Pandemic preparedness and response in VUCA healthcare environments using an interprofessional framework: a scoping review

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Collaboration among medical doctors, nurses, and physiotherapists—central to ward-based care—proved pivotal in managing rapidly evolving clinical protocols and surging patient demands. Objective: This scoping review aimed to map IPC strategies employed by medical doctors, nurses, and physiotherapists during the COVID-19 pandemic, assess their impact on pandemic preparedness and response, and identify opportunities for integrating these practices into health professional education to enhance VUCA readiness. Methods: Following Arksey and O'Malley’s methodological framework, a scoping review was conducted to systematically map existing literature on IPC during the COVID-19 pandemic. Comprehensive searches of PubMed, Scopus, Web of Science, PsycINFO, ERIC, and Google Scholar were performed using Boolean logic. Studies were eligible if they examined collaborative practices among healthcare professionals, with particular focus on medical doctors, nurses, and physiotherapists across varied healthcare settings. Two independent reviewers screened 760 records, achieving high inter-rater reliability (Cohen’s kappa = 0.87), resulting in 14 studies included in the final synthesis. Results: Five key IPC strategy themes emerged: (1) enhanced interprofessional communication, (2) role flexibility and boundary adaptation, (3) collaborative leadership development, (4) continuous interprofessional education and capacity-building, and (5) peer support mechanisms. Nursing appeared in 92.9% of studies, medicine in 71.4%, and physiotherapy in 21.4%. Collaborative teams demonstrated a 34% greater capacity to adapt care protocols and a 28% reduction in medical errors compared to less collaborative teams. A three-phase thematic framework was developed,tracing the evolution of IPC from pre-pandemic baseline conditions through crisis-activated competencies to future preparedness strategies. Conclusions: Interprofessional collaboration—especially among medical doctors, nurses, and physiotherapists—proved to be a core competency in managing the complexities of VUCA healthcare environmentsduring the pandemic. Despite these demonstrated benefits, only 23% of healthcare education programs include substantial interprofessional components. Embedding interprofessional communication, role clarity, and collaborative problem-solving into health curricula is essential for preparing professionals to meet future healthcare challenges. These findings offer an evidence-based foundation for transforming education and service delivery to support resilient, team-based care in crisis conditions. Interprofessional collaboration pandemic preparedness VUCA environments healthcare education crisis management COVID-19 simulation-based learning collaborative competencies Figures Figure 1 Introduction The COVID-19 pandemic created VUCA environments—volatile, uncertain, complex, and ambiguous—that disrupted traditional healthcare delivery and demanded agile, collaborative interprofessional practice across diverse healthcare settings. Clinicians faced rapidly changing protocols, resource scarcity, and overwhelming patient volumes. These conditions required teamwork that transcended professional hierarchies and established practice boundaries fundamentally challenging traditional models of healthcare delivery and professional interaction. Research has demonstrated the critical importance of interprofessional collaboration during crisis periods. Studies among physiotherapists and other allied health professionals revealed how healthcare teams moved through distinct adaptation phases ( 1 , 2 ). Teams progressed from initial disruption to restructured collaboration models that fostered professional growth and enhanced cohesion. Similarly, physicians and nurses emphasized that mutual humility and patient-cantered focus strengthened collaborative relationships, even amid unprecedented stress and resource constraints ( 3 , 4 ). Building on these foundational collaborative relationships, the pandemic catalysed innovative initiatives that demonstrated the potential for enhanced interprofessional practice. Virtual collaboration platforms, rapid protocol development teams, and cross-disciplinary care bundles enabled evidence-based practice and fluid knowledge-sharing across professional boundaries ( 5 – 7 ). Importantly, higher-quality interprofessional collaboration was associated with improved clinician wellbeing and reduced psychological distress demonstrating both clinical and human resource benefits ( 8 , 9 ). However, translating these crisis-driven advances into educational practice reveals significant gaps in preparing healthcare professionals for VUCA environments. Recent graduates reported unclear role definitions, insufficient interprofessional communication training, and limited collaborative competency development during their undergraduate education ( 10 , 11 ). These educational deficits become particularly problematic during crisis situations when rapid, effective collaboration is essential for patient safety and system functioning. In response to these challenges, international IPE initiatives have emerged, including online modules, simulation-based team training, and case-based learning approaches ( 2 , 11 ). These educational efforts align with WHO's Framework for Action on Interprofessional Education and Collaborative Practice (2010), which advocates interprofessional learning as essential for building responsive health systems. Despite these insights, there remains a gap in understanding how specific interprofessional collaboration strategies developed during COVID-19 can systematically inform health professional education. (Al Salem et al., 2024; Devi et al., 2024). Despite these insights, there remains a gap in understanding how specific interprofessional collaboration strategies developed during COVID-19 can systematically inform health professional education. The pandemic created an unprecedented natural experiment in collaborative practice adaptation, generating valuable empirical evidence about effective crisis collaboration strategies. Yet these lessons have not been comprehensively translated into educational frameworks for future crisis preparedness ( 12 , 13 ). Aim This scoping review systematically mapped interprofessional collaboration strategies involving medical doctors, nurses, and physiotherapists during the COVID-19 pandemic. It evaluated their effectiveness in enhancing pandemic preparedness and workforce capacity, and identified evidence-based opportunities to embed these collaborative practices into health professional education curricula. Through this analysis, the review aims to develop a comprehensive theoretical framework that can guide both educational curriculum development and organizational preparedness strategies for future VUCA healthcare environments. Methods Framework and protocol We followed the framework by Arksey and O'Malley (2005), enhanced by ( 14 ) and JBI methodology. A comprehensive protocol was pre-registered on the Open Science Framework (OSF) ( https://doi.org/10.17605/OSF.IO/A6F3D ) , detailing objectives, eligibility criteria using Population-Concept-Context framework, selected databases, and timeframe (COVID-19 pandemic period 2022 to early 2024). Inclusion criteria were specifically defined as studies examining collaborative practices among healthcare professionals during the pandemic, with focus on medical doctors, nurses, and physiotherapists across diverse healthcare settings; peer-reviewed articles published in English; and studies providing clear examination of collaborative practices with measurable outcomes or detailed qualitative descriptions. Exclusion criteria included studies focusing solely on single professions without interprofessional interaction; non-English publications; studies without clear examination of collaborative practices; and opinion pieces or editorials without empirical data Patient and the public involvement No patients or members of the public were involved in the design, conduct, or reporting of this scoping review, which is consistent with established methodology for scoping reviews focused on professional practice synthesis. Search strategy and selection We systematically searched PubMed, Scopus, Web of Science, PsycINFO, ERIC, and Google Scholar using Boolean operators: ("interprofessional collaboration" OR "interprofessional teamwork" OR "multidisciplinary teams") AND ("COVID-19" OR "pandemic" OR "SARS-CoV-2") AND ("medical doctors" OR "nurses" OR "physiotherapists" OR "healthcare professionals"). The search strategy was developed iteratively with input from the researchers and pilot-tested to ensure comprehensive capture of relevant literature. Additional hand-searching of reference lists from included studies and key journals was conducted to identify any missed articles. Two independent reviewers screened 760 records, resulting in 43 full-text articles assessed for eligibility. Disagreements between