Interprofessional education in the SUS and the readiness of health students to learn to work together as a team

Camile Fernandes Schmitz¹,  Everson Meireles²,  Ramona Fernanda Ceriotti Toassi³

^1,3 Federal Univesity of Rio Grande do Sul (UFRGS). Porto Alegre (RS), Brasil. ²Federal University of Bahia Recôncavo (UFRB). Santo Antônio de Jesus (BA), Brasil.

Introduction

The training of health professionals involves a teaching-learning system that is predominantly uniprofessional, restricting interaction and shared learning between different professions. This is a characteristic that is observed not only in Brazil,^1-3 but also internationally,⁴ which hinders the training in the professional sphere, since, throughout the course, there is a distancing between students from different areas of health, reducing their readiness to work as a team.^2,5

The development of collaborative skills for teamwork as from undergraduate studies has been increasingly demanded, especially due to the complexity of health needs, to the aging population with its vulnerabilities and/or subjected to various processes of vulnerability (e.g. black people, women, residents of peripheral areas, LGBTQIA+), and to the high number of new cases of chronic diseases.^4,6-7 Teamwork based on collaborative practices in a network with users-families-community is thus established as a strategy for strengthening the national health system (SUS - Sistema Único de Saúde), which is essential to ensure comprehensive care and patient safety.^3,8-9

For the qualification of the healthcare workforce, interprofessional education (IPE) activities are recommended in undergraduate and postgraduate curricula, as well as in continuing education activities for multidisciplinary teams.^6,10-11 IPE encourages the development of collaborative skills for teamwork and recognition of the importance of each profession in the healthcare process,^3,12,13 occurring when students from two or more courses interact with each other, exchanging knowledge and learning together to advance teamwork, thus promoting better results in the field of healthcare.^6,10,14

The current National Curriculum Guidelines (NCG) for undergraduate health courses specifically address the need for IPE by including teamwork from an interprofessional and collaborative perspective as a characteristic of the graduate profile.¹⁵ IPE has been observed in short courses,¹⁶ in undergraduate teaching activities,^2,12,17-18 in curricular internships,^17-18 and in extracurricular/elective activities, such as extension projects/programs and in the Education through Work for Health Program (Programa de Educação pelo Trabalho - PET-Saúde).^7,19-22 Despite the advances, the vast majority of these initiatives are characterized as non-mandatory activities in the curricula, which weakens the proposal to institutionalize IPE as a structuring policy for the training of healthcare professionals.^8,20-21,23

One of the aspects that affects the development of teamwork skills based on interprofessional-collaborative practices is the readiness of students to engage in shared learning. IPE has been associated with improvements in professional practice related to effective teamwork and patient safety, enhancing readiness to learn ‘with’ and ‘about’ different professions and encouraging collaborative behaviors (attitudes)^14,20,22,24. As a result, IPE stands out as a powerful educational strategy for improving and strengthening health systems and teams, qualifying care centered on the needs of individuals-families-community.^6,8,14,24

Studies show that the readiness to engage in shared learning between different professions is greater among students at the beginning of their undergraduate studies, especially when IPE is not continuously present in the curriculum,^9,24 as well as among students who participated in IPE activities during their undergraduate studies when compared to those who did not have such experiences.¹⁸

This study aims to analyze the perception of undergraduate students in health courses who experienced IPE activities with teams from the Family Health Strategy (FHS)/SUS regarding their readiness to learn together and work as a team.

Method

A cross-sectional study was conducted with students from 11 undergraduate health courses at a public university in southern Brazil who experienced IPE activities in SUS practice settings alongside FHS teams.

This IPE activity lasts 60 hours (four hours per week for four months) and is elective or additional (not mandatory) to the undergraduate curriculum, according to the definition of each course. In order for places to be offered to students (five places per course), there must be a professor from the professional core involved in the activity. There are tutoring and concentration activities. Tutoring includes extension hours, which take place in Health Units, with groups of eight to ten students and two professors from different courses, who interact and learn with professionals from the FHS multiprofessional team, especially with Community Health Agents. Concentration sessions, on the other hand, bring all groups together at the university to share, discuss, and articulate the theoretical and practical aspects of what they are experiencing. The study units of the activity are territory and territorialization, the teamwork process and interprofessionality, as well as healthcare for families-communities.²⁵ During the research period, the following courses participated in the IPE activity: Biological Sciences, Pharmacy, Physiotherapy, Speech Therapy, Veterinary Medicine, Nutrition, Dentistry, Psychology, Public Policies, Public Health, and Social Work. The absence of the Nursing and Medicine courses is noteworthy, as there were no professors from those courses assigned to work in the teaching activity during that period.

A total of 142 students from 11 undergraduate health courses who had finished the IPE activity from 2021 (after the pandemic period of emergency remote teaching) to 2024 were invited to participate in the study (Table 1). Students who requested cancellation of their registration for the IPE activity or who did not finish it due to lack of attendance were excluded.

Table 1 - Students who finished the IPE activity. Porto Alegre (RS), Brazil, 2021 to 2024.

Undergraduate courses	Students who finished the IPE activity				Total
	2021 (n)	2022 (n)	2023 (n)	2024 (n)	n	%
Biological Sciences	2*	1	3†	3	9	6.3
Pharmacy	3	4	9	6	22	15.5
Physiotherapy	3	7	7*	2	19	13.4
Speech Therapy	1	–	4	4	9	6.3
Veterinary Medicine	1	1	2	–	4	2.8
Nutrition	3	–	–	1	4	2.8
Dentistry	3*	4	13	17	37	26.1
Public Policies	–	–	1	1	2	1.4
Psychology	3*	–	4*	12	19	13.4
Public Health	–	2	1	–	3	2.1
Social Work	3	2	4	5	14	9.9
Total	22	21	48	51	142	100.0

* Course/year in which there was the return of one e-mail.

