Immersive Explorations: Transformative Experiences in Inter-Professional Education through Scenario-Based Learning

Abstract

This chapter discusses the importance of scenario-based learning in interprofessional education and its transformative effects from theory to practice. The literature review shows that there is a growing interest and importance in this field between 2006 and 2023. Scenario-based learning offers students and health professionals the opportunity to develop practical skills through real-world scenarios. Educational theories (behaviorism, cognitivism, constructivism, connectionism, and experiential learning) support the design and implementation of this learning approach. Key principles of scenario writing include setting learning objectives, relevance to the target audience, realism, participant-centered development, inclusion of complex cognitive skills, use of activities and tools, detailed and clear descriptions, encouragement of reflective and critical thinking, evaluation, and feedback mechanisms. Ideal interprofessional education scenarios should be based on interprofessional knowledge exchange, be realistic, and develop students’ problem-solving and decision-making skills. This process should be standardized through scenario templates and continuously reviewed. In this section, where all the theoretical knowledge is put into practice, an example of a workshop and an example of a scenario prepared in the workshop are presented.

1. Introduction

Interprofessional education is a learning model that emphasizes the sharing of knowledge and skills between two or more different professional groups. In the ever-changing environment of healthcare, Interprofessional Education (IPE) is becoming increasingly important. This chapter focuses on the intricacies of IPE scenario writing for new graduates in preparation for the complexities of collaborative practice in healthcare settings. We begin by examining the basic principles of IPE and highlighting the importance of promoting a collaborative, patient-centered approach among health professionals.

At the center of the discussion is the art and science of scriptwriting, combining theoretical knowledge with practical application. This chapter aims to guide educators in creating realistic, engaging, and educational scenarios that will effectively prepare undergraduate students for the challenges of interprofessional teamwork. Through these scenarios, students can experience the dynamics of healthcare settings and gain valuable insight into the communication, coordination, and ethical issues necessary for quality patient care.

In this journey of discovery, we highlight the impact of well-crafted scenarios on student engagement, critical thinking, and the development of a collaborative generation. Our aim is not only to inform but also to prepare tools to create effective learning experiences that inspire the next generation of healthcare professionals.

In this section, interprofessional education is emphasized as a key component and the role of scenario-based learning in this context and how the sample scenarios were developed are discussed in detail. Within the scope of experience sharing, the importance of scenario-based learning, scenario writing processes, and sample scenario development experiences were shared in detail.

2. Interprofessional education: definition and importance

Interprofessional education is a learning process in which professionals from different professions such as health, social engineering, communication, etc. come together to learn and teach through each other, sharing experience and knowledge. This type of education is critical for solving complex problems and promoting effective communication [1, 2]. By its very nature, interprofessional education is an educational strategy in which different health professionals benefit from their own knowledge, skills, and attitudes as well as the knowledge, skills, and attitudes of other health professionals with whom they receive training and, most importantly, from their professional and educational experiences. When this interaction is created, the existing knowledge, skills, and attitudes of individuals change radically, enabling them to gain new gains through this interaction and reflection [3, 4]. IPE provides opportunities for students and professionals to understand the roles, responsibilities, and perspectives of different disciplines and to adopt a patient-centered approach. In the literature, there are many learning methods for the implementation of interprofessional education. One of the key aspects to improving students’ interprofessional collaboration, communication, and understanding of professional roles, values, ethics, and team-based patient care is to integrate interactive elements into teaching and learning. These methods include educational approaches such as scenario-based learning, peer learning, team-based learning, team-based case analysis, small group activities, problem-based learning, role-playing, digital learning platforms, videos, and simulation. The vast majority of these methods are actually based on scenario and team learning in IPE [5, 6, 7, 8].

Student-centered, active learning strategies such as team-based learning, scenario-based learning, and problem-based learning are reported to be increasingly used in health professions classrooms [7, 9]. It was stated that in order to achieve maximum efficiency with these approaches, people should have knowledge about the theoretical background of the subject before the lesson, and the time allocated in these programs should be organized in a way to support collaborative learning [9, 10]. Especially in educational activities involving students from different disciplines, it is stated in the literature that students should interact with each other in small groups and teams while discussing or working, and as a result of this interaction, feedback should be given about the product produced by the teams [7, 11]. Although the level of evidence is low, the positive change in student attitudes supports the continued inclusion of IPE in health professional education to improve collaboration skills and patient care outcomes [12].

The most commonly used scenario-based learning (SBL) program in interprofessional education helps students develop their ability to analyze situations and generate solutions [13]. It is an educational approach that utilizes real-life scenarios. This method involves students working together to analyze and solve problems based on realistic situations and allows them to apply their knowledge and skills in a practical context. SBL has been recognized as an effective strategy to promote deeper learning and understanding as it provides students with the opportunity for active learning and critical thinking [14].

