Shaping collaborative practice: a qualitative case study of educators’ experiences in integrated interprofessional education

Abstract

Background

Preparing a collaboration-ready health and social care workforce capable of delivering high-quality, patient-, client-, family-, and community-centred care requires the integration of interprofessional education (IPE) into pre-licensure curricula. Such a curriculum employs experiential and situated learning approaches to engage students in progressively complex, real-world, team-based learning activities. Although the literature broadly supports IPE, few studies have examined the impacts of integrated IPE curricula on fostering effective interprofessional collaborative practice across health and social care professions.

Methods

This qualitative case study explored these impacts from the perspectives of classroom-based facilitators and practice-based preceptors involved in delivering IPE in Canada. Data were collected through semi-structured individual interviews with twenty-six participants from four Canadian post-secondary institutions and were analyzed inductively using thematic content analysis.

Findings and Discussion

Key findings emerged across six themes: (1) Gender Representation; (2) Availability of Facilitators and Preceptors; (3) Mode of Delivery; (4) Nature of Curriculum; (5) Perception of Interprofessional Education as Extracurricular; and (6) Limited and Inequitable Access to Practice-Based Interprofessional Education. These themes reflect persistent structural and institutional barriers, as well as opportunities to improve IPE delivery.

Conclusions

To advance meaningful interprofessional collaborative practice in health and social care, institutions should offer substantial incentives to increase faculty and clinician involvement in IPE delivery; utilize both in-person and online modes of delivery; and foster inter-institutional partnerships. These strategies support the World Health Organization’s call for the sustainable integration of IPE into professional degree programs in health and social care, ultimately aiming to improve patient-, client-, family-, and community-centred care.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12909-026-08677-y.

Background

According to the World Health Organization [1–3] and the Global Health Workforce Alliance [4], evolving epidemiological profiles, exponentially ageing populations, and rising costs are increasing the demands on global health and social care delivery systems. Recent global public health and social care crises, such as the COVID-19 pandemic, have only further exposed these systems’ deficiencies in effectively addressing the current needs of their patients and clients [5]. These challenges are compounded by global shortages of health and social care practitioners, with projections estimating a deficit of 15 million practitioners by 2030 [6]. These pressing challenges underscore the urgent need for health and social care professionals to be well-prepared for effective interprofessional collaborative practice [7, 8].

The World Health Organization [2] defines interprofessional collaborative practice (IPCP) as occasions when “multiple [practitioners] from different health and social care professional backgrounds work together […] to deliver the highest quality of care,” (p. 7). According to the Canadian Interprofessional Health Collaborative (CIHC), effective IPCP requires practitioners to be proficient in six interprofessional competency domains: interprofessional communication; patient-, client-, family-, and community-centred care; role clarification; team functioning; interprofessional conflict resolution; and collaborative leadership [9]. Approaches that address and enhance health and social care practitioners’ knowledge, skills, and dispositions in the six interprofessional competency domains have the potential to lead to improved patient-, client-, family-, and community-oriented outcomes.

Ideally, practitioners should be effectively trained and prepared for IPCP prior to licensure or certification. As such, coordinated planning and collaborative partnerships among the multi-tiered sectors comprising health and social care professional degree programs, delivery systems, and policymaking are warranted. One approach demonstrated to lead to effective IPCP and its intended patient-, client-, family-, and community-oriented outcomes is interprofessional education [10–12].

Interprofessional education (IPE) is defined by the Centre for the Advancement of Interprofessional Education (CAIPE) as “occasions when members or students of two or more [health and social care] professions learn with, from and about each other to improve collaboration and the quality of care and services” (p. 1 [13]), . By emphasizing that students learn with, from, and about each other, IPE embodies the constructivist principles [14–16] that highlight the importance of social experiences in acquiring interprofessional knowledge, skills, and dispositions. One approach to implement IPE is through an integrated curriculum model, comprising a series of structured, interactive, interprofessional experiences that encompass both classroom-based and practice-based components. These experiences lead to direct student-centred outcomes [17, 18] and enable students to form a community of practice [19], ultimately improving patient-, client-, family-, and community–oriented outcomes that can be sustained over time and into professional practice [20–24].

The present study

Incorporating team-based approaches in health and social care professional education programs is intended to prepare diverse professional teams to collaborate effectively in primary care settings and other health provision sectors. Over the last two decades, extensive Canadian literature has documented notable developments in these fields [20–33]. Moreover, while many Canadian post-secondary institutions have adopted what they refer to as ‘integrated’ IPE curricula within their pre-licensure programs, very little research has evaluated the actual impacts of these models or whether those impacts are sustained over time and into professional practice [34–36].

