Nurse Education Today 36 (2016) 348353

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Nurse Education Today

journal homepage: www.elsevier.com/nedt

Capturing readiness to learn and collaboration as explored with an

interprofessional simulation scenario: A mixed-methods research study
Kelly L. Rossler a,, Laura P. Kimble b,1
a
b

Louise Herrington School of Nursing of Baylor University, 3700 Worth Street, Dallas, TX 75246, USA
Piedmont Healthcare Endowed Chair in Nursing, Georgia Baptist College of Nursing of Mercer University, 3001 Mercer University Drive, Atlanta, GA 30341, USA

a r t i c l e

i n f o

Article history:
Accepted 21 August 2015
Keywords:
Simulation
Interprofessional education
Collaboration
Readiness to learn
Pre-licensure
Mixed-methods

s u m m a r y
Background: Didactic lecture does not lend itself to teaching interprofessional collaboration. High-delity human
patient simulation with a focus on clinical situations/scenarios is highly conducive to interprofessional education.
Consequently, a need for research supporting the incorporation of interprofessional education with high-delity
patient simulation based technology exists.
Objectives: The purpose of this study was to explore readiness for interprofessional learning and collaboration
among pre-licensure health professions students participating in an interprofessional education human patient
simulation experience.
Methods: Using a mixed methods convergent parallel design, a sample of 53 pre-licensure health professions students enrolled in nursing, respiratory therapy, health administration, and physical therapy programs within a
college of health professions participated in high-delity human patient simulation experiences. Perceptions of
interprofessional learning and collaboration were measured with the revised Readiness for Interprofessional
Learning Scale (RIPLS) and the Health Professional Collaboration Scale (HPCS). Focus groups were conducted
during the simulation post-brieng to obtain qualitative data. Statistical analysis included non-parametric, inferential statistics. Qualitative data were analyzed using a phenomenological approach.
Results: Pre- and post-RIPLS demonstrated pre-licensure health professions students reported signicantly more
positive attitudes about readiness for interprofessional learning post-simulation in the areas of team work and
collaboration, negative professional identity, and positive professional identity. Post-simulation HPCS revealed
pre-licensure nursing and health administration groups reported greater health collaboration during simulation
than physical therapy students. Qualitative analysis yielded three themes: exposure to experiential learning,
acquisition of interactional relationships, and presence of chronology in role preparation. Quantitative and
qualitative data converged around the nding that physical therapy students had less positive perceptions of
the experience because they viewed physical therapy practice as occurring one-on-one rather than in groups.
Conclusion: Findings support that pre-licensure students are ready to engage in interprofessional education
through exposure to an experiential format such as high-delity human patient simulation.
2015 Elsevier Ltd. All rights reserved.

Didactic lecture formats continue to be the conventional medium

used in educating undergraduate health professions students
(Baneld et al., 2012; Smith et al., 2012); however, the growing complexity of health care warrants the need to effectively engage with all
members of the health care team. Educators must nd better ways
to prepare students for professional practice. Interprofessional collaboration supports nursing students making the transition to professional practice by gaining greater competency in engaging with
the health care team, which has the potential to yield better patient
outcomes (American Association of Colleges of Nursing , 2008, p. 22;
Corresponding author. Tel.: +1 214 818 7981 (Ofce); fax: +1 214 820 3375.
E-mail addresses: Kelly_Rossler@baylor.edu (K.L. Rossler), Kimble_LP@Mercer.edu
(L.P. Kimble).
1
Tel.: +1 678 547 6781 (Ofce); fax: +1 678 547 6777.

http://dx.doi.org/10.1016/j.nedt.2015.08.018
0260-6917/ 2015 Elsevier Ltd. All rights reserved.

Stein-Parbury & Liaschenko, 2007). However, the didactic lecture does

not lend itself to teaching interprofessional collaboration. High-delity
human patient simulation with a focus on clinical situations/scenarios
is highly conducive to interprofessional education. Consequently, a
need for research supporting the incorporation of interprofessional education with high-delity patient simulation based technology has
been identied by multiple researchers, interprofessional collaborative
partners, and practice initiatives (Institute for Healthcare Improvement,
2012; Interprofessional Education Collaborative Expert Panel, 2011;
Patel et al., 2012; Titzer et al., 2011). A student enrolled in any type of
health professions program of study needs to successfully complete
program-specic requirements as well as gain a license or other required documentation to enter into the professional practice setting.
When enrolled in individual programs of study, these pre-licensure students are not guaranteed exposure to interprofessional or collaborative

K.L. Rossler, L.P. Kimble / Nurse Education Today 36 (2016) 348353

349

education pertaining to other practice disciplines. The purpose of this

mixed-methods study was to explore readiness for interprofessional
learning and collaboration among pre-licensure health professions students participating in an interprofessional education human patient
simulation experience. Specically, the research questions were:

simulation as a teaching methodology can positively enhance interprofessional collaboration among pre-licensure health professions students
enrolled in their unique programs of study is necessary.