The role of scenario writing in interprofessional education is to shape a future that improves some aspects of the present. Scenario writers formulate their ideas by visualizing them within an interprofessional reality. These scenarios describe not only what reality could be like, but also improvements in interprofessional education and how they could be realized. Creative scenarios are one of our most effective tools, like knowledge, to accelerate and strengthen interprofessional relationships; they are important for repairing relationships that break down faster than is usually recognized [15].

3. Scenario-based learning: basic principles

A scenario provides a systematic and narrative description of a particular future. In education, scenarios can provide realistic and feasible alternative futures, enabling health professionals to think and learn in complex decision-making processes. This helps participants to assess situations from different perspectives, consider possible outcomes, and develop strategic thinking skills under uncertainty. For example, a scenario could examine the possible outcomes of different treatment approaches in the event of a specific health crisis, so that professionals can make the most appropriate decision among various scenarios [16].

Scenario-based learning is an effective teaching strategy that provides students with learning opportunities around a specific scenario or story This method allows students to better understand and apply knowledge by using real-world scenarios [14, 17].

Scenario-based learning is emerging as an effective tool in global health education. SBL uses scenarios that mimic real-world conditions, assigning participants a specific role and engaging them in a series of problem-solving or situation exploration activities around a realistic story. This approach helps learners develop their cognitive, metacognitive, and affective skills [14].

Nowadays, the use of scenarios in healthcare education has become an indispensable learning tool for students. As communication errors and misunderstandings pose a critical challenge to improving healthcare delivery, scenario writing in interprofessional education is becoming increasingly important to overcome these challenges [15, 18].

In the context of interprofessional learning, the act of scriptwriting requires creativity, and a multiprofessional approach should be adopted. Creativity is defined in the literature as a phenomenon that includes at least four basic characteristics. First, it produces something original, that is, it is different and innovative. It is also useful for improving an existing situation and is valuable because of the improvement it brings. Creativity is a multifaceted phenomenon that results in some kind of tangible or intangible product. It is a process in which each individual’s creativity needs to be assessed and utilized because scriptwriting is a creative activity that is fed by different perspectives. Creative thinking involves a range of cognitive abilities that interact with each other. These abilities include generating a variety of ideas quickly, shifting to different concepts with mental flexibility, generating statistically rare and unique responses, conducting detailed analyses, and keeping an open mind. These cognitive capacities are thought to work integratively through collaboration. These capacities are developed in a collaborative effort through the interaction of people from different areas of expertise and approaches to problem-solving. As shown in the following section, the integration of these attributes, each of which is critical to the development of a creative scenario, is important for effectively guiding the creative process [15].

The aim of this study is to emphasize how scenario writing is critical to enhance communication, increase understanding, and improve educational processes among health professionals and to provide an interprofessional perspective to understand the impact of scenarios used in interprofessional education on student diversity and the health system.

4. Sharing experience on scenario development in interprofessional education

The theoretical background of the scenarios and the planned workshop was tried to be created with the literature on scenario writing in interprofessional education, and a workshop booklet was prepared with the information in the literature and designed to be used as a guide in the trainer meetings. The discussions were carried out with the concept framework prepared with the support of the literature, areas of competence in IPE, scenario-based training examples, and measurement and evaluation tools in the literature were compiled and shared with the faculty members at the workshop.

4.1 Findings from the literature review

As a result of the review of studies on scenario writing in interprofessional education and the Google school literature search in the field of scenario-based interprofessional education, a total of 39 articles were accessed between 2006 and 2023. Of these 39 articles, 9 are related to simulation applications but do not provide direct information about the use of scenarios. Most of the remaining 30 articles were published in 2023 (n:12; 40%) and 2022 (n:4; 13.33%), and the articles published in these years constitute more than 50% of the total. When all 30 articles are read, it is seen that 26 of them use scenarios in simulation applications, but no detailed information about scenario-based applications is given. When four articles were analyzed, the information in the Table 1 below was obtained [8, 17, 19, 20].

