Bridging the gap: healthcare students’ perceptions and attitudes toward interprofessional learning and collaboration

Abstract

Background

Interprofessional education (IPE) is being increasingly recognized globally as an essential component of healthcare curricula. Given the limited research on healthcare students’ perceptions of interprofessional learning and collaboration in Saudi Arabia, this quantitative cross-sectional study evaluated the perceptions and attitudes of healthcare students from five colleges (Medicine, Pharmacy, Applied Medical Sciences, Dentistry, and Nursing) across all five years of study toward interprofessional learning and collaboration via the Readiness for Interprofessional Learning Scale (RIPLS) and Interdisciplinary Education Perception Scale (IEPS).

Methods

A cross-sectional survey was conducted at five healthcare colleges at Jouf University, Saudi Arabia. A total of 501 students (260 from Medicine, 63 from Pharmacy, 63 from Applied Medical Sciences, 61 from Dentistry, and 54 from Nursing) distributed across years 1–5 completed the validated quantitative questionnaires that used the RIPLS and IEPS. Descriptive statistics, independent t tests, ANOVA with post hoc comparisons, and Pearson’s correlation were employed. Internal consistency was evaluated via Cronbach’s α.

Results

The RIPLS scores; measuring readiness for interprofessional learning significantly increased across the academic years, transitioning from the first year (M = 2.86) to the fifth year (M = 4.48; p < 0.001), indicative of increased readiness for interprofessional learning as students progressed. The IEPS scores; measuring perceptions of professional competency and collaboration, peaked during the second and third years but experienced a modest decline in subsequent years (p = 0.018), suggesting evolving professional identity perceptions. Gender differences were significant, with junior male students initially reporting higher scores, whereas senior female students demonstrated stronger teamwork orientation (p = 0.028). A moderate positive correlation was observed between the RIPLS and IEPS scores (r = 0.356, p < 0.001), indicating that students with greater confidence in their profession showed more willingness to engage in interprofessional learning. Both scales demonstrated excellent reliability (RIPLS α = 0.943, IEPS α = 0.914).

Conclusion

Healthcare students showed positive attitudes toward interprofessional learning and collaboration, which were influenced by gender and academic progress. The results support the integration of early, sustained, and gender-sensitive interprofessional education within healthcare curricula. Longitudinal and multi-institutional studies preferably using mixed-methods approaches are needed to validate these trends and explore causality.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12909-026-08749-z.

Introduction

IPE is a crucial component in academia for enhancing healthcare professional training of healthcare students to deliver patient care within a collaborative team setting [1]. The World Health Organization (WHO) defines IPE as a process in which “students from two or more professions learn about, from, and with each other to facilitate effective collaboration and enhance health outcomes” [2, 3]. IPE is considered essential for preparing students for effective interprofessional collaboration, which is crucial for promoting patient safety and improving the quality of healthcare [4]. An extensive literature search indicates that IPE can positively impact learners’ attitudes, knowledge, abilities, and behaviors, collectively referred to as collaborative competences [5, 6].

Implementing IPE presents significant challenges. While most colleges recognize the extensive advantages of IPE globally, the methods and strategies for implementation vary [7]. The fundamental elements of IPE include team collaboration and collective action, the creation of shared knowledge, effective knowledge dissemination, and mutual comprehension. Conversely, the predominant challenges encountered were the absence of interconnections and coordination across the curricula of multiple professions [8], the absence of team culture and ignorance of the roles and scopes of other healthcare professions [9].

Contemporary undergraduate research indicates a propensity to incorporate IPE at an earlier stage, including the first year of study; nevertheless, the optimal timing for implementing practical education (PE) interventions within the medical curriculum has yet to be established [2, 10]. Perceptions and attitudes are affective elements influencing student behavior; specifically, strong attitudes direct conduct, whereas weak attitudes are influenced by behavior [11]. Students must possess sufficiently robust attitudes to direct their conduct when demonstrating interprofessional collaboration (IPC) in authentic or simulated healthcare scenarios. In the context of IPE, this indicates that when IPC is the educational objective for our students, it is essential to evaluate the robustness of their attitudes rather than merely observing their behaviors [4].

In Saudi Arabia, IPE is an emerging educational pedagogy. The Arab Network for Interprofessional Education (ANIC) was established approximately seven years ago to promote interprofessional learning across the region [12]. At Jouf University, there is currently no formal or structured interprofessional education (IPE) curriculum embedded within the healthcare programs. However, students are exposed to various informal and practice-based interprofessional interactions through volunteer and community health initiatives, collaborative student research, informal team-based tasks, some joint academic activities, simulation sessions, and clinical rotations. These experiences provide opportunities for students from different health disciplines to collaborate, despite the absence of a dedicated IPE course. Therefore, the use of the Readiness for Interprofessional Learning Scale (RIPLS) and the Interdisciplinary Education Perception Scale (IEPS) instruments in this study were appropriate for assessing students’ baseline readiness for interprofessional learning and their perceptions of professional collaboration. The findings are intended to help identify existing gaps and inform the development of future IPE initiatives at Jouf University.

All healthcare programs at Jouf University follow a five-year curriculum structure, ensuring consistent educational timelines across professions. Clinical training generally begins towards the end of third year, providing opportunities for interprofessional interaction, though these experiences are not yet part of a formal IPE curriculum. To assess students’ readiness for interprofessional learning and their perceptions of professional identity and collaboration, two widely used instruments—the RIPLS and the IEPS—were employed. Both instruments were chosen for this study to provide complementary perspectives on students’ readiness for interprofessional learning and their perceptions of professional identity and collaboration.

