The status of interprofessional education for healthcare students in South Korea: a scoping review focusing on simulation-based education

Article information

Korean J Med Educ. 2024;36(3):303-314

Publication date (electronic) : 2024 August 29

doi : https://doi.org/10.3946/kjme.2024.304

Sunmin Lee ¹

, Myung Chun Kim ²

, Jongyoon Kim^,³

¹College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Suncheon, Korea

²Department of Medical Education, Kyung Hee University College of Medicine, Seoul, Korea

³Department of Medicine, Graduate School, Kyung Hee University, Seoul, Korea

Corresponding Author: Jongyoon Kim (https://orcid.org/0000-0003-0569-7452) College of Pharmacy, Dongduk Women’s University, 60 Hwarang-ro 13-gil, Seongbuk-gu, Seoul 02748, Korea Tel: +82.2.940.4517 Fax: +82.2.940.4195 email: jyoonkim@dongduk.ac.kr

Received 2024 January 25; Revised 2024 April 25; Accepted 2024 June 3.

Abstract

Simulation-based education is gaining attention worldwide as it is recognized as effective in fostering collaborative skills in healthcare students. We conducted a comprehensive review of simulation-based interprofessional education (IPE) to examine the current state of simulation-based IPE. This scoping review systematically analyzed studies on simulation-based IPE in South Korean healthcare education, following established guidelines. Relevant articles were comprehensively searched, and key data on simulation methods, implementations, and educational effectiveness were extracted for analysis. The present study included nine quantitative studies and one mixed-methods study. The majority of participants were undergraduate nursing and medical students. The duration of IPE interventions ranged from 2 hours to 2 weeks. Education methods included standardized patients, high-fidelity simulators, and role-playing. Educational outcomes focused on measuring IPE competencies and satisfaction levels, concentrating on Kirkpatrick levels 1 and 2. While most studies reported high satisfaction levels, there is a need for objective evaluation of educational effectiveness. As simulation-based IPE in Korean healthcare education evolves, there is a need for greater inclusivity of diverse roles, multidisciplinary respect, and scenario development allowing active participation across professions. Establishing institutional frameworks, community linkages, and a deep understanding of IPE’s purpose and essence among practitioners is crucial for its academic maturation.

Keywords: Students; Health occupations; Interprofessional relations; Simulation training

Introduction

Interprofessional education (IPE), an educational approach aimed at enhancing collaboration and improving care quality through mutual learning among healthcare professionals, has emerged as a global trend in response to workforce shortages [1]. Following the World Health Organization’s strong endorsement in 2007, IPE has gained widespread adoption across healthcare education programs in the United States, Canada, the United Kingdom, Australia, and Europe. Whereas in South Korea, IPE has been increasingly implemented in both curricular and non-curricular domains, with recent studies focusing on related keywords and its real-world application in education [2].

IPE operates through the development of programs that foster close collaboration among various healthcare professionals, centering on core factors of clinical practice such as patients, problems, situations, and tasks [1]. Numerous studies have demonstrated IPE’s effectiveness in training healthcare providers to apply problem-solving abilities in clinical situations through collaborative care experiences [3,4]. Additionally, understanding interprofessional collaboration methods aids students in developing the teamwork skills necessary for collaborative care teams, maximizing limited healthcare personnel and financial resources while creating a more synergistic healthcare system.

By 2017, at least 14 out of 40 medical schools in South Korea had adopted IPE, primarily in higher-grade levels, allocating approximately 5% of total education time to lecture-based, clinical practice, and interactive education aimed at promoting understanding of other professions and improving communication skills [5]. IPE has been applied through various educational methods, including simulation-based approaches such as role-playing activities, standardized patient encounters, high-fidelity mannequins simulating patient impairments, and computerbased virtual reality applications that allow students to experience collaborative clinical practice [6,7].

These simulation-based approaches have been recognized as effective alternatives to traditional instructorled lectures, facilitating the acquisition of attitudes, capabilities, skills, and knowledge required for teambased care and patient health improvement. Notably, simulation enables contextual learning in a safe, mistaketolerant environment that closely resembles reality, allowing for the integration of non-technical skills (communication, cooperation, coordination, teamwork) with technical proficiencies, and can be effectively applied to undergraduate classes by instructors familiar with clinical practice [8,9].