1. Do perceptions of readiness to learn among pre-licensure students

enrolled in a health professions program of study change following
an interprofessional education simulation experience?

David A. Kolb offered his experiential learning theory as a new approach incorporating a holistic integrative perspective on learning
that combines experience, perception, cognition, and behavior to dene the nature of what constitutes experiential learning (1984, p. 21).
Learning involves human adaptation whereby knowledge is created
through the transformation of experience (Kolb, 1984, p. 38). The
learning process consists of (a) adaptation rather than content;
(b) knowledge transformation which was continuously recreated, not
acquired; and (c) learning. During experiential learning, knowledge is
transformed from an encounter with an experience. A learner transforms from the knowledge gained and from participating in the learning
experience set in an environment conducive to learning.
Educating with simulation has offered the capability to promote
learning by opening up cognitive processes of students of various learning styles through sociocultural dialogue during communal lived experiences in a safe learning environment (Jeffries, 2007). Simulation also
aligns with theories based on constructivism. Interprofessional education affords students from different professions the capacity to come together to learn not only about, but from one another in an active and
collaborative manner. Kolbs experiential learning theory supports an
active process for interprofessional education whereby those engaged
in the process work with one another to gain knowledge of individual
health care roles. A learner participating in a simulation activity involving interprofessional education can immerse themselves during the
simulation, reect on transactions which occurred during the simulation experience from multiple perspectives, and integrate knowledge
gained to transform their own practices.

2. Are there differences among health professions pre-licensure students in perceptions of readiness to learn and collaboration following
an interprofessional education simulation experience?
3. What are the pre-licensure health professions student participants perceptions of the interprofessional education simulation
experience?
4. To what extent do the quantitative and qualitative results converge?
Interprofessional Education and Readiness to Learn with
Simulation Technology
Interprofessional education (IPE) is increasingly recognized as a
necessary tool in transforming the education of health care
professionals (Frank & Chen, 2010; Institute of Medicine, 2010; King
et al., 2012). Specically, interdisciplinary collaboration is identied as
a necessity for improving patient outcomes through competency in
performance of clinical skills and patient safety initiatives. An ability to
effectively collaborate among health care disciplines in the areas of
communication, role identication, team working skills, and conict
resolution are critical components of practice for health care professionals (Poore et al., 2014). Demands from hospital systems for novices
entering the health care professions to think critically as fully engaged
members of the health care team has led to the need for alternative
teaching strategies in health care education (Gore & Schuessler, 2013;
McLaughlin, 2010; Norman, 2012; Wellard & Heggen, 2010; Wolfgram
& Quinn, 2012; Yanhua & Watson, 2011). Interprofessional education
collaborative experiences taught in the educational setting help prelicensure students to enter the health care setting better prepared to
engage in an interdisciplinary environment (Thibault, 2011).
Creating substantial interprofessional collaborative educational experiences within colleges of health professions is challenging. Over the
past 10 years, research has demonstrated that interprofessional education can be implemented within nursing education with high-delity
human patient simulators. Institutional barriers to interprofessional education have been identied as workplace infrastructure, location,
teaching in silos, turf protection, issues with mutual respect, and
lack of administrative support and funding (Gore et al., 2012, p. e128).
However, student-focused barriers to interprofessional education have
not been thoroughly investigated. Specically, readiness of both prelicensure and practicing health care professionals to engage in interprofessional education formats.
Academic programs exploring the potential to cross curricular
boundaries to develop collaborative teaching experiences would need
to examine readiness of the student to engage in such activities. Readiness, also associated with competence, can vary for every student learner (Bandali et al., 2012). Critical elements of readiness have been
identied as psychomotor skills specic to discipline, core competency
skills, and reective practice. Even when these critical elements are addressed, student preparedness and readiness to engage in IPE activities
can be impacted by knowledge and attitudes toward this type of learning platform (Lamb & Shraiky, 2013). If a student is not ready to engage
in IPE, then interactions essential for meaningful collaboration to take
place may be lost. Faculty need to consider how to create an interprofessional learning environment promoting characteristics of relationships
among professional groups, teamwork, role identication, and a benet
to personal growth, professional practice, and patients. Exploration of
the readiness to learn and understanding of how high-delity patient