Article names	Authors	Published in Journal	Year of Publication	Objective	Conclusion	Scenario used	Professions and students mentioned in the article	Methods used	Practical applications
Encouraging Study in Health Sciences: Informing School Students Through Interprofessional Healthcare Simulations [19]	Christian Moro, Charlotte Phelps	Simulation in Healthcare	31/05/2023	The article does not mention specific interprofessional training scenarios.	Case-based learning with inter-professional hands-on experiences is effective in introducing students to future work options and career pathways in primary and allied health.	Participants worked on 3 simulated scenarios during the 1-day event.	“Health Simulation Experience” introduces high school students to careers in healthcare.	Using a case-based learning approach	The “Health Simulation Experience” is an effective way to inform high school students about careers in health. The use of case-based learning with inter-professional hands-on experiences is an effective approach to introduce students to future work options and career paths in primary and allied health care.
Engaging Student Learners in Interprofessional Simulations using Halloween-Themed Scenarios [20]	Chase DuBois	Interprofessional Practice & Education	19/07/2023	The article describes the development and implementation of Halloween-themed interprofessional simulation scenarios for healthcare students to develop their emergency management and teamwork skills.	The largest perceived change was observed in Communication.	Scenarios addressed cardiac arrest and CPR/AED skills, opioid overdose and Narcan treatment, emphasizing bleeding control and identifying hazards in the home environment for patient safety.	Health students from various disciplines such as athletic training, biology, clinical research, exercise science, wellness, medicine, nursing, public health, recreational therapy, respiratory therapy and social work participated in the simulations.	Single group post-test questionnaire design.	Improving communication skills in health students
Patient safety interprofessional education program using medical error scenarios for undergraduate nursing and medical students in Korea [8]	Hea Kung Hur Ki Kyong Kim, Young Mi Lim, Junghee Kim, Kyung Hye Park, Yon Chul Park	Journal of Interprofessional Care	08/03/2023	The article discusses a patient safety interprofessional education program that uses medical error scenarios to enhance patient safety motivation and interprofessional learning attitudes among medical and nursing students.	The results of the medical scenario review of the patient safety IPE program showed increased motivation for patient safety among students and contributed to improving IPE learning attitudes by enhancing teamwork and collaboration.	The patient safety IPE program uses medical error scenarios.	The study aimed to improve attitudes to interprofessional learning among medical and nursing students.	Lectures, case studies, role-play and simulation activities	Improved motivation for patient safety among students
Does Interprofessional Scenario-Based Simulation Training Change Attitudes Toward Interprofessional Learning – A Pretest-Posttest Study [17]	Marit Hegg Reime, Morten Aarflot, Fred-Ivan Kvam	Journal of Multidisciplinary Healthcare	22/12/2022	To investigate readiness for interprofessional learning (IPL) among Norwegian healthcare students at undergraduate, graduate, and postgraduate levels before and after participating in a one-day scenario-based simulation training course.	Our sample of Norwegian healthcare students shows readiness for IPL. The RIPLS has the ability to measure important changes in attitudes both within each profession and across professions.	Hypovolemic shock, anaphylactic reaction, a child with a febrile seizure and low blood sugar, and a trauma patient who lost consciousness due to increased intracranial pressure	The study included undergraduate and graduate nursing students as well as medical students who participated in a one-day scenario-based simulation training course.	A pre-test-post-test survey design was used.	One-day scenario-based simulation training was used as an intervention method. The practical applications of this training aimed to improve patient observation, clinical reasoning, problem-solving, leadership, teamwork, communication, prioritization, delegation, and medication administration skills, with participants experiencing both participant and observer roles.

Table 1.

Findings from the literature review.

Çelik et al. has implemented a scenerio based peer-learning approach in their study with European dental studentsi, which has been significantly motivating and echanching the readiness of the cohort [21].

These findings indicate that the scenario-based learning approach is gaining increasing attention and importance in interprofessional education. The articles focus on innovative training methodologies that allow learners to develop practical skills through real-world scenarios. By focusing on scenario-based interprofessional education, the articles emphasize the importance of educational design and facilitation. This approach can help students and experienced healthcare professionals develop teamwork skills and support the effective use of simulation technologies. In summary, these articles show that scenario-based interprofessional education plays a critical role in health professional education and how simulation can transform this field [8, 17, 19, 20].

The use of scenarios in interprofessional education is considered a teaching strategy. When designing teaching strategies, the adult learning theory, which is considered within the constructivist theory [22], active learning theory [23], and experience-based learning theories [24] are also utilized [25]. Other educational theories underpinning SBL design and implementation include [14]:

Behaviorism: Emphasizes learning through repetitive practice and measures the learner’s performance against specified learning objectives. This approach is useful in teaching cognitive skills for tasks that require automatization.

Cognitivism and Constructivism (constructivism, cognitivism): In these approaches, where knowledge is treated as an individual construct, learners are expected to actively process information and relate it to their existing knowledge in order to make sense of new information. SBL enables learners to explore knowledge interactively.

Connectivism: Proposes that learning is a process that occurs by making connections between information sources (nodes). SBL supports this theory by enabling learners to make connections between different sources and forms of knowledge.

Experiential learning: It focuses on the active participation of the learner and learning through an action-reflection cycle. SBL reinforces this approach by offering learners the opportunity to practice and receive feedback in a safe environment.