To address these research gaps, this qualitative embedded single-case study [37], underpinned by the constructivist paradigm [38], explored the impacts of pre-licensure integrated IPE curriculum models on IPCP from the perspectives of classroom-based facilitators and practice-based preceptors at four Canadian post-secondary institutions. In so doing, this study addressed the research question: What are the experiences (e.g., enablers, barriers/challenges, implications, and outcomes) of health and social care educators when delivering integrated IPE curricula? These educators play a pivotal role in shaping students’ interprofessional competencies and bridging classroom and clinical learning environments.

Addressing the impacts of integrated IPE has been prioritized by the Global Confederation for Interprofessional Education and Collaborative Practice, which emphasizes “developing evidence of impact along the continuum from IPE to IPCP in [patient-, client-, family-, and community-centred] service delivery” (p. 7 [39]), . Additionally, researchers, health and social care leaders, and policymakers in countries where IPE and IPCP are still emerging continue to look to Canada’s global leadership in research, policymaking, and professional practice. More importantly, through this multi-institutional collaborative effort, our findings aim to inform best practices in IPE curriculum design and delivery, supporting policy efforts to strengthen the health and social care workforce globally and ultimately improve patient-, client-, family-, and community-centred care.

Methods

This qualitative embedded single-case study [37] explored the experiences of classroom-based facilitators and practice-based preceptors involved in delivering integrated IPE curricula. Using semi-structured individual interviews, data were collected from four Canadian post-secondary institutions: the Universities of British Columbia (UBC), Manitoba (UofM), Toronto (UofT), and Montréal (UdeM). This study was approved by the Non-Medical Research Ethics Board at Western University (#120360).

Theoretical and conceptual frameworks

This study was theoretically guided by the Framework for Productive Engaged Learning in the Professions [40], which describes the interplay between the theories of experiential learning, social constructivism, and situated learning—leading to proficiency in interprofessional competencies [9], establishment of communities of practice [19], and eventual improvement of health and social care delivery systems through IPCP [24] (Fig. 1). Moreover, this study was conceptually framed by Verma et al.’s [41] acts of authentication. Recent shifts in health and social care professional education emphasize authentic, contextual, and situated learning experiences where knowledge, skills, and dispositions develop inclusively and interconnectedly [42]. Underpinned by socio-constructivist and situated cognition theories, Verma et al. highlight that meaningful learning experiences working synergistically to develop knowledge, skills, and dispositions constitute acts of authentication. These in situ learning experiences incorporate productive disciplinary engagement [43], learner discourses, and participation within a community of practice. Productive disciplinary engagement represents progressive, substantive learning that underscores the disciplines’ core knowledge, skills, attitudes, and behaviors. Learner discourses and community engagement support learners moving toward productive disciplinary practices and cultivate norms of authentic learning transferable across academic, technical, and professional domains.

Fig. 1.

Framework for productive engaged learning in the professions [40]

Site selection

Participating institutions were purposively selected for implementing integrated IPE curricula matching our research focus. These curricula share five key attributes: (1) established, central administrative offices and centres coordinating inter-program relationships, faculty development, and allocation of adequate resources and funding for successful IPE delivery; (2) longitudinal IPE spanning two to three years, systematically incorporated into programmatic coursework; (3) IPE delivery theoretically informed and guided by several social constructivist learning theories and conceptual frameworks; (4) longitudinal scaffolding of IPE opportunities throughout the curriculum, reflecting student-centred pedagogy that leads to direct student-centred outcomes; and (5) patient-, client-, family-, and community-oriented approaches enabling students to form communities of practice. (For further details [44]), .

Additionally, these four institutions offer programs in the seven largest health and social care professions in Canada—dentistry, medicine, nursing, occupational therapy, pharmacy, physical therapy, and social work—from which the participants were recruited. Collectively, they represent a substantial proportion of Canadian health and social care professional students (range: 700 to 1,600 students per institution; N = 4,700) and significantly influence IPE curriculum implementation nationally and internationally.

Participants

Participants met three inclusion criteria: (1) affiliation with a prelicensure health or social care professional degree program; (2) proficiency in English sufficient for interview participation; and (3) minimum of three years’ experience facilitating interprofessional learner groups within an integrated IPE curriculum. The three-year minimum criterion excluded facilitators with limited knowledge of IPE standards and facilitation challenges.