reviewers were resolved through discussion, with a third reviewer consulted when consensus could not be reached. Ultimately, 14 studies met the final inclusion criteria. Inter-rater reliability was high, with Cohen's kappa = 0.87, indicating excellent agreement. Covidence software was used throughout to manage the screening and data extraction process, ensuring systematic documentation of all decisions. Data extraction, synthesis and analysis Data extraction captured collaboration strategies, outcomes, barriers, facilitators, and educational implications using a standardized extraction form developed specifically for this review and pilot-tested on three studies before full implementation. Data extraction was conducted by two independent reviewers, with discrepancies resolved through discussion and third-party consultation when necessary. Thematic analysis was conducted using Braun and Clarke's six-phase approach, employing both inductive and deductive coding strategies. The analysis was guided by the Interprofessional Education Collaborative (IPEC) and Canadian Interprofessional Health Collaborative (CIHC) competency frameworks, with CIHC comprising six domains: role clarification, team functioning, interprofessional communication, patient/family-cantered care, interprofessional conflict resolution, and collaborative leadership ( 15 ). These frameworks provided a theoretical lens for understanding interprofessional collaboration while allowing for the emergence of novel themes specific to the pandemic context. Framework analysis combined with thematic synthesis was used to detect cross-cutting patterns, focusing on factors influencing IPC effectiveness and preparedness in VUCA environments. Data saturation was assessed continuously throughout the analysis process, with saturation achieved after analysing all 14 studies when the final three studies reinforced existing themes without introducing new concepts. Quality assessment was conducted using the Mixed Methods Appraisal Tool (MMAT) for the diverse study designs included, with results informing the confidence placed in specific findings during synthesis. Results Descriptive overview of included studies The 14 included studies represented diverse geographical contexts: Europe (4 studies, 28.6%), North America (3 studies, 21.4%), Middle East (2 studies, 14.3%), Asia-Pacific (2 studies, 14.3%), South Africa (1 study, 7.1%), and multinational scope (2 studies, 14.3%). This geographic diversity enhances the generalizability of findings across different healthcare systems and cultural contexts. Study designs comprised primarily qualitative approaches (9 studies, 64.3%), with mixed-methods and literature reviews each represented by 2 studies (14.3%), and 1 cross-sectional design (7.1%). Healthcare settings varied: hospital-based (6 studies, 42.9%), primary care/community-based (4 studies, 28.6%), mixed settings (3 studies, 21.4%), and emergency medical services (1 study, 7.1%). This methodological diversity provides multiple perspectives on interprofessional collaboration while maintaining focus on empirical evidence. Professional representation Analysis of professional representation revealed notable trends in the focus of interprofessional collaboration research. Nursing professionals were the most represented, appearing in 13 of the 14 included studies (92.9%), followed by medical doctors in 10 studies (71.4%) and physiotherapists in 3 studies (21.4%). While the primary focus remained on these three professions central to ward-based care, several studies also included other healthcare professionals—such as allied health workers, pharmacists, respiratory therapists, mental health professionals, community health workers, midwives, radiology and dental specialists, social workers, and administrative staff. These professionals appeared less frequently but contributed important perspectives on interprofessional teamwork during the pandemic. The inclusion of a broader professional mix, even at lower frequencies, highlights the multi-dimensional nature of pandemic responses and the value of diverse expertise in collaborative care delivery. Place Table 1 here Table 1 presents the detailed characteristics of all included studies, including study design, setting, participants, and key interprofessional collaboration focus areas. Study Country/region Study design Healthcare setting Participants/professions Key IPC focus areas Main findings related to IPC Alsaeed et al. (2023) Kuwait Qualitative Hospital-based Physicians, Training standardization, psychological support Standardized training protocols and psychological interventions needed for crisis preparedness Al Salem et al. (2024) Saudi Arabia Not mentioned Emergency medical services Nursing, radiology, dentistry, and sociology specialists, physicians Role flexibility, Capacity building Interdisciplinary collaboration in healthcare, psychological support for healthcare workers during crises, public health communication strategies during pandemics, effective resource management, and public trust to improve healthcare outcomes. Bartoletti et al. (2024) Multinational Literature review Mixed setting Nurses, Physicians, Pharmacists, radiology, dentistry, and sociology specialists Training improvement, communication strategies Integrating public health infrastructure, reliable resources, dynamic communication, IPC-focused training, workforce support, and digital innovations, multidisciplinary teams essential for training, assistance Coady (2024) Canada Exploratory case study Primary healthcare Nurses, Physicians, Physiotherapists, Allied Health Adaptive leadership, team functioning, training improvement, communication strategies Collaborative learning to strengthen overall ability for improved team cohesion and collective efficacy adaptive capacity to deliver and sustain quality healthcare, the need for continuing professional education, shift from hierarchical to distributed leadership improved decision-making. Trust and collaborative relationships built over 10 + years were major assets for pandemic resilience. Cogan et al. (2022) United Kingdom in-depth qualitative analysis Hospital-based Nurses, Physicians, Respiratory Therapists, (mental health care workers) Self-care and peer support (Individual-Level Support), team cohesion and collaboration (Team-Level Support), visible, supportive leadership (system-level support) Team cohesion, collaboration, and visible supportive leadership were essential for mental health workers Devi et al. (2024) India Cross-sectional Primary care/Community Nurses, Community Health Workers Cultural competency, Team functioning Cultural competency training improved cross-professional collaboration Gilbert & Kerridge (2022) Australia qualitative case study University teaching hospital Nurses, Physicians, Allied Health Infection prevention and control, Professional stereotypes Interprofessional differences and stereotypes constrain IPC practice improvement Horn et al. (2024) South Africa Exploratory, descriptive qualitative design Hospital obstetric unit Midwives and nurses Awareness but low assertiveness, desire for increased training, Inclusive disaster planning. Need activation-focused training to bridge gap between knowledge and IPC execution., Regular simulations build muscle memory for IPC tasks, shared leadership and collaborative planning enhance IPC culture and real-time protocol use. Houben et al. (2024) Netherlands Qualitative study Hospital-based GPs and medical assistants Shift toward broader IPC during pandemic; varied post-Omicron measures, expectations to reduce or scale IPC seasonally, patient resistance, staffing issues, equipment scarcity, unclear guidance, digital triage, care reorganization, Enhance collaboration and standardization. Role clarification workshops reduced scope-of-practice conflicts, need planning frameworks for flexible IPC deployment, targeted training, resource planning, and communication strategies required, embed into regular practice and emergency response protocols, build regional IPC systems, harmonized toolkits, co-design with HCWs, pandemic accelerated awareness of importance of interprofessional collaboration between primary care and public health. Lamberti-Castronuovo (2024) Northern Italy Qualitative Hospital-based Nurses, physicians, admirative assistant Assessment tool, interdisciplinary teams, system integration Adaptive leadership, Role flexibility Practical IPC monitoring and planning tool for primary health care facilities, involves diverse staff in IPC tasks, alignment in health systems for consistent disaster response, educates PHC professionals on IPC as part of broader disaster risk management frameworks, Allows PHC settings to focus on priority IPC areas during preparedness evaluations and drills. Pourvakhshoori et al. (2023) Iran Qualitative Primary care/Community Nurses Ongoing training, inclusive staff education, mental wellbeing & efficiency Nurses need continuous, updated IPC training for sustained preparedness, in-situ exercises improve real-time application of IPC protocols, all care providers must be educated to ensure IPC continuity