Theoretical Framework

Methodology
Design
In this QUAN and QUAL type of methodology, both strands of the
quantitative and qualitative processes occurred concurrently and were
prioritized equally (Creswell & Plano-Clark, 2011). For the quantitative
data, an exploratory, descriptive design was used to explore the readiness of pre-licensure health professions students to participate in an interprofessional simulation, examine if readiness to learn changed after
the simulation experience, and evaluate the effectiveness of the simulation experience as a teaching modality.
Qualitative data were collected and analyzed using a descriptive
phenomenological approach. The focus of the analysis was on describing the meaning of the experience from the perspective of the health
professions students (Giorgi, 2009). Phenomenology provided a mechanism to examine the how and what of the individual study participants experiences of participating in an interprofessional simulation
scenario (Creswell, 2007). Quantitative and qualitative ndings were
merged to address the mixed-methods question.
Setting and Sample
The setting for the research was the simulation laboratory in a college of health professions located in the Southeastern United States. A
non-probability, convenience purposive sampling method was used to
recruit an interprofessional sample (N = 53) of pre-licensure health
professions students. All participants met the following inclusion/exclusion criteria: (1) enrolled in a health professions program of study;
(2) having the ability to comprehend, read, and write in English;
(3) and being greater than 18 years of age. Students were excluded
from participation if they had previously participated in an

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K.L. Rossler, L.P. Kimble / Nurse Education Today 36 (2016) 348353

interprofessional student learning simulation or multidisciplinary role

play scenario.
Data Collection Quantitative Strand
All participants completed a demographic data form and two quantitative self-report instruments: the revised Readiness for Interprofessional Learning Scale [RIPLS, (McFadyen et al., 2005)], and the Health
Professional Collaboration Scale [HPCS, (Reese et al, 2010)].
Readiness for Interprofessional Learning Scale
The revised RIPLS was used to measure readiness for interprofessional learning. It consists of 19 items on a ve-point Likert scale response format yielding four subscales for which reliability data are
available (McFadyen et al., 2005). The subscales are teamwork and collaboration with a Cronbachs alpha value of 0.88, negative professional
identity with a Cronbachs alpha value of 0.76, positive professional
identity with a Cronbachs alpha value of 0.81, and roles and responsibilities with a Cronbachs alpha value of 0.43. Cronbachs alphas for the
total RIPLS have been reported as 0.84 and 0.89. For each subscale,
higher scores indicate more positive attitudes about interprofessional
education (McFadyen et al., 2006).
Health Professional Collaboration Scale
The HPCS measured perceptions of collaboration during the simulation experience (Resse et al, 2010). This instrument consists of 12 items
with a ve-point Likert scale response format. Internal consistency reliability of 0.95 was reported by Reese et al. (2010). The possible range of
scores is 1260 with higher scores indicating more positive perceptions
of collaboration.

each interprofessional group were provided a 10-minute pre-brieng

with an introduction to the study to include operational denitions, scenario objectives, and their discipline-specic roles in the scripted scenario. Participants were provided a packet containing the pre-brieng
materials and numerically coded study instruments in paper/pencil format. All participants completed the demographic data form and RIPLS
pre-simulation. The investigator facilitated the 20-minute high-delity
patient simulation from a computer control panel located in the simulation laboratory. Student roles included a primary and/or secondary
nurse, a respiratory therapist, health care administrator, and physical
therapist. Fifteen simulations with interprofessional student groups
were conducted. The investigator attempted to have two participants
from nursing and one participant each from respiratory therapy, physical therapy, and health care administration for each simulation group
experience. However, because of scheduling conicts, it was not possible to have the targeted interprofessional representation in all groups.
All 15 groups included representation from nursing, and a total of 4
groups had representation from all disciplines. The post-simulation
RIPLS and HPCS were administered upon completion of the simulation
scenario.
Data Collection Qualitative Strand
Data collection for the qualitative strand occurred within the context
of a 30-minute debrieng session for each of the simulation groups.
Focus group interviewing was conducted during each group debrieng
to obtain data about participants perceptions of the interprofessional
profession education high-delity simulation. Focus group data were
collected using methods recommended by Creswell and Plano-Clark
(2011). The focus group format permitted data to be collected from
multiple interprofessional viewpoints in an efcient amount of time
(Polit & Beck, 2012). The focus group interviews were audio taped and
transcribed verbatim.