Twenty-six facilitators and preceptors representing twelve health and social care professions were interviewed (Table 1). Approximately 77% were affiliated with the seven largest professions: dentistry (n = 2), medicine (n = 5), nursing (n = 2), occupational therapy (n = 3), pharmacy (n = 4), physical therapy (n = 3), and social work (n = 1). Participants had an average of 20 years of experience in professional practice (range: 5–46) and eight years of experience facilitating IPE (range: 3–20). Approximately 58% (n = 15) facilitated classroom-based IPE, one facilitated practice-based IPE, and 38% (n = 10) facilitated IPE in both settings.

Table 1.

Participants’ demographics

Pseudonym		Gender	Primary Affiliation	Years in Profession	Role in IPE	Years in IPE
1	Aaliyah	Woman	Speech-language pathology	19	Classroom-based	7
2	Abigail	Woman	Dental Hygiene	28	Classroom-based	14
3	Amelia	Woman	Kinesiology	23	Classroom-based	15
4	Avery	Woman	Nursing	5	Classroom & Practice-based	4
5	Benjamin	Man	Physical Therapy	22	Classroom & Practice-based	8
6	Chloe	Woman	Medicine	20	Classroom-based	7
7	Darius	Man	Medicine	20	Classroom-based	3
8	Elizabeth	Woman	Dentistry	37	Classroom-based	15
9	Emily	Woman	Pharmacy	22	Classroom & Practice-based	4
10	Emma	Woman	Occupational Therapy	23	Classroom & Practice-based	5
11	Hannah	Woman	Pharmacy	46	Classroom-based	8
12	Isabella	Woman	Physical Therapy	20	Classroom-based	3
13	James	Man	Dentistry	22	Classroom & Practice-based	7
14	Jenna	Woman	Social Work	8	Classroom-based	6
15	Julia	Woman	Occupational Therapy	32	Classroom & Practice-based	6
16	Kim	Woman	Medicine	23	Classroom & Practice-based	10
17	Luna	Woman	Nursing	8	Classroom-based	5
18	Lucy	Woman	Pharmacy	5	Classroom-based	3
19	Madeline	Woman	Speech-language pathology	12	Classroom-based	6
20	Mariam	Woman	Occupational Therapy	10	Classroom-based	10
21	Noah	Man	Medicine	10	Practice-based	10
22	Sophia	Woman	Physical Therapy	25	Classroom & Practice-based	20
23	Violet	Woman	Clinical Psychology	13	Classroom & Practice-based	13
24	Victoria	Woman	Physician Assistant	24	Classroom-based	13
25	William	Man	Pharmacy	14	Classroom & Practice-based	6
26	Zoe	Woman	Medicine	15	Classroom-based	6

Data collection and analysis

Participants were recruited via convenience sampling through email invitations drafted by the researchers and distributed by institutional IPE offices and centres (Table 2). The email included a link to a Qualtrics questionnaire [45] collecting (1) demographic information (primary affiliation, gender, years in profession, role and years involved in IPE), (2) informed consent and contact details (institutional email addresses), and (3) scheduling preferences for interviews. Demographic data were analyzed using IBM SPSS Statistics for Windows, Version 26 [46].

Table 2.

Offices/Centres for interprofessional education at participating Post-Secondary institutions

Post-Secondary Institution	Office/Centre of Interprofessional Education
University of British Columbia	University of British Columbia (UBC) Health
Université de Montréal	Interfaculty Operational Committee (CIO-UM) and Office of Collaboration and Patient Partnership (DCPP)
University of Manitoba	Office of Interprofessional Collaboration (OIPC)
University of Toronto	Centre for Advancing Collaborative Healthcare and Education (CACHE)

The semi-structured interview guide (see Supplementary File 1) was developed by the research team specifically for this study. Semi-structured individual interviews allowed participants to share unique perspectives and yet permitted use of consistent topics across interviews. Interviews explored perceived enablers of and barriers to IPE delivery and strategies employed to promote IPCP in their students. Examples of questions used included: Do you feel that your contributions to IPE are appreciated by your institution? What kinds of challenges or obstacles do you usually encounter when facilitating IPE? What approaches do you use to encourage students to collaborate in IPE activities? Questions were informed by the Framework for Productive Engaged Learning in the Professions [40], linking participants’ knowledge, skills, and dispositions to acts of authentication [41] and community of practice formation [19]. Interviews lasted 25 to 75 min, and were conducted via Zoom, video-recorded, and transcribed verbatim. Transcripts were member-checked [38] to enhance credibility. Participants received a $100 Amazon.ca eGift Card as a token of appreciation for their time.