† Course/year in which there was the return of two e-mails.

 

The data were collected after completion of the IPE activity through the online application of the validated and expanded Portuguese version of the Readiness for Interprofessional Learning Scale (RIPLS-40),¹⁸ adding information on the students' context, including their IPE experiences in undergraduate education, extension, and research. The students received, via individual e-mail messages, the link to access the Free and Informed Consent Form and the research instrument, which were made available on a web interface. The invitations were forwarded for four consecutive weeks.

Originally proposed by Parsell and Bligh,²⁶ the RIPLS is a scale that allows the assessment of students' readiness to engage in interprofessional learning. It has items designed to assess three dimensions/factors: 1. Teamwork and collaboration; 2. Professional identity; 3. Patient-centered healthcare. Responses to each item are recorded on a five-point Likert scale (1 = Strongly disagree; 2 = Disagree; 3 = Neither agree, nor disagree; 4 = Agree; 5 = Strongly agree). The scores are obtained from the simple arithmetic mean of the responses to the items in each dimension/factor assessed and represent the student's readiness to engage in shared and collaborative learning. The lower the score, the lower the readiness to engage in shared and collaborative learning and, therefore, the lower the readiness to engage in IPE.²⁴ Previous studies have presented evidence of validity based on internal structure, external criteria, and reliability (1. Teamwork and collaboration, α = 0.89; 2. Professional identity, α = 0.47 to 0.58; 3. Patient-centered healthcare, α = 0.83 to 0.85) for the use of the RIPLS-40 in Brazil.^7,18,27

The collected data were organized in an IBM SPSS Statistics 23.0 spreadsheet, from which they were analyzed descriptively (frequencies and percentages) and inferentially (group comparison). The internal consistency of the RIPLS-40 factors for the sample in this study was calculated by using Cronbach's alpha (α) index. The information characterizing the sample and the activities experienced by students/graduates during their undergraduate studies was categorized by course, considering four groups (A, B, C, and D) based on participation in IPE activities: A = “I did not participate”; B = “I participated only with students from my course”; C = “I participated along with students/professionals from other health courses”; D = “I participated in a shared manner, actively interacting with students from other courses - IPE.” Following that, the RIPLS-40 scores obtained for the four groups mentioned above were compared by means of statistical tests appropriate for each case (Student's t-test or ANOVA), at a level of p ≤ 0.05.

The research was approved by the Research Ethics Committee of the Federal University of Rio Grande do Sul (CAAE: 52635616.2.0000.5347/Opinion 1.868.125).

Results

Out of the 142 students who participated in IPE activities between 2021 and 2024, 56 participated in the study (39.4%) However, 10 were excluded from the analysis because they did not respond adequately to the methodological control question of the instrument (Pharmacy – n = 4; Speech Therapy – n = 2; Dentistry – n = 4). Thus, the sample consisted of 46 participants from the courses of Biological Sciences, Pharmacy, Physiotherapy, Speech Therapy, Veterinary Medicine, Nutrition, Dentistry, Psychology, Public Policies, Public Health, and Social Work. Most of the participants were female (69.6%), aged between 21 and 26 years (67.3%), and undergraduate students who were halfway through their courses (62.1%). The courses with the highest participation were Dentistry (43.5%); Physiotherapy (10.9%); and Psychology (8.7%) (Table 2).

Table 2 - Characterization of the study sample. Porto Alegre (RS), Brazil, 2025. 

Variables	n	%
Sex (n = 46)
Female	32	69.6
Male	14	30.4
Age group (n = 46)
21 to 23 years	13	28.2
24 to 26 years	18	39.1
27 to 30 years	9	19.6
31 to 33 years	3	6.5
34 to 36 years	1	2.2
37 to 40 years	1	2.2
45 to 52 years	1	2.2
Undergraduate course (n = 46)
Biological Sciences	3	6.5
Pharmacy	3	6.5
Physiotherapy	5	10.9
Speech Therapy	3	6.5
Veterinary Medicine	2	4.3
Nutrition	1	2.2
Dentistry	20	43.5
Public Policies	1	2.2
Psychology	4	8.7
Public Health	1	2.2
Social Work	3	6.5
Academic status (n = 46)
Undergraduate student	29	63.1
Professional who finished their undergraduate degree*	11	23.9
Professional who finished their undergraduate degree and is a graduate student*	6	13.0
Current stage of the undergraduate program (n = 29)
Beginning of the course	4	13.8
Halfway through the course	18	62.1
Finishing the course	7	24.1

* Group of study participants who had already finished their undergraduate degrees when the data were collected.

In the teaching activities experienced during undergraduate studies, shared learning through interaction between students from different professional backgrounds, characteristic of IPE, was observed by 97.6% of participants in the IPE elective activity with FHS/SUS teams, 21.7% in technical visits, and 13% in curricular internships in the SUS. In extension, 28.2% identified the experience in interprofessional activities, and 15.2% in research. Among extracurricular activities, 13.1% perceived IPE in extracurricular internships, and 36.9% in other extracurricular activities, such as the Education through Work for Health Program (PET-Saúde). Participants in the Dentistry course stood out as those with the highest number of IPE experiences in teaching, extension, and extracurricular activities (Table 3).