The RIPLS scale, developed in 1999, was one of the earliest instruments designed to assess attitudes toward interprofessional learning [13]. It is a three-factor scale that includes 19 components. It has been translated and adapted into other languages [14]. The RIPLS is a validated quantitative tool that uses a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree) to assess students’ readiness for interprofessional learning. It evaluates three main dimensions: (1) readiness for teamwork and collaboration (2), perceptions of professional identity (both positive and negative indicators), and (3) understanding of roles and responsibilities [15]. RIPLS is education-focused and designed to measure attitudinal readiness for collaborative learning experiences among diverse professional disciplines within academic settings.

Luecht et al. (1990) developed and validated the IEPS scale, which comprises 18 items rated on a 6-point scale. It comprises four subscales [16]. The IEPS is also a validated quantitative tool that uses a 6-point Likert scale (1 = strongly disagree to 6 = strongly agree, reverse scored) to measure perceptions of interprofessional collaboration and professional identity. It evaluates four key areas: (1) professional competency and autonomy (2), the need for cooperation among professions (3), actual cooperation and collaborative practice, and (4) understanding the value and contributions of other professions [17]. The IEPS is more practice-oriented, focusing on how students perceive their own profession in relation to others and how they envision working collaboratively in clinical settings.

Despite its popularity, the RIPLS has been questioned in some studies due to some psychometric issues and underlying factor structure [18, 19]. Nevertheless, it continues to be widely used internationally and provides valuable baseline data into students’ readiness for interprofessional learning. The IEPS complements the RIPLS by providing deeper insights into professional identity development and perceptions of interprofessional collaboration. Together, these instruments provide a more comprehensive understanding of both attitudinal readiness (RIPLS) and role perception (IEPS), which are critical for planning and designing effective IPE implementation [20]. It is important to recognize that RIPLS is education-focused while IEPS emphasizes practice-related perceptions, and this distinction is important when interpreting results.

IPE is a crucial component in the enhancement of healthcare professional training and has been assessed from various viewpoints across multiple countries and professions to increase the quality of healthcare. In a review, almost 50% of the data indicated a substantial enhancement in favorable attitudes toward interprofessional collaboration [2]. Nonetheless, diverse opinions regarding IPE have been reported across various academic levels [21]. IPE has demonstrated advantages in numerous worldwide scenarios [22, 23]. Nonetheless, attitudes toward and preparedness for IPE differ across cultural and institutional contexts [24]. There have been few studies on IPE in Saudi Arabia [25–27].

The aim of the current study was to evaluate the perceptions and attitudes of healthcare students toward interprofessional learning and collaboration to determine their readiness for IPE. The RIPLS and modified IEPS scales were used to determine perceptions and attitudes toward interprofessional learning and collaboration. These scales are designed to determine the readiness of students for IPE, which, in turn, helps in formulating new curricula on the basis of feedback from these surveys.

Research Question: What are the attitudes and perceptions of healthcare students at Jouf University regarding interprofessional learning and collaboration, and how do these perspectives differ by gender, academic year, and professional discipline?

Rationale: Assessing students’ readiness for interprofessional learning and their perceptions of professional identity and collaboration is essential for informing the development and potential integration of IPE initiatives and guiding future curriculum development. This study aims to provide baseline metrics on students’ attitudes and identify specific areas where IPE can be strengthened to better prepare students for collaborative practice in healthcare settings.

Study objectives

1. To evaluate healthcare students’ readiness for interprofessional learning using the RIPLS.

2. To assess healthcare students’ perceptions of professional competency and collaboration using the IEPS.

Methodology

Setting and participants

This study employed an exploratory, cross-sectional design to assess baseline attitudes and perceptions toward interprofessional learning and collaboration, rather than to test predefined hypotheses. This approach is appropriate in institutional contexts such as Jouf University, where no formal interprofessional education curriculum is currently in place and prior institutional data are limited. The study was conducted at Jouf University across five healthcare colleges: The College of Medicine, Dentistry, Health Sciences, Nursing and Pharmacy. All programs follow a five-year curriculum structure. The study was conducted from May 2025 to August 2025 and targeted undergraduate students from all academic years. Informal interprofessional learning opportunities have occurred over the past five years, with students in the current fifth year having the maximum exposure as their clinical rotations start from end of the third year.

A convenience sampling method was used to recruit participants from all five healthcare colleges from first to the fifth academic year. Students were recruited through classroom and lecture hall announcements; and electronic questionnaires were distributed via institutional email and learning management systems to ensure that absent students also had the opportunity to participate. This approach aimed to reduce selection bias and ensure broader representation across the student population. Participation was entirely voluntary, anonymous, and did not impact the academic progression. Students were informed that they could decline participation without any consequences.

All the enrolled students were eligible to participate in the study. The inclusion criteria were (1) active enrollment in one of the five healthcare colleges and (2) willingness to provide informed consent. The exclusion criteria were as follows: (1) students who were unwilling to provide informed consent and (2) students who completed internships or postgraduate training to ensure comparability of results across undergraduate cohorts.

Data collection

We employed two validated instruments, the RIPLS scale [13] and the modified IEPS scale [16, 20, 28]. Both the instruments were originally developed and validated in previous studies and have been widely employed to assess interprofessional learning attitudes and perceptions. The present study did not develop a new questionnaire; instead, it used these established tools with minor adaptation of the IEPS for local context. The English version of the scales is provided as Supplementary File 1.

1. Readiness for Interprofessional Learning Scale (RIPLS): A 19-item questionnaire using a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree). The RIPLS assesses readiness for teamwork and collaboration, perceptions of professional identity, and understanding of roles and responsibilities. Some items are reverse-scored to detect response bias [13].