Qualitative data were inductively coded and thematically analyzed by both authors using NVivo 12 [47]. Multiple coding cycles continued until sufficient information power was reached [48], ensuring data relevance to the research question.

Findings and discussion

This qualitative case study explored the experiences of classroom-based facilitators and practice-based preceptors delivering an integrated IPE curriculum. Key findings emerged across six themes: (1) Gender Representation; (2) Availability of Facilitators and Preceptors; (3) Mode of Delivery; (4) Nature of Curriculum; (5) Perception of Interprofessional Education as Extracurricular; and (6) Limited and Inequitable Access to Practice-Based Interprofessional Education.

Gender representation

As survey responses were reviewed, it became apparent that the majority of participants identified as women. This observation informed subsequent interview questions, which sought to explore participants’ perspectives on the gendered composition of IPE facilitation and whether this pattern held particular significance for them. The findings reported below therefore reflect a deliberate analytic focus on how gender was understood, interpreted, and experienced by participants, rather than an a priori assumption about its relevance.

Approximately 81% (n = 21) of the participants were women. Participants suggested this proportion reflects the broader gender imbalance across both health and social care professions and those who facilitate IPE. According to a recent Statistics Canada report, approximately 75% of all care workers and 80% of students enrolled in health and social care professional degree programs in Canada are women [49, 50]. This trend is particularly pronounced in professions such as nursing, occupational therapy, pharmacy, physical therapy, social work, and speech-language pathology, which together represent 58% of the professional affiliations of study participants.

One participant (Hannah) remarked that such gender disparities may have developed “naturally.” Participants also noted that the majority of facilitators, preceptors, and patient and client partners they work with are also women. In contrast, men were perceived as gravitating toward administrative or private sector roles, where greater financial compensation may disincentivize voluntary IPE involvement. As Emma observed, men are often “drawn more to areas that involve more prestige and power,” while Violet added that individuals “motivated by status are less likely to become involved in these initiatives.”

Although male participants acknowledged these patterns, they did not typically frame them as gendered inequities. Rather, their accounts tended to normalize the predominance of women in IPE as a reflection of existing professional demographics or structural realities within health and social care. This contrast suggests that gendered dimensions of participation may be more readily perceived by those who experience their effects directly, while remaining less visible to those for whom such dynamics are not personally constraining.

These participant perspectives align with prior research on gendered participation in patient and client partnerships, where women are more frequently represented in voluntary or caregiving roles [51–53]. These findings reinforce broader societal patterns in gendered labor division and raise concerns about equity in faculty and clinical engagement in IPE. While the predominance of women facilitators may reflect the feminized nature of caring professions, it also highlights potential systemic undervaluing of IPE work, particularly when it lacks formal compensation or prestige. This echoes Racine et al. [54], who noted that gendered expectations often shape faculty engagement, with female educators more likely to assume collaborative and teaching-focused responsibilities. Future research may explore how gender dynamics influence recognition, workload distribution, and leadership roles within IPE delivery systems.

Availability of facilitators and preceptors

Although most participants acknowledged an adequate pool of faculty and clinicians who could facilitate IPE, they emphasized the substantial challenges in recruiting willing participants. Several reasons were cited: a persistent perception that IPE lacks value, particularly among faculty who either assume collaboration is already embedded in their training (Violet) or work in siloed, single-discipline contexts (Isabella); intrinsic motivation influenced participation, as one facilitator described: “I volunteer to facilitate only IPE sessions that are on topics that are of interest to me or within my own professional experience” (Mariam); and limited awareness among newer faculty and clinicians about existing IPE opportunities, reflecting insufficient internal communication and inconsistent messaging from IPE offices or leadership (Mariam).

These findings align with Racine et al. [54], who noted that nursing faculty expressed uncertainty and a lack of readiness to integrate IPE, citing limited formal education about IPE principles and a need for clearer institutional direction. This suggests that IPE facilitators may benefit from structured onboarding, training, and leadership support, particularly in departments where IPE is less embedded in the culture.

Another significant barrier was the lack of meaningful incentives to support and recognize IPE facilitation. While teaching-stream faculty may leverage IPE work for their teaching dossiers or Progression Through the Ranks reports, research-stream faculty felt undervalued, as Victoria shared: “We certainly don’t get enough recognition from our home departments.” The work itself was often described as burdensome: “It’s much more onerous and requires a lot more preparation” (Violet), yet it was frequently uncompensated or undercompensated. Even when financial incentives were offered, they were not competitive: “Remuneration in private practice is so much higher [that] it isn’t a sufficient incentive” (Isabella). Julia noted the broader issue of relying on goodwill:

We rely on the good will of our clinical community to provide free service with nothing in return. If there was a budget, I think you could better recognize and show value and appreciation to the people who bring forth their expertise.