Most reports and review articles on IPE application experiences originate from the United States, Canada, or Europe, with a focus on community and patientcenteredness, meta-analyses and systematic literature reviews have evaluated the educational effects of simulation-based IPE [10,11]. However, studies on the educational effectiveness of simulation-based IPE remain scarce in South Korea, and healthcare faculty and students’ perceptions of IPE have been reported to be relatively low [12].

As the need for IPE in Korean healthcare education continues to grow, a comprehensive review of simulationbased education, recognized as the most effective approach to enhancing its efficacy, is warranted [13]. This study aims to identify existing gaps and challenges in healthcare student education by conducting a comparative analysis of simulation-based IPE in South Korea and to explore future directions for improvement

Methods

This study conducted a scoping review of articles meeting the inclusion criteria among studies exploring the application of simulation-based education methods in IPE within the South Korean healthcare context. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews protocol recommended by the Joanna Briggs Institute guidelines. A comprehensive literature search was performed between November 9 and 19, 2023, targeting original articles and dissertations published from 2000 to October 2023. International literature was accessed through PubMed, EMBASE, and the Cochrane Library, while Korean literature was retrieved from the Korean Medical Database, Research Information Sharing Service, KoreaMed, and Google Scholar.

The primary objective of the review was to systematically identify and analyze how simulation-based education methods were utilized and evaluated in IPE initiatives within the healthcare field in South Korea. Additionally, the study aimed to examine whether the simulation-based IPE approaches encompassed various healthcare specialties.

The inclusion criteria for the literature search were as follows: studies conducted in South Korea, education at the undergraduate or higher level within the healthcare field, implementation of IPE involving at least two professions, and the application of simulation-based education methods. Conversely, the exclusion criteria comprised studies conducted outside of South Korea, education not related to healthcare, education targeting only a single profession, studies that did not measure outcome variables, articles without full-text availability, studies that did not incorporate simulation-based education within IPE, and articles neither written in Korean nor English. Regardless of the study design, all articles related to the topic were considered eligible for inclusion, except for qualitative studies and review articles.

The search terms were carefully constructed to align with the topic and research objectives, utilizing a combination of relevant medical subject headings and similar terms. The search queries combined terms such as “Students, Health Occupations,” “Interprofessional Relations,” “Simulation Training,” and “Korea,” as well as additional terms like “nursing,” “pharmacology,” “medicine,” “university,” “undergraduate,” “health,” “medical school,” “college of medicine,” “professional,” “multi-professional,” “occupational,” “occupation,” “multidisciplinary,” “department,” “specialty,” “simulation,” “mock,” “simula*,” and “practicum.”

The articles identified through the literature search were collected and organized using Refworks (ProQuest, Ann Arbor, USA; https://refworks.proquest.com/). Subsequently, their titles and abstracts were evaluated based on the predefined inclusion and exclusion criteria. Initially, 1,949 articles from Korean sources and 32 articles from international sources were identified. After removing 333 duplicate articles, 1,981 articles underwent further screening. Articles deemed irrelevant to the inclusion criteria (n=1,635), review articles (n=1), studies without full-text availability (n=1), and qualitative studies (n=1) were excluded, resulting in a final selection of 10 articles. Two independent researchers evaluated the relevant articles and resolved any disagreements through discussion to finalize the article selection (Fig. 1).

Fig. 1.

Preferred Reporting Items for Systematic Reviews and Meta-Analyses Flow Chart of Study Selection

To extract key information, data analysis was performed using predefined keywords collected from each relevant literature source. The identified general characteristics included author, year, participants’ professions, grade level, age, IPE duration, and outcome parameters. Regarding the simulation-based education applied in IPE, the study extracted information on subtopics, education structure, methods, outcome variables, and the degree of effectiveness reported.

Simulation methods were classified according to their multidimensional aspects, including whether they were based on human simulation or computer simulation, as well as the type or fidelity of the simulation employed, as described by Elshama [14] in 2020. The research examined the specific methodologies utilized in the educational simulations. The reported educational effectiveness was reviewed and categorized according to Kirkpatrick’s Expanded Outcomes Typology, which delineates four levels of educational effectiveness: reaction, attitude, behavior, and results [15].