Demographic Form
Results
A demographic form collected data about the age, gender, individual
program of enrollment, and semester of enrollment of the study
participants.
Interprofessional High-delity Patient Simulation Scenario
The investigator developed a high-delity patient simulation scenario translated from a geriatric role play case study already identied as
appropriate for interprofessional use for pre-licensure students. The patient simulation scenario and participant assigned roles were reviewed
for accuracy and validity with experienced interprofessional committee
faculty members from the disciplines of nursing, respiratory therapy,
health care administration, and physical therapy. The scenario involved
a 68-year-old widow admitted into the hospital setting with complex
health care issues to include an acute ankle sprain, high blood pressure,
dementia, chronic cough, and osteoporosis. Socio-economic challenges
presented in the scenario included living alone in a two-story building
on a limited income, social isolation, and a daughter who lived out of
town. During the pre-brieng and through the simulation, participants
were provided access to a comprehensive medical chart complete
with current physical exam, physician order sets specic to each discipline, laboratory values, arterial blood gas data, pulmonary function
test results, and an ankle x-ray. The simulated patient interacted with
the study participants verbally via pre-recorded scripted responses.
Procedures
Prior to the initiation of the study, approval was obtained by the Institutional Review Board. Participants were recruited during fall of their
rst or second year of study via face-to-face overview of the study during classroom time, distribution of yers, and via-e-mail. Participants in

Table 1 summarizes the demographic characteristics of the sample.

Approximately 50% of the sample was nursing students with similar
percentages of respiratory therapy, health administration, and physical
therapy students.
Prior to analysis, data were examined for missing values. Minimal
missing data were noted. Nominal and ordinal data were examined
with frequencies and percentages. Interval/ratio data were examined

Table 1
Sample demographic characteristics (N = 53).
Characteristic
Age in years
1827
2837
3847
4857
Gender
Female
Male
Program of enrollment
Nursing
RT
HA
PT
Semester of Enrollment
1st semester junior
2nd semester junior
1st semester senior
Fall 1st year semester
Fall 2nd year semester
Missing

32
12
05
04

60.4
22.6
09.5
07.5

45
08

84.9
15.1

25
10
10
8

47.2
18.9
18.9
15.0

20
14
11
04
03
01

37.7
26.4
20.8
07.5
05.7
01.9

Note: RT = respiratory therapy, HA = health administration, PT = physical therapy.

K.L. Rossler, L.P. Kimble / Nurse Education Today 36 (2016) 348353

with measures of central tendency, and normality assessment was conducted. Subscale scores for the RIPLS demonstrated non-normal distributions. Consequently, non-parametric statistical analyses were
conducted to address the quantitative study questions. Internal consistency reliability of each study instrument was examined using
Cronbachs alpha. Cronbachs alpha was acceptable for all RIPLS subscales except roles and responsibilities, which had low reliability for
both pre-simulation and post-simulation.
To address the rst quantitative research question, a Wilcoxon
signed rank test was used to examine change over time in the RIPLS
from prior to and post the simulation scenario experience. Table 2 provides descriptive statistics demonstrating change in perceptions of
readiness for interprofessional learning pre- and post-simulation. Prelicensure health professions students reported signicantly more
positive attitudes about readiness for interprofessional learning
post-simulation in the areas of team work and collaboration (Z = 3.7,
p b .001), negative professional identity (Z = 3.4, p = .001), and positive professional identity (Z = 4.4, p b .001). Readiness for professional
learning in the area of roles and responsibilities (Z = .008, p = .99)
was unchanged.
To address the second quantitative research question, a Kruskal
Wallis test, the non-parametric equivalent of a one-way ANOVA, was
used to test for differences among the four different pre-licensure health
professions groups on the post-simulation RIPLS and HPCS scores.
Table 3 summarizes these comparisons. The health professions student
groups demonstrated statistically signicant differences in the RIPLS
subscale of negative professional identity and health professional collaboration. Post hoc analysis with MannWhitney U revealed prelicensure nursing and health administration groups reported signicantly more positive attitudes about readiness for interprofessional
education and greater health collaboration during simulation than
physical therapy students. The respiratory therapy groups were not signicantly different from any other health profession groups.
The qualitative research question about perceptions of the interprofessional simulation experience was addressed with the focus interview
data. Data were analyzed using a three-step phenomenological process
of naive reading, structural analysis, and interpretations (Creswell,
2013). Verbatim transcriptions of the qualitative data were collected
via audiotape. Data were organized by student study groups, and
codes were developed. Subsequent exploration of the transcripts and
identied codes led to the discovery of meaningful patterns related to
the true essence of the phenomena (Creswell, 2013). Analysis of the
qualitative data concluded with interpretations expressed in three
themes: exposure to experiential learning, acquisition of interactional relationships, and presence of chronology in role preparation. Each
of the themes will be discussed individually.
Exposure to Experiential Learning
Within the focus groups, students emphasized how simulation offered a safe environment where students could interact with students
from other disciplines in a short period of time. Specically, a PT student
spoke of how I liked the concept of simulation to get people familiar
with what everybody does. A nursing student verbalized how