SBL design and implementation, based on educational theories, helps to understand the learning process and realize effective practices. This approach can be applied to global health-related topics, especially in complex and risky environments, for example in areas such as disaster medicine and humanitarian health. Moreover, SBL offers a cost-effective solution to increase equitable access to global health education by reducing training costs in the long term compared to traditional methods. Therefore, SBL is seen as an important tool in achieving global health goals [14].

Based on these theories, the following are the basic principles obtained during scenario writing as a result of the literature review.

5. Basic principles of scenario writing in interprofessional education

The basic principles of scenario writing in interprofessional education identified after the literature review are given below [5, 6, 8, 14, 17, 19, 20, 26, 27, 28, 29].

Identifying learning objectives: The scenario should be in line with the identified learning objectives. Scenarios need to be developed in such a way that they address interprofessional rather than vocational learning objectives. However, they should not prevent other learning points from emerging. The learning objectives should be appropriate to the participants’ needs and interprofessional competencies. They can cover a variety of areas such as human factors and medical or clinical issues.

Diversity and appropriateness of the target audience: Interprofessional scenarios should target participants from different professional groups and be appropriate to their needs and knowledge levels. It is important that the scenario is appropriate to the needs of the target group in terms of interprofessional competencies rather than their professional knowledge and skill level.

Realism: The scenario should be constructed to reflect real-life situations, organized, and implemented in a realistic way. The realism of the scenarios is important to enhance the participants’ experience and enable them to easily adapt them to their clinical practice. It is important to have scenarios that require interprofessional collaboration. These scenarios may include dramatic moments or conflictual situations that will elicit emotional responses from learners. The scenario should be designed to keep learners constantly engaged and enrich the learning experience.

Participant-centered scenario development: Scenarios should be structured to include communicating with patients, family members, caregivers, and health professionals in a sensitive and responsible manner (interprofessional communication practice); using one’s knowledge of one’s own role and the roles of other health professionals to assess patients’ needs (roles and responsibilities); applying principles of team dynamics to perform effectively in different team roles (teamwork); and practicing with professionals from other disciplines while maintaining mutual respect and shared values (interprofessional practice values). The scenario should include the perspectives and collaboration of different disciplines and professions.

Embody complex mental skills: These should include skills such as problem-solving, critical thinking, synthesis, and evaluation. By providing limited information to scenario participants, scenarios should be written that allow them to examine the situation and gather more information on their own.

Using activities and tools: Activities such as discussion, role play, and simulation should be utilized.

Detailed and clear descriptions: Characters, places, and events in the script should be described clearly and in detail.

Promote reflective and critical thinking: Participants should reflect on their personal, social, and professional values.

Evaluation and feedback: The scenario should have mechanisms for evaluation and feedback. In an effective SBL, feedback is one of the most critical elements of the learning process, enabling learners to receive explanatory feedback on their actions. Explanatory feedback enhances learning more than correct or incorrect feedback and can increase learner engagement. It is important that the scenarios include elements to assess the competence areas identified for interprofessional education (collaboration, teamwork, ethics communication skills, etc.).

Scenarios should be written on a detailed and reusable template.

5.1 Ideal interprofessional education scenario

Interprofessional education (ITA) scenarios should be based on learners’ knowledge levels and interprofessional knowledge exchange. They should be designed to be appropriate to the level of knowledge of learners from each professional group, with sufficient theoretical background and a structure that can be associated with prior knowledge. In order to facilitate the achievement of the intended learning objectives, frequently encountered situations in society should be selected as case studies and their biological, psychological, and social aspects should be discussed with a multidisciplinary approach. The scenario should include detailed time, place, and identity information to increase realism; it should be supported with visual materials; and a language appropriate to social ethics should be used. The flow should follow the natural sequence of clinical practice. Analytical reasoning skills should be encouraged for simple problems and intuitive reasoning skills for complex situations. IPE mentors should develop scenarios with detailed and guided notes, including guiding questions to ensure that students achieve their learning objectives. These scenarios, with careful attention to spelling and grammar, should serve as ideal learning materials that develop students’ problem-solving and decision-making skills and prepare them for real-life and professional practice. This process should be standardized with a scenario template and continuously reviewed by the team or committee [5, 6, 8, 26, 27, 28, 29].

To summarize; when developing an interprofessional education scenario;

Scenarios should be prepared according to learning outcomes and competence areas identified in interprofessional education.

Not every scenario has to cover all competencies.

Scenarios should be written in accordance with real patient histories and students’ cultures.

Scenarios may contain dramatic moments or conflicting situations that will cause students to react emotionally, but they should be written by establishing cause-effect relationships that do not allow for discussion.

Scenarios should focus on specific team-based issues. Examples of dysfunctional or poor teamwork, especially negative events resulting from communication breakdowns and lack of cooperation, can be good triggers for discussion and learning.