Table 3 - Activities undertaken by students/graduates during their undergraduate studies, by course. Porto Alegre (RS), Brazil, 2025.

	Did not undertake IPE						Undertook IPE
	Did not participate (Group A)		Participated only with students from the same course (Group B)		Participated along with students from other health courses (Group C)		Participated in a shared manner, interacting actively with students from other courses - IPE (Group D)
	n	%	n	%	n	%	n	%
IPE activity in FHS (teaching)
Biological Sciences	–	–	–	–	–	–	3	6.5
Pharmacy	–	–	–	–	–	–	2	4.3
Physiotherapy	–	–	–	–	1	2.2	5	10.9
Speech Therapy	–	–	–	–	–	–	3	6.5
Veterinary Medicine	–	–	–	–	–	–	2	4.3
Nutrition	–	–	–	–	–	–	1	2.2
Dentistry	–	–	–	–	–	–	20	43.5
Public Policies	–	–	–	–	–	–	1	2.2
Psychology	–	–	–	–	–	–	4	8.7
Public Health	–	–	–	–	–	–	1	2.2
Social Work	–	–	–	–	–	–	3	6.5
Total	--	--	--	--	1	2.2	45	97.8
Technical visit (teaching)
Biological Sciences	3	6.5	–	–	–	–	–	–
Pharmacy	–	–	3	6.5	–	–	–	–
Physiotherapy	4	8.7	–	–	–	–	1	2.2
Speech Therapy	2	4.3	–	–	–	–	1	2.2
Veterinary Medicine	–	–	2	4.3	–	–	–	–
Nutrition	–	–	1	2.2	–	–	–	–
Dentistry	9	19.6	3	6.5	3	6.5	5	10.9
Public Policies	–	–	1	2.2	–	–	–	–
Psychology	3	6.5	1	2.2	–	–	–	–
Public Health	–	–	–	–	–	–	1	2.2
Social Work	–	–	1	2.2	–	–	2	4.3
Total	21	45.6	12	26.1	3	6.5	10	21.8
Curricular internships in the SUS (teaching)
Biological Sciences	2	4.3	1	2.2	–	–	–	–
Pharmacy	–	–	1	2.2	1	2.2	1	2.2
Physiotherapy	4	8.6	–	–	–	–	1	2.2
Speech Therapy	3	6.5	–	–	–	–	–	–
Veterinary Medicine	–	–	1	2.2	–	–	1	2.2
Nutrition	1	2.2	–	–	–	–	–	–
Dentistry	14	30.4	3	6.5	1	2.2	2	4.3
Public Policies	1	2.2	–	–	–	–	–	–
Psychology	4	8.6	–	–	–	–	–	–
Public Health	–	–	–	–	1	2.2	–	–
Social Work	1	2.2	–	–	1	2.2	1	2.2
Total	30	65.0	6	13.1	4	8.8	6	13.1
Extension activities
Biological Sciences	1	2.2	–	–	–	–	2	4.3
Pharmacy	1	2.2	2	4.3	–	–	–	–
Physiotherapy	–	–	2	4.3	2	4.3	1	2.2
Speech Therapy	–	–	1	2.2	1	2.2	1	2.2
Veterinary Medicine	1	2.2	1	2.2	–	–	–	–
Nutrition	–	–	1	2.2	–	–	–	–
Dentistry	4	8.7	9	19.6	3	6.5	4	8.7
Public Policies	–	–	–	–	1	2.2	–	–
Psychology	2	4.3	–	–	–	–	2	4.3
Public Health	–	–	–	–	–	–	1	2.2
Social Work	1	2.2	–	–	–	–	2	4.3
Total	10	21.8	16	34.8	7	15.2	13	28.2
Research activities
Biological Sciences	–	–	1	2.2	2	4.3	–	–
Pharmacy	–	–	1	2.2	1	2.2	1	2.2
Physiotherapy	1	2.1	2	4.3	1	2.2	1	2.2
Speech Therapy	1	2.1	–	–	1	2.2	1	2.2
Veterinary Medicine	1	2.1	1	2.2	–	–	–	–
Nutrition	–	–	1	2.2	–	–	–	–
Dentistry	4	8.6	9	19.6	6	13.0	1	2.2
Public Policies	–	–	1	2.2	–	–	–	–
Psychology	1	2.1	1	2.2	1	2.2	1	2.2
Public Health	–	–	–	–	–	–	1	2.2
Social Work	1	2.2	1	2.2	–	–	1	2.2
Total	9	19.2	18	39.3	12	26.1	7	15.4
Extracurricular Internships
Biological Sciences	2	4.3	1	2.2	–	–	–	–
Pharmacy	–	–	1	2.2	1	2.2	1	2.2
Physiotherapy	4	8.7	–	–	–	–	1	2.2
Speech Therapy	3	6.5	–	–	–	–	–	–
Veterinary Medicine	–	–	1	2.2	–	–	1	2.2
Nutrition	1	2.1	–	–	–	–	–	–
Dentistry	14	30.4	3	6.5	1	2.2	2	4.3
Public Policies	1	2.1	–	–	–	–	–	–
Psychology	4	8.7	–	–	–	–	–	–
Public Health	–	–	–	–	1	2.2	–	–
Social Work	1	2.2	–	–	1	2.2	1	2.2
Total	30	65.0	6	13.1	4	8.8	6	13.1
Other extracurricular Activities
Biological Sciences	1	2.1	–	–	1	2.2	1	2.2
Pharmacy	–	–	–	–	2	4.3	1	2.2
Physiotherapy	1	2.2	–	–	1	2.2	3	6.5
Speech Therapy	–	–	–	–	1	2.2	2	4.3
Veterinary Medicine	–	–	1	2.2	–	–	1	2.2
Nutrition	–	–	1	2.2	–	–	–	–
Dentistry	4	8.7	7	15.2	4	8.7	5	10.8
Public Policies	–	–	1	2.2	–	–	–	–
Psychology	1	2.2	–	–	2	4.3	1	2.2
Public Health	–	–	–	–	–	–	1	2.2
Social Work	–	–	1	2.2	–	–	2	4.3
Total	7	15.2	11	24.0	11	23.9	17	36.9