351

simulation allowed for a bunch of pieces of little puzzles coming together and a RT student commented exciting, being the rst time
being around the patient just interacting during the simulation.
Most students were positive about the simulator providing feedback
and realistic, real-time interaction. However, not all health professions
had the same perception. This was particularly true of PT students
who viewed their interactions with patients and other health professions as occurring more one-on-one. One PT student remarked, a PT
might have one other person in the room with them at the time . . . it
wouldnt be ve people in the room trying to assess. Student perceptions were consistent with current literature promoting simulation as
a means to enhance student learning in a safe and realistic educational
environment (Roche et al., 2012; Seybert et al., 2012; Wogram &
Quinn, 2012).
Acquisition of Interactional Relationships
Participants wanted to acquire interactional relationships through
communication and appreciation of other disciplines. The IPE simulation helped them gain the communication skills that we would need
to develop. One student stated, I think the point is learning how to
communicate with one another and we just kind of winged it. Students
consistently expressed the desire to learn to communicate effectively
during a patient care situation and on an interprofessional basis. The
scenario made one cognizant of the fact that they did not share a common language. A health administration student expressed how it was
like talking Greek to me. I was just hearing Greek. These comments
reected the absence in universality of vocabulary among professions.
One student stated how he/she wanted to see what the different professions do . . . being to being. Another nursing student remarked,
it's good in nursing to get to know all the people in the different roles
. . . what they do and to form relationships. Students recognized that interprofessional interactions were often rare in the educational setting,
with one student stating, you dont interact exactly one-on-one with
each other before youre actually in a clinical setting.
Presence of Chronology in Role Preparation
The third qualitative theme focused on students perceptions of role
preparation and how this preparation evolved over time on an individual basis as each student progressed within their program of study. A
nursing student reported how pulling information from past semesters
helped during the simulation experience. A respiratory therapy student
reported how it was my rst year and everything and they're seniors
to communicate feeling unprepared to enter into the learning opportunity with students who had progressed farther in their program of
study. A nursing student expressed how the simulation scared me in
a way because . . . I really dont know how other professions work and
how I am supposed to work together prior to even knowing all aspects
of the nurses role. Im a brand new baby something and it was my
year and everything and theyre seniors were used to communicate
feeling unprepared to enter into the learning opportunity based on progression of their program of study and learning role boundaries.

Table 2
Pre-simulation to post-simulation change in readiness for interprofessional learning subscales (N = 53).
Pre-simulation

RIPLS
Teamwork and collaboration
Negative professional identity
Positive professional identity
Roles and responsibilities

Post-simulation

M (SD)

Median

M (SD)

Median

41.4 (3.4)
13.5 (1.8)
18.1 (1.8)
11.4 (2.0)

42.00
15.00
19.00
11.00

42.8 (2.8)
14.2 (1.2)
19.2 (1.3)
11.4 (2.1)

44.00
15.00
20.00
12.00

Note. RIPLS = Readiness for Interprofessional Learning Scale.

Statistically signicant change from pre-simulation to post-simulation using Wilcoxin signed rank test.

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K.L. Rossler, L.P. Kimble / Nurse Education Today 36 (2016) 348353

Table 3
Comparisons of health professions groups on readiness to learn and collaboration following a high-delity patient simulation.

Variable
RIPLS subscales
Teamwork
and cooperation
Negative professional identity
Positive professional identity
Roles and responsibilities
HPCS

Nursing
(N = 25)

Respiratory therapy
(N = 10)

Health administration
(N = 10)

Physical therapy
(N = 8)

Test
statistic

Mean rank

Mean rank

Mean rank

Mean rank

X2

p value

28.22

29.20

29.60

17.19

4.28

0.23

11.60
5.32
1.97
11.42

0.01
0.15
0.58
0.01

30.18
27.82
28.98
29.62a

29.45
26.75
24.85
21.79

28.60
32.30
22.00
29.55a

12.00
18.13
29.75
10.81b

Note. RIPLS = Readiness for Interprofessional Learning Scale; HPCS = Health Professional Collaboration Scale. Mean ranks with differing superscripts signicantly differed at p b .05.

