of Governors.