 

The distribution of responses from health students and graduates to the RIPLS-40 items showed averages above ‘4 – Agree’ for the three factors of the scale, with 4.70 for Factor 1; 4.44 for Factor 2; and 4.43 for Factor 3 (Table 4).

Table 4 - Distribution of responses to the RIPLS-40 items (n = 46). Porto Alegre (RS), Brazil, 2025.

RIPLS-40 factors/items1	% of responses per point on the Likert scale					Measures of central trend
	1	2	3	4	5	M*	SD†
Factor 1. Teamwork and collaboration (α = 0.92; M = 4.70; SD = 0.35)
01. Learning alongside other students will help me become a more effective member of a healthcare team.	0.0	0.0	0.0	17.4	82.6	4.83	0.38
02. Patients would ultimately benefit if healthcare students worked together to solve patients' problems.	0.0	0.0	0.0	6.5	93.5	4.93	0.25
03. Shared learning with other healthcare students will increase my ability to understand clinical problems.	0.0	0.0	0.0	21.7	78.3	4.78	0.42
04. Learning alongside other healthcare students during undergraduate studies would improve relationships after graduation.	0.0	0.0	4.3	26.1	69.6	4.65	0.57
05. Communication skills should be learned together with other healthcare students.	0.0	0.0	4.3	26.1	69.6	4.65	0.57
06. Shared learning will help me think positively about other professionals.	0.0	0.0	13.0	26.1	60.9	4.48	0.72
07. For the learning in small groups to work, students need to trust and respect each other.	0.0	0.0	0.0	19.6	80.4	4.80	0.40
08. Teamwork skills are essential in the learning of all healthcare students.	0.0	0.0	0.0	21.7	78.3	4.78	0.42
09. Shared learning will help me understand my own limitations.	0.0	0.0	8.7	34.8	56.5	4.48	0.66
12‡. Clinical problem-solving skills should only be learned with students from my own course.	0.0	0.0	0.0	39.1	60.9	4.61	0.49
13. Shared learning with students from other healthcare professions will help me communicate better with patients and other professionals.	0.0	0.0	4.3	19.6	76.1	4.72	0.54
14. I would like the opportunity to work on projects in small groups with students from other healthcare professions.	0.0	0.0	4.3	41.3	54.3	4.50	0.59
15. Shared learning will help clarify the nature of patients' problems.	0.0	0.0	0.0	32.6	67.4	4.67	0.47
16. Shared learning during my undergraduate studies will help me become a professional who works better in a team.	0.0	0.0	2.2	28.3	69.6	4.67	0.52
40. It is important for healthcare professionals to establish common goals for teamwork.	0.0	0.0	0.0	41.3	58.7	4.59	0.50
Factor 2. Professional identity (α = 0.39; M = 4.44; SD = 0.47)
10‡. I avoid wasting my time learning alongside students from other healthcare professions.	2.2	2.2	6.5	30.4	58.7	4.41	0.88
11‡. It is unnecessary for undergraduate students in the healthcare field to learn together.	2.2	2.2	0.0	15.2	80.4	4.70	0.79
21‡. I would feel uncomfortable if another healthcare student knew more about a topic than I did.	0.0	2.2	10.9	43.5	43.5	4.28	0.75
38. In order to carry out my professional activities, it is important to know the duties of other healthcare professionals.	0.0	2.2	8.7	50.0	39.1	4.26	0.71
Factor 3. Patient-centered healthcare (α = 0.76; M = 4.43; SD = 0.34)
25. I like to understand the problem from the patient's perspective (patient situation).	0.0	0.0	4.3	37.0	58.7	4.54	0.59
26. Establishing a relationship of trust with my patients is important to me (patient situation).	0.0	0.0	0.0	28.3	71.7	4.72	0.46
27. I try to show compassion to my patients (patient situation).	0.0	0.0	6.5	19.6	73.9	4.67	0.60
28. Thinking of the patient as a person is important for prescribing the right treatment (patient situation).	0.0	0.0	4.3	19.6	76.1	4.72	0.54
29. In my profession, skills for interacting and cooperating with patients are necessary (patient situation).	0.0	2.2	6.5	26.1	65.2	4.54	0.72
31. The patient is co-responsible for their care.	0.0	4.3	19.6	52.2	23.9	3.96	0.79
32. The quality of patient care depends on the knowledge and skills of various healthcare professions.	0.0	0.0	4.3	52.2	43.5	4.39	0.58
33. The patient's opinion can change my clinical conduct.	2.2	10.9	19.6	50.0	17.4	3.70	0.96
34. Coordination between healthcare professionals is essential for the quality of patient care.	0.0	0.0	0.0	30.4	69.6	4.70	0.47
35. Understanding the patient's life context contributes to the quality of care.	0.0	0.0	0.0	21.7	78.3	4.78	0.42
36. The patient's family should participate in care.	0.0	4.3	17.4	43.5	34.8	4.09	0.84
37. The professional's bond with the patient and their family influences the quality of care.	0.0	2.2	8.7	32.6	56.5	4.43	0.75
39. The patient should participate in decisions about their treatment plan.	0.0	0.0	13.0	47.8	39.1	4.26	0.68

* M: Mean. † SD: Standard deviation. ‡ Items that are inverted for the purpose of calculating the factor score and internal consistency of each factor.