The mixed-methods question focused on convergence of the quantitative and qualitative ndings. Quantitative and qualitative data were
examined and similarities and differences were identied (Creswell &
Plano-Clark, 2011). The signicant increase in readiness for interprofessional learning observed in the quantitative data was supported by the
qualitative themes revealing students' views that the experience provided a realistic environment for communicating and collaborating
with students from other professions. The quantitative data also revealed that physical therapy students had less positive attitudes about
interprofessional learning than nursing and health administration students. The qualitative provided insight into this nding as physical therapy students expressed that the scenario was not necessarily consistent
with physical therapy practice which they perceived to occur one-onone with patients and other health care professionals.
Discussion
The purpose of this study was to explore pre-licensure health professions students' readiness for interprofessional learning and perceptions
of health collaboration when participating in a high-delity human patient simulation. Findings demonstrated that students had more positive attitudes about interprofessional learning following simulation.
Findings from this research study suggest how pre-licensure students
are ready to engage in interprofessional education through exposure
to an experiential format such as high-delity human patient simulation. They experienced interactions which can enhance communication,
an appreciation for other disciplines, and the ability to contribute to the
whole when providing care in practice. These ndings are consistent
with prior studies where use of a standardized patient facilitated communication skills and promoted teamwork (Barnett et al., 2011) and
collaborative relationships between academia and hospital institutions
(Waxman et al., 2011). The importance of effective communication
strategies during interprofessional collaboration (Berg et al., 2010)
was also supported by the qualitative data.
When examining the revised RIPLS pre-simulation and postsimulation data results, there was not a signicant change in the subscale for roles and responsibilities. This was likely related to the low internal consistency reliability of the subscale. Roles and responsibilities
vary for the different health professions and the low Cronbachs alphas
indicate items within this subscale were not homogenous.
Findings from the HPCS around how the different health professions
viewed each other with respect to interprofessional collaboration need
closer examination. Findings indicated that perceptions of collaboration
were different among the student groups with pre-licensure nursing
and health administration students reporting greater collaboration
than physical therapy students. Likewise, ndings from the RIPLS
post-simulation revealed how the different health professions
viewed each other in relation to negative professional identity
whereby nursing and health administration students reported less
negative attitudes toward learning with other health care professionals than physical therapy students. While the simulation scenario was translated from an existing role play scenario currently

utilized for interprofessional education, the scenario might not

have translated accurately for use with a high-delity human patient
simulator to meet the educational needs of a physical therapy student. The negative professional identity subscale of the RIPLS contains questions such as I dont want to waste my time learning
with other health care students and It is not necessary for undergraduate health care students to learn together(McFadyen et al.,
2005, p.1). Physical therapy students in this study appeared to
view group interactions as not consistent with current physical therapy practice. Bridges and colleagues reported how pre-licensure students need to understand their own professional identity while
gaining an understanding of other professional's roles on the health
care team (Bridges et al., 2011, p. 1). These physical therapy students may already have had a strong sense or knowledge of both collaboration and professional identity which would not have changed
after participating in the simulated learning experience. This aligns
with ndings from Ateah et al. (2011) where physical therapy students were identied as having the traits of interpersonal skills and
condence as a profession prior to and post an interprofessional immersion experience.
The logistics for implementing this study were challenging. Despite
being a part of the same college of health professions and administrative
support from college administration, it was difcult to schedule simulation sessions when all health professions could attend. Differences in
class schedules and clinical rotations limited the times when health professions could be together. The study was conducted in one site by a sole
investigator; consequently, ndings should be generalized with caution
to other colleges of health professions. Since the predominant health
professions group represented in the simulation groups were prelicensure nursing students, it remains unclear how ndings would
have differed if a greater proportion of other health professions students
had been represented. The low reliability of the roles and responsibilities subscale of the revised RIPLS is problematic, and in future research,
the items may need to be analyzed separately.
Conclusion
Findings from this research study support pre-licensure students are
ready to engage in interprofessional education through exposure to an
experiential format such as high-delity human patient simulation.
They perceived the interprofessional interactions during the simulation-enhanced interprofessional communication, increased their
appreciation for other disciplines, and delineated their discipline's contribution to the whole when providing care in practice. As pre-licensure
students transition to professional practice, the ability to successfully
collaborate with other disciplines will be key to assuring quality patient
outcomes. A high-delity patient simulation was the conduit for the occurrence of interactional relationships among study participants. Identifying the existence of readiness to learn in an interprofessional manner
starts dialogue on how to best prepare students for engaging in an interprofessional learning experience with high-delity patient simulation
as a teaching modality which can in turn impact entry into practice.