This reflects Racine et al.’s [54] finding that even when faculty held positive beliefs about IPE, their willingness to engage was influenced by perceived workload, lack of institutional support, and unclear benefits for career advancement.

In addition, logistical and scheduling conflicts—especially for clinicians with demanding practice obligations—further limited participation. Violet and Julia both emphasized that the IPE teaching load often pulls clinicians away from patient care, which is difficult to justify in overstretched health care settings, particularly during and since the COVID-19 pandemic. Julia elaborated:

It means that I have to ask my employer if I can take that time off work to [facilitate IPE]. There’s no budget for it and the managers are not obliged to release those people to get engaged in those sessions.

These findings reinforce existing literature indicating that the successful integration of IPE depends heavily on the availability and motivation of faculty and clinicians [55]. While faculty may conceptually support IPE, the practical barriers—lack of time, institutional support, professional recognition, and financial compensation—limit their capacity to contribute meaningfully [54]. This creates a fragile system that is highly dependent on volunteerism and goodwill, rendering IPE programs vulnerable to disruption, particularly during periods of crisis or systemic strain.

Ultimately, IPE implementation cannot rely solely on goodwill or isolated champions. Instead, institutions must adopt a systemic approach that aligns policy, resources, and recognition structures to support faculty and clinician engagement in IPE, ensuring long-term sustainability and impact on IPCP. To address these challenges, we recommend that health and social care professional degree programs and their administrative leadership develop structured incentive programs, ranging from modest recognition (e.g., parking validation, public acknowledgement) to contractual adjustments that allow IPE facilitation time to be counted toward workload and promotion criteria; foster inter-institutional collaborations that share facilitators and preceptors across programs and disciplines to reduce the burden on individual sites; enhance outreach efforts by embedding IPE liaisons within departments and clinical sites to raise awareness and improve communication about opportunities; offer professional development programs that increase faculty’s knowledge, readiness, and confidence to facilitate IPE—especially among early-career professionals and those from underrepresented disciplines; and engage professional bodies and licensing boards to promote IPE participation as a recognized component of continuing professional development, thus normalizing it across the continuum of health and social care professions education.

Mode of delivery

The shift to online IPE delivery during the COVID-19 pandemic was described as both a facilitator and a barrier to implementation. Many participants noted that the transition improved facilitator engagement by offering greater scheduling flexibility and eliminating logistical barriers such as commuting and room booking. As Aaliyah explained, “You can hire people from all over the place. We have been able to hire people who are 10 hours away. It exposes our students to other realities.” Students—particularly those on satellite or rural campuses—also benefited from improved accessibility, mitigating a sense of exclusion: “They might otherwise feel disenfranchised” (Julia).

Recent literature suggests that the effectiveness of IPE is shaped less by modality alone than by the quality of pedagogical design and facilitation. Studies examining virtual and hybrid IPE models indicate that while online delivery can enhance access and logistical feasibility, it may also limit informal interaction and relationship-building if not intentionally structured [56, 57]. These findings align with participants’ accounts, which emphasized that although virtual platforms expand reach, they may constrain the relational depth necessary for meaningful interprofessional learning.

However, several drawbacks to online delivery were identified, particularly in relation to technology, communication, and relational dynamics. Participants emphasized that digital platforms can hinder the ability of facilitators, preceptors, and patient and client partners to build rapport and provide real-time guidance. Julia remarked, “You’re not going to have those ‘water cooler’ conversations [online]. That’s where those relationships build. They don’t happen as naturally on Zoom as they would in-person.” Facilitators also expressed difficulty managing simultaneous breakout sessions, noting they were often unable to circulate meaningfully or support all groups effectively.

The online format appeared to limit the development of interpersonal skills and the sense of professional community. Decreased eye contact, limited nonverbal communication, and a reduction in spontaneous conversation were commonly reported. Several participants also highlighted student disengagement, noting that some turned off cameras, appeared distracted, or adopted a passive approach. These findings are consistent with previous research showing that the virtual environment can diminish the interactive and social dimensions critical to IPE [58, 59]. In particular, activity-based and experiential components—key to the ‘learning with, from, and about each other’ model—were compromised in online settings.

