Interprofessional education (IPE) is gradually recognized as essential to patient safety and implemented as a standard for healthcare education through professional organization recommendations and accrediting bodies. Given the increasing adoption of experiential and team-based learning, healthcare simulation (HCS) has become a preferred vehicle for IPE. As healthcare professional educators explore simulation as a platform for IPE, a need to better understand the state of the science has become apparent. This descriptive comparative study examines how the most commonly used simulation modalities and IPE teaching methods (low-technology versus high-technology; multiprofessional versus collaborative team-based activities; observational versus active methods; standardized patients versus mannequins) affect participants' post-test scores in perceived teamwork and collaboration in pre-licensure students while controlling for factors shown previously to affect these perceptions. A total of 716 medical, nursing, pharmacy, and physician assistant students completed a survey on teamwork and collaboration perceived before and after a HCS enhanced IPE lab. Stratified by profession, the students were randomly allocated into small interprofessional teams that underwent one of six simulation modalities. A secondary analysis of data from an evaluation of an interprofessional lab was used in this exploration of HCS as a platform for IPE. Using mixed between-within repeated measures ANOVA, perceptions of teamwork and collaboration did not improve significantly for high-technology methods (p > .05) over low-technology methods, however, the difference in means between posttest surveys differed significantly, suggesting that there was an intervention effect. There was no significant difference in perceptions of teamwork and collaboration in team-based methods and multiprofessional methods (p > .05), as well as active and observing participants. Enhanced mannequin-based simulation significantly increased (p < .05) students' perceptions of teamwork and collaboration compared to enhanced standardized patient based simulation. From the findings for initiatives in simulation-enhanced IPE, a framework has been proposed for the development of simulation-enhanced IPE and a format for the reporting of research. Deficiencies were identified both in the existing literature (e.g. gaps in knowledge and reporting, low rigor in research design, variability between studies, multiple confounding variables) and in the study (e.g. retrospective analysis, organization of lab, limitations of equipment and simulators, time and ceiling bias). Acknowledgement of these issues may strengthen future research. By exploring a number of proposed modalities for simulation-enhanced IPE and students' perceptions of teamwork, the findings of this study support a better understanding of IPE using HCS, inform recommendations for use, and identify areas to further join the HCS and IPE fields.

LLU Discipline





School of Nursing

First Advisor

Winslow, Betty J.

Second Advisor

Haviland, Mark G.

Third Advisor

Jones, Patricia

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Interprofessional Relations; Health Occupations - education; Nursing - education; Interdisciplinary approach in education

Subject - Local

Healthcare simulation; Interprofessional education; Nursing



Page Count

216 p.

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses & Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives

Included in

Nursing Commons