Results

This study included nine quantitative studies and one mixed-methods study (incorporating both quantitative and qualitative components), wherein only the quantitative results were analyzed. Following three publications on simulation-based IPE in 2020, two studies were published in 2021, three in 2022, and two in 2023. The majority of participants were undergraduate nursing and medical students (nine out of 10 studies), with one study additionally including pharmacy students, resulting in a total of three disciplines represented. The remaining study involved nursing students and undergraduates from six allied health sciences majors (nursing, physical therapy, radiography, health administration, clinical pathology, and occupational therapy). Sample sizes ranged from 12 to 166 participants, spanning third- to sixth-year undergraduate students [16-23] (Table 1).

Table 1.

Characteristics of the Included Studies

The duration of IPE interventions varied from 2 hours to 2 weeks, comprising a combination of lecture-based education, problem-based learning, team-based learning, and simulation-based education. Regarding simulation methods, one studies employed simulated patients, utilizing holographic standardized patients (n=2) or role-playing approaches (n=5). Four studies utilized highfidelity simulators, while five articles incorporated role-playing methods for education. Two studies utilized in-school simulation labs and developed scenarios based on the educational needs of professional groups to organize simulation content. Six studies included medication-related content in the scenarios, with two studies incorporating pharmacist shadowing and virtual hospital role simulations. Three articles covered prescription errors such as medication dosing, dispensing errors, and expiration dates, while another article addressed patient histories and medication instructions. The main outcome variables were educational satisfaction and IPE competencies, including teamwork, collaboration, and communication [16-23] (Table 2).

Table 2.

Simulation-Based Interprofessional Education Studies in Korea

Regarding study design, two studies reported survey findings on satisfaction with the IPE program, five assessed effectiveness through pre- and post-comparisons, and three were quasi-experimental before-and-after comparison studies. In terms of evaluating effectiveness, eight out of 10 studies included a satisfaction survey and a comparison of parameters before and after IPE, while one study analyzed the correlation between parameters and causes. The Readiness for Interprofessional Learning Scale was the most commonly used outcome measure (five out of 10 studies), with four studies reporting statistically significant changes in scores before and after IPE. Based on Kirkpatrick’s criteria for educational outcomes, most studies focused on attitudes (level 1) or satisfaction (level 2), with only two studies measuring behavioral change at level 3 out of 4, and no study covering level 4 (training efficacy) [16-23] (Table 3).

Table 3.

Outcomes after Interprofessional Simulation as Described in the Studies

Discussion

In a previous review, it was reported that approximately 47% of medical colleges in South Korea implemented lecture-based IPE, primarily focused on introducing the nature and scope of other healthcare professions [5]. However, strictly adhering to the World Health Organization’s definition of IPE as “two or more professionals learning together,” the application rate would have been lower if lecture-based classes or volunteer work aimed solely at understanding other professions were excluded. A study on medical education professionals in South Korea cited curriculum adoption and development as the most frequent barriers to IPE implementation, including an already excessive curriculum workload, difficulties in organizing joint classes due to differences across disciplines, lack of awareness regarding the need for IPE, and attitudinal or perceptual issues among healthcare professionals [5]. These findings suggest that the Korean medical education sector and healthcare professionals are still in a preparatory stage for actively implementing IPE, lagging behind the maturation of IPE in North America and Europe over the past half-century [24].

The present study discussed IPE cases that applied simulation-based education in South Korea, where students from different healthcare majors collaborated. In this way, it investigated the feasibility and scope of utilizing simulation-based education in the development of IPE curricula. This exploration of the current status of active IPE development is significant, as the IPE curriculum framework is a paradigm for health functions, focusing on client needs and evidence-based decisionmaking for problem-solving [25].

Regarding the participants, all 10 selected studies included nursing students, nine involved medical students, one included undergraduate nursing and health science students (clinical pathology, health administration, occupational therapy, physical therapy, and radiology), and one study additionally included pharmacy students. Thus, most studies were concentrated on medical and nursing students in South Korea, highlighting the need for greater diversity in healthcare disciplines represented, aligning with recommendations from international reviews.