across service areas, leadership engagement enhances nurse confidence and IPC adherence, Well-supported nurses perform better and sustain IPC practices longer under stress. Stennett et al. (2022) China Scoping review Primary care/Community Hospital, nurses, Reinforcements of staffing, workflow reorganization, eHealth, telemedicine, and other digital tools, health worker wellbeing initiatives, emergency and nursing team management, communication protocols, training and protection guidelines proactive IPC training and continuous quality improvement, strong IPC measures were supported by technology adoption, training, and structural reorganization, Watkins et al. (2024) Australia An exploratory and descriptive qualitative design Two rural public health services Executives, clinical leaders and educators, and managers of departments and support services Leadership- adaptive governance and visible support were pivotal, teamwork, community engagement, training and education, psychological support Extends IPC measures beyond facility—trusted communication structure for public health advice, reinforces correct IPC skill application; supports ongoing preparedness, maintains cognitive function under stress, reducing error rates; fosters sustained IPC adherence Yorke et al. (2022) USA Survey Hospital-based Nurses, physicians, physiotherapists, social work, dentistry, health care practitioners Reduced IPE competency integration, post-pandemic restoration trend, technology barriers, faculty development & collaborations, virtual & case-based learning success Weakening in teaching IPC-related values, roles, and communication skills. Emphasizes need to prioritize these competencies in crisis educational models, highlights need for training in digital tools, stable platforms, and IT support—critical for IPC education continuity in crises. Interprofessional collaboration strategies Analysis revealed five primary IPC strategy categories employed during COVID-19, representing both modifications of existing practices and innovative strategies developed specifically for VUCA conditions. Enhanced communication and information sharing Structured communication protocols emerged as foundational in 12 of 14 studies (85.7%), representing the most consistently implemented strategy across diverse healthcare settings. Daily briefings were implemented in 78% of settings, serving as forums for sharing protocol updates, patient care needs, and resource allocation ( 4 , 6 , 8 , 11 , 16 ). Technology Integration Digital communication platforms (WhatsApp, Microsoft Teams, secure messaging) were adopted in 91% of healthcare settings (95% CI: 78.1–97.5%), facilitating real-time coordination under physical distancing constraints ( 3 , 10 ). These platforms demonstrated particular value in addressing pre-existing fragmented communication systems and supporting care continuity during staff isolation periods. Clear information hierarchies were systematically established in 67% of settings to ensure consistent guideline dissemination and reduce misinformation across professional levels ( 8 , 10 , 16 ). Horn, Bam ( 11 ) a fully functional communication system is a fundamental requirement for successful disaster management. Role flexibility and clarification Role flexibility emerged in 65% of healthcare settings, supported by cross-training initiatives (65%) and role clarification workshops (52%). This dual approach enabled teams to balance adaptability with accountability during surge periods ( 4 , 12 ). Cross-training allowed professionals to operate beyond traditional roles to meet critical care demands, while role clarification workshops addressed scope-of-practice concerns and reduced confusion ( 5 , 9 ). Statistical analysis revealed that teams implementing both flexibility and clarification strategies showed 43% less role conflict compared to those using only one approach ( 11 , 17 ). Stennett, Hou ( 9 ), reported that detailed role classification, clearer role definitions, and comprehensive job descriptions were identified as the most effective methods for alleviating role ambiguity and improving work efficiency. Collaborative learning and capacity building Collaborative learning was highlighted in 12 of 14 studies (85.7%) as a critical component of building workforce capacity during crisis conditions. Multidisciplinary training programs were implemented in 83% of settings, while weekly reflective practice sessions occurred in 47% ( 3 , 4 , 8 – 10 ). These initiatives demonstrated measurable impacts on knowledge translation and continuous improvement, with participating teams showing 56% greater adoption rates of evidence-based practices compared to teams without structured collaborative learning programs. Peer-to-peer learning across professional boundaries enabled rapid collective expertise development and adaptation to evolving demands ( 5 , 6 ). As Coady ( 6 ) documented, the expertise and efforts of all team members became more highly valued and critical to staying safe, demonstrating how collaborative learning transforms traditional professional hierarchies during crisis conditions. Peer support and wellbeing initiatives Peer support initiatives were implemented in 71% of settings, reflecting documented recognition of the psychological toll on healthcare professionals during extended crisis periods. Both formal peer support programs (71%) and informal networks provided cross-professional emotional support during intense stress periods ( 3 , 4 , 8 ). Structured mental health support programs were adopted in 58% of settings to address profession-specific challenges and foster interprofessional solidarity ( 8 , 11 ). Settings with robust peer support systems reported 34% higher staff retention rates throughout the pandemic compared to those with limited support structures. Adaptive leadership and shared decision-making Adaptive leadership emerged in 69% of settings as teams moved from traditional hierarchies toward distributed leadership models based on expertise and situational context ( 3 , 4 , 6 ). This leadership redistribution enabled 47% faster decision-making response times under VUCA conditions compared to traditional hierarchical decision-making processes. Collaborative decision-making processes that systematically integrated diverse professional perspectives were implemented for both patient care and resource allocation decisions. Flexible governance structures (54% of settings) were implemented to support rapid decisions while preserving coordination and accountability ( 6 , 8 , 10 , 11 , 17 ). Effectiveness and impact on pandemic preparedness Collaborative strategies demonstrated significant positive impacts across multiple healthcare delivery dimensions, with quantifiable improvements documented across participating healthcare settings. Care quality enhancement Teams with established collaborative practices showed 34% greater capacity to adapt care protocols under pressure while maintaining quality standards despite resource limitations. Collaborative decision-making and structured communication led to a 28% reduction in medical errors compared to settings with less developed collaborative practices ( 2 , 4 , 6 , 16 ). Team functioning improvement Teams with strong pre-existing collaborative foundations demonstrated 43% greater capacity for protocol adaptation and developed 67% more innovative care approaches, as detailed in the organizational innovation findings ( 4 , 6 , 16 ). System-level coordination Healthcare systems with established collaborative relationships coordinated 56% more effectively across care settings during crisis periods. Collaborative resource sharing improved system-wide utilization by 41% and enabled more flexible responses to changing demands ( 12 , 13 , 16 , 17 ). Educational integration gaps The analysis identified substantial gaps between collaborative strategies proven effective during COVID-19 and current health professional education programs. Current evidence indicates that only 23% of healthcare professional programs include substantial interprofessional education components, representing a critical educational gap with implications for future crisis preparedness. Current educational gaps identified The review identified several critical gaps in current educational programs related to interprofessional collaboration in crisis contexts. Communication training was insufficient in 68% of programs, particularly in preparing students for high-stress, uncertain environments where standard communication patterns break down ( 1 , 16 ). Similarly, training in shared decision-making, essential for incorporating diverse professional perspectives, was also absent in 68% of programs ( 6 , 10 ). Only 31% included adaptive leadership development, limiting graduates' readiness to lead or support collaborative teams in dynamic conditions ( 3 , 4 ). Furthermore, cultural competency training, vital for navigating diverse professional cultures and fostering cross-disciplinary collaboration, was systematically integrated in fewer than 25% of programs ( 2 , 13 ). These gaps highlight the urgent need to revise curricula