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1. dependent variable(s) and the instrument(s) used to measure them.

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how the data for the dependent variable(s) were collected.

the intervention and procedures for delivering it.

the key results for the study, including any p-values, reported. the conclusions the researchers drew.

2. Appraise and debate the quality of the data collection methods and determine whether the conclusions of the study were supported by the statistical results.  Consider the following questions:

o Were the measurement instruments reliable and valid?  Why or why not? 

o Was treatment fidelity for the intervention ensured?  Why or why not?

o Were the conclusions of the study were supported by the statistical results, as indicated by the variable values and the p-values if reported?

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Journal of Interprofessional Care

ISSN: 1356-1820 (Print) 1469-9567 (Online) Journal homepage:

Determining the effectiveness of an
interprofessional educational intervention for
teamwork competencies among nursing, physical
therapy, and pharmacy students

Lee Ann Waltz

To cite this article: Lee Ann Waltz (2019): Determining the effectiveness of an interprofessional
educational intervention for teamwork competencies among nursing, physical therapy, and
pharmacy students, Journal of Interprofessional Care, DOI: 10.1080/13561820.2019.1682531

To link to this article:

Published online: 07 Nov 2019.

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Determining the effectiveness of an interprofessional educational intervention for
teamwork competencies among nursing, physical therapy, and pharmacy students
Lee Ann Waltz

School of Nursing and Health Professions, University of the Incarnate Word, San Antonio, TX, USA

Interprofessional education is recognized widely as an essential component to improving patient outcomes
but little progress has beenmade toward understanding the impact of specific educational interventions on
interprofessional competencies. The purpose of this study was to evaluate the effectiveness of a case study
exercise aimed at improving students’ teamwork competencies. A pre and posttest design was used to
evaluate the effectiveness of two approaches to an educational intervention. The treatment group com-
bined nursing, physical therapy, and pharmacy students; the control group involved only nursing students.
The Team Skills Scale (TSS) was used tomeasure interprofessional teamwork competencies and open-ended
questions were used to elicit students’ views. Mean pretest scores were similar for both the treatment and
control groups. Following the intervention, posttest TSS scores were significantly higher for both the
treatment group and control groups. However, posttest scores for the treatment group were significantly
higher than the control group (mean score change 19.2 for treatment group versus 10.0 for control group),
indicating that the face-to-face interaction between students of different professions had a greater impact.
Themes that emerged from the open-ended questions support the quantitative findings, indicating that the
intervention was useful for improving teamwork competencies.

Received 18 July 2018
Revised 18 September 2019
Accepted 14 October 2019

Interprofessional education;
teamwork; communication;
collaboration; quantitative

  • Introduction
  • In the 2013 report Transforming and Scaling Up Health
    Professionals’ Education and Training, the World Health
    Organization emphasized that teamwork has increasingly become
    the standard in today’s health settings, resulting in the need for all
    health professionals to effectively collaborate across disciplines. To
    enter the workforce armed with the skills necessary for this model
    of practice, interprofessional education (IPE) must be considered
    as a means of improving health care members understanding of
    each other’s roles, and developing collaborative attitudes and
    behaviors (WorldHealthOrganization, 2013).Despitewidespread
    recognition of the need for IPE in academic settings, amultitude of
    barriers inhibit progress including a lack of partners within insti-
    tutions willing to engage in an interprofessional agenda, a need for
    faculty development in IPE, and scheduling conflicts
    (Interprofessional Education Collaborative, 2011). As educators
    have struggled to overcome these barriers, a growing number of
    research studies have been conducted to discover the bestmethods
    for conducting IPE. While initial research demonstrates that IPE
    improves communication and teamwork, more studies are neces-
    sary to guide healthcare educators on the value of specific educa-
    tional activities. The purpose of this study was to evaluate the
    efficacy of two approaches to an educational intervention aimed
    at improving students’ interprofessional teamwork competencies.

  • Methods
  • The study employed a quasi-experimental, pre and posttest
    design. Convenience and purposive sampling was used to recruit

    baccalaureate nursing, doctoral physical therapy (PT), and doc-
    toral pharmacy students from a private university in the south-
    west region of the United States. Nursing students were recruited
    from a Community Health Nursing, a requisite senior level
    course. PT and pharmacy students were recruited to participate
    in the study by the physical therapy and pharmacy faculty and
    institutionally approved flyers.