2. The IEPS scale, originally developed by Luecht et al. (1990), is an 18-item, four-subscale instrument assessing perceptions of professional competence, the need for cooperation, interprofessional teamwork and the ability to understand the contributions of other professions [16]. We employed a modified 13-item version of the IEPS after reviewing the literature that used shortened forms of the scale to enhance the contextual appropriateness for our student population [20, 28]. The items were rated on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree, with reverse scoring), with higher scores indicating more positive perceptions. The modified version underwent reliability assessment (Cronbach’s α) in our dataset to ensure internal consistency.

In addition to the RIPLS and IEPS scales, a demographic questionnaire captured participants’ age, gender, college affiliation, year of study, and prior exposure to interprofessional learning activities. Data collection took place over a three-month period during the 2024–2025 academic year. Electronic questionnaires were distributed through the university’s learning management system as well as by email. Students were given two weeks to complete the surveys, and a reminder email was sent after the first week.

Both instruments have been previously validated across multiple international settings and have demonstrated good psychometric properties [20, 28–30]. The questionnaires were translated into Arabic and back translated to ensure linguistic accuracy and cultural relevance for use in the Saudi context. As Jouf University does not currently offer a formal interprofessional education curriculum, the findings reflect students’ readiness for and perceptions of interprofessional learning rather than the outcomes of implemented IPE interventions.

Data analysis

Statistical analysis was performed using SPSS version 26.0 (IBM Corp., Armonk, NY, USA). Descriptive statistics including means, standard deviations, frequencies, and percentages were generated to summarize participant demographics and survey responses.

For inferential statistics, independent samples t-tests were applied to compare mean scores between two groups (e.g., male vs. female students, junior vs. senior students). One-way ANOVA followed by Tukey’s HSD post hoc comparisons, was used to assess differences in mean scores across multiple groups (e.g., different academic years, different colleges). Effect sizes were calculated using Cohen’s d for t-tests and eta-squared (η²) for ANOVA to evaluate the practical significance of results. For Cohen’s d, values of 0.2, 0.5, and 0.8 were interpreted as indicating small, medium, and large effect sizes, respectively. Two-way ANOVA was performed to examine interaction effects between gender and student level (junior vs. senior).

Pearson’s correlation coefficient was used to examine association between RIPLS and IEPS scores. Internal consistency reliability of both scales was evaluated using Cronbach’s alpha (α), with 95% confidence intervals reported. Statistical significance was set at p < 0.05 for all analyses. The RIPLS (19 items) and the modified IEPS (13 items) were evaluated separately to ensure the reliability of the adapted instrument in the current study context.

The purpose of this study was to assess students’ readiness for interprofessional learning and their perceptions of professional collaboration, The insights gained from the findings are intended to support curriculum development and guide the implementation of IPE initiatives at Jouf University.

Ethical considerations

Participation in the study was entirely voluntary. All procedures were conducted in accordance with the ethical standards for research involving human participants and adhered to the principles of the Declaration of Helsinki. The study protocol was reviewed and approved by the Ethics Committee of Jouf University [Approval number: HAPO-13-S-001]. Electronic informed consent was obtained from all participants prior to accessing the questionnaires. To mitigate any ethical concerns regarding recruitment during class time, students were clearly informed that participation was voluntary, their responses would remain anonymous, and completing the survey would have no impact on their academic performance. Students were also given the option to complete the survey outside class hours if they wished. All data were securely stored on password-protected servers accessible only to the research team and were fully anonymized to protect participant confidentiality.

Results

Participant demographics

The RIPLS and the modified IEPS scales used consisted of 19 items and 13 items, respectively (Table 1). Males were predominant (66.7%), and the predominant age group overall was 20–23 years (79.2%). This gender distribution reflects the overall student population at Jouf University’s healthcare colleges.

Table 1.

RIPLS and the IEPS scales

Readiness for Interprofessional Learning Scale (RIPLS)	Modified Interdisciplinary Education Perception Scale (IEPS).
Teamwork and collaboration	Competency and autonomy
1. Learning with other students will help me become a more effective member of a healthcare team.	1. Individuals in my profession are well-trained.
2. Patients would ultimately benefit if healthcare students worked together to solve patient problems.	2. Individuals in my profession are very positive about their goals and objectives.
3. Shared learning with other healthcare students will increase my ability to understand clinical problems.	3. Individuals in my profession are very positive about their contributions and accomplishments.
4. Learning with healthcare students before qualification would improve relationships after qualification.	4. Individuals in my profession trust each other’s professional judgment.
5. Communication skills should be learned with other healthcare students.	5. Individuals in my profession are extremely competent.
6. Shared learning will help me to think positively about other professionals.	Perceived need for cooperation
7. For small-group learning to work, students need to trust and respect each other.	6. Individuals in my profession need to cooperate with other professions.
8. Team-working skills are essential for all healthcare students to learn.	7. Individuals in my profession must depend upon the work of people in other professions.
9. Shared learning will help me to understand my own limitations.	Perception of actual cooperation
Negative professional identity	8. Individuals in my profession are able to work closely with individuals in other professions.
10. I do not want to waste my time learning with other healthcare students.	9. Individuals in my profession are willing to share information and resources with other professionals.
11. It is not necessary for undergraduate healthcare students to learn together.	10. Individuals in my profession have good relations with people in other professions.
12. Clinical problem-solving skills can only be learned with students from my own department.	11. Individuals in my profession think highly of other related professions
Positive professional identity	12. Individuals in my profession work well with each other.
13. Shared learning with other healthcare students will help me to communicate better with patients and other professionals.	13. I would welcome the opportunity to work on small group projects with other health and social care students/professionals
14. I would welcome the opportunity to work on small-group projects with other healthcare students.
15. Shared learning will help to clarify the nature of patient problems.
16. Shared learning before qualification will help me become a better team worker.
Roles and responsibilities
17. The function of nurses and therapists is mainly to provide support for doctors.
18. I am not sure what my professional role will be.
19. I have to acquire much more knowledge and skills than other healthcare students

Over half of the participants (51.9%, n = 260) were from the College of Medicine. The contribution from other colleges is as follows: College of Pharmacy (12.57%, n = 63), College of Applied Medical Sciences (12.57%, n = 63), College of Dentistry (12.18%, n = 61), and College of Nursing (10.78%, n = 54). The overrepresentation of medical students reflects the larger cohort size in the College of Medicine compared to other healthcare programs.

