Collaborative, digital and sustainable skills through multimodal simulations: evidence-based, interprofessional training in primary health care – the REALISE study

Abstract

Interprofessional collaboration is crucial for enhancing healthcare delivery, particularly in primary care settings, where effective teamwork between healthcare and social professionals (HCSPs) is essential. Despite its importance, there is limited research on the impact of structured interprofessional training programs on interprofessionality in simulated environments, particularly concerning primary care contexts. The REALISE study constitutes of a prospective feasibility study examining the impact on interprofessionality of multimodal, interprofessional learning paths on HCSPs as well as students within a simulated primary healthcare (PHC) setting. The three-week learning paths were specially developed, proprietary, case-oriented, and consisted of simulations (acting patients, high-fidelity manikins, virtual reality) and didactic on- and offline elements. The study employed a mixed-methods approach, incorporating three conducted interprofessional intervention groups to evaluate outcomes across both quantitative (two standardized assessments: Interprofessional Collaborative Competency Attainment Survey (ICCAS), Interprofessional Socialization and Valuing Scale 9a&b (ISVS)) and qualitative (proprietary open-ended questions) domains. Data was collected before (t0), directly after (t1) and two months after t1 (t2) to evaluate the impact on interprofessional collaboration. Regarding the quantitative outcomes, no significant change was observed in participants’ ISVS scores between pre- and post-intervention assessments, neither in the entire sample (t0 = 5.41 ± 1.20, t1 = 5.85 ± 1.18; p  = 0.108), nor in the student or HCSP group. Also, no time*group effects became evident. This suggests stable self-perceived values and attitudes toward interprofessional collaboration. In contrast, ICCAS scores increased significantly in total and across all dimensions (e.g., total score t₀ = 3.00 ± 0.77, t₁ = 3.99 ± 0.53; p  < 0.001, d  = 0.91). The strongest effects for the entire sample were observed in the dimensions “Team Functioning” (0.973) and “Collaboration” (0.922) and significant time*group (students vs. HCSPs) effects were found in 3 of the 6 dimensions (“Collaboration”, “Roles and Responsibilities” and “Team Functioning”), indicating substantial self-reported improvements in interprofessional competencies following the training and differences in amplitude of improvements. The results of the qualitative thematic analysis showed clear differences and overlaps between groups and time points. At t0, the students described communication difficulties, unclear responsibilities and role confusion as central challenges. In contrast, HCSPs focused on structural problems such as time pressure and limited coordination. At t1, the students reported increased role clarity and improved team communication, while HCSPs noted greater awareness of their own role and greater flexibility in interdisciplinary cooperation. As part of the follow-up (t2) the HCSPs reported a further deepening of interprofessional cooperation in their daily practice. While participants’ self-perceived attitudes remained stable, significant improvements in interprofessional competencies such as team functioning and collaboration, showed that the training effectively supported collaborative practice. The intervention was feasible to implement and was positively evaluated across all professional groups.