Enferm Clin.

2020;30(S3):132---135

www.elsevier.es/enfermeriaclinica

Health science students perception on professional

learning after the application of IPE夽
Arlinda Sari Wahyuni a,∗ , Evi Karota b , Dedi Ardinata a

a
Faculty of Medicine, Universitas Sumatera Utara, Indonesia
b
Faculty of Nursing, Universitas Sumatera Utara, Indonesia

Received 27 August 2019; accepted 16 December 2019

KEYWORDS Abstract
Interprofessional Objective: To study students’ perceptions based on IPE learning model in hospital.
education; Method: This study is performed using a method of quantitative which involved 20 respon-
Learning; dents from four faculties, including faculties of medicine, pharmacy, nursing, and public health.
Health; All respondents were from the Universitas Sumatera Utara, quantitative methods were based
Perception on quasi-experimental design type nonequivalent control group design pre and post interven-
tions. The questionnaire using interprofessional Learning Readiness Scale (RIPLS) which has
been validated. The data were analyzed by t-dependent.
Results: This study showed a significant increase in the perception (p < 0.05) on each aspect
of learning IPE (except aspects of the communication and team work with p > 0.05) after this
intervention.
Conclusion: These finding conclude that the IPE model learning can be used as a strategy to
make sure all aspects of professionalism can be done in medical practice in the future.
© 2020 Published by Elsevier España, S.L.U.

Introduction around the world are getting increasingly complex that

The community that seeks for quality health care is more
likely to increase these days. Problems and challenges
夽 Peer-review under responsibility of the scientific committee of
the International Conference of Indonesian National Nurses Asso-
ciation (ICINNA 2019). Full-text and the content of it is under
responsibility of authors of the article.
∗ Corresponding author.
E-mail address: arlinda@usu.ac.id (A.S. Wahyuni).
health care needs a solution that must involve some pro-
fessions in practice.1---3 Efficient and effective collaboration
between health professionals providing better health care
to fulfill the main needs of patients and their families. How-
ever, some facts show a team of health professionals in the
health service did not have a good collaboration that results
in medical error.
The incidence of a medical error to be the cause of death
is ranked 5th in the United States, reporting 120,000 peo-
ple died in hospital due to medical error. One important
issue that causes the medical error is poor communication

https://doi.org/10.1016/j.enfcli.2019.12.043
1130-8621/© 2020 Published by Elsevier España, S.L.U.
Health science students perception
between health care professions, lack of cooperation and
team collaboration as well as the provision of health services
which is not integrated.4,5 The Interprofessional Education
(IPE) is one way that offers a solution for the future in solving
problem. IPE occurs when two or more health care students’
study to improvise the quality and skills in health care pro-
fessions as well as to be prepared as a team in the future.
Students will be trained to work and contribute as a
team, listening to various opinions, discuss a problem, and
gain trust between other health care professions.6 Amer-
ican College of Clinical Pharmacy (ACCP) in 2011 explains
that competence that can be achieved by students using
the model of IPE by using the four elements of competence
such as knowledge, attitudes, skills, and abilities profes-
sional teamwork. Interprofessional learning Education (IPE)
in clinical practice/field of health sciences for students will
provide experience in working collaboratively with other
professions at an early stage of learning.7
Application IPE learning model is also one attempt to
make students to reach the standard of competence in the
field of health workers. Implements of IPE methods in early
learning are very important. Previous study showed that
97% students never joined in IPE activities. In the health
sciences faculties, 57% of nursing students had heard IPE
information, but more than 90% of the students from the
other faculties had never heard the IPE information.8 This
will make interprofessional collaboration learning in clini-
cal practice ineffective, because the students did not get
collaborative learning experience before. So that preferring
IPE learning is needed for health science students to achieve
optimally.
The learning process can increase four elements interpro-
fessional competencies, such as knowledge, skills, behavior,
and ability to cooperate. IPE module is also one kind of
preparation that can help students to face the outside world
of health profession.8 Although some previous studies have
shown that IPE program has a positive influence on how
students can see the contribution and ability of different
health professions, there is evidence to support that the
IPE program only has a small effect on the perception of
students.9 This study aims to determine the perception of
students from the University Sumatera Utara on interprofes-
sional model.
Method
This quasi-experimental design type nonequivalent control
group design pre and post interventions using a question-
naire interprofessional Learning Readiness Scale (RIPLS)
which has been validated. This research was conducted in
four of faculty from the Universitas Sumatera Utara which
includes the faculty of medicine, nursing, pharmacy, and
public health in clinical practice.
This research was conducted in a primary health care.
Forty students selected by inclusion criteria including
(1) student stage of profession program, (2) already com-
pleting one semester of college, (3) willing to be a
respondent in each faculty by adjusting one’s college sched-
ule. Ethical consideration was approved by the ethics
commission of RSUP H. Adam Malik (No. 275/tgl/KEPKUSU-
RSUP HAM/2018).
133
IPE model learning program
The applied IPE intervention model is through lectures (pre-
clinical), tutorials, case studies, practicums, presentation,
field study (health centers, family interventions, and pre
and postnatal health care centers). The Students are divided
into 4 groups, where each group consists of 4 health pro-
fessions. The length of time pre and post-test intervention
was carried out for 2 weeks. Furthermore, the learning out-
comes are assessed through seven aspects, namely: (1) the
perception of the effectiveness of IPE; (2) the benefits of
IPE; (3) communication and teamwork; (4) clinical ability;
(5) the perception of patient safety; (6) respect to other
professions.
Statistical analysis
Characteristics of the study sample were determined by
using descriptive statistics. Aspects of the learning outcomes
of IPE and then analyzed using t-test dependent.
Results
Table 1 shows the characteristics of survey respondents
consisting of faculty, gender, age. Based on this study,
5 respondents were chosen from each faculty. A total num-
ber of 20 students were involved and is determined the
percentage of female students were 70% and male 30%.
Table 2 shows the perception of students before and
after learning the aspect of IPE. Perception assessed the
effectiveness of learning IPE, benefits, communication and
teamwork, clinical capabilities, the perception of patient
safety, and respect for the other professions. This study
showed a significant increase in the perception of respon-
dents (p < 0.05) on each aspect after learning IPE (except
the aspects of communication and teamwork, p > 0.05) after
the intervention.
Table 3 shows the statistical analysis of all aspects after
the learning of IPE which showed an increase in the aver-
age value of respondents’ perception research that was
significant (p < 0.05) after the intervention. However, the
correlation test showed a weak result (<0.25) between the
Table 1 Characteristics of responden (n = 20).
Characteristics of faculty n (%)
Medical 5 25
Nursing 5 25
Pharmacy 5 25
Public health 5 25
Gender
Woman 14 70
Man 6 30
Age (years)
20 4 20
21 8 40
22 7 35
23 1 5
134 A.S. Wahyuni et al.

