This observational study evaluated the impact of IPE on pharmacy students in clinical practice. Participants completed self-administered questionnaires assessing the IPE program before and after a hospital internship. The questionnaires were distributed and collected by the faculty.

A total of 68 fifth-year pharmacy students at the University of Tokushima who underwent hospital practical training at the Tokushima University Hospital in the 2018–2019 academic year were included in the study. None of the students had any experience with IPE programs. Before inclusion, the purpose, methods, risks and benefits, protection of personal information, modification or discontinuation of the study, handling of research results, consent and withdrawal, and conflicts of interest regarding the study were explained to all participants. The study was conducted in compliance with the Ethical Guidelines for Medical Research Involving Human Subjects and with the approval of The Ethics Committee of Tokushima University Hospital (approval number: 3544). We informed the participants in writing that their participation in the study would not affect their academic performance and obtained their written consent.

The participants learned the required clinical training curriculum set by the government, that is, the knowledge and skills of the basic tasks required for hospital pharmacists and patient care, irrespective of consent. IPE was conducted with physicians and sixth-year medical students in the Department of Respiratory Collagen Disease, who provided their consent to participate. Therefore, 13 pharmacy students who accepted practical training in the Department of Respiratory and Collagen Diseases consented to participate in IPE. The remaining 55 students were non-IPEs, intervening in patient care that included collaboration with other healthcare professionals, both ward pharmacists and other healthcare professionals, to minimize the differences in educational content. The IPE program was implemented as part of students’ clinical training, with participants randomly assigned 1:1 to a pharmacist for practice. The random allocation was blinded, ensuring that the selection process was objective and not influenced by students’ preferences or motivations toward team-based medicine. This minimized the risk of selection bias, where highly motivated students might have preferentially joined the IPE group. Additionally, we reviewed the GPA of both groups and found no significant differences, further validating our results.

Although COVID-19 began to spread in 2019, it did not affect the facilities where this study was implemented, and all procedures were carried out in accordance with the research plan. Medical students enrolled in the Faculty of Medicine at Tokushima University during the clinical training period were included in the study. Three pharmacists, one physician in the Department of Respiratory Collagen Disease, and two Tokushima University Hospital faculty members were responsible for conducting the IPE.

In IPE, a patient admitted to the Department of Respiratory and Collagen Diseases at Tokushima University Hospital during practical training was used as a case for planning medical care. At the time of admission, the patient consented to students’ participation in the medical procedures for the purpose of clinical education. A group of two to three pharmacy students and two to three medical students discussed the treatment and care for effective patient discharge and the post-discharge treatment and care for them and their families. The training was divided into two sessions—orientation and practical training—with around a week gap between them (Fig. 1). The orientation consisted of (a) an introduction of the mentor/self-introduction (15 min.), where the mentor and the students briefly introduced themselves; (b) an explanation of IPE outline and its significance (10 min.), where the mentor explained the day’s training schedule and the implication of IPE; and (c) selection of cases for training (20 min.), where the mentor and the students selected suitable cases for practice among the cases that the students were already in charge of. For the selected case, each student had to check the patient’s medical record and understand their condition. The practical training consisted of (d) an explanation of the patient’s condition at the time of admission by pharmacy students (5 min.), where they explained the details of the initial interview, such as the medication status and history that might affect the treatment; (e) an explanation of the current treatment by medical students (15 min.), where they explained the treatment progress before and after hospitalization, including diagnostic imaging; (f) a question-and-answer session with other undergraduate students (15 min.), where the students asked their queries; (g) development of a post-discharge treatment plan (15 min.), which identified and discussed the problems in home life and outpatient care; and (h) feedback from a mentor (10 min.), where teachers gave feedback to the group.

Clinical practice-based-IPE program. The plan implemented in this study is shown in the figure; the IPE program was developed over three orientation sessions and five training sessions

The survey items were SBOs, KiSS-18, and RIPLS. The survey was administered to the non-IPE and IPE groups before and after training. Questionnaire responses were obtained from all participating students for pre-education data after consent was obtained and for post-education data following IPE implementation. The contents of the team medicine SBOs, KiSS-18, and RIPLS are presented in Table 1. A five-point Likert scale was used for the SBOs, KiSS-18, and RIPLS. For RIPLS, the factors were Factor 1: Teamwork and collaboration; Factor 2: Understanding the need for IPE; and Factor 3: Professionalism in the profession [16].

Factor 1 was categorized into items 1–9 and 13–16; Factor 2 into items 10 and 11; and Factor 3 into items 12 and 17–19. They were evaluated based on the total score of each category. Items 10–12 and 17–18 were reversed items.

The questionnaires were collected by using students’ attendance numbers for identification. The information was anonymized after collection by setting a different identification number and using it for analysis. Only responses from participants who completed all survey items were included in the analysis. Incomplete or missing responses were excluded to ensure data reliability and validity. This exclusion criterion was applied uniformly across both the IPE and non-IPE groups to maintain the integrity of the comparisons made in the study. The pre- and post-practice ratings of the SBOs, KiSS-18, and RIPLS were compared. For each dependent variable (SBOs, KiSS-18, and RIPLS Factors 1–3), a linear mixed model analysis was conducted with the research participant as the variable factor, and the time factor (before and after the training), the group (non-IPE vs. IPE), the interaction term (group with time factor), and the value of the dependent variable before training as fixed factors. The effect size was evaluated by η2. The statistical significance level was set at 0.05 on both sides. The statistical software IBM SPSS Statistics v. 24.0 (IBM Corp., NY, USA) was used for analysis.