    Both the treatment and control groups independently par-
    ticipated in a case study exercise that involved developing
    interprofessional care plans for a geriatric patient who has
    recently undergone a below the knee amputation. Prior to the
    study, permission was granted to use the case study titled
    Interdisciplinary Geriatric Assessment: Mr. Ames, which was
    developed by the Center for Interdisciplinary Geriatric
    Assessment at the University of Missouri-Columbia (Weston
    et al., 2012). The purpose of the case study was to promote an
    interprofessional approach for planning and managing treat-
    ment of older adults with complex medical, psychological, and
    social needs. A packet of information with details regarding
    the patient was provided to students for each stage of the case
    study, and included assessment information from the disci-
    plines of nursing, occupational therapy, physical therapy,
    social services, psychological services, podiatry, and respira-
    tory therapy. The exercise involved students developing a total
    of five interprofessional plans at various stages of treatment
    including discharge planning from the inpatient setting, an
    inpatient rehabilitation unit, home health services, and transi-
    tion back to the family and community. Upon completion of
    each care plan, the faculty facilitated a debriefing. The total

    CONTACT Lee Ann Waltz 4301 Broadway, San Antonio, TX 78209


    © 2019 Taylor & Francis Group, LLC

    time to complete the entire exercise for both the treatment
    and control groups was approximately six hours in one day.

    Group assignment

    Nursing students were randomized to a treatment or control
    group. PT and pharmacy students were assigned to the treat-
    ment group. The treatment group consisted of 16 nursing, 6 PT,
    and 3 pharmacy students for a total of 25 in the group. Subjects
    were placed in groups of 5–6 students to collectively discuss the
    case study and develop the plans of care. The case study groups
    were comprised of five groups that contained a combination of
    2–3 nursing, 1–2 PT, and 0–1 pharmacy students. The 3 phar-
    macy students were rotated to a different table following each
    round of care plan development so that by the end of the
    intervention, all nursing students in the treatment group had
    similar amounts of interaction time with the pharmacy students.

    The control group consisted of 17 nursing students. The
    control group participated in the same exercise, and were
    placed in three case study groups of 5–6 students to work
    together and develop the interprofessional plans of care.

    Data collection

    Students completed the Team Skills Scale (Hepburn, Tsukuda, &
    Fasser, 1998) before and after the intervention to measure the
    effectiveness of the educational intervention in the treatment and
    control group. The instrument is comprised of 17 items that are
    rated on a 5-point scale designed to measure self-reported team
    skills. Summing the scores results in a range of 17 to 85, with
    higher scores reflecting greater estimates of team skills.
    A demographic data sheet was collected prior to the intervention,
    and open-ended questions were collected after the intervention to
    elicit students’ views regarding the impact of the activity.


    IBM SPSS version 22 was used to analyze demographic and
    Team Skills Scale (TSS) data. A paired-samples t- test was
    conducted to evaluate the impact of the intervention on
    students’ scores on the TSS. Assumptions for the use of
    a parametric test were assessed by a review of histograms,
    Q-Q plots, and Kolmogorov-Smirnov which indicated
    approximately normal data. Responses to open-ended ques-
    tions were categorized using thematic content analysis.

    Ethical considerations

    Prior to recruitment of participants, approval for the study
    was obtained from the University of Texas Medical Branch
    Institutional Board and the University of the Incarnate Word
    Institutional Review Board.

  • Results
  • Forty-two students completed the study. All students com-
    pleted the demographic questionnaire, the Team Skills Scale
    (TSS) pretest and posttest, and open-ended questions regard-
    ing the value of the educational intervention. Internal

    consistency for the TSS was strong, with a Cronbach’s alpha
    of .89 for the pretest, and .94 for the posttest. Table 1 presents
    post hoc analysis findings for the pre and posttest scores of
    the TSS for the treatment and control groups. Mean change
    scores were higher in the treatment group (19.2) versus the
    control group (10.0). Using Cohen’s guidelines, a large effect
    size was noted for both the treatment and control groups.

    In the analysis of responses to open-ended questions about
    the students’ views regarding the educational intervention,
    four themes were shared by both the treatment and control
    group: 1) improved understanding of other health professions
    roles; 2) importance of working as a team; 3) importance of
    communication; and 4) increased appreciation of other health
    professions. In the treatment group, an additional theme of
    increased confidence about future collaboration with other
    health professions was noted, which the students attributed
    to a positive experience of interacting with other health pro-
    fessions during the activity.