Despite these limitations, most participants expressed strong support for a hybrid model that strategically integrates both formats. As Victoria explained, “There is a time and place for both.” Under this model, activity-based, skills-intensive sessions are delivered in-person to promote engagement and relationship-building, while didactic or discussion-based components are conducted online to enhance accessibility and reduce scheduling conflicts. This blended approach echoes recommendations in the literature [60], which advocate for hybrid models that leverage the strengths of both virtual and in-person learning environments. Taken together, these findings suggest that while virtual modalities can enhance access and logistical feasibility, they are best positioned as complementary to—rather than replacements for—in-person learning when the goal is to foster relational, communicative, and collaborative competencies central to IPE, particularly those requiring trust-building, shared decision-making, and interprofessional sense-making.

The shift to online IPE delivery represents an important adaptive response to the COVID-19 pandemic, but one that surfaced complex challenges requiring ongoing attention. Consistent with findings by Joseph et al. [58] and Mukherjee et al. [59], this study highlights that while virtual IPE offers notable logistical benefits—including increased facilitator diversity and broader student access—it also introduces pedagogical and relational limitations that may impact learning outcomes. IPE’s emphasis on relational competencies—such as trust, communication, and collaboration—can be difficult to cultivate in online settings that lack nonverbal cues and informal interactions.

Faculty and program administrators should be deliberate in aligning delivery modes with learning objectives. For example, online platforms may be appropriate for interprofessional ethics discussions or case-based analysis, but simulation-based, patient-centred activities may be more effective in-person. Where online delivery is used, investments in robust technological infrastructure and facilitator training are critical. In addition, incorporating camera-on policies, real-time facilitation techniques, and smaller breakout groups may help foster more active engagement.

Future research should examine how hybrid delivery models impact IPE learning outcomes longitudinally, including their influence on students’ interprofessional identity formation and readiness for IPCP. Institutions should also consider the perspectives of patient and client partners, whose experiences with virtual engagement remain underexplored but are vital to comprehensive IPE.

Nature of curriculum

The core, mandatory IPE sessions typically bring students together from all participating programs, which necessitates the use of broad, generic topics. Participants argued that this format can feel inauthentic and irrelevant to many students, reducing their perceived value and engagement. Instead, participants advocated for more focused topics involving students from professions that will ultimately work together—profession-specific groupings that mirror real-world interprofessional teams—and for content targeted to shared practice settings. Noah emphasized the importance of replicating professional practice, with the aim to “mirror what happens in real practice.”

To achieve this, participants also recommended establishing formal inter-institutional partnerships between their programs and other professional programs (e.g., dental hygiene, pharmacy technician, physical therapy assistant) offered at other institutions to expand and enrich IPE experiences. This approach, where inter-institutional relationships extend beyond the intra-institutional IPE curriculum, has been deemed progressive and exemplary by the CIHC’s Accreditation Standards Committee [61].

The preference for more focused, profession-specific groupings within IPE sessions aligns with growing evidence that authentic interprofessional learning occurs when students engage in activities that closely reflect their future IPCP environments [62, 63]. Broad, generic topics may dilute relevance and reduce student engagement, as also reported by Hill et al. [64], who emphasize that meaningful interaction is critical for effective IPE.

Moreover, the call for inter-institutional partnerships resonates with contemporary trends advocating for expanded collaborative networks across educational institutions to better simulate complex healthcare teams [64]. Such partnerships can provide diverse experiential learning opportunities and help overcome resource limitations that individual programs may face. Embedding IPE within real-world practice contexts not only enhances learning authenticity but may also improve students’ readiness for IPCP post-graduation. This is especially important given that learners’ perceptions of relevance and applicability directly influence their motivation and engagement in IPE activities [62].

Future curriculum development should, therefore, prioritize tailored, context-specific IPE experiences, foster cross-institutional collaboration, and integrate learning activities that simulate authentic team-based care. Doing so can improve both educational outcomes and, ultimately, patient-centred care quality by better preparing graduates for the complexities of interprofessional teamwork.

Perception of interprofessional education as extracurricular

Although IPE is formally integrated within the curricula [44], participants highlighted that its scheduling and format often convey unintended hidden curriculum messages. For example, many IPE sessions are scheduled on Thursday and Friday evenings or weekends, times when students may be fatigued or otherwise preoccupied, leading them to perceive IPE as non-essential and secondary. Furthermore, despite the mandatory nature of many IPE sessions, these activities are frequently non-credit-bearing, reinforcing the perception that “this is just extra” and “not what I will be graded on” (William). Consequently, some students lack clarity on the value of IPE and approach sessions with minimal engagement, believing that “we have to just answer these questions for this activity and get out of here” (Mariam).