With respect to educational level, most of the participants were second-year students (27.35%, n = 137), followed by third-year students (24.15%, n = 121), fourth-year students (19.36%, n = 97), first-year students (16.17%, n = 81), and fifth-year students (12.97%, n = 65). (Table 2). This distribution reflects the typical enrollment patterns across academic years at the institution.

Table 2.

Student demographics

Category	Subcategory	Number	Percentage (%)
Age Distribution	< 20	32	6.4
	20–23	397	79.2
	24–26	67	13.3
	27–32	5	1.0
Gender	Male	334	66.67
	Female	167	33.33
College Affiliation	College of Medicine	260	51.90
	College of Pharmacy	63	12.57
	College of Applied Medical Sciences	63	12.57
	College of Dentistry	61	12.18
	College of Nursing	54	10.78
Educational Level	1st Year	81	16.17
	2nd Year	137	27.35
	3rd Year	121	24.15
	4th Year	97	19.36
	5th Year	65	12.97

RIPLS and IEPS response patterns

Table 3 presents the distribution of responses for selected RIPLS and IEPS items.

Table 3.

RIPLS and IEPS statements and scores

Category	Statement	Score 5	Score 4	Score 3	Score 2	Score 1
RIPLS Scale	Learning with others makes me a more effective team member.	51.90%	10.38%	17.96%	10.98%	8.78%
	Patients benefit from interprofessional teamwork.	53.29%	10.58%	18.56%	9.38%	8.18%
	Shared learning improves clinical problem-solving.	52.30%	12.57%	16.77%	9.18%	9.18%
	Communication skills should be learned interprofessionally.	51.10%	12.57%	19.36%	7.58%	9.38%
	Teamwork skills are vital for all healthcare students.	54.49%	13.17%	16.37%	7.78%	8.18%
	“I don’t want to waste time learning with other professions.” (Reverse-scored)	9.78%	8.98%	18.36%	12.38%	50.50%
IEPS Scale	My profession is well-trained.	16.17%	29.94%	31.54%	12.18%	10.18%
	My profession trusts others’ professional judgment.	13.57%	32.73%	29.34%	13.57%	10.78%
	My profession needs to cooperate with other professions.	17.56%	29.14%	26.15%	14.37%	12.77%
	My profession works well with other professions.	15.77%	32.93%	26.55%	13.37%	11.38%

For RIPLS items assessing positive attitudes toward interprofessional learning, most students expressed agreement. For example, 54.49% strongly agreed that “teamwork skills are vital for all healthcare students,” and 53.29% strongly agreed that “patients benefit from interprofessional teamwork.” The reverse-scored item “I don’t want to waste time learning with other professions” showed that 50.50% strongly disagreed, indicating positive attitudes toward interprofessional learning.

There was strong support for shared learning (> 50% scores of 4–5 on RIPLS). Analysis of the RIPLS professional identity item ‘I am not sure what my professional role will be/is’ revealed a non-linear developmental pattern across academic years (Fig. 1). Professional role uncertainty increased from 28.7% in first-year students to 80.4% in fourth-year students before partially decreasing to 69.2% in the final year.

Fig. 1.

Professional role uncertainty by academic year, based on RIPLS item: “I am not sure what my professional role will be/is.” (A) Percentage of students reporting uncertainty using two thresholds: agree/strongly agree (scores 4-5) and strongly agree only (score 5). (B) Count of students by certainty status. Error bars represent 95% confidence intervals for percentages (Panel A). Total sample sizes: 1st year n=80, 2nd year n=134, 3rd year n=121, 4th year n=97, 5th year n=65

For IEPS items, responses were more distributed across the scale. Approximately 32.93% agreed that “my profession works well with other professions,” while 31.54% were neutral about whether “my profession is well-trained.” These patterns suggest that while students generally have positive attitudes toward interprofessional learning, their perceptions of their own professional identity and collaborative practices are still developing.

Year-wise differences in RIPLS and IEPS scores

Table 4 presents the mean RIPLS and IEPS scores across academic years. RIPLS results revealed strong evidence that RIPLS scores differ across years (Significant ANOVA: F (4, 496) = 20.17, p < 0.001, η² = 0.140). Score progression from the 1st year (2.86 ± 1.46) to the 5th year (4.48 ± 0.99) clearly increased (Δ = +1.62 from the 1st to the 5th year) with a large effect size (η² = 0.140). This progressive increase indicates that students’ readiness for interprofessional learning strengthens as they advance through their educational program. Post hoc findings revealed that the 1st-year scores were lower than those in all other years (all p < 0.05), whereas the 4th/5th-year scores were higher than those in the 2nd/3rd-year years (p < 0.05). No significant difference was observed between the 4th and 5th years (p = 0.994) (Table 4).

Table 4.