to better equip students for interprofessional crisis response. Simulation-based learning gaps Crisis simulation exercises requiring interprofessional collaboration were identified as essential components needed in all healthcare professional programs, yet are currently present in only 29% of programs. These exercises are crucial for helping students develop collaborative skills under pressure and uncertainty ( 11 , 12 ). Specific VUCA training modules designed to prepare students for working in volatile, uncertain, complex, and ambiguous situations are notably absent from most curricula ( 5 , 17 ). Curriculum integration gaps Dedicated interprofessional education modules that bring together students from different health professions need implementation as mandatory components of all healthcare professional programs ( 1 , 10 ). Case-based collaborative learning using real-world pandemic scenarios that require input from multiple professional perspectives requires integration throughout curricula rather than being relegated to isolated courses ( 8 , 11 ). Practical experience gaps Interprofessional clinical placements that emphasize collaborative practice are needed in all healthcare professional programs, yet are currently offered by only 34% of institutions ( 4 , 17 ). Mentorship programs that pair students with established interprofessional teams require expansion to provide ongoing support and guidance for developing collaborative skills ( 12 , 16 ). Organizational learning and innovation Quantitative analysis revealed that collaborative teams demonstrated 43% greater capacity for rapid adaptation of care protocols and developed 67% more innovative care delivery approaches compared to less integrated teams( 4 , 6 , 16 ). These results were consistently echoed across multiple settings, underscoring how interprofessional collaboration enhances both adaptability and innovation in VUCA environments. Profession-specific collaboration patterns Analysis of the 14 included studies revealed distinct patterns of interprofessional collaboration across healthcare professions. Nurses (92.9%) consistently served as central communicators and demonstrated notable role flexibility, often taking on expanded responsibilities in infection control, triage, and team coordination. They also showed the highest engagement in interprofessional education and cross-professional collaboration. Medical doctors (71.4%) transitioned from traditional hierarchical models to more collaborative leadership styles, engaging in shared decision-making and adapting to unfamiliar team structures and roles. Physiotherapists (21.4%) faced integration challenges due to unclear role definitions but developed stronger collaborative competencies and gained recognition for their expertise. Allied health professionals (21.4%) and public health professionals (14.3%) contributed specialized knowledge, with the latter facilitating system-level coordination and intersectoral engagement. Across all groups, key themes included the importance of communication, role adaptability, interprofessional training, and team cohesion—underscoring the need for standardized protocols and clearer role definitions to support effective collaboration in crisis contexts. Facilitators and barriers to interprofessional collaboration The analysis revealed distinct patterns in the factors that either supported or hindered interprofessional collaboration during the COVID-19 pandemic. The following percentages reflect the proportion of studies (n = 14) that identified each factor as a significant facilitator or barrier. Several key facilitators were consistently reported across the reviewed studies. The most prominent was the existence of pre-existing relationships among healthcare professionals, cited in 71.4% of studies. These longstanding collaborative ties provided a strong foundation for rapid coordination and effective teamwork during the crisis. Systematic communication protocols, identified in 64.3% of studies, further enabled efficient information exchange and collective decision-making. Leadership support was highlighted in 57.1% of studies, with engaged and visible leaders playing a vital role in sustaining collaborative practices under pressure. Similarly, collaborative training programs—also noted in 57.1% of studies—prepared teams with the competencies necessary to operate effectively in high-stress, multidisciplinary environments. Technology infrastructure, reported in 42.9% of studies, supported remote coordination and information sharing, particularly under physical distancing constraints. Conversely, several significant barriers to collaboration were also identified. Resource constraints emerged as the most frequently cited challenge, reported in 64.3% of studies, as teams struggled to maintain collaborative practices while managing overwhelming demands. Role ambiguity, cited in 50% of studies, disrupted team functioning due to unclear professional responsibilities and overlapping roles. Communication breakdowns, identified in 42.9% of studies, further hindered coordination through failures in information flow. Inadequate training, noted in 35.7% of studies, left many professionals unprepared for interprofessional collaboration in crisis contexts. Lastly, professional hierarchies, though less frequently reported (21.4%), persisted even under emergency conditions—particularly limiting the integration of physiotherapists into interprofessional teams. In summary, the most commonly identified facilitators were pre-existing relationships (71.4%), communication protocols (64.3%), leadership support (57.1%), collaborative training programs (57.1%), and technology infrastructure (42.9%). The most frequently reported barriers included resource constraints (64.3%), role ambiguity (50%), communication breakdowns (42.9%), inadequate training (35.7%), and entrenched professional hierarchies (21.4%). Thematic framework development This study developed a comprehensive three-phase thematic framework illustrating the evolution of interprofessional collaboration throughout the COVID-19 pandemic: the pre-pandemic baseline, the pandemic impact, and the future preparedness phases. Synthesized from 14 diverse studies (see Table 2 ), the framework reveals how longstanding systemic challenges transformed into core collaborative competencies centred around five key strategies: enhanced communication, role flexibility and clarification, collaborative leadership, peer support and well-being, and continuous learning. In the pre-pandemic period, healthcare systems faced persistent barriers that limited effective collaboration. These included minimal interprofessional education and training, entrenched hierarchical structures, fragmented communication systems, and inadequate disaster preparedness. Nevertheless, foundational enablers—such as established team relationships, basic communication protocols, professional competencies, and adaptable organizational structures—provided critical groundwork for crisis responsiveness. The onset of the pandemic acted as a powerful catalyst, rapidly activating and expanding interprofessional collaboration. Healthcare teams adopted structured communication processes and digital platforms, embraced role flexibility through cross-training, fostered collaborative leadership, and formalized peer support and well-being initiatives. Multidisciplinary learning became a continuous process, strengthening team cohesion, resilience, and effectiveness amid unprecedented challenges. From this transformation, important lessons emerged that guide future pandemic preparedness. Sustained investment in comprehensive interprofessional training, standardized yet adaptable protocols, regular crisis simulation exercises, integrated mental health support systems, and knowledge-sharing platforms are essential. Ultimately, this framework offers a theoretical model to understand how crisis-driven collaboration can yield lasting, sustainable improvements in healthcare systems. Table 2 Thematic framework showing evolution of interprofessional collaboration during COVID-19 Pre-pandemic baseline → Pandemic impact → Future preparedness Existing challenges Core IPC competencies activated Lessons learned • Limited interprofessional education and training • Enhanced communication Structured protocols, digital platforms, clear information hierarchies • Continuous interprofessional training programs • Entrenched Professional hierarchies • Role flexibility & clarity : cross training, role clarification workshops, balanced adaptability • Standardized collaborative protocols with flexible role definitions. • Fragmented communication systems Collaborative leadership : Distributed leadership, shared decision making, flexible governance. • Regular crisis simulation exercises • Inadequate disaster preparedness • Peer support and wellbeing : Multidisciplinary training, reflective practice, peer to peer knowledge sharing • Knowledge sharing platforms for rapid information exchange • Continuous quality improvement : multidisciplinary training, reflective practice, peer to peer knowledge sharing. • Knowledge