13 1 General introduction impact of IPE in improving the knowledge, skills, and attitudes of students about collaborative teamwork. Spaulding et al. (2021) observed significant improvements in 17 out of the 19 studies that evaluated the attitudes towards other disciplines. There were 7 studies that assessed change in collaborative behaviour, and they all found significant improvements. Mixed results were found among the 12 studies that assessed progress of collaborative skills. Saragih et al. (2024) performed a review about the impact of interprofessional education on collaborative practice of healthcare professionals. The results showed that interprofessional education significantly improved interprofessional knowledge and attitudes towards other professionals. Level 4: Effects on patient outcomes The fourth Kirkpatrick level, effects on patient outcomes and organizational practice, seems to be the most difficult outcome to measure. In 2016, Reeves et al. (2016) stated in their review, that there is limited but increasing evidence related to changes in organizational practice and benefits to patients. Rutherford-Hemming and Lioce (2018) also found, in their review about IPE in nursing, that more studies with rigorous research designs are needed to compare outcomes to determine the effects on patient outcomes. Recently, Cadet et al. (2024) performed a scoping review, describing the evidence linking IPE interventions to improving the delivery of safe and effective patient care. The 94 papers included offered a wealth of data that demonstrated a positive relationship between IPE interventions and a number of important quality health indicators, such as mortality, length of stay, medical errors and patient satisfaction. They argue for further implementation and evaluation of IPE interventions to improve patient outcomes. A recent review of Shuyi et al. (2024) evaluated the effectiveness of interprofessional education for medical and nursing professionals and students on all four Kirkpatrick levels. They found improvements on all levels after IPE. There are gaps in the literature about IPE that can be investigated. First, most research on IPE initiatives focus on the first two or three Kirkpatrick-levels (Reeves et al., 2016). Level four is the most desirable to measure, because it can determine whether IPE has an effect on clinical outcome. When IPE is offered in undergraduate curricula, it’s challenging to measure outcomes at level four, because students generally do not share responsibility for patient care in clinical practice. And when they do, it is usually under strict supervision. Nevertheless, it is important to measure outcomes at the highest level possible, because those outcomes make a difference for the clinical care for patients.
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