RIPLS and IEPS scores with yearwise differences

Scale	Year	n	Mean ± SD	ANOVA (F, p)	Significant Post hoc Comparisons (Tukey HSD)	Effect Size (η²)
RIPLS	1st year	81	2.86 ± 1.46	F = 20.17, p < 0.001	1st vs. 2nd, 3rd, 4th, 5th (all p < 0.05)	0.140 (Large)
	2nd year	137	3.77 ± 1.39		2nd vs. 4th, 5th (p < 0.05)
	3rd year	121	3.86 ± 1.31		3rd vs. 4th, 5th (p = 0.021, p = 0.016)
	4th year	97	4.39 ± 1.12		4th vs. 5th (p = 0.994, NS)
	5th year	65	4.48 ± 0.99
IEPS	1st year	81	3.02 ± 1.36	F = 3.01, p = 0.018	1st vs. 2nd, 3rd (p < 0.05)	0.024 (Small)
	2nd year	137	3.44 ± 1.01		2nd vs. 4th (p = 0.132, NS)
	3rd year	121	3.49 ± 1.09		3rd vs. 4th, 5th (p = 0.132, p = 0.718, NS)
	4th year	97	3.11 ± 1.29		4th vs. 5th (p = 0.933, NS)
	5th year	65	3.26 ± 1.18

The IEPS results revealed a significant difference across years (ANOVA: F(4, 496) = 3.01, p = 0.018, η² = 0.024), indicating a statistically significant but small effect. The score pattern peaked in the 2nd and 3rd years (3.44–3.49), with a modest decline in the 4th year (3.11 ± 1.29) and partial recovery in the 5th year (3.26 ± 1.18) with a small effect size (η² = 0.024). Post hoc findings revealed no significant pairwise differences after correction (Table 4). This trend indicates that students’ perceptions of professional competency and collaboration may evolve distinctly than their readiness for interprofessional learning.

Gender differences in RIPLS and IEPS scores

Table 5 presents gender differences in RIPLS and IEPS scores, stratified by junior (years 1–3) and senior (years 4–5) student levels. Junior students showed significant gender differences on both scales. For the IEPS scale, males scored higher (M = 3.5, SD = 1.04) than females did (M = 3.1, SD = 1.25; t = -2.83, df ≈ 337, p = 0.005), with a small effect size (d = -0.32). For the RIPLS scale, males reported greater team effectiveness (M = 3.8, SD = 1.38) than females did (M = 3.3, SD = 1.45; t = -3.47, p = 0.001, d = -0.38) (Table 5), these findings indicate that male students in early years expressed greater readiness for interprofessional learning and more positive perceptions of professional competency.

Table 5.

Mean scores and sex differences in the RIPLS and IEPS scores

Level	Scale	Female N	Female (Mean)	Female (SD)	Male (N)	Male (Mean)	Male (SD)	t	df	p	Cohen’s d
Junior	IEPS (Profession Well-Trained)	140	3.1	1.25	199	3.5	1.04	-2.83	≈ 337	0.005	-0.32
Junior	RIPLS (Team Effectiveness)	140	3.3	1.45	199	3.8	1.38	-3.47	≈ 337	0.001	-0.38
Senior	IEPS (Profession Well-Trained)	27	2.9	1.12	135	3.2	1.26	-1.41	≈ 160	0.166	-0.29
Senior	RIPLS (Team Effectiveness)	27	4.7	0.71	135	4.4	1.12	2.26	≈ 160	0.028	0.40

Note: Junior students are defined as those in years 1–3, while senior students are those in years 4–5. This classification applies uniformly across all healthcare programs, which follow a five-year curriculum structure

Senior students exhibited mixed results: In the IEPS scale, no significant gender difference (p = 0.166) was observed, whereas in the RIPLS scale, females scored higher (M = 4.7, SD = 0.71) than males did (M = 4.4, SD = 1.12; t = 2.26, p = 0.028), with a moderate effect (d = 0.40). suggesting stronger teamwork orientation and readiness for interprofessional collaboration among female students in advanced years. Gender disparities in perceptions of teamwork (RIPLS) and professional competence (IEPS) vary by training level, with junior males scoring higher overall and senior females outperforming in teamwork (Table 5).

Gender × student level interaction

Table 6 presents the results of a two-way ANOVA the effects of gender and student level on RIPLS scores revealed significant main effects for both gender (F(1, 497) = 7.34, p = 0.007, ηp² = 0.015) and student level (F(1, 497) = 34.48, p < 0.001, ηp² = 0.065). Most importantly, a significant interaction was found between gender and student level (F(1, 497) = 8.79, p = 0.003, ηp² = 0.017), indicating that gender differences in RIPLS scores depend on whether students are juniors or seniors. Specifically, male students show higher scores in junior years, but female students show higher scores in senior years, suggesting that gender differences in attitudes toward interprofessional learning evolve as students’ progress through their education.

Table 6.

Two-way ANOVA results for RIPLS scores (Gender × student level Interaction)

Effect	F value	p value	ηp²	Significance
Gender (Main Effect)	7.34	0.007	0.015	*
Student Level (Main Effect)	34.48	< 0.001	0.065	***
Gender × Student Level (Interaction)	8.79	0.003	0.017	**

*Note: ηp² = partial eta-squared (effect size)

*p < 0.05

**p < 0.01

***p < 0.001

Correlation between RIPLS and IEPS scores

Table 7 presents the correlation analysis between RIPLS and IEPS scores. A moderate positive correlation (r = 0.356) exists between the RIPLS and IEPS scores. Higher RIPLS scores are associated with higher IEPS scores. The p value (< 0.001) indicates that this correlation is extremely unlikely to be due to chance (Table 7). The findings indicate that students with higher readiness for interprofessional learning (RIPLS) also tend to have more positive perceptions of professional competency and collaboration (IEPS). This relationship suggests that confidence in one’s own profession is associated with greater willingness to engage in interprofessional learning activities. The effect size is moderate according to Cohen’s guidelines (0.3 ≤ |r| < 0.5), indicating a meaningful relationship between the two constructs.

Table 7.