Note:¹ The item/factor ratio considers the findings of Toassi, Meireles and Peduzzi^¹⁸ for the factorial structure of the RIPLS-40 in the sample from Rio Grande do Sul.

 

No significant difference was found between the gender, age, education, undergraduate program, and stage of the program variables for any of the three RIPLS-40 factors (Table 5).

Table 5 - Comparisons of the results obtained for the three factors of the Readiness for Interprofessional Learning Scale (RIPLS-40) according to the gender, age group, education level, and stage of the course variables. Porto Alegre (RS), Brazil, 2025.

RIPLS factors	Group variables/ Categories	nn	Mean	Standard deviation	Significance of the comparison test* p
	Sex
Factor 1. Teamwork and collaboration	Female	32	4.72	0.30	0.341
	Male	14	4.58	0.43
Factor 2. Professional identity	Female	32	4.45	0.42	0.619
	Male	14	4.32	0.57
Factor 3. Patient-centered healthcare	Female	32	4.46	0.31	0.415
	Male	14	4.34	0.40
	Age group
Factor 1. Teamwork and collaboration	21 to 24 years	19	4.70	0.29	0.796
	≥ 25 years	27	4.66	0.39
Factor 2. Professional identity	21 to 24 years	19	4.39	0.38	0.571
	≥ 25 years	27	4.43	0.52
Factor 3. Patient-centered healthcare	21 to 24 years	19	4.45	0.29	0.729
	≥ 25 years	27	4.40	0.38
	Education leve
Factor 1. Teamwork and collaboration	Undergraduate degree	32	4.65	0.37	0.508
	PG/Graduate	14	4.73	0.31
Factor 2. Professional identity	Undergraduate degree	32	4.40	0.43	0.577
	PG/Graduate	14	4.45	0.56
Factor 3. Patient-centered healthcare	Undergraduate degree	32	4.44	0.33	0.710
	PG/Graduate	14	4.40	0.38
	Course
Factor 1. Teamwork and collaboration	Dentistry	20	4.61	0.40	0.371
	Other courses	26	4.73	0.30
Factor 2. Professional identity	Dentistry	20	4.31	0.48	0.177
	Other courses	26	4.49	0.45
Factor 3. Patient-centered healthcare	Dentistry	20	4.37	0.34	0.334
	Other courses	26	4.47	0.34
	Stage of the course
1. Teamwork and collaboration	Beginning	4	4.72	0.44	0.148
	Halfway through	18	4.59	0.31
	Finishing	7	4.64	0.51
	Graduate	17	4.77	0.30
2. Professional identity	Beginning	4	4.44	0.47	0.369
	Halfway through	18	4.35	0.45
	Finishing	7	4.36	0.38
	Graduate	17	4.50	0.53
3. Patient-centered healthcare	Beginning	4	4.37	0.44	0.927
	Halfway through	18	4.43	0.34
	Finishing	7	4.37	0.29
	Graduate	17	4.45	0.37

* Nonparametric tests: Mann-Whitney for comparison of two groups; Kruskall-Wallis for comparison of three or more groups.

Discussion

IPE activities during undergraduate studies are expected to promote improved interactions between different professions and (re)cognition of the role of each professional group in the care process, which should be centered on the health needs of individuals-families-community,^10,14,20 and should be cross-cutting as well as increase throughout professional training.^16,28 Despite the relevance of such activities and their mention and recommendation in reference documents for the training of the health workforce,^6,10,28 the Brazilian reality still presents pedagogical projects that insert IPE in a restricted way in health courses.²¹ Among the main challenges for implementing IPE activities in health curricula are limitations in physical space and in experienced and available professors, in addition to rivalry and hierarchy between courses/professions that generate resistance to shared learning, as well as distinct schedules between undergraduate curricula. ^2,5,19 Hence, there is a gap between undergraduate students who, in the professional sphere, need to develop collaborative skills for teamwork and for strengthening the SUS.^3,8-9 Therefore, research involving health students who are interested in learning about IPE experiences in undergraduate programs and who are open to shared learning is justified, since they have the potential to contribute to the analysis of the context in which such activities are developed in the curricula of health courses in the country and their effects on student behavior.

The results obtained regarding the internal consistency of the factors assessed by the RIPLS-40 in the sample of the present study reasonably reproduced findings from previous studies: 1. Teamwork and collaboration, α = 0.92; 2. Professional identity, α = 0.39; 3. Patient-centered healthcare, α = 0.76), showing more favorable results for the interpretation of factors 1 and 3, and less favorable for factor 2.^7,18,27

The participants in this study recognized the presence of different IPE activities linked to their undergraduate training, especially in teaching, in extracurricular activities and in extension, and to a lesser extent in research. This result confirms the findings in the literature that IPE is more frequent in non-compulsory curricular activities,^7,17-22 demonstrating a weakness in training for interprofessional teamwork. Likewise, this may suggest to students that interprofessional learning is less important than learning related to the specific knowledge of their profession, thus affecting their commitment to such activities.⁸