6. Scenario development in interprofessional education

The scenario should be developed jointly by the representatives of the faculties and departments where it is planned to be used. First of all, a workshop or meeting should be organized with the participation of at least one trainer representing all departments that will take part in interprofessional education.

6.1 Pre-workshop preparation

The purpose, title, and teaching method of our training program were determined through qualitative interviews conducted during the needs analysis phase. As a result of the literature review after the title selection, it was decided to address especially medical error scenarios and situations where medical errors may occur in interprofessional education (IPE) in accordance with the World Health Organization’s 2010 recommendation that patient safety should be included in educational curricula to prevent medical errors. The main aim of the program is to enable students to gain knowledge, skills, and attitudes about interprofessional patient safety. Prior to the scenario development phase, the workshop design, scenarios, and evaluation methods were prepared, supported by literature research by five medical educators. The information obtained as a result of these preparations was collected in a booklet. To facilitate educators’ contribution to the workshop, a trainer’s guide was created, providing information on interprofessional education, core competencies, local and global examples, scenario-based learning, and assessment tools. The clinical scenarios in this guide aim to help health professionals better understand each other’s roles and responsibilities and recognize the importance of teamwork and collaboration. The scenarios reinforce the concept and theories of Interprofessional Education (IPE) by putting them into practice. These scenarios can be used for small group activities and simulations in both undergraduate education and continuing professional development. Scenario-based education (SBE) is seen as an effective method for health professional students to acquire the competencies they will need in their careers, offering students the opportunity to work together and achieve common goals. Moreover, this method provides students with valuable experiences by providing a broad perspective on the roles and responsibilities of different professions in healthcare [30, 31]. In light of this information, scenario-based learning is an important tool to enable health professionals to learn interactively and to strengthen interprofessional collaboration.

Scenario development in interprofessional education workshop example (Table 2).

Session 1: Introduction, Discussion, and Meeting Expectations

Duration 15 min

Description: Meeting of educators from the Faculty of Medicine, Dentistry, Health Sciences

Objectives: Introducing the participants to each other and collecting expectations; Activities: Short introductions of the participants.; Receiving expectations with the help of software

Session 2: Deciding on Context and Conceptual Framework

Duration 60 min

Description: Introducing the concept of interprofessional education and establishing the conceptual framework

Objectives: To give information about the importance and aims of interprofessional education.; To introduce the role of script writing in interprofessional education.; Activities: An interactive presentation about interprofessional education and screenwriting.; Group discussion on the characteristics of good screenwriting.

Session 3: Identifying the Competencies of the Interprofessional Education Program

Duration 30 min; Individual study (15 min) Identification of competence areas with common consensus (15 min)

Description: Determination of program competencies in accordance with national and international core competencies

Objectives: To identify and agree upon a set of core competencies essential for effective interprofessional education (IPE) in healthcare.; To understand how these competencies can be integrated into educational scenarios to promote collaborative practice among health professionals.; To design educational activities that foster the development of identified IPE competencies.; Activities: Introduction to IPE competencies: It starts with a presentation that outlines what IPE competencies are, why they are important, and how they contribute to the quality of healthcare delivery.; Group discussion and brainstorming: It encouraged participants to consider IPE competencies that address gaps or challenges in current healthcare practice.; Competency mapping exercise: Participants are tasked with mapping out how the competencies they have identified can be integrated into educational scenarios. This includes detailing specific learning objectives that align with each competency, and proposing methods for teaching and assessing these competencies.; Competency prioritization and selection: Participants present their proposed competencies and the rationale behind their selection to the entire workshop.; It was used techniques like voting or consensus-building exercises to finalize the list of competencies.

Session 4: Creation of patient scenarios suitable for planned core competence and qualifications

Duration: 60 min.; Presentation (20 min.) Working on scenarios (40 min.)

Description: To make suggestions for scenario writing to be used in interprofessional education and to develop scenarios to be used in education

Objectives: Participants to develop their own scenarios.; Creating scenarios that emphasize interprofessional cooperation and communication.; Activities: Participants develop the drafts created by the program managers.; Each participant shares his/her scenario with other participants and receives feedback.; Evaluation of the scenarios in terms of realism, educational value, and interprofessional integration.