Correlation results for the RIPLS vs. IEPS

Metric	Value	Interpretation
Pearson Correlation (r)	0.356	Moderate positive relationship
p value	< 0.001	Extremely statistically significant (not due to chance)
Effect Size	Moderate	Cohen’s guideline: 0.3 ≤ |r| < 0.5
Direction	Positive	Higher RIPLS scores associate with higher IEPS scores

Internal consistency reliability

Table 8 presents the internal consistency reliability of both scales. Cronbach’s alpha results show excellent internal consistency for both scales (RIPLS/IEPS). All scales exceeded the threshold for excellent reliability (α > 0.9), indicating strong internal consistency (Table 8).

Table 8.

Internal consistency of RIPLS/IEPS

Scale	Cronbach’s Alpha (α)	95% CI	Reliability Level	Interpretation
RIPLS	0.943	[0.935, 0.950]	Excellent	Very high item consistency
IEPS	0.914	[0.902, 0.924]	Excellent	Strongly coherent scale

Discussion

IPE provides valuable opportunities for healthcare students to engage with peers from other specialties and develop the competencies required for effective interprofessional practice [28]. Its primary aim is to improve students’ capacity for coordinated collaborative care by enhancing key elements of interprofessional competence such as communication, role clarity, and teamwork, thereby facilitating improved health outcomes [2]. Prompt and well-structured implementation of IPE as an educational approach connects students from different disciplines, resulting in greater interprofessional collaboration and contributing to the strengthening of their professional identity [28].

This study examined healthcare students’ readiness for interprofessional learning and their perceptions of professional competency and collaboration at Jouf University, Saudi Arabia. The results of the present study demonstrate that students generally hold positive attitudes toward interprofessional learning and collaboration, with these attitudes being influenced by academic progression and gender.

The response rate in our survey was 99.20%. Demographics revealed a predominantly young (20–23 years), male majority sample, with most of the participants from the College of Medicine (Table 2). The distribution is suggestive of the regional context of healthcare education and provides context for the findings. In their study, Desiree Annabel Lie et al. reported a response rate of 82%, with the majority being females aged 25–30 years [20]. Prior exposure to interprofessional learning activities in our study was low (21.8%), suggesting a need for early curricular integration.

Progressive increase in readiness for interprofessional learning

High agreement with positive RIPLS statements, especially those reflecting the value of teamwork and shared learning, indicate firmly rooted positive perceptions and strong foundational attitudes toward interprofessional learning and collaboration. In contrast, the reverse-scored item “I don’t want to waste time learning with other professions” was associated with substantial disagreement, reflecting a consistent endorsement of interprofessional values (Table 3). Professional role uncertainty showed a non-linear developmental pattern, increasing from 28.7% in first-year students to 80.4% in fourth-year students before partially decreasing to 69.2% in the final year. This suggests that clinical training may initially heighten rather than resolve role ambiguity, with implications for interprofessional education timing and support.

The most notable finding was the marked progression in RIPLS scores, which increased substantially from first-year students (2.86 ± 1.46) to fifth-year students (4.48 ± 0.99), representing an increase of 1.62 points. A consistent upward trend in the RIPLS scores with academic progress (p < 0.001) (Table-4) indicates increased appreciation for interprofessional collaboration and team-based care as students advance through academic years. This is likely influenced by greater clinical exposure and opportunities for collaborative learning experiences. The large effect size (η² = 0.140) underscores the practical importance of these differences. Similar findings have been reported by researchers in several studies [31–35].

First-year students consistently scored lower than all other academic levels did, which implies that the students are primarily engaged in acquiring discipline-specific foundational knowledge and have a limited understanding of other healthcare professions as well as a lack of clinical exposure. The marked improvement between the first and second years (2.86 to 3.77) indicates that early clinical exposure and introductory interprofessional activities positively influence student attitudes, supporting the need for early integration of IPE in healthcare curricula.

RIPLS scores peaked at the fourth (4.39 ± 1.12) and fifth years (4.48 ± 0.99), with no significant difference between these groups. This plateau effect suggests that by the fourth year, students have developed a mature outlook on interprofessional collaboration that remains stable through graduation. Their extensive clinical experience, exposure to multidisciplinary healthcare teams, and advanced understanding of patient care complexities contribute to this sustained high level of readiness for interprofessional learning.

However, it is important to acknowledge that this study cannot attribute differences in RIPLS scores to formal IPE activities, as Jouf University does not currently offer a structured IPE curriculum. Students start their clinical placements towards the end of third academic year, and these authentic practice environments likely play a major role in shaping their readiness for interprofessional collaboration. Prior research has shown that clinical exposure itself can foster interprofessional learning by providing natural opportunities for teamwork and shared problem-solving among students from different health professions [36, 37]. Because the quantitative tools used in this study cannot establish causality or distinguish the influence of informal interprofessional exposures from that of routine clinical training, this represents an important limitation. Future mixed-methods research is needed to explore the specific factors that shape students’ attitudes and perceptions toward interprofessional learning in greater depth.

Evolving perceptions of professional identity and collaboration

Compared with the RIPLS results, the IEPS results exhibited a distinctly different pattern. Second- and third-year students presented peak IEPS scores (3.44–3.49), followed by a modest decline in the fourth year (3.11 ± 1.29) and partial recovery in the fifth year (3.26 ± 1.18), which may reflect “reality shock” in the clinical years. While still showing year-level differences, the progression was less linear, and the effect size was notably smaller. Although ANOVA yielded a statistically significant result (p = 0.018), post hoc analyses did not reveal significant pairwise differences except between the 1st year and the 2nd/3rd year (Table-4). These findings indicate that students in the early and middle years of study may develop idealized perceptions of their profession and interprofessional collaboration. As they progress to clinical years and encounter real-world healthcare environments, they may experience challenges that temper these perceptions. Several factors may contribute to this pattern, though without qualitative data, these remain interpretative hypotheses requiring further investigation:

1. Clinical Reality and Workplace Challenges: Senior students in their clinical training may face challenges such as professional hierarchies, communication barriers, resource constraints, and time pressures all of which can hinder effective interprofessional collaboration [38–40]. These experiences may lead to more realistic, though potentially less idealized, perceptions of collaborative practice.