Among the interprofessional activities characterized by shared learning with interaction between students from different professions, stood out the IPE activity with FHS/SUS teams (elective), which was experienced by all participants in the study; curricular internships in the SUS; and extracurricular activities, such as PET-Saúde. These activities take place in SUS learning scenarios, where teamwork requires the integrated and collaborative performance of different health professionals in search of a comprehensive approach that articulates actions for health promotion, prevention, and recovery. This highlights the potential of the SUS for learning and interprofessional work.^1,12,19

In this study, the results of the RIPLS scale showed students with high readiness to engage in shared learning – with a mean score above 4 – which was also observed in studies conducted in Brazil with health students.^{7,17,18,22,27}

Regarding the factors on the scale, Factor 1, Teamwork and collaboration, had the highest agreement score (mean = 4.70). The “shared learning during undergraduate studies will help me become a professional who works better in a team” and the benefits achieved “if health students worked together to solve patients’ problems” questions had the highest agreement results (100% agree/strongly agree). This same result was found in national studies,^7,9,17,18,22 demonstrating students' understanding and appreciation of shared learning between different courses/professions.

Regarding Factor 2, Professional identity, high percentages of disagreement were observed in items related to “wasting time learning alongside students from other health professions” (89.1% disagree/strongly disagree), and “it is unnecessary for undergraduate health students to learn together ” (95.6% disagree/strongly disagree), corroborating studies conducted by Feitosa, Gomes and Silva⁹ and Tompsen et al.¹⁷ However, these results should be interpreted with caution, as this factor/dimension of the scale has shown poor internal consistency/reliability indices in the present study and in the aforementioned previous studies.^7,17,18,26

In Factor 3, Patient-centered healthcare, which is a collaborative skill to be developed for effective teamwork²⁹ (Canadian Interprofessional Health Collaborative, 2024), two of the 13 items had means below 4, with percentages of disagreement – “the patient is jointly responsible for their care” (item 31), and “the patient’s opinion can change my clinical conduct” (item 33), similar to the findings of Marques and Costa,²² suggesting these students’ lower readiness to involve patients/users in their care process and confirming the tendency toward a professional-centered care logic. The percentages of disagreement also observed in items 36, 37, and 39, which deal with the recognition of user participation in decisions about their care, are in line with this lower readiness.

No significant differences were found in the dimensions assessed by the RIPLS-40 between undergraduate courses. This result can be understood based on the experience in the IPE discipline in the SUS, which enabled the development of positive attitudes toward shared learning/working, thus producing homogeneous responses among participants.

As a limitation of the study, it is worth considering the small number of participating students (46 out of 142), combined with the difference in participation between courses and the absence of Nursing and Medicine students, which may have affected the results. For this reason, there was no intention to use the collected data for theoretical and psychometric refinements of the RIPLS-40, but the findings reaffirm the already established importance of new studies that can improve the scale with robust and rigorous psychometric analyses.^17,18 Another aspect that deserves attention in the analysis is the number of participants from the Dentistry program (20 of the 37 participants – 54% of the sample). Among the courses that took part in the IPE activity in the SUS during the analyzed period, Dentistry students were the ones who attended the most, which may be associated with greater visibility of the discipline in the course, since it is the Dentistry Undergraduate Committee that offers it each semester, holding the course code. It should be added that this interest among students in participating in IPE activity can also be explained by the work perspective of dental surgeons, since Brazil has a National Oral Health Policy that ensures that dental professionals are integrated into the oral health teams of the FHS, which is the learning environment for the IPE discipline.³⁰ Furthermore, all participants in the study had already undertaken the elective activity focused on IPE in SUS/FHS practice settings, i.e., they intentionally sought out the teaching activity in their curricula, which may suggest that they were already students with positive attitudes and an interest in IPE. Hence, despite the recognition of IPE in promoting collaborative attitudes^8,16,20 and in increasing the readiness for shared learning,^22,24 it is not possible to determine the extent to which the IPE discipline in the SUS was responsible for the group's high readiness for shared learning. Future studies that apply the scale at the beginning and at the end of the IPE activity in the SUS and that include students who did not participate in it, adding courses not included in this study, such as Nursing and Medicine, which are part of the FHS teams, are recommended, as well as longitudinal studies that can monitor changes in students' behavior/attitudes after participating in these IPE curricular activities.

Conclusion

            This research demonstrated that health students who participated in interprofessional activities in the SUS learning environment showed a high readiness to engage in shared learning, reinforcing evidence that IPE activities are associated with positive attitudes and with a high readiness among students to engage in shared learning/interprofessional work. The challenge of students recognizing the participation of users in decisions about their care persists, as does the need to include IPE in health curricula as a mandatory activity throughout the different stages of professional training.

Authors’ contributions

Study design: Camile Fernandes Schmitz and Ramona Fernanda Ceriotti Toassi. Data collection: Camile Fernandes Schmitz. Data analysis and interpretation: Camile Fernandes Schmitz, Everson Meireles and Ramona Fernanda Ceriotti Toassi. Manuscript writing: Camile Fernandes Schmitz and Ramona Fernanda Ceriotti Toassi. Manuscript critical review:  Camile Fernandes Schmitz, Everson Meireles and Ramona Fernanda Ceriotti Toassi. Approval of the final version of the text: Camile Fernandes Schmitz, Everson Meireles and Ramona Fernanda Ceriotti Toassi.

Conflict of interest

The authors declared that there is no conflict of interest.

Funding

This study was supported by the Rio Grande do Sul State Research Support Foundation (FAPERGS)/Federal University of Rio Grande do Sul (UFRGS), scientific initiation scholarship.