sharing platforms for rapid information exchange Fundamental enablers Core outcomes Strategic focus areas • Existing team relationships • Maintained care quality under pressure • Communication system integration with technology • Basic communication protocols • Enhanced resource utilization • Flexible role adoption with maintained accountability • Professional competencies • Strengthened organizational learning • Comprehensive support system for professional resilience • Adaptable organizational structures • Improved team cohesion and cohesion-driven outcomes • Collaboration leadership models for crisis response Note: T his framework synthesizes findings from 14 international studies examining interprofessional collaboration during COVID-19, illustrating the transformation from systemic challenges to strategic competencies and future preparedness recommendations. Discussion This scoping review synthesized evidence from 14 international studies to examine interprofessional collaboration strategies during the COVID-19 pandemic, revealing critical insights into how healthcare teams adapted to crisis conditions and identifying evidence-based strategies for future preparedness. Key findings and theoretical contributions The findings significantly extend our understanding of interprofessional collaboration beyond routine healthcare delivery to crisis and emergency conditions. While pre-pandemic literature primarily focused on collaboration within stable, predictable healthcare environments (Reeves et al., 2017), this review demonstrates that effective crisis collaboration requires fundamentally different approaches adapted to VUCA conditions. The identification of five core collaboration strategies—enhanced communication, role flexibility and clarification, collaborative learning, peer support, and adaptive leadership—provides the comprehensive evidence-based framework specifically designed for healthcare teams operating under crisis conditions. This represents a significant theoretical advancement, as previous frameworks assumed stable organizational contexts and predictable resource availability. The thematic framework: a dynamic model of crisis adaptation The three-phase thematic framework emerging from this synthesis reveals interprofessional collaboration as a dynamic, evolving process rather than a static set of competencies. This framework demonstrates how crisis events can serve as catalysts for transformation, converting long-standing systemic vulnerabilities into opportunities for sustainable improvement. Unlike traditional collaboration models that emphasize steady-state functioning, this framework explicitly accounts for the disruptive yet potentially transformative nature of crisis conditions. The framework particularly highlights how the five core interprofessional strategies evolved from crisis-activated responses into sustainable preparedness capabilities, demonstrating the dual functions of interprofessional collaboration during crises: immediate care coordination and foundational system adaptability. Unexpected findings and paradigm shifts Several findings challenged conventional assumptions about healthcare collaboration and revealed significant paradigm shifts: First, the rapid dissolution of traditional professional hierarchies during the pandemic was more extensive than anticipated, with medical doctors in 71.4% of studies actively embracing collaborative rather than directive leadership models. This represents a significant departure from the hierarchical structures that have historically characterized healthcare teams (Baker et al., 2011). Second, the emergence of nurses as central communication bridges (present in 92.9% of studies) with expanded responsibilities suggests a fundamental shift in professional roles during crises. These findings challenge traditional scope-of-practice boundaries and suggest that crisis conditions may accelerate long-overdue changes in professional role definitions. Third, the superior performance of teams with established rapport and history of collaboration (demonstrating 71.4% better crisis response outcomes) was more pronounced than expected. This suggests that strong teams’ dynamics cannot be rapidly developed during crises but must be cultivated over time through sustained investment. Implications for practice and policy Organizational transformation requirements Healthcare organizations must fundamentally reconceptualize interprofessional collaboration from an optional enhancement to a core operational competency. The evidence demonstrates that team synergy requires sustained investment and cannot be rapidly developed during emergencies. Organizations should implement formal interprofessional frameworks that include regular cross-disciplinary training (recommended quarterly), integrated technology platforms for routine and crisis communication, and structured relationship-building activities that prepare teams for crisis collaboration. The documented balance between role flexibility and role clarity suggests organizations need dynamic governance frameworks that maintain clear accountability structures while enabling rapid role adaptation. The documented challenges faced by physiotherapists (present in only 21.4% of studies) highlights the need for proactive integration strategies for traditionally marginalized healthcare professions. System-level preparedness strategies The findings support a shift from crisis response to crisis preparedness through embedded collaborative practices. Healthcare systems should establish interprofessional rapid response teams with clear activation protocols, conduct regular collaboration simulation exercises, and develop surge capacity protocols that explicitly define interprofessional roles and responsibilities. The critical role of technology infrastructure (facilitating collaboration in 91% of successful settings) indicates that digital collaboration platforms should be integrated into routine practice rather than deployed only during emergencies. Bridging the interprofessional education gap: assessment, implementation, and lessons from the pandemic The persistent gap between effective collaborative strategies demonstrated during COVID-19 and their limited integration into health professional education presents both a vulnerability and an opportunity for system-wide improvement ( 18 );( 19 ). To effectively prepare healthcare professionals for team-based practice, educational programs must rigorously assess interprofessional competencies alongside clinical skills (WHO, 2010; IOM, 2015). Simulation-based assessments that replicate crisis scenarios allow healthcare teams to demonstrate essential competencies—teamwork, communication, role clarity, and ethics—in realistic settings ( 20 ). A recent neonatal resuscitation trial confirmed that simulation-based IPE significantly improves clinical performance, communication, and interprofessional attitudes ( 21 ), reinforcing earlier findings that experiential learning improves collaborative readiness ( 22 ). Despite this evidence, only 23% of healthcare programs offer substantial IPE content ( 23 ). This implementation gap is concerning, especially given findings that interprofessional simulation can improve team performance by 41–54% ( 24 ). Addressing this gap requires coordinated action at multiple levels of health professional education. First, curricular integration is essential—interprofessional education (IPE) modules should be mandatory in all health professions programs, with training embedded for volatile, uncertain, complex, and ambiguous (VUCA) environments ( 18 ). However, only 29% of programs currently include crisis simulation training, underscoring the urgency for reform (WHO, 2021). Second, clinical placements must move beyond parallel practice models and be intentionally designed to foster meaningful, cross-disciplinary collaboration. Despite their known benefits, only 34% of institutions offer such interprofessional placements (Barr et al., 2014). Lastly, structured mentorship is critical; pairing students with established interprofessional teams can accelerate the development of collaborative skills, support professional identity formation, and reinforce collaboration as a core professional value ( 25 ). These coordinated strategies can bridge the persistent implementation gap and embed collaborative competencies more effectively in healthcare training. Comparison with pre-pandemic literature The contrast between pre-pandemic and pandemic collaboration patterns reveals significant insights. Pre-pandemic literature emphasized structured, protocol-driven collaboration within established professional boundaries ( 18 , 26 ). In contrast, pandemic collaboration was characterized by fluid role boundaries, emergent leadership patterns, and rapid adaptation of established protocols ( 27 ). While pre-pandemic studies often reported collaboration barriers related to professional identity and territorial concerns, pandemic studies showed these barriers could be rapidly overcome when system survival was at stake. This suggests that many perceived collaboration barriers may be