K.L. Rossler, L.P. Kimble / Nurse Education Today 36 (2016) 348353

Acknowledgements
Dr. Tanya Sudia
Associate Dean for Research and Scholarship
Interim Graduate Program Director and Professor
Louise Herrington School of Nursing of Baylor University
Dr. Lisa Broussard
Acadian Ambulance Endowed Professor in Nursing
Hamilton Medical Center Endowed Professor in Nursing
Department Head and Associate to the Dean
University of Louisiana at Lafayette
College of Nursing and Allied Health Professions
References
American Association of Colleges of Nursing, 2008. The Essentials of Baccalaureate Education for Professional Nursing Practice. Author, Washington, DC.
Ateah, C.A., Snow, W., Wener, P., McDonald, L., Metge, C., Davis, P., Fricke, M., Ludwig, S.,
Anderson, J., 2011. Stereotyping as a barrier to collaboration: does interprofessional
education make a difference? Nurse Educ. Today 31, 208213. http://dx.doi.org/10.
1016/j.nedt.2010.06.004.
Bandali, K.S., Craiz, R., Ziv, A., 2012. Innovations in applied health: evaluating a
simulation-enhanced interprofessional curriculum. Med. Teach. 34, e176e184.
http://dx.doi.org/10.3109/0142159X.2012.642829.
Baneld, V., Fagan, B., Janes, C., 2012. 20092012 Spacelabs innovation project award:
charting a new course in knowledge: creating life-long critical care thinkers. Dynamics 23, 2428.
Barnett, G.V., Hollister, L., Hall, S., 2011. Use of the standardized patient to clarify interdisciplinary team roles. Clin. Simul. Nurs. 7, e169e173. http://dx.doi.org/10.1016/j.ecns.
2010.01.004.
Berg, B.W., Wong, L., Vincent, D.S., 2010. Technology-enabled interprofessional education
for nursing and medical students: a pilot study. J. Interprof. Care 24, 601604. http://
dx.doi.org/10.3109/13561820903373194.
Bridges, D.R., Davidson, R.A., Odegard, P.S., Maki, I.V., Tomkowiak, J., 2011. Interprofessional collaboration: three best practice models of interprofessional education. Med.
Educ. Online 16, 110. http://dx.doi.org/10.3402/meo.v16i0.6035.
Creswell, J.W., 2007. Qualitative Inquiry & Research Design: Choosing Among Five Approaches. 2nd ed. Sage Publications, Inc., Thousand Oaks, CA.
Creswell, J.W., 2013. Qualitative Inquiry & Research Design: Choosing Among Five Approaches. 3rd ed. Sage Publications, Inc., Thousand Oaks, CA.
Creswell, J.W., Plano-Clark, V.L., 2011. Designing and Conduction Mixed Methods Research. 2nd ed. Sage, Los Angeles, CA.
Frank, J., Chen, L.C., 2010. Health Professionals for a New Century: Transforming Education to Strengthen Health Systems in the Interdependent World. Harvard University
Press, Cambridge, MA http://dx.doi.org/10.1016/S0140-6736(10)61854-5 (Retrieved
from www.thelancet.com).
Giorgi, A., 2009. The Descriptive Phenomenological Method in Psychology: A Modied
Husserlian Approach. Duquesne University Press, Pittsburgh, PA.
Gore, T., Schuessler, J.B., 2013. Simulation policy development: lessons learned. Clin.
Simul. Nurs. 9, e319e322. http://dx.doi.org/10.1016/jecns.2012.04.005.
Gore, T., Van Gele, P., Ravert, P., Mabire, C., 2012. A 2010 survey of the INACSL membership about simulation use. Clin. Simul. Nurs. 8, e125e133. http://dx.doi.org/10.
1016/j.ecns.2012.01.002.
Institute for Healthcare Improvement, 2012. What is open school? Retrieved from http://
www.ihi.org/offerings/IHIOpenSchool/overview/Pages/default.aspx
Institute of Medicine, 2010. A Summary of the February 2010 Forum on the Future of
Nursing: Education. National Academies Press, Washington, D.C. (Retrieved from
http://www.iom.edu/Reports/2010).
Interprofessional Education Collaborative Expert Panel, 2011. Core Competencies for Interprofessional Collaborative Practice: Report of an Expert Panel. Interprofessional
Education Collaborative, Washington, D.C.

353

Jeffries, P.R. (Ed.), 2007. Simulation in Nursing Education: From Conceptualization to