Two of the studies involved students from disciplines other than medicine and nursing. In the study by Kang and Kang [19] in 2022, students from six health-related majors formed interprofessional teams of six members, with one student from each major, and practiced collaborative patient care approaches. This immersive practice experience was evaluated, with no reported differences in effectiveness across professions. On the other hand, the study by Jung et al. [26] in 2020, which included pharmacy students, reported significant improvements in perceptions toward IPE for medical, nursing, and pharmacy students in pre- and post-program comparisons. However, pharmacy students did not experience an increase in self-efficacy for interprofessional experiential learning, in contrast to medical and nursing students. In response to these findings, the authors suggested that the current status of curricula and attitudes within the healthcare industry may have influenced the self-efficacy of pharmacy students. Additionally, upon examining the scenarios presented in the study, it appears that they were primarily focused on medication errors caused by nurses or doctors, with limited opportunities for pharmacists to actively engage in problem-solving. This observation highlights the importance of in-depth reflection and research on the meaning of IPE, emphasizing that merely presenting the concept of IPE is insufficient; instead, educational methods that provide each profession with opportunities to practice in given situations can enhance training effectiveness [27]. In essence, it is crucial to apply insights that present directions for solving common problems to all professions, allowing for a synergistic positive effect.

The education methods most commonly employed in IPE were role-playing simulations (five cases), standardized patient encounters (three cases, including two using holographic patients), and high-fidelity simulations (four cases). These simulation methods were not biased against any particular approach and generally demonstrated high satisfaction and effectiveness [28]. Simulation scenarios covered various topics, including emergency department simulations, patient safety scenarios involving prescription errors, chronic obstructive pulmonary disease management, dementia care for community-dwelling elderly, chest pain assessment, postpartum hemorrhage, and pediatric viral croup. Developing more diverse scenarios, in addition to those reported thus far, and the practical implementation of curricula through intercollege collaborations remain challenges for simulationbased IPE in South Korea.

While most studies reported relatively high satisfaction with IPE (ranging from 3.86 to 4.73 out of 5, on average), objective evaluation of effectiveness is crucial given the required efforts and costs for successful IPE implementation, such as preparing specialized scenarios, virtual environments, dedicated laboratories, and facilitating collaboration between different colleges and curricula coordination. An objective evaluation method through research designs including a control group can be usefully employed in this regard. Within this study, three papers employed a quasi-experimental design. One utilized a random assignment table generated by sequentially applying the permutation of a random number generator from a random assignment program (Jeon [17] in 2022). Another employed a semi-randomized split method (Park and Park [29] in 2021), while the third used random drawing (Jung et al. [26] in 2020). Regarding homogeneity testing according to the general characteristics between the two groups based on randomization results, Jung et al. [26] in 2020 reported a lack of homogeneity between the intervention and control groups, and analysis of variance was analyzed after calculating the mean and standard deviation to address this. In the study by Park and Park [29] in 2021, while sex and age were reviewed, there was a statistical difference in ages between the two groups (p-value <0.001). In the study by Jeon [17] in 2022, in addition to age and gender, homogeneity tests were performed for various characteristics, such as satisfaction with major, satisfaction with clinical practice, overall school life satisfaction, and interpersonal satisfaction during clinical practice, between the intervention (n=20) and control (n=19) groups, and there were no statistical differences in all baseline characteristics. Additionally, randomized clinical trials should be conducted to confirm the educational effects.

In terms of the effectiveness evaluation results for both groups, the study by Jeon [17] in 2022 found positive effects in the intervention group compared to the control group before and after the program implementation for a total of five indicators measured, including readiness, knowledge in specific fields, self-efficacy, team awareness, and problem-solving ability. In the study by Jung et al. [26] in 2020, the effect was clearly shown to differ depending on the research environment, such as self-efficacy for interprofessional experience (p=0.000). Meanwhile, Park and Park [29] in 2021 reported no significant change in potential interest both before and after the IPE implementation, and no statistically significant difference in the satisfaction survey of medical studies. Examining the content of the IPE programs, the study by Jung et al. [26] in 2020 guided students to identify problems and lasting solutions through role-playing, while the study by Jeon [17] in 2022 facilitated active participant expression by recruiting volunteers rather than as part of a class, creating an environment where active participation was inevitable through the practice environment of groups of five.