Session 5: Designing Assessment Tools for Scenarios

Duration: 60 min.; Sharing the prepared sample scenario and introduction to educational assessment methods (20 min) Working on the Measurement Evaluation Tool (40 min)

Description: Sharing of sample scenarios and measurement evaluation tools prepared by program managers and development of materials prepared as a group

Objectives: To design assessment tools that measure the achievement of learning objectives in developed scenarios.; To inform participants about effective assessment methods and teach them how to integrate these methods into their scenarios.; To evaluate the alignment of scenarios with real-world healthcare practices.; Activities: Introduction to educational assessment methods: A brief presentation introducing effective measurement and assessment methods. Examples might include multiple-choice questions, true/false questions, short answer questions, self-assessment surveys, 360-degree feedback, portfolio assessments, and performance assessments under observation.; Scenario-based assessment design: Participants work self to design unique assessment tools for their developed scenarios. Each participant creates assessment tools that align with the learning objectives of their scenario.; Participants discuss how their scenario’s learning objectives align with their measurement and assessment tools and develop a plan.; Development and application of assessment tools: Each participant shares their designed assessment tools with other participants, helping to create a collection of scenario-based assessment tools.; Review and finalization of assessment tools: Participants revise their assessment tools considering the feedback received and create their final versions.

Session 6: Evaluation and closing

Duration: 15 min.

Description: Collect feedback from the participants to make an overall evaluation of the workshop.

Objectives: To make an overall evaluation of the workshop.; To collect feedback from the participants.; Activities: Participants give verbal feedback on all sessions of the workshop.

Table 2.

Scenario development workshop on interprofessional education.

6.1.1 Workshop objective

The goal is to ensure that participants who serve as educators in undergraduate and postgraduate education across all fields at higher education institutions train health professionals (such as Dentistry, Medicine, Health Sciences, Nursing, Physical Therapy and Rehabilitation, Nutrition, and Dietetics, etc.) become acquainted with the concept of interprofessional education, gain knowledge about the processes related to integrating it into their own educational programs, and acquire the skill of writing scenarios to be used in interprofessional education.

6.1.1.1 Session 1: Introduction, discussion, and meeting expectations

Ten faculty members actively serving in educational roles at the Faculty of Medicine, Dentistry, and Health Sciences (Departments of Nutrition and Dietetics, Physiotherapy, and Nursing) were invited, and seven faculty members accepted the invitation and participated in the workshop.

6.1.1.2 Session 2: Decision-making and conceptual framework development

6.1.1.2.1 Presentation

What is interprofessional education, its aims, and objectives? (10 mins).

Providing information on national and international core competency areas (10 mins).

In the literature, national core education and international interprofessional education framework programs have been evaluated. Among these framework programs, the framework presented by CAIPE is identified as the most commonly used framework for interprofessional competencies [4] and the introduction of other framework programs has been conducted [2, 32, 33, 34, 35, 36, 37, 38, 39, 40].

Information about professional roles and responsibilities (10 mins).

Deciding on the purpose, outcomes, and the faculties and departments that will be covered by this education program (20 mins).

An interactive presentation about screenwriting (10 mins).

6.1.1.3 Session 3: Identifying the competencies of the interprofessional education program

Individual work to identify program competencies and qualifications in accordance with the national and international core competency areas mentioned in the previous session (15 mins).

Determining faculty core competency areas with the collective contribution of all educators: reaching a consensus to establish a single set of core competencies and qualifications (15 mins).

6.1.1.3.1 Determined program core competencies for Turkey

Professional roles and responsibilities: It is essential for an individual to understand their own role and the roles and responsibilities of other health personnel related to their profession. For the effective delivery of health services and the advancement of public health, it is important for individuals to know their own duties and those of other health professionals, as well as how professional roles complement each other. This understanding ensures the harmony of roles and responsibilities, which is a common competency across most health professions [38].

Interprofessional ethics and values: This involves collaborating with individuals from different professional groups to ensure mutual respect and the preservation of common values. Those working in the health sector must learn to share and uphold mutual respect and common values to work effectively with others. This includes recognizing personal or colleague-originated biases and misconceptions and valuing the opinions and suggestions of other health professionals as much as one’s own [38].

Interprofessional team and teamwork: To plan, deliver, and evaluate patient/community-centered care and public health programs and policies that are safe, timely, efficient, effective, and equitable, it is necessary to interact effectively within diverse teams and apply the principles of team dynamics. This requires the ability to work collaboratively across professional boundaries and to engage in practices that promote a cooperative and coordinated approach to patient and community care [38].

Interprofessional communication: Health professionals must communicate with sensitivity and responsibility that supports a team approach for the promotion, and maintenance of health, prevention of illnesses, and treatment, with patients, their families, communities, and professionals in health and other fields. This involves effective communication strategies that facilitate collaboration and understanding among diverse healthcare team members, ensuring that care is patient-centered and that health outcomes are optimized [38].

Lifelong Learner: This competency highlights the ability of individuals to keep their knowledge up to date and to remain open to learning at all stages of their lives. Interprofessional education plays a critical role in this area because it enables the integration of knowledge and skills from various disciplines. This integration enhances learning capabilities in a way that allows individuals to solve complex problems they may encounter throughout their careers and to develop innovative solutions. Health professionals should be able to integrate their professional competencies, encompassing continuous professional development and lifelong learning, with interprofessional learning and daily work routines [31].