undergoing IPE based learning. Communication between

Table 2 Perception of learning ipe before and after
each group of students has a good effect on the percep-
intervention.
tion and knowledge of other health professions. Opportunity
IPE aspect assessed Mean IPE p-Value acquired through informal interaction has an important
value for each other to learn their respective professions. In
Pre Post this aspect, informal contact, interaction, and socialization
Effectiveness IPE 1.55 1.95 0.008 with students from other faculties have a significant effect
Benefits IPE 2.85 3.45 0.004 on perception, action, and knowledge of their profession in
Communication and teamwork 3.45 3.85 0.104 other health faculties.9,11
Clinical capabilities 5.40 6.10 0.012 A research-based post-course survey indicates that
Patient safety 6.95 7.85 0.001 students believe that, collaboration, respect, and commu-
Respect toward other profession 1.45 1.85 0.002 nication is an important component in the practice of
interprofessional collaboration. As a result of quantita-
tive design will reflect the three domains of competence
Table 3 Correlation aspects of learning model perception interprofessional collaborative practices which defined as
IPE. Interprofessional Collaborative, consisting of the roles or
responsibilities, communication, and teamwork.16
IPE learning model Mean Correlation P-value
Competency of a nurse in Indonesia to improvise the
Before 16.10 0.007 0.002 management of health care and nursing list as follow, (1)
After 19.10 competence-based on ethics, (2) a good relationship in the
health services, (3) the interprofessional relationship and
research. This description indicates that the application of
respondent’s perception before and after the intervention IPE learning models in the academic stage is very impor-
of IPE learning model tant. WHO states that IPE learning modules are also one of
the programs that are established to facilitate the prepa-
Discussion ration of students before entering the workforce.17 Similar
to all IPE learning activities, development of initiation and
There is an increase in the average value of respondents’ decision-taking requires collaboration with an existing orga-
perception significantly to the effectiveness and benefits of nization, determination among the team to create a learning
IPE model (p = 0.008 and 0.004). This is consistent with pre- activity, learning objectives, and get feedback from lesson.
vious studies by Fallatah (2015), in which almost all medical These activities will give them good experience learning.
students, nursing, young doctors, and residents reached an IPE model learning requires the cooperation and partic-
agreement that IPE is very essential learning model with a ipation of a wide range of students from all health faculty.
good level of significance (p = 0.008). The effectiveness and IPE learning module strategy can be effective and useful
benefits of IPE learning model, especially for collaboration for specific needs. These learning strategies can enhance
and communication capabilities between student.10 Based the positive effects of interprofessional collaboration in the
on Table 2 it is obtained that the average value of commu- future for those who work in the medical field.10
nication and collaboration capabilities have a nonsignificant Furthermore, the limitation of this study is the prepa-
increase after application IPE model study (p = 0.104). ration of clinical learning practice schedules/field study
These results are in line, but different to the research practices at the same time from four faculties of health
conducted in Surakarta, America, and Italy where a sig- sciences, Universitas Sumatera Utara.
nificant increase in the average value of respondent’s
perception was found after the implement of IPE learning
model (p = 0.000; p < 0.001; p = 0.038). This is because stu-
Conclusions
dents generally realized that other professions also have the
same competence and autonomy to solve health problems. IPE learning strategies can improvise student perceptions
The activity that requires team cooperation will improvise toward other health care into a more positive direction. This
communication skills and professionalism among the team strategy can be used to improvise the aspects of professio-
members.11---14 nalism in the future and is expected to provide health care
Perceptions about the ability of all respondents showed solutions that efficiently and effectively.
an increase in the average value was significant (p = 0.012).
Similar results were found in studies conducted by Zan- Conflicts of interest
otti (2015) and Gill (2017), in which the average value of
respondent’s perceptions regarding clinical ability tends to The authors have no conflicts of interest to declare.
increase with significant results (p < 0.001).12,15 Research
conducted in Surakarta show the same results for an appre-
ciation of other professions after learning model of IPE. Acknowledgements
There is an increased value of perception among all study
respondents. This is due to the thoughts that all respondents This research study has been supported by funding Direc-
have which are each profession has its role and function and torate of Research and Community Service (DRPM) Ministry
there is no specific profession which is most important in a of Research, Technology and Higher Education Republic of
team. This stereotype will be changed significantly before Indonesia 2018.
Health science students perception
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