2. Professional Identity Consolidation: During the later years of training, students often focus on developing their individual professional identity and core competencies, which could temporarily lessen their emphasis on interprofessional aspects [41–43]. This represents a natural part of professional development and does not necessarily indicate negative attitudes toward collaboration.

3. Increased Awareness of Professional Boundaries: Clinical experiences often deepens students’ understanding of scope of practice limitations, professional responsibilities, and accountability, which may, in turn, shape their perceptions of interprofessional interactions [42, 44].

It is important to note that these explanations are speculative and not directly substantiated by the data collected in this study. Future research employing qualitative approaches such as focus groups or interviews would provide deeper insight into the factors underlying the observed IEPS score trends and offer a richer understanding of students lived experiences with interprofessional learning and collaboration. Despite these findings, the scale exhibited excellent internal consistency, as indicated by Cronbach’s alpha (α = 0.914), supporting its reliability in assessing the target construct (Table 8). A clear-cut emphasis has been laid down by several studies whereby the importance of professional identity has been clearly explained, and its incorporation is considered necessary while reframing medical education [45–49].

Gender and academic level differences and their evolution

The gender-related trends observed in this study reveal dynamic shifts as students’ progress through their education.

Level-dependent gender effects

A complex interaction was observed between gender and educational level, with the relationship varying significantly between junior and senior students. This interaction effect (F = 8.79, p = 0.003) indicates that gender differences in attitudes toward interprofessional learning and collaboration are not consistent across all educational levels (Table 5).

Junior student gender patterns

Among junior students, male students reported higher RIPLS and IEPS scores than their female counterparts, suggesting greater initial readiness for interprofessional learning and more positive perceptions of professional competency. Male students had greater team effectiveness perceptions (3.8 vs. 3.3) and higher professional competence ratings (3.5 vs. 3.1) (Table 5). Although statistically significant, these differences reflect small to moderate effect sizes.

Senior student gender reversal

Among seniors, a contrasting trend was observed, where females achieved higher RIPLS scores (4.7 vs. 4.4; p = 0.028) but no significant difference in IEPS scores (Table 5). This reversal suggests that female students’ attitudes toward interprofessional collaboration strengthen more substantially and that they develop strong team-related competencies with greater experience and maturity. Two-way ANOVA (p = 0.003) further validated this interaction, confirming that gender-related differences are context dependent and influenced by academic level (Table 6).

The significant interaction between gender and student level (p = 0.003) indicates that gender-related differences in attitudes toward interprofessional learning are dynamic and evolve as the students’ progress through their education. Several factors may help explain these patterns; however, these should be interpreted as possibilities rather than established explanations:

1. Cultural and Gender Role Influences: Cultural norms and gender expectations in Saudi Arabia may influence how male and female students initially perceive their professional roles and collaborative relationships. These perceptions may evolve as students gain more education and clinical experience [50, 51].

2. Learning and Adaptation: As their training progresses, female students may develop stronger collaborative attitudes and teamwork skills, possibly as an adaptive response to the professional settings they encounter [51, 52]. However, this interpretation requires validation through qualitative research to understand the actual experiences and perspectives of students.

3. Confidence Development: The findings do not indicate that female students lack confidence overall. Rather, the trends suggest that female students’ attitudes toward interprofessional collaboration become stronger particularly in senior years, which may be linked to professional maturity, greater clinical exposure, or effective engagement with interprofessional activities [53].

It is critical to emphasize that these gender differences should be interpreted cautiously and not used to make causal conclusions without solid evidence. The findings indicate that adopting gender-responsive approaches in the design of future IPE initiatives may be beneficial; however, such strategies should be informed by a clear understanding of students’ actual needs and experiences rather than assumptions about gender-related deficits.

Correlation between the RIPLS and IEPS

The RIPLS includes items that assess both positive and negative indicators of professional identity. Positive professional identity involves confidence in one’s professional role and recognition of one’s contributions to patient care, while negative professional identity involves professional superiority, stereotyping of other professions, and reluctance to collaborate [43, 44].

A statistically significant, moderate positive correlation (r = 0.356, p < 0.001) was observed between the RIPLS score and the IEPS score (Table 7). This underscores the relationship between students’ willingness for interprofessional learning and self-perceptions within their profession. Students who place greater value on interprofessional learning tend to have a stronger sense of professional identity, reinforcing the relationship of these constructs in health profession education [54, 55]. This evidence challenges the notion that interprofessional education might undermine professional identity or cause role uncertainty. The findings support a complementary model of professional development, where strong professional identity enhances rather than hinders interprofessional collaboration readiness. The moderate strength of this correlation indicates that these constructs, while related, represent different facets of professional development. This distinction has important implications for curriculum development, highlighting the need to address professional identity formation and interprofessional competency development as separate but complementary objectives, each requiring targeted educational strategies.

However, it should be noted that this study assessed confidence in one’s profession through IEPS items related to perceptions of professional training and competency. Although such confidence may relate to aspects of professional identity, the two concepts are not the same. Future research should employ instruments specifically developed to measure professional identity formation to more accurately explore how it relates to readiness for interprofessional learning.

Reliability and measurement considerations

Both scales demonstrated excellent internal consistency (RIPLS α = 0.943, IEPS α = 0.914), confirming their reliability and supporting the validity of the findings (Table 8). These coefficients indicate that the scales reliably captured the targeted constructs across a varied sample of healthcare students.