Collaborative Leadership: Collaborative practice is where health workers from diverse professional backgrounds work together with patients, their families, caregivers, and communities to deliver the highest level of care. In such teamwork, the presence of a leader to manage team dynamics is essential, and the leader can come from any profession. Interprofessional collaboration is a fundamental part of the competencies for health professionals, requiring the ability to collaborate within a framework of skills such as trust, respect, and shared decision-making with colleagues and those from other health professions. The existence of trust and open communication channels among health professionals plays a crucial role in ensuring patient safety and is important in determining a leader during collaboration. This collaboration should be considered from a broad perspective, not only among health workers but also including patients and their families, encompassing all individuals in the health system and society [2, 41, 42, 43, 44].

Patient Relations, Recognizing Needs: Placing the patient’s needs and beneficial situations at the center of collaborative work requires approaching patients, their families, healthcare providers, and communities as stakeholders in a patient-centered health management system. This emphasizes the importance of understanding and responding to the individual needs of patients, ensuring that care is tailored to their specific circumstances and preferences. It calls for a commitment to actively listen and engage with patients and their support networks to make informed decisions that reflect the best interests of the patient [38, 41, 42, 43, 44].

In alignment with these competency areas, scenarios are to be prepared by the workshop managers for the next session.

6.1.1.4 Session 4: creating patient scenarios in accordance with the planned core competencies and competencies

Sharing the prepared sample scenario (20 min).

Working on scenarios (40 min).

This session allowed participants to develop their skills in creating effective patient scenarios in line with the planned core competencies and attributes and provided a valuable resource for use in interprofessional education.

A discussion was held on the scenario examples shared with the trainers participating in the workshop. The scenarios prepared by the nurses working in the Department of Medical Education, Public Health, Family Medicine and Emergency Health Services and Teaching in Nursing with the support of the literature were developed by ensuring the suitability of these scenarios for our country and our university education program due to the differences in the roles and responsibilities of health workers involved in health service delivery according to countries and regions, differences in the health workers represented and cultural differences.

After various reviews of the patient safety scenarios, 40 min session was conducted by the lecturers to ensure content validity. It included the implementation of patient safety IPE, observations, feedback, debriefing, and facilitation.

In these sessions, the trainers identified the important areas in terms of their own professions, especially the boundaries that need to be discussed, the points where professions overlap with each other, positive and negative features, and examples of scenarios suitable for the knowledge and skills that students should gain in line with the competencies determined in this session in the workshop.

6.1.1.5 Session 5: designing assessment tools for scenarios

Success Criteria and Evaluation; After determining the success criteria of scenario-based learning methods in interprofessional education, they should be evaluated effectively [14]. In this section, methods and evaluation criteria that can be used to assess student achievement are discussed. The assessment-evaluation process aims to determine to what extent the objectives set in the design phase of the program have been achieved. The measurement tools to be used in the assessment-evaluation process are determined in advance. The assessment tools, in which the developed scenarios and rubrics will be used, are designed to objectively measure the skills, knowledge, and attitudes gained by the students.

Following the creation of the scenarios, a consensus was reached with the faculty members participating in the workshop in accordance with the scenario within the framework of the competency areas for the previously compiled assessment-evaluation form used to measure the knowledge and skill gains targeted in scenario-based learning programs in the literature. Accordingly, standardization studies were carried out for the seven basic skills assessment sections, sub-headings of each basic skill heading, and scaling for each core competency area.

6.1.1.6 Session 6: evaluation and closing

At the end of the workshop, a closing speech is given by the program managers. In this speech, an overview of the workshop is presented and the contributions of the participants are acknowledged.

Four scenarios covering all core competency areas were developed in the Interprofessional Education Programme booklet. Table 3 shows the sample scenario, competency areas, and reflection questions.