In IPE, understanding one another professionally implies a strong grasp of each other’s conceptual models, roles, and responsibilities, as this fundamental requirement is essential for effective collaboration [4]. In contrast, the activities conducted in the study by Park and Park [29] in 2021 comprised an online lecture (30 minutes), an interactive theater based on a pre-developed scenario, and group discussions (duration unspecified). The interactive theater involved role-playing based on the given scenario as the primary IPE activity, allowing participants to experience situations faced by professionals from other disciplines. However, such content may not sufficiently facilitate interactive opinion exchange and active negotiation processes across professions. Effective IPE is known to occur when teams focus on patient-centered shared goals, simultaneously experiencing the diverse interests and power asymmetries of various partners in treatment and associated negotiations [4]. Despite being a quasi-experimental study with a relatively high design quality (grade 2 out of 3 on the Johns Hopkins Appraisal), this study yielded different educational effectiveness results compared to others with similar designs. This suggests that specific variables in implementation, voluntary participation, and problem-solving experiences may have a greater impact on participants’ perceived satisfaction and educational effectiveness than the research design itself. It is necessary to recognize that IPE is not an educational goal but a means, and to implement it in a manner that maximizes the nature of situational knowledge and cooperation, considering the complexity of healthcare delivery [30].

This study examined all simulation-based IPE targeting students in the healthcare field in South Korea, aiming to explore the current status of IPE in Korean healthcare and the direction in which it should be guided. However, this study has several limitations. The limited number of control group studies and inconsistent outcome measures precluded a comprehensive conclusion, which is also why a meta-analysis has not been conducted yet. Additionally, as this study focused on reviewing IPE research conducted in South Korea to assess cost-effective educational quantitative effectiveness, the review primarily concentrated on quantitative studies. While one study design included some qualitative components, and other qualitative research has been conducted, further investigations from different perspectives are needed. Additionally, difficulties were encountered in categorizing conclusive findings about educational effectiveness due to the diverse educational purposes of the indicator results. To establish clear educational outcomes, it is necessary to engage in multidisciplinary consultation on unified educational objectives.

Conclusion

IPE is evolving across various healthcare settings in different countries, and simulation-based education represents an important methodology in this domain. While research on IPE in Korean healthcare education has been ongoing since 2020, it remains in its infancy. There is a need for greater inclusion of diverse healthcare roles and the cultivation of an attitude and culture that respects multidisciplinary perspectives. The development of scenarios incorporating multiple viewpoints can maximize training effectiveness by providing opportunities for professionals in each field to play an active role. Establishing long-term linkages with community healthcare through national and local support is necessary, as well as strengthening the institutional framework for multidisciplinary collaboration. Above all, as a key factor in the maturation of IPE in South Korea, practitioners of simulation-based IPE education should deeply understand, explore, and implement the purpose and essence of IPE education to lay the academic foundation for IPE education and research.

Acknowledgements

None.

Notes

Funding

No financial support was received for this study.

Conflicts of interest

No potential conflicts of interest relevant to this article was reported.

Author contributions

Conception or design of the work: SL, JK; data collection: SL, JK; data analysis: SL, JY; data interpretation: SL, MCK, JK; drafting the article: SL, JK; critical revision of the article: SL, MCK, JK; and final approval of the version to be published: SL, MCK, JK.