  • Discussion
  • While pretest TSS scores reflected similar teamwork compe-
    tencies among students in both the treatment and control
    group, posttest TSS scores were significantly higher in the
    treatment group. Similar findings have also been noted by
    other researchers who detected significant improvement in
    subjects exposed to an IPE intervention compared to
    a control group (Ruebling et al., 2014; Wang, Shi, Bai,
    Zheng, & Zhao, 2015). While the findings reflect that the
    intervention resulted in the greatest benefit for students in
    the treatment group, the findings also suggest that the virtual
    input of other health professions used in the control group
    was also beneficial. Limitations of the study include a small
    sample size, and representation from only three health profes-
    sions within one educational institution. Although the gener-
    alizability of the findings is limited, the findings may be useful
    to other healthcare educators in planning IPE activities.

  • Conclusion
  • While the findings of this study support that face-to-face interac-
    tion of health care professions students maximizes confidence in
    interprofessional teamwork competencies, it also supports that
    virtual exercises involving only one health care profession can be
    beneficial. Therefore, when face-to-face interaction is not feasible,
    educational interventions that provide virtual interprofessional
    input should be considered as an alternative method for develop-
    ing teamwork competencies.

    Table 1. TSS pre and posttest scores for treatment and control groups (N = 42).

    mean SD

    mean SD



    change p

    (n = 17)

    57.9 9.38 67.9 6.41 10.0 9.1 <.001 1.10

    (n = 25)

    57.0 6.01 76.2 7.2 19.2 8.4 <.001 2.29

    Note: nursing student TSS mean pretest scores (n = 16): treatment group 57.3,
    control group 57.9. P values (two-tailed) based on paired t-test. Effect size
    computed with Cohen’s d.

    2 L. A. WALTZ

  • Acknowledgments
  • I would like to express my deep gratitude to the students who partici-
    pated in this study, and to my dissertation committee for their support
    and guidance. I would also like to thank Richard E. Oliver, Ph.D.,
    FASAHP for granting permission to use the Interdisciplinary Geriatric
    Assessment Case Study, and Kenneth Hepburn, PhD for granting per-
    mission to use the Team Skills Scale.

  • Declaration of Interest
  • The author reports no conflicts of interest. The author alone is respon-
    sible for the content and writing of this article.

  • Notes on contributor
  • Lee Ann Waltz PhD, RN, CNE is an Assistant Professor at the University
    of the Incarnate Word in San Antonio, Texas. Dr. Waltz has been a
    Registered Nurse since 1986 in a wide variety of health care settings. Her
    background in nursing includes geriatrics, mental health, medical-surgi-
    cal, and home health. Dr. Waltz has been teaching in the undergraduate
    nursing program at the University of the Incarnate Word since 2007. Her
    research interests include interprofessional education and collaboration,
    technology in education, and simulation.

  • References
  • Hepburn, K., Tsukuda, R., & Fasser, C. (1998). Team skills scale, 1996. In
    K. Siegler, T. Hyer, T. Fulmer, & M. Mezey (Eds.), Geriatric inter-
    disciplinary team training (pp. pp. 264–5). New York: Springer.

    Interprofessional Education Collaborative. (2011). Core competencies for
    interprofessional collaborative practice: Report of an expert panel.
    Washington, DC: Author.

    Ruebling, I., Pole, D., Breitbach, A. P., Frager, A., Kettenbach, G.,
    Westhus, N., … Carlson, J. (2014). A comparison of student attitudes
    and perceptions before and after an introductory interprofessional
    education experience. Journal of Interprofessional Care, 28(1), 23–27.

    Wang, R., Shi, N., Bai, J., Zheng, Y., & Zhao, Y. (2015). Implementation
    and evaluation of an interprofessional simulation-based education
    program for undergraduate nursing students in operating room nur-
    sing education: A randomized controlled trial. BMC Medical
    Education, 1–7. doi:10.1186/s12909-015-0400-8

    Weston, D., Petterborg, L. J., Oliver, R. E., Baldwin, D. J., Dobey, T.,
    Sanford Hargrove, M., … Reid-Arndt, S. (2012). Interdisciplinary
    geriatric assessment: Mr. Ames. Retrieved from http://shp.missouri.

    World Health Organization. (2013). Transforming and scaling up health
    professionals’ education and training: World health organization edu-
    cation guidelines 2013. Geneva, Switzerland: Author.


    • Abstract
    • Introduction
      Group assignment
      Data collection
      Ethical considerations
      Declaration of Interest
      Notes on contributor

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