Participants advocated for a culture shift that embeds IPE more deeply and authentically across the curriculum rather than treating it as a stand-alone component:

I think one of the key pitfalls is to think about the IPE curriculum as a stand-alone curriculum. I really think that that is detrimental and is a limitation to the scaffolding that IPE requires. IPE should be embedded throughout all aspects of the curriculum, not as a stand-alone curriculum. I don’t think we have accomplished that yet. To me, that’s not reflective of practice. (William)

What I would love to see is more blended learning between the professional groups in their core activities. So, when you’re doing a course in biomechanics, for example, then that course should have physical therapy, occupational therapy, and kinesiology students all together learning about biomechanics. They should be living and breathing it together. (Julia)

Based on these insights, health and social care professional degree programs are encouraged to offer for-credit, comprehensive IPE opportunities that promote meaningful engagement and help students recognize the relevance and importance of interprofessional competencies. Additionally, scheduling IPE activities earlier in the week and during daytime hours (e.g., Monday or Tuesday mornings) may help convey institutional commitment and signal that IPE is valued equally alongside uni-professional components.

These findings echo concerns in the literature regarding the hidden curriculum in IPE, where logistical factors such as timing and credit non-allocation implicitly communicate its lower priority to students [65]. Studies have shown that when IPE is treated as peripheral or optional, student motivation and engagement diminish, undermining the development of essential interprofessional competencies [62].

Embedding IPE throughout the curriculum, especially through blended or integrated learning approaches, has been demonstrated to enhance interprofessional understanding and teamwork skills [66]. Making IPE credit-bearing further reinforces its legitimacy and encourages deeper student investment [67]. Ultimately, institutional culture, reflected in policies, scheduling, and curricular integration, plays a crucial role in shaping students’ perceptions and experiences of IPE. Addressing these systemic factors is vital to fostering a genuine commitment to IPCP.

Limited and inequitable access to practice-based interprofessional education

Participants acknowledged that current students demonstrate greater knowledge of, and respect for, other professions compared to previous cohorts. However, they emphasized that practice-based IPE exposure remains limited and uneven, particularly in primary care and community settings. William expressed a strong desire for more comprehensive and varied experiential learning opportunities:

I wish we had an IPE activity for every single therapeutic area and also for every, single type of practice-based environment that students may see on practicum. So, I’d love to see what IPE looks like in a busy, community pharmacy that’s a retail chain versus an independent [pharmacy] versus a primary care center versus a long-term care center. Even the same case [across settings] would be helpful. (William)

Julia similarly highlighted the inequities in placement quality stemming from institutional partnerships:

[Some] hospitals, community sites, and private practices don’t have a connection to the IPE curriculum. When I send a student off to do a placement in a hospital that cannot offer a structured IPE placement, that student is not going to get the same experience as everyone else. That creates inequities. (Julia)

To address these gaps, IPE offices and centres are recommended to develop and provide more diverse and equitable practice-based learning opportunities across a broader range of primary care and community settings, aligned with the CIHC’s six interprofessional competency domains [9]. Expanding partnerships to include unpartnered sites would also foster the adoption of an interprofessional culture within these workplaces, thereby preparing students more effectively for the collaborative demands of real-world IPCP.

Limitations and future directions

This study has several limitations that should be acknowledged. First, no single profession was represented across all four participating institutions, which may have limited the breadth of perspectives captured. Future research should employ purposeful sampling strategies to ensure comprehensive multi-professional representation across all participating sites, enhancing the richness and transferability of findings.

Second, the design and sequencing of screening questionnaires and interview questions may have introduced question-order, recall, and social desirability biases, potentially influencing participant responses.

Third, participants had variable levels of experience with IPE facilitation and preceptorship (ranging from 3 to 20 years, with a mean of 8 years), which may have affected the depth and nature of insights shared.

Fourth, as the data were collected from four large Canadian institutions, the findings may have limited generalizability to smaller institutions or non-Canadian educational contexts. Diverse health and social care professions education systems internationally may face unique challenges or opportunities not captured here.

For future research, it is recommended to explore the perspectives of students and early-career graduates who have recently transitioned into professional practice, to better understand the downstream impacts of integrated IPE curricula. Additionally, further study is warranted on how primary care settings and other health service sectors cultivate and sustain an interprofessional workplace culture, which is critical to reinforcing effective IPCP beyond the academic environment.