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Author(s) (year)	Article title	Students’ future profession	Sample size (no.)	Grade (year of grade)	Student age (yr)
Shon [22] (2023)	Development and evaluation of interprofessional education for pediatric nursing	Nursing and medical students	Nursing students (9); medical students (3)	Nursing students (34); medical students (3)	23.6±1.3
Hur et al. [16] (2023)	Patient safety interprofessional education program using medical error scenarios for undergraduate nursing and medical students in Korea	Nursing and medical students	Nursing students (55); medical students (47)	Nursing students (4); medical students (3)	NA
Kang and Kang [19] (2022)	Mixed reality-based online interprofessional education: a case study in South Korea	Nursing and medical students	Nursing students (15); medical students (15)	Nursing students (4); medical students (3)	NA
Jeon [17] (2022)	Development and effects of a Sim-IPE program for dementia management in community-dwelling elders using standardized patient	Nursing and medical students	Experimental group (20); control group (19)	NA	Experimental group (22.45±1.27); control group (22.84±1.34)
Kang and Hwang [18] (2022)	Development and application of simulation module on interprofessional education for nursing and health science students	Nursing and health science (clinical pathology, health administration, occupational therapy, physical therapy, radiology)	Nursing (23); clinical pathology (19); health administration (20); occupational therapy (20); physical therapy (20); radiology (17)	NA	21.3
Kim et al. [20] (2021)	Development and evaluation of an inter-professional education course at a medical school in Korea	Nursing and medical students	1st year: medical students only (72); 2nd year: medical students (94) and nursing students (75)	Nursing students (4); medical students (34)	NA
Kim and Kim [21] (2021)	Difference of perceived readiness for interprofessional learning among medical and nursing students after simulation-based interprofessional education	Nursing and medical students	Nursing students (41); medical students (94)	NA	NA
Yu et al. [23] (2020)	Effectiveness of simulation-based interprofessional education for medical and nursing students in South Korea: a pre-post survey	Nursing and medical students	Nursing students (44); medical students (43)	Nursing students (4); medical students (5)	NA

Table 2.

Simulation-Based Interprofessional Education Studies in Korea

Author(s) (year)	Description of activity	Simulation subject	Pharmacy-related section	Applied simulation methods	IPE activity duration	IPE competencies included/outcomes
Shon [22] (2023)	Orientation and ice break (1 hr); HoloPatient assessment (1 hr); twins team-based learning (2 hr)	Chronic obstructive pulmonary disease	No	HSPs	4 hr	Teamwork and collaboration; negative professional identity; positive professional identity; roles and responsibilities
Hur et al. [16] (2023)	Module 1: online lecture individual (1 hr 15 min), team-based practice (20 min), team-based case analysis & root cause analysis (50 min), high-fidelity simulation (1 hr 5 min); module 2: online lecture individual (45 min), team-based practice (20 min), role-play (50 min), high-fidelity simulation (1 hr 5 min)	Prescription error; oral prescription error; blood transfusion error	Yes	Role-play; high-fidelity simulation	3 hr	Roles and responsibilities; interprofessional communication; teamwork; values for interprofessional practice
Kang and Kang [19] (2022)	Part 1: clinical reasoning cycle using HoloPatient (2 hr); part 2: online IPE using group discussion, selected presentations, and non-judgmental feedback (1 hr 40 min); part 3: debriefing (2 hr)	Emergency department	No	HSPs	2 hr	Satisfaction with their mixed reality-based online; interprofessional learning experience
Jeon [17] (2022)	Pre-education (50 min); pre-briefing (20 min); simulation (30 min); debriefing (1 hr 30 min); reflection note (10 min)	Dementia management of community-dwelling elderly	Yes	Simulated patients	3 hr 50 min	Readiness for IPE; self-efficacy for IPE; attitude toward teamwork; problem-solving; education satisfaction
Kang and Hwang [18] (2022)	Problem-based learning (2 hr); simulation education (2 hr)	Managing patients with multiple fractures	Yes	IPE-simulated practice modules	16 hr	Satisfaction; self-confidence; learning flow
Kim et al. [20] (2021)	Two-week IPE curriculum was designed based on the core competencies for IPCP guidelines (interactive lectures, discussions, shadowing, small-group discussions, simulation, role-playing)	Human-centeredness/patient-centeredness; patient experience; patient safety; values/ethics for interprofessional practice; roles/responsibilities; communication with patients; communication with other professionals (teams and teamwork, respect)	Yes	Multi-profession simulation session; role-play	Two-week IPE course (interactive lectures, discussions, small-group discussions, and simulations; and was given to diverse medical students)	Satisfaction with the IPE program; readiness for IPE; behavioral change
Kim and Kim [21] (2021)	Half a day of team-building games; simulation; board games; case discussion	Medical & nursing error (adult and child); disclosure at bedside; teamwork; patient safety	Yes	High-fidelity simulation (simulation, role-playing)	Half a day	Readiness for IPE collaboration/cooperation; leader/leadership; consideration; synergy; communication
Yu et al. [23] (2020)	Pre-briefing (20 min); pre-scenario activities (20 min); task training (20 min); simulation (20 min); debriefing (20 min)	(1) Adult simulation scenario: module 1: a patient complaining of chest pain; module 2: a maternal scenario of a postpartum hemorrhage	No	Simulation scenario template: students intervened according to manikin actions based on programming data, and in this process, team members communicated and collaborated with each other	3 hr 20 min	1. ATTITUDES: relevance of IPE; relevance of simulation; communication; situational awareness; roles and responsibility
						2. JSAPNC: shared educational and collaborative relationships; caring as opposed to curing; nurse autonomy; physician authority
		(2) Pediatric scenario: module 3: a child presents with mild viral croup (each team experienced a total of two scenario modules)				3. IPEC competency: interprofessional interaction; interprofessional value