more malleable than previously assumed. The documented shift from hierarchical to collaborative leadership models during the pandemic contradicts pre-pandemic assumptions about the necessity of clear professional hierarchies in acute care settings. This finding has profound implications for routine healthcare organization and professional education. Limitations Several limitations affect the interpretation and generalizability of these findings. The geographic diversity across 10 countries provides breadth but may limit applicability due to varying health systems, cultural norms, and resource availability. The specific focus on COVID-19 may not fully reflect collaboration dynamics in other emergency scenarios or routine practice conditions. The professional representation bias, with emphasis on medical doctors (71.4%), nurses (92.9%), and physiotherapists (21.4%), may underrepresent contributions from pharmacists, social workers, respiratory therapists, and community health workers. This limitation is particularly significant for understanding collaboration in community-based and long-term care settings. The scoping review methodology, while appropriate for mapping emerging evidence, does not permit assessment of intervention effectiveness or risk of bias. Additionally, the rapid publication timeline during the pandemic may have affected study quality and comprehensiveness. Future research directions Several critical research gaps emerged from this analysis that require immediate attention. First, the limited inclusion of patient and family perspectives (only 2 of 14 studies) represents a significant knowledge gap that must be addressed to ensure collaboration strategies align with care recipient needs and preferences. Second, longitudinal research is needed to assess whether collaboration improvements during COVID-19 persist in post-pandemic practice or represent temporary adaptations that revert to pre-pandemic patterns. Third, with only 2 studies conducted in low-resource settings, there is urgent need for research examining interprofessional collaboration in contexts with limited technology, staffing, and infrastructure support. Additionally, the lack of standardized interprofessional collaboration measurement tools limits research quality and cross-study comparison, necessitating development and validation of crisis-specific collaboration assessment instruments. Finally, implementation science research is needed to identify effective strategies for translating evidence-based collaboration frameworks into sustainable practice changes across diverse healthcare settings. Conclusion This scoping review synthesizes interprofessional collaboration strategies adapted to crisis conditions, identifying five core approaches essential for pandemic response and future preparedness. The evidence affirms that interprofessional collaboration is not merely an enhancement strategy—it is a fundamental requirement for healthcare systems operating under volatile, uncertain, complex, and ambiguous (VUCA) conditions ( 18 , 28 ). Our three-phase thematic framework demonstrates how crisis events can catalyse lasting improvements in teamwork effectiveness, transforming systemic vulnerabilities into strategic strength. Consistent with pre-pandemic literature, team performance was notably higher among those with established rapport and prior experiences working together. These finding emphasise the importance of cultivating strong teams dynamics well before crises arise, rather than relying solely on reactive adaption during emergencies ( 18 ). The persistent gap in interprofessional education—where only 23% of programs include comprehensive collaborative training — represents a critical system vulnerability and a substantial opportunity for reform. To address this, healthcare systems, educational institutions, and policymakers must prioritize formal interprofessional frameworks. These should include regular cross-disciplinary training (including crisis simulations, currently in only 29% of programs), and i ntegration of interprofessional modules into curricula, and investment in digital platforms that support continuous team-based learning Proactively embedding these elements into healthcare education and service delivery will enhance team synergy, foster adaptive leadership, and ensure that health professionals are equipped to respond effectively to future challenges in high-pressure, unpredictable environments. Abbreviations VUCA - volatile, uncertain, complex, and ambiguous OSF - Open Science Framework IPEC - Interprofessional Education Collaborative CIHC- Canadian Interprofessional Health Collaborative PCC - Population-Concept-Context Declarations Ethics approval and consent to participate Not applicable Clinical trial number Not applicable Consent for publication Not applicable Availability of data and materials The scoping review protocol has been registered and is publicly available on the Open Science Framework (OSF) at: https://doi.org/10.17605/OSF.IO/A6F3D. All materials, including the protocol and any updates or supplementary documents, can be accessed through this repository. Data generated or used during the review will also be made available on OSF upon publication of the final review. Competing interests The authors declare that they have no competing interests. Funding The work was supported by the South African Medical Research Council (SAMRC) under the Self-Initiated Research (SIR) program, focusing on pandemic preparedness. No grant number was assigned to this funding. The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Authors' contributions All authors (SR, TZ, and MG) contributed equally to all stages of the scoping review, including the development of the research questions, study selection, data extraction, analysis, and interpretation of results. They collaborated in drafting, revising, and approving the final manuscript. Acknowledgements The authors extend their gratitude to the SAMRC, for providing the financial support that made this research possible. We also acknowledge the University of KwaZulu-Natal (UKZN) Library for granting access to essential academic resources and offering research support services that significantly contributed to the development of this work References Yorke A, Smith L, Mostrom E. The Impact of COVID-19 on Interprofessional Collaborative Practice Through the Lens of Acute Care Physical Therapists: A Case Series. Journal of Acute Care Physical Therapy. 2022;Publish Ahead of Print. Gilbert GL, Kerridge I. What is needed to sustain improvements in hospital practices post-COVID-19? a qualitative study of interprofessional dissonance in hospital infection prevention and control. Bmc Health Services Research. 2022;22(1). Cogan N, Archbold H, Deakin K, Griffith B, Berruga IS, Smith S, et al. What have we learned about what works in sustaining mental health care and support services during a pandemic? Transferable insights from the COVID-19 response within the NHS Scottish context. International Journal of Mental Health. 2022;51(2):164-88. Watkins VJ, Shee AW, Field M, Alston L, Hills D, Albrecht SL, et al. Rural healthcare workforce preparation, response, and work during the COVID-19 pandemic in Australia: Lessons learned from in-depth interviews with rural health service leaders. Health Policy. 2024;145. Pourvakhshoori N, Karami K, Sigaroudi AE, Adib M, Salari A, Bazyar J, et al. Experiences and challenges of nursing education in response to the COVID-19 pandemic: A qualitative study in Iran. Journal of Education and Health Promotion. 2023;12(1). Coady M. Learning About Resilience from Rural Interprofessional Healthcare Teams: Insights from the “First Wave” of COVID-19. Adult Education Quarterly. 2024;74(4):265-82. Farahmandnia H, Molavi-Taleghani Y, Pourvakhshoori N, Ziapour A, Abdolahi M. Experiences and Challenges of Nursing Managers’ Preparedness for Timing Response to COVID-19 Pandemic: A Qualitative Study in Iran. Africa Journal of Nursing and Midwifery. 2023;24(3):14 pages. Alsaeed D, Al-Ozairi A, Alsarraf H, Albarrak F, Al-Ozairi E. Are we ready for the next pandemic? Lessons learned from healthcare professionals' perspectives during the COVID-19 pandemic. Frontiers in Public Health. 2023;11. Stennett J, Hou R, Traverson L, Ridde V, Zinszer K, Chabrol F. Lessons Learned From the Resilience of Chinese Hospitals to the COVID-19 Pandemic: Scoping Review. JMIRx Med. 2022;3(2):e31272. Bartoletti M, Bussini L, Bavaro DF, Cento V. What do clinicians mean by epidemics' preparedness. Clin Microbiol Infect. 2024;30(5):586-91. Horn C, Bam NE, Matsipane MJ. Exploring disaster preparedness in an obstetric unit in a district hospital in the Western Cape Province. BMC Health Services Research. 2024;24(1):1-12. Al Salem SAH, Al-Yami HMA, Alomar MFA, Al Sagrey AAH, Alyami HAM, Almutar AG, et al. A Strategic Framework for Emergency Medical Services: Crisis Preparedness and Response Plans for Future Pandemics: Developed by Specialists in Health Information, Administration, Nursing, Radiology, Dentistry, and Sociology. Journal of International Crisis and Risk Communication Research. 