Evaluation. National League for Nursing, New York, NY.
King, S., Greidanus, E., Major, R., Loverso, T., Kowles, A., Carbonaro., M., & Bahry, L., 2012. A
corss-institutional examination of readiness for interprofessional learning.
J. Interprof. Care 26, 108114. http://dx.doi.org/10.3109/13561820.2011.640758.
Kolb, D.A., 1984. Experiential Learning: Experience as the Sources of Learning and Development. Prentice Hall, Upper Saddle River, N.J.
Lamb, G., Shraiky, J., 2013. Designing for competence: spaces that enhance collaboration
readiness in healthcare. J. Interprof. Care 27 (52), 1423. http://dx.doi.org/10.3109/
13561820.2013.791671.
McFadyen, A.K., Webster, V., Strachan, K., Figgins, E., Brown, H., McKechnie, J., 2005. The
readiness for interprofessional learning scale: a possible more stable sub-scale
model for the original version of RIPLS. J. Interprof. Care 19, 595603. http://dx.doi.
org/10.1080/13561820500430157.
McFadyen, A.K., Webster, V.S., Maclaren, W.M., 2006. The test-retest reliability of a revised
version of the Readiness for Interprofessional Learning Scale (RIPLS). J. Interprof. Care
20, 633639. http://dx.doi.org/10.1080/13561820600991181.
McLaughlin, M.P., 2010. Medical simulation in the community college health science curriculum: a matrix for future implementation. Community Coll. J. Res. Pract. 34,
462476. http://dx.doi.org/10.1080/1068920903235811.
Norman, J., 2012. Systematic review of the literature on simulation in nursing education.
Assoc. Black Nurs. Fac. J. 24-28 (Retrieved from http://www.ncbi.nlm.nih.gov/
pubmed/22774355).
Patel, E., Nutt, S.L., Qureshi, I., Lister, S., Panesar, S.S., Carson-Stevens, A., 2012. Leading
change in health-care quality with the institute for healthcare improvement open
school. Br. J. Hosp. Med. 73, 397400.
Polit, D.F., Beck, C.T., 2012. Nursing Research: Generating and Assessing Evidence for
Nursing Practice. 9th ed. Lippincott, Williams, & Wilkins, Philadelphia, PA.
Poore, J.A., Cullen, D.L., Schaar, G.L., 2014. Simulation-based interprofessional education
guided by Kolbs experiential learning theory. Clin. Simul. Nurs. 10, e241e247.
http://dx.doi.org/10.1016/j.ecns.2014.01.004.
Reese, C.E., Jeffries, P.R., Engum, S.A., 2010. Learning together: using simulations to develop nursing and medical student collaboration. Nurs. Educ. Perspect. 31, 3337.
Roche, J., Schoen, D., Kruzel, A., 2012. Human patient simulation versus written case studies for new graduate nurses in nursing orientation: a pilot study. Clin. Simul. Nurs. X,
e1e7. http://dx.doi.org/10.1016/j.ecns.2012.01.004.
Seybert, A.L., Smithburger, P.L., Kobulinsky, L.R., Kane-Gill, S.L., 2012. Simulation-based
learning versus problem-based learning in an acute care pharmacotherapy course.
Simul. Healthc. 7, 162165. http://dx.doi.org/10.1097/SIH.0b013e31825159e3.
Smith, K.V., Witt, J., Klaassen, J., Zimmerman, C., Chen, A., 2012. High-delity simulation
and legal/ethical concepts: a transformational experience. Nurs. Ethics 19, 390398.
http://dx.doi.org/10.1177/0969733011423559.
Stein-Parbury, & Liaschenko, J., 2007. Understanding collaboration between nurses and
physicians as knowledge at work. Am. J. Crit. Care 16, 470477 Retrieved from
www.aacn.org.
Thibault, G.E., 2011. Interprofessional education: an essential strategy to accomplish the
future of nursing goals. J. Nurs. Educ. 60, 313317. http://dx.doi.org/10.3928/
01484834-20110519-03.
Titzer, J.L., Swenty, C.F., Hoehn, W.G., 2011. An interprofessional simulation promoting
collaboration and problem solving among nursing and allied health professional students. Clinical Simulation in Nursing X, e1e9. http://dx.doi.org/10.1016/j.ecns.2011.
01.001 (March).
Waxman, K.T., Nichols, A.A., OLeary-Kelley, C., Miller, M., 2011. The evolution of a statewide network: the bay area simulation collaborative. Simul. Healthc. 6 (6),
345351. http://dx.doi.org/10.1097/SIH0b013e31822eaccc.
Wellard, S.J., Heggen, K.M., 2010. Are laboratories useful ction? : a comparison of Norwegian and Australian undergraduate nursing skills laboratories. Nurs. Health Sci. 12,
3944. http://dx.doi.org/10.1111/j.1442-2018.2009.00481.x.
Wolfgram, L.J.B., Quinn, A.O., 2012. Integrating simulation innovatively: evidence in
teaching in nursing education. Clin. Simul. Nurs. 8, e169e175. http://dx.doi.org/10.
1016/j.ecns.2010.09.002.
Yanhua, C., Watson, R., 2011. A review of clinical competence assessment in nursing.
Nurse Educ. Today 31, 832836. http://dx.doi.org/10.1016/j.nedt.2011.05.003.