Implications for healthcare education

Curriculum development

The upward trend in RIPLS scores highlight the importance of planning for early and sustained IPE integration. Early exposure can help cultivate positive attitudes toward interprofessional learning, while continued activities in later years can further strengthen and refine collaborative skills.

Support for clinical-year students

The modest decline in IEPS scores during clinical years indicates that the students may require additional support to effectively navigate the challenges of interprofessional collaboration in real practice settings. This could include structured reflection opportunities, mentorship from interprofessional teams, and guided debriefing sessions to process clinical experiences [37, 56].

Gender-responsive approaches

The shifting gender patterns suggest that IPE initiatives should be designed to engage all students effectively while remaining sensitive to potential gender-related variations in attitudes and experiences. This does not imply developing different interventions for male and female students but rather ensuring that IPE activities are inclusive and responsive to diverse learning needs.

Professional identity integration

Given that both IPE activities and clinical exposure appear to shape students’ development of interprofessional competencies, curricula should purposefully link classroom-based IPE with clinical practice opportunities. This alignment can help students transfer learning from educational settings to real-world collaborative practice [57, 58].

Strengths and limitations

This study has several strengths, including the use of two validated instruments that provide complementary insights into students’ readiness for interprofessional learning and their professional perceptions, a relatively large sample size spanning multiple healthcare professions and all academic years, and rigorous statistical analysis with effect size reporting.

However, several important limitations must be acknowledged:

1. Cross-Sectional Design: The study’s cross-sectional design limits the ability to draw conclusions about causality or track individual students’ attitude changes over time. Longitudinal research following the same cohort throughout their academic progression would provide more robust evidence on how attitudes evolve and what factors shape these changes.

2. Convenience Sampling: The use of convenience sampling may have led to selection bias, potentially attracting higher participation from more engaged students. Furthermore, the overrepresentation of medical students (51.9%) and second-year students (27.35%) may affect the extent to which the findings can be applied to other disciplines and academic cohorts.

3. Single Institution: The data were drawn from a single university in Saudi Arabia, which may restrict generalizability to other institutions with different IPE implementations, student demographics, or cultural environments.

4. Use of Quantitative Methods and Lack of Causal Explanation: The exclusive use of quantitative instruments restricts the study’s ability to fully understand why students hold certain attitudes or what specific factors influence their perceptions. Incorporating qualitative or mixed-methods approaches such as interviews, focus groups, or open-ended survey questions would provide deeper insight into students’ experiences and help clarify the mechanisms underlying observed patterns.

5. Response Rate and Recruitment Method: Although the 90.20% response rate is commendable, recruitment through class announcements and during scheduled class sessions may have created perceived pressure to participate despite assurances of voluntary participation. This could potentially affect the representativeness of the sample.

6. Age of RIPLS Instrument: Although RIPLS has been critiqued for being somewhat outdated, it remains widely used internationally and provides valuable comparative data. Future research might consider incorporating newer instruments or developing culturally adapted tools tailored to the Saudi context.

Future research directions

Future research should address these limitations through:

1. Longitudinal studies tracking individual students’ attitudes over time.

2. Multi-institutional studies across different Saudi universities.

3. Mixed-methods research combining quantitative surveys with qualitative interviews or focus groups to explore causality and understand students lived experiences.

4. Development and validation of culturally adapted instruments for assessing IPE outcomes in Middle Eastern contexts.

Conclusion

The study highlights a generally positive outlook among healthcare students of Jouf university toward interprofessional collaboration and professional identity, with noticeable improvement over academic progress. Gender and academic progression significantly influenced these attitudes, with male students showing initially higher scores in junior years while female students demonstrated stronger teamwork orientation in senior years. The moderate association between RIPLS and the IEPS further emphasizes the link between readiness for teamwork and perceptions of professional identity.

These findings underscore the importance of considering early integration of interprofessional education within health curricula and encouraging tailored strategies with respect to gender and academic level. However, the modest decline in professional perception scores during clinical years highlights the need for additional support to help students navigate real-world interprofessional collaboration challenges. The results provide valuable information for educators involved in designing IPE programs to better prepare graduates for interprofessional practice.

Future research should employ longitudinal and mixed-methods approaches to validate these trends and explore causality as well as develop evidence-based strategies for enhancing IPE effectiveness in preparing healthcare students for collaborative practice.

Abbreviations

IPE

Interprofessional education

RIPLS

Readiness for Interprofessional Learning Scale

IEPS

Interdisciplinary Education Perception Scale

IPC

Interprofessional collaboration

PE

Practical education

Authors’ contributions

Conceptualization, E.A., F.A. and M.I.; methodology, E.A., F.A. and M.I.; software, E.A., F.A. and M.I.; validation, F.A., E.A., and M.A.; formal analysis, F.A. and M.A.; investigation, E.A., F.A. and M.A.; resources, E.A., F.A. and M.A.; data curation, E.A., F.A. and M.A.; writing—original draft preparation, E.A., F.A. and M.I.; writing—review and editing, E.A., F.A., M.I., and M.A.; visualization, E.A., F.A. and M.A.; supervision, E.A., and F.A.; project administration, E.A., F.A. and M.A.; funding acquisition, E.A. All authors have read and agreed to the published version of the manuscript.

Funding

“This work was funded by the Deanship of Graduate Studies and Scientific Research at Jouf University under grant No. (DGSSR-2025-NF-01-019)”.

Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Declarations

Ethics approval and consent to participate

The study adhered to the Declaration of Helsinki, and the study protocol was approved by the Ethics Committee of Jouf University [Approval number: HAPO-13-S-001]. Informed consent to participate in the study was obtained from all the participants.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.