Conclusions

This multi-institutional qualitative case study examined how integrated IPE is enacted by classroom-based facilitators and practice-based preceptors and what, in their view, most helps or hinders learners’ readiness for IPCP. Across four Canadian institutions, six cross-cutting themes surfaced: gendered patterns of participation; constrained availability of facilitators and preceptors; the affordances and limits of online versus in-person delivery; the need for authentic, practice-proximal curricula; hidden-curriculum signals that de-prioritize IPE; and inequitable access to practice-based IPE. Taken together, these findings depict implementation systems that are aspiration-rich but structurally fragile in that they are over-reliant on volunteerism, unevenly resourced, and too often organized in ways that obscure IPE’s centrality to professional formation.

Our analysis suggests clear, actionable levers to mitigate the fragility of IPE delivery. First, institutions should align incentives and workload models with the real demands of IPE delivery, ensuring recognition in promotion/advancement pathways and offering practical supports that make participation feasible for clinicians and faculty. Second, programs should intentionally match delivery mode to pedagogical intent. For example, using in-person formats for relationship-dependent, skills-intensive learning and leveraging online formats for didactic, case-analytic, and geographically distributed activity, within coherent hybrid designs. Third, curricula should privilege situated, profession-mix configurations that mirror actual team grouping patterns and shared practice settings, supplemented by inter-institutional partnerships that broaden the range and authenticity of experiences. Fourth, credit-bearing integration, scheduled in core hours, should replace peripheral, after-hours placements that tacitly signal “extra” rather than essential learning. Finally, IPE offices should expand and equalize practice-based opportunities across primary care and community contexts, so all learners are afforded opportunities to encounter and train within the full setting of team-based care.

These recommendations are congruent with emerging empirical and review evidence. Recent mixed-methods research shows that IPE can measurably strengthen collaboration perceptions and interprofessional identity, especially among teams starting from lower baselines, underscoring the value of early, well-scaffolded experiences that help learners “belong,” “commit,” and work across roles in disciplined ways [68]. Similarly, a contemporary scoping review maps IPE’s most consistent gains to the IPEC core domains, teams/teamwork, roles and responsibilities, communication, and values/ethics, while also cataloguing the very challenges our participants described (logistics, power dynamics, communication barriers, and workload) [69].

Our study contributes practice-proximal nuance to this literature by illuminating how institutional arrangements and hidden-curriculum cues shape educators’ willingness and capacity to deliver IPE at scale. In particular, we show why sustainable IPE cannot rest on goodwill alone and why structural reforms, budgeted time, recognition, and cross-site sharing, are prerequisites for equity of access and consistency of quality. These insights reinforce calls to embed IPE within core curricula and standards, rather than treating it as an adjunct to uniprofessional training.

Integrated IPE, when adequately resourced, deliberately hybridized, authentically contextualized, credit-bearing, and equitably distributed, can accelerate the formation of collaboration-ready graduates and strengthen the conditions for IPCP in real settings. Realizing that promise, however, requires moving IPE from the margins of policy and scheduling into the mainstream of how health and social care professionals are educated, so that learning “with, from, and about” one another becomes both ordinary and expected, and the dividends accrue to patients, clients, families, communities, and the workforce alike.

Abbreviations

CAIPE

Centre for the Advancement of Interprofessional Education

CACHE

Centre for Advancing Collaborative Healthcare and Education

CIHC

Canadian Interprofessional Health Collaborative

CIO-UM

Interfaculty Operational Committee

DCPP

Office of Collaboration and Patient Partnership

IPCP

Interprofessional Collaborative Practice

IPE

Interprofessional Education

OIPC

Office of Interprofessional Collaboration

UBC

University of British Columbia

UdeM

Université de Montréal

UofM

University of Manitoba

UofT

University of Toronto

Authors’ contributions

MA conceptualized the study, designed the methodology, and conducted the data analysis. AP contributed to coding and thematic analysis. Both authors collaborated on drafting, revising, and finalizing the manuscript. Both authors read and approved the final manuscript.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Data availability

The datasets generated and/or analyzed during the current study are not publicly available due to restrictions to protect participant confidentiality but are available from the corresponding author on reasonable request and with permission of the participating institutions.

Declarations

Ethics approval and consent to participate

This study was approved by the Non-Medical Research Ethics Board (NMREB) at Western University (Protocol #120360). All participants received a letter of information and provided informed consent prior to participation. Participation was voluntary, and all data were anonymized to ensure confidentiality. The study was conducted in accordance with the ethical standards of the institutional research committee and with the 1964 Declaration of Helsinki and its later amendments.

Consent for publication

All participants provided informed consent for the use of anonymized quotations in publications arising from this study. No personally identifiable information is included.

Competing interests

The authors declare no competing interests.