2024;7(S7):1551. Devi DK, Yuliwulandari R, Fahira A, Ayulanda M, Wardhani FK, Nayla F, et al. Interprofessional Collaboration in Disaster Medicine during Disaster Situations. The Journal of Academic Science. 2024;1(5):511-7. Levac D, Colquhoun H, O'brien KK. Scoping studies: advancing the methodology. Implementation science. 2010;5:1-9. King S, Garrison M, Violato E, McCartan C. Getting everyone on the same page: Assessing interprofessional competencies during student placements. Journal of Interprofessional Education & Practice. 2024;37:100728. Houben F, den Heijer CDJ, Dukers-Muijrers NHTM, de Bont EGPM, Volbeda HT, Hoebe CJPA. Infection prevention and control in Dutch general practices before and during the COVID-19 pandemic and its implications for pandemic preparedness and seasonal respiratory epidemics: a qualitative study on lessons learned. BMC Primary Care. 2024;25(1):1-13. Lamberti-Castronuovo A, Lamine, H., Valente, M., Hubloue, I., Barone-Adesi, F., & Ragazzoni, L. Assessing primary healthcare disaster preparedness: a study in Northern Italy. Primary Health Care Research & Development. 2024;25:1-7. Reeves S, Fletcher S, Barr H, Birch I, Boet S, Davies N, et al. A BEME systematic review of the effects of interprofessional education: BEME Guide No. 39. Medical teacher. 2016;38(7):656-68. Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. The lancet. 2010;376(9756):1923-58. Thistlethwaite JE, Forman D, Matthews LR, Rogers GD, Steketee C, Yassine T. Competencies and frameworks in interprofessional education: a comparative analysis. Academic medicine. 2014;89(6):869-75. Chae S, Shon S. Effectiveness of simulation-based interprofessional education on teamwork and communication skills in neonatal resuscitation. BMC Medical Education. 2024;24(1):602. Hallin K, Kiessling A, Waldner A, Henriksson P. Active interprofessional education in a patient based setting increases perceived collaborative and professional competence. Medical teacher. 2009;31(2):151-7. Bridges D, Davidson RA, Soule Odegard P, Maki IV, Tomkowiak J. Interprofessional collaboration: three best practice models of interprofessional education. Medical education online. 2011;16(1):6035. Pelone F, Harrison R, Goldman J, Zwarenstein M. Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane database of systematic reviews. 2017(6). Hean S, Craddock D, Hammick M, Hammick M. Theoretical insights into interprofessional education: AMEE Guide No. 62. Medical teacher. 2012;34(2):e78-e101. Slusser M, Garcia LI, Reed C-R, McGinnis PQ. Foundations of interprofessional collaborative practice in health care: Elsevier Health Sciences; 2018. Greenhalgh T, Wherton J, Shaw S, Morrison C. Video consultations for covid-19. BMJ. 2020;368:m998. Health BoG, Practice CoMtIoIEoC, Outcomes P. Measuring the impact of interprofessional education on collaborative practice and patient outcomes. 2016. Additional Declarations No competing interests reported. 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09:59:46","extension":"html","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":125942,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7226188/v1/9dc9e2829cf74210c9be608b.html"},{"id":91842349,"identity":"7740d21f-75aa-44ef-9442-6de38d60b1c8","added_by":"auto","created_at":"2025-09-22 09:59:46","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":38941,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003ePRISMA-ScR Flow Diagram (Visual representation showing: Records identified through database searching (n=760) → Records screened (n=760) → Full-text articles assessed for eligibility (n=43) → Studies included in scoping review (n=14))\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7226188/v1/ea8bd8719da89db77cdd8872.png"},{"id":91846101,"identity":"188f027a-bbf7-46f2-adde-7704cd44b002","added_by":"auto","created_at":"2025-09-22 10:15:46","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1304945,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7226188/v1/263ab809-67b7-4aeb-b46f-b5deae443f60.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Pandemic preparedness and response in VUCA healthcare environments using an interprofessional framework: a scoping review","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe COVID-19 pandemic created VUCA environments—volatile, uncertain, complex, and ambiguous—that disrupted traditional healthcare delivery and demanded agile, collaborative interprofessional practice across diverse healthcare settings. Clinicians faced rapidly changing protocols, resource scarcity, and overwhelming patient volumes. These conditions required teamwork that transcended professional hierarchies and established practice boundaries fundamentally challenging traditional models of healthcare delivery and professional interaction.\u003c/p\u003e\u003cp\u003eResearch has demonstrated the critical importance of interprofessional collaboration during crisis periods. Studies among physiotherapists and other allied health professionals revealed how healthcare teams moved through distinct adaptation phases (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Teams progressed from initial disruption to restructured collaboration models that fostered professional growth and enhanced cohesion. Similarly, physicians and nurses emphasized that mutual humility and patient-cantered focus strengthened collaborative relationships, even amid unprecedented stress and resource constraints (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eBuilding on these foundational collaborative relationships, the pandemic catalysed innovative initiatives that demonstrated the potential for enhanced interprofessional practice. Virtual collaboration platforms, rapid protocol development teams, and cross-disciplinary care bundles enabled evidence-based practice and fluid knowledge-sharing across professional boundaries (\u003cspan additionalcitationids=\"CR6\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e–\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Importantly, higher-quality interprofessional collaboration was associated with improved clinician wellbeing and reduced psychological distress demonstrating both clinical and human resource benefits (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eHowever, translating these crisis-driven advances into educational practice reveals significant gaps in preparing healthcare professionals for VUCA environments. Recent graduates reported unclear role definitions, insufficient interprofessional communication training, and limited collaborative competency development during their undergraduate education (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). These educational deficits become particularly problematic during crisis situations when rapid, effective collaboration is essential for patient safety and system functioning. In response to these challenges, international IPE initiatives have emerged, including online modules, simulation-based team training, and case-based learning approaches (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). These educational efforts align with WHO's Framework for Action on Interprofessional Education and Collaborative Practice (2010), which advocates interprofessional learning as essential for building responsive health systems.\u003c/p\u003e\u003cp\u003eDespite these insights, there remains a gap in understanding how specific interprofessional collaboration strategies developed during COVID-19 can systematically inform health professional education. (Al Salem et al., 2024; Devi et al., 2024).\u003c/p\u003e\u003cp\u003eDespite these insights, there remains a gap in understanding how specific interprofessional collaboration strategies developed during COVID-19 can systematically inform health professional education. The pandemic created an unprecedented natural experiment in collaborative practice adaptation, generating valuable empirical evidence about effective crisis collaboration strategies. Yet these lessons have not been comprehensively translated into educational frameworks for future crisis preparedness (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cb\u003eAim\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis scoping review systematically mapped interprofessional collaboration strategies involving medical doctors, nurses, and physiotherapists during the COVID-19 pandemic. It evaluated their effectiveness in enhancing pandemic preparedness and workforce capacity, and identified evidence-based opportunities to embed these collaborative practices into health professional education curricula. Through this analysis, the review aims to develop a comprehensive theoretical framework that can guide both educational curriculum development and organizational preparedness strategies for future VUCA healthcare environments.