3 51 The differences in content of health care plans The score ratios in the ‘consultations’ category were not better in the IPE group than in the UPE group. This is in contrast to earlier research by Sanders et al. (2023), where students reported better knowledge about referring to other disciplines after IPE. Overall, all students scored relatively low ratios on all four cases, between 0.20 and 0.34. This could be due to different reasons. First, the health care plan which was used to compare the students’ plans with, should not be seen as “an answer key to a test”, where one expects the best students to score near 90% or 100%. The validated health care plan was a compilation of plans of different specialists and should be interpreted as a list of things you could do ‘right for this patient’. Students wrote down some of these items, and were ‘rewarded’ for each right item, but students at this stage may not be capable of having oversight for all items. Therefore, we did not expect students to get a total ratio of 1. To better interpret the level of students’ knowledge and skills compared to the standard health care plan, 13 residents were asked to write health care plans for case 4. Their mean ratio was 0.27, while the UPE group scored 0.22 and the IPE group scored 0.30. Therefore we conclude that the low ratios were not due to our sample, but mainly due to the ‘procedure’: the high standard and the way of assessing. This leads to the second possible reason: the assessment of the care plans may have been too strict. For example, when students had written down ‘delirium interventions’, without examples or specifications, there were no points given. In educational settings teachers try to train students to be more specific and explain what they mean, to ensure that they have an understanding of what they write down. In clinical practice there would probably be questions asked about a vague formulation and the item would be specified and executed. If assessed more leniently, the scores would have been higher. This did not matter while comparing the scores as all plans were assessed in the same way and in a blinded manner. Third, students commented that they would have appreciated receiving feedback after each assignment. Because the sessions about case 1 were spread over a one-year period, and all treatment plans of 1 case were assessed at the same time when all sessions were completed to ensure consistency in the assessment, it was not possible to give feedback to each student individually between each assignment. If feedback had been provided, the scores may have been higher. The insights generated by this study can help to shape future case-based IPE to enhance the quality of students’ health care plans. Directly before a session a teacher can provide information on how to formulate health care plans, and also make the different perspectives of nursing and medical students more explicit. Afterwards the health care plans should be assessed within a short period and students should receive feedback before writing the next health care plan. Differences between writing it on your own or with someone from a different profession can also be discussed with students, to make the different perspectives more comprehensible and
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