Acknowledgments

To the Rio Grande do Sul State Research Support Foundation (FAPERGS) and to the Federal University of Rio Grande do Sul (UFRGS).

References

1. Peduzzi M. O SUS é interprofissional [Internet]. Interface (Botucatu). 2016 [cited 2025 Apr 25];20(56):199-201. DOI: https://doi.org/10.1590/1807-57622015.0383

2. Costa JB, Mazzi NR, Peduzzi M, Germani ACCG, Silva JAM, Agreli HLF, Nascimento AG, Belber GS, Leonello VM. Caracterização das experiências de educação interprofissional na formação em saúde na Universidade de São Paulo [Internet]. Rev Esc Enferm USP. 2023 [cited 2024 Nov 02];57:e20230118. DOI: https://doi.org/10.1590/1980-220X-REEUSP-2023-0118en

3. Gonçalves JRSN, Gonçalves RN, Rosa SV, Orsi JSR, Paula KMS, Moysés SJ, Werneck RI. Potentialities and limitations of Interprofessional Education during graduation: a systematic review and thematic synthesis of qualitative studies [Internet]. BMC med educ. 2023 [cited 2025 Mar 05];23:236. DOI: https://doi.org/10.1186/s12909-023-04211-6

4. Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, Fineberg H, Garcia P, Ke Y, Kelley P, Kistnasamy B, Meleis A, Naylor D, Pablos-Mendez A, Reddy S, Scrimshaw S, Sepulveda J, Serwadda D, Zurayk H Health professionals for a new century: transforming education to strengthen health systems in an interdependent world [Internet]. The Lancet. 2010 [cited 2024 June 15];376:1923-58. DOI: https://doi.org/10.1016/S0140-6736(10)61854-5

5. Farinha AL, Jaeger FP, Marchiori MRCT, Budel LJ, Colomé JS. Educação interprofissional nas práticas de integração ensino-serviço-comunidade: perspectivas de docentes da área da saúde [Internet]. Esc Anna Nery. 2023 [cited 2024 Nov 29];27:e20220212. DOI: https://doi.org/10.1590/2177-9465-EAN-2022-0212pt

6. Organização Mundial da Saúde. Marco para ação em educação interprofissional e prática colaborativa [Internet]. Genebra: OMS. 2010 [cited 2024 Aug 12]. Avaliable from: https://untref.edu.ar/uploads/Marco%20formacion%20interprofesional%20OMS-portugues.pdf

7. Cavinatto TJ, Mininel VA, Peduzzi M, Leite DR, Meireles E, Toassi RFC, Silva JAM. Experiências extracurriculares e disponibilidade para a educação interprofissional em cursos de graduação em saúde [Internet]. Saberes Plur. 2022 [cited 2025 Jan 21];6(2):1-13. DOI: https://doi.org/10.54909/sp.v6i2.128200

8. Reeves S. Por que precisamos da educação interprofissional para um cuidado eficaz e seguro [Internet]. Interface (Botucatu). 2016 [cited 2023 June 12];20(56):185-96. DOI: https://doi.org/10.1590/1807-57622014.0092

9. Feitosa LN, Carneiro P, Gomes P, Silva RM. Disponibilidade para aprendizagem interprofissional em cursos de saúde em uma faculdade do Nordeste do Brasil [Internet]. J Health Biol Sci. 2023 [cited 2024 Dec 20];11(1):1-13. DOI: https://doi.org/10.12662/2317-3076jhbs.v11i1.4346.p1-13.2023

10. Barr H, Low H. Introdução à educação interprofissional [Internet]. Reino Unido: Centro para o Avanço da Educação Interprofissional (CAIPE). 2013[cited 2024 Dec 4]. Available from: https://www.rets.epsjv.fiocruz.br/biblioteca/introducao-educacao-interprofissional

11. Maffissoni AL, Martini JG, Lazzari DD, Vendruscolo C, Sanes MS, Bresolin P. Disponibilidade de residentes e preceptores para práticas interprofissionais: estudo de métodos mistos [Internet]. Rev latino am enferm. 2024 [cited 2024 Dec 13];32:e4395. DOI: https://doi.org/10.1590/1518-8345.7374.4395

12. Toassi RFC, Olsson TO, Lewgoy AMB, Bueno D, Peduzzi M. Ensino de graduação em cenários da atenção primária: espaço para aprendizagem interprofissional [Internet]. Trab. Educ Saúde. 2020 [cited 2025 July 24];18(2):e0026798. DOI: https://doi.org/10.1590/1981-7746-sol00267

13. Pereira AKAM, Batista SHSS, Soares PDFL, Figueiredo LRU, Souza RMP, Costa MV. Planning of Interprofessional education initiatives for the development of interprofessional competencies: an analysis based on the PET-Health Interprofessionality/Brazil [Internet]. J Interprof Care. 2025 [cited 2024 Nov 23];39(2):248-56. DOI: https://doi.org/10.1080/13561820.2025.2462127

14. Reeves S, Perrier L, Goldman J, Freeth D, Zwarenstein M. Interprofessional education: effects on professional practice and healthcare outcomes [Internet]. Cochrane Database of Syst Rev on-line. 2013 [cited 2023 Jul 11]. DOI: https://doi.org/10.1002/14651858.CD002213.pub3

15. Lima RBD, Miranda ES, Silva ALA, Freitas SEAP. Interprofissionalidade nas diretrizes curriculares nacionais brasileiras dos cursos da área da saúde [Internet]. Avaliação (Campinas). 2024 [cited 2025 Jan 10];29:e024020. DOI: https://doi.org/10.1590/1982-57652024v29id279379