IPE: Interprofessional education, HSPs: Holographic standardized patients, IPCP: Interprofessional collaborative practice, ATTITUDES: Attitude towards Teamwork in Training Undergoing Designed Educational Simulation, JSAPNC: Jefferson Scale of Attitudes toward Physician-Nurse Collaboration, IPEC: Interprofessional Education Collaborative.

Table 3.

Outcomes after Interprofessional Simulation as Described in the Studies

Author(s) (year)	Study design	Outcome measure	Results
Shon [22] (2023)	Satisfaction survey; pre-post test	(1) Program satisfaction (5-point Likert scale); (2) RIPLS	(1) 4.33±0.49; (2) p=0.005
Hur et al. [16] (2023)	Satisfaction survey; prospective, quasi-experimental pre-post test design	(1) RIPLS; (2) Safety Motivation Scale; (3) Simulation Design Scale; (4) program satisfaction (5-point Likert scale)	(1) p<0.001; (2) p=0.002; (3) 0.96; (4) 3.87 (program design)
Kang and Kang [19] (2022)	Case study design satisfaction survey	Modified Satisfaction with Simulation Experience Scale survey	p=0.030; medical 151.07±11.907 (max: 165); nursing 161.67±13.367 (max: 165)
Jeon [17] (2022)	Non-equivalent control group; pre-test and post-test design	(1) RIPLS; (2) Korean version of Self-efficacy for Interprofessional Experimental Learning Scale; (3) TeamSTEPPS Teamwork Attitudes Questionnaire; (4) problem-solving score; (5) education satisfaction score	(1) p=0.044; (2) p=0.030; (3) p=0.014; (4) p=0.042; (5) p<0.001
Kang and Hwang [18] (2022)	Convergent design of the mixed study: (1) satisfaction survey, (2) correlation analysis, (3) multiple linear regression analysis	Student satisfaction and self-confidence in learning	Satisfaction (r=0.66) and self-confidence (r=0.81)
Kim et al. [20] (2021)	Satisfaction survey; pre-post test	Kirkpatrick’s educational outcome model; changes in RIPLS score after the IPE program; (1) level 1: reaction: After the training, we asked all students to describe their satisfaction with the IPE program; (2) level 2: modification of attitudes/perceptions & acquisition of knowledge/skills; (3) levels 3 and 4: behavioral change and change in organizational practice & benefit to patients	The 360° evaluation by nurses revealed that students became more favored as teammates (overall satisfaction with them as teammates increased from 3.1/5 to 3.4/5) compared to medical interns before IPE training, and complaints from nurses about medical interns were significantly less frequent 1 year after the training
Kim and Kim [21] (2021)	One-group pretest-posttest design	RIPLS	p<0.001
Yu et al. [23] (2020)	Pre- and post-measures through quantitative surveys completed	(1) ATTITUDES; (2) JSAPNC; (3) IPEC competency	(1) Medical p<0.05, nursing <0.001; (2) medical p>0.05, nursing <0.01; (3) medical p<0.01, nursing <0.001

RIPLS: Readiness for Inter-professional Learning Scale, IPE: Interprofessional education, ATTITUDES: Attitude towards Teamwork in Training Undergoing Designed Educational Simulation, JSAPNC: Jefferson Scale of Attitudes toward Physician-Nurse Collaboration, IPEC: Interprofessional Education Collaborative.