Home Healthcare Services
Educator:
Facilitator:
Team members: Nutrition; Tooth; Physiotherapy; Nursing; Medicine
Competences expected to be gained; roles-responsibilities relationships with the patient, recognizing their needs Interprofessional communication ethical-values team and teamwork lifelong learning collaborative leadership
Scenario: Ayşe Ünlü, a 75-year-old woman with diabetes, was diagnosed with type 2 diabetes 8 years ago. Her blood sugar control is variable and her weight fluctuates a lot. Ayşe, who lives alone, had a total hip replacement operation 3 months ago due to a hip fracture and a physiotherapist comes to her home regularly for exercise. During one of her visits, the physiotherapist noticed a wound on Ayşe’s left heel. Seeing that the wound is gradually increasing, she calls the home health unit and asks for the patient to be evaluated in this respect. The physician in charge of the home health unit, who arrived in accordance with his appointment, made the initial examination of the patient, planned the wound care, and stated that he would refer a nutritionist for sugar regulation and a nurse for wound care. In the following days, the nutritionist receives the information about the patient from the physician due to the intensity of her appointments and communicates the nutrition list and recommendations to the patient through the nurse. The nurse visits Ayşe for regular wound care and observes that the wound does not close despite the dressings. Mrs. Ayşe then applies a homemade mixture prepared by her neighbor to her foot. The nurse becomes aware of this situation and the physiotherapist who comes to rehabilitation warns the nurse to inform the physician. The nurse decides to follow the patient for a while. On the next visit, the nurse sees that the wound has become oozing and the leg is bruised. The nurse informs the physician in charge of the home health unit.
Discussion questions: After reading the scenario to one of the students, create a discussion environment with the following questions. Briefly note the answers to the questions and prepare a 10 minute presentation with the team at the end of the session.; Which professional groups are included in the scenario? Describe the roles and responsibilities of each professional group in the scenario? and What are the roles and responsibilities that are done and not done (should be)? When you think according to your own professional group, what did this patient primarily need? What are his/her needs? In order to meet the needs of the patient, which communication between professional groups can be different from the scenario? Sample communication sentences should be requested? List the professional groups in terms of preventing the patient’s foot wound from progressing? State your possible cooperation suggestion and why? How do you evaluate the relationships between health professionals in the above scenario? Is there teamwork between them? In your opinion, what should be the distribution of tasks that should be followed in routine in terms of sharing and clarifying roles? How did the above scenario make you feel?
The trainer is expected to pay attention to the following issues during the scenario discussion.; Define team structure, roles and responsibilities, Ask them what they understand by the word “value” (principles, beliefs, ethics, standards, conscience, virtues...) What are professional values? Firstly, do no harm (the motto of patient safety, emphasize the other principle of do not harm colleagues and other health professionals), always act by thinking whether what I am doing or trying to do will harm my colleague or other health personnel. If roles are duplicated, we need to think about how we can best combine our efforts. When working, talking to each other, referring, and discharging patients, use clear language and explanations should be detailed. In case of an inappropriate practice by another health worker, a professional should wonder: why is he/she doing this, why did he/she do it? If in doubt, ask. When you ask a colleague to fulfill a task, explain the purpose of the request. For health professionals who are not aware of their values, challenging others or not knowing others’ different or opposing values can lead to potential conflict. If not mentioned in the definition of values, you can include in the discussion words or terms that refer specifically to some real values that health professionals have in common: you can think of professional values such as being fair and kind, being fair, telling the truth, respecting, following the law, being hardworking, helping other people, altruistic, honest, self-confident, putting the patient first, etc. Identify barriers to team effectiveness. Mutual support ve Collaboration konusunda tartışma ortamı yaratın. Draw attention to Interprofessional Communication. Emphasize team members who are unable to provide an accurate transmission, and who are unable to communicate as soon as possible. Assess the behavior of team members who do not speak up or challenge. Emphasize team members who do not listen effectively. Discuss what could happen as a result. In this scenario, emphasize the lack of mutual support and the lack of necessary skills. Could the lack of clear knowledge of roles and responsibilities, lack of cooperation of team members, lack of a collaborative approach, and unethical behavior of health professionals have caused the patient’s wound to become infected? What is prioritization? Discuss the task of prioritization in roles and responsibilities. Discuss what they think about the ability to ask for consultation, which professional groups can ask for consultation in this case, and how formal consultation should be done. (Emphasize the late consultation skill in the scenario)

Table 3.

Sample scenario template.

7. Conclusion and recommendations

This book chapter emphasizes the importance of scenario-based learning in interprofessional education and discusses the basic principles to be considered in the implementation of this strategy and an example of good practice in scenario development. This learning approach allows the development of critical thinking, communication, and teamwork skills in tackling complex health problems while fostering collaboration between students. As a result, this approach has the potential to create positive impacts on both professional development and patient outcomes. Ongoing research will help us to understand the implications of scenario-based learning in even greater depth and optimize its integration into health education practice.

Acknowledgments

The authors would like to extend their heartfelt gratitude to all individuals and institutions that have contributed to the development and realization of this work. Special thanks are directed toward the workshop participants, whose insights and active engagement have significantly enriched this study. We are particularly grateful to FIT, HS, EŞ, HD, ZS, GÇ, GK, GB, ÖÇÖ, and SÇ for their valuable contributions and dedication to the project. Their involvement has been instrumental in shaping the outcomes of this research. Additionally, we acknowledge the support provided by our respective institutions, which facilitated the environment necessary for our collaborative efforts. This project has benefited from the diverse perspectives and expertise of all those involved, reflecting the interprofessional nature of scenario-based learning in inter-professional education.

Conflict of interest

There is no conflict of interest.