16. Guinat M, Greppin-Bécherraz C, Staffoni L, Didier A, Santschi V. Impact of an interprofessional training on students’ attitudes toward interprofessional education [Internet]. J Interprof Care. 2021 [cited 2025 Aug 10];2024;39(1):92-102. DOI: https://doi.org/10.1080/13561820.2024.2408377

17. Tompsen NN, Meireles E, Peduzzi M, Toassi RFC. Educação interprofissional na graduação em Odontologia: experiências curriculares e prontidão dos estudantes [Internet]. Rev Odontol UNESP. 2018 [cited 2025 Feb 02];47(5):309-20. DOI: https://doi.org/10.1590/1807-2577.08518

18. Toassi RFC, Meireles E, Peduzzi M. Interprofessional practices and readiness for interprofessional learning among health students and graduates in Rio Grande do Sul, Brazil: a cross-sectional study [Internet]. J Interprof Care. 2021 [cited 2025 Jan 17];35(3):391-9. DOI: https://doi.org/10.1080/13561820.2020.1773419

19. Alves FAP, Medeiros KS, Santos EG, Araújo GKN, Santos LMS, Souto RQ, Lúcio FPS, Borba AKOT, Jardim VCF. A interdisciplinaridade como estratégia de ensino e aprendizagem [Internet]. Rev enferm UFPE on line. 2019 [cited 2025 July 29];13:e240192. DOI: https://doi.org/10.5205/1981-8963.2019.240192

20. Brinco R, França T, Magnago C. PET-Saúde/Interprofissionalidade e o desenvolvimento de mudanças curriculares e práticas colaborativas [Internet]. Saúde debate. 2022 [cited 2024 Dec 11];46(spe6):55-69. DOI: https://doi.org/10.1590/0103-11042022E606

21. Benevides R, Miranda ES, Abrahão AL, Pereira S. Educação interprofissional nos cursos da área da saúde de uma universidade pública [Internet]. Saúde debate. 2023 [cited 2025 July 08];47(139):905-17. DOI: https://doi.org/10.1590/0103-1104202313913

22. Marques JFL, Costa MV. PET-Saúde Interprofissionalidade e a prontidão dos estudantes para a aprendizagem interprofissional [Internet]. Saúde Soc. 2023 [cited 2025 Jan 17];32;e220878pt. DOI: https://doi.org/10.1590/S0104-12902023220878pt

23. Prevedello AS, Góes FSN, Cyrino EG. Educação interprofissional na formação em saúde no Brasil: revisão de escopo [Internet]. Rev Bras Educ Méd. 2022 [cited 2024 Nov 11];46(3):e110. DOI: https://doi.org/10.1590/1981-5271v46.3-20210006

24. Peduzzi M, Norman I, Coster S, Meireles E. Adaptação transcultural da escala de prontidão para aprendizagem interprofissional no Brasil [Internet]. Rev Esc Enferm USP. 2015 [cited 2024 Nov 23];49(Special Issue2):7-14. DOI: https://doi.org/10.1590/S0080-623420150000800002

25. Toassi RFC, Lewgoy AMB, Hoff M. A proposta pedagógica: um caminho (re)construído pela interação e colaboração. In: Lewgoy AMB, Bueno D, Toassi RFC., editores. Integrar para aprender sobre saúde: a experiência interprofissional do cuidado nos territórios. 1. ed. Porto Alegre: Editora Rede Unida, 2024; p. 54-70. Avaliable from: https://lume.ufrgs.br/handle/10183/277239

26. Parsell G, Bligh J. The development of a questionnaire to assess the readiness of health care students for interprofessional learning (RIPLS) [Internet]. Med Educ. 1999 [cited 2025 July 24];33(2):95-100. DOI: https://doi.org/10.1046/j.1365-2923.1999.00298.x

27. Meireles E, Silva LS, Santana LAA, Toassi RFC, Silva JAM, Peduzzi M. Evidências de validade e confiabilidade para uso da Escala de Prontidão para Aprendizagem Interprofissional (RIPLS-40) em estudantes da Bahia [Internet]. Saberes Plur. 2024 [cited 2025 June 29];8(1):e139272. DOI: https://doi.org/10.54909/sp.v8i1.139272

28. Institute of Medicine. Mensurando o impacto da educação interprofissional na prática colaborativa e nos desfechos dos pacientes [Internet]. Washington, DC: The National Academies Press. 2015 [cited 2025 July 06]. DOI: https://doi.org/10.17226/21726

29. Canadian Interprofessional Health Collaborative. Marco de competências para o avanço da colaboração [Internet]. CIHC, Vancouver. 2024 [cited 2024 Aug 21]. Available from: https://cihc-cpis.com/wp-content/uploads/2024/06/CIHC-Competency-Framework.pdf

30. Souza GCA, Kusma SZ, Moysés SJ, Roncalli AG. Implantação da Política Nacional de Saúde Bucal e sua influência sobre a morbidade bucal em capitais brasileiras na primeira década do século XXI [Internet]. Cad Saúde Pública. 2021 [cited 2025 July 06];37(12):e00320720. DOI: https://doi.org/10.1590/0102-311X00320720

Corresponding Author

Ramona Fernanda Ceriotti Toassi

E-mail: ramona.fernanda@ufrgs.br

The Author(s) 2026.  This work is licensed under Creative Commons Attribution 4.0 International. License text for use: https://creativecommons.org/licenses/by/4.0/deed.pt_BR