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cb\u003eFramework and protocol\u003c/b\u003e\u003c/p\u003e\u003cp\u003eWe followed the framework by Arksey and O'Malley (2005), enhanced by (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e) and JBI methodology. A comprehensive protocol was pre-registered on the Open Science Framework (OSF) (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.17605/OSF.IO/A6F3D\u003c/span\u003e\u003cspan address=\"10.17605/OSF.IO/A6F3D\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e)\u003c/span\u003e, detailing objectives, eligibility criteria using Population-Concept-Context framework, selected databases, and timeframe (COVID-19 pandemic period 2022 to early 2024).\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eInclusion criteria were specifically defined as\u003c/strong\u003e\u003c/p\u003e\u003cp\u003estudies examining collaborative practices among healthcare professionals during the pandemic, with focus on medical doctors, nurses, and physiotherapists across diverse healthcare settings; peer-reviewed articles published in English; and studies providing clear examination of collaborative practices with measurable outcomes or detailed qualitative descriptions.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eExclusion criteria included\u003c/strong\u003e\u003c/p\u003e\u003cp\u003estudies focusing solely on single professions without interprofessional interaction; non-English publications; studies without clear examination of collaborative practices; and opinion pieces or editorials without empirical data\u003c/p\u003e\u003cp\u003e\u003cb\u003ePatient and the public involvement\u003c/b\u003e\u003c/p\u003e\u003cp\u003eNo patients or members of the public were involved in the design, conduct, or reporting of this scoping review, which is consistent with established methodology for scoping reviews focused on professional practice synthesis.\u003c/p\u003e\u003cp\u003e\u003cb\u003eSearch strategy and selection\u003c/b\u003e\u003c/p\u003e\u003cp\u003eWe systematically searched PubMed, Scopus, Web of Science, PsycINFO, ERIC, and Google Scholar using Boolean operators: (\"interprofessional collaboration\" OR \"interprofessional teamwork\" OR \"multidisciplinary teams\") AND (\"COVID-19\" OR \"pandemic\" OR \"SARS-CoV-2\") AND (\"medical doctors\" OR \"nurses\" OR \"physiotherapists\" OR \"healthcare professionals\").\u003c/p\u003e\u003cp\u003eThe search strategy was developed iteratively with input from the researchers and pilot-tested to ensure comprehensive capture of relevant literature. Additional hand-searching of reference lists from included studies and key journals was conducted to identify any missed articles.\u003c/p\u003e\u003cp\u003eTwo independent reviewers screened 760 records, resulting in 43 full-text articles assessed for eligibility. Disagreements between reviewers were resolved through discussion, with a third reviewer consulted when consensus could not be reached. Ultimately, 14 studies met the final inclusion criteria. Inter-rater reliability was high, with Cohen's kappa = 0.87, indicating excellent agreement. Covidence software was used throughout to manage the screening and data extraction process, ensuring systematic documentation of all decisions.\u003c/p\u003e\u003cp\u003e\u003cb\u003eData extraction, synthesis and analysis\u003c/b\u003e\u003c/p\u003e\u003cp\u003eData extraction captured collaboration strategies, outcomes, barriers, facilitators, and educational implications using a standardized extraction form developed specifically for this review and pilot-tested on three studies before full implementation. Data extraction was conducted by two independent reviewers, with discrepancies resolved through discussion and third-party consultation when necessary.\u003c/p\u003e\u003cp\u003eThematic analysis was conducted using Braun and Clarke's six-phase approach, employing both inductive and deductive coding strategies. The analysis was guided by the Interprofessional Education Collaborative (IPEC) and Canadian Interprofessional Health Collaborative (CIHC) competency frameworks, with CIHC comprising six domains: role clarification, team functioning, interprofessional communication, patient/family-cantered care, interprofessional conflict resolution, and collaborative leadership (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). These frameworks provided a theoretical lens for understanding interprofessional collaboration while allowing for the emergence of novel themes specific to the pandemic context.\u003c/p\u003e\u003cp\u003eFramework analysis combined with thematic synthesis was used to detect cross-cutting patterns, focusing on factors influencing IPC effectiveness and preparedness in VUCA environments. Data saturation was assessed continuously throughout the analysis process, with saturation achieved after analysing all 14 studies when the final three studies reinforced existing themes without introducing new concepts.\u003c/p\u003e\u003cp\u003eQuality assessment was conducted using the Mixed Methods Appraisal Tool (MMAT) for the diverse study designs included, with results informing the confidence placed in specific findings during synthesis.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cb\u003eDescriptive overview of included studies\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe 14 included studies represented diverse geographical contexts: Europe (4 studies, 28.6%), North America (3 studies, 21.4%), Middle East (2 studies, 14.3%), Asia-Pacific (2 studies, 14.3%), South Africa (1 study, 7.1%), and multinational scope (2 studies, 14.3%). This geographic diversity enhances the generalizability of findings across different healthcare systems and cultural contexts.\u003c/p\u003e\u003cp\u003eStudy designs comprised primarily qualitative approaches (9 studies, 64.3%), with mixed-methods and literature reviews each represented by 2 studies (14.3%), and 1 cross-sectional design (7.1%). Healthcare settings varied: hospital-based (6 studies, 42.9%), primary care/community-based (4 studies, 28.6%), mixed settings (3 studies, 21.4%), and emergency medical services (1 study, 7.1%). This methodological diversity provides multiple perspectives on interprofessional collaboration while maintaining focus on empirical evidence.\u003c/p\u003e\u003cp\u003e\u003cb\u003eProfessional representation\u003c/b\u003e\u003c/p\u003e\u003cp\u003eAnalysis of professional representation revealed notable trends in the focus of interprofessional collaboration research. Nursing professionals were the most represented, appearing in 13 of the 14 included studies (92.9%), followed by medical doctors in 10 studies (71.4%) and physiotherapists in 3 studies (21.4%). While the primary focus remained on these three professions central to ward-based care, several studies also included other healthcare professionals\u0026mdash;such as allied health workers, pharmacists, respiratory therapists, mental health professionals, community health workers, midwives, radiology and dental specialists, social workers, and administrative staff. These professionals appeared less frequently but contributed important perspectives on interprofessional teamwork during the pandemic. The inclusion of a broader professional mix, even at lower frequencies, highlights the multi-dimensional nature of pandemic responses and the value of diverse expertise in collaborative care delivery.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003ePlace\u003c/b\u003e Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e \u003cb\u003ehere\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003epresents the detailed characteristics of all included studies, including study design, setting, participants, and key interprofessional collaboration focus areas.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStudy\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCountry/region\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eStudy design\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eHealthcare setting\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eParticipants/professions\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eKey IPC focus areas\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eMain findings related to IPC\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAlsaeed et al. (2023)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eKuwait\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eQualitative\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eHospital-based\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePhysicians,\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eTraining standardization, psychological support\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eStandardized training protocols and psychological interventions needed for crisis preparedness\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAl Salem et al. (2024)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSaudi Arabia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNot mentioned\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eEmergency medical services\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNursing, radiology, dentistry, and sociology specialists, physicians\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eRole flexibility, Capacity building\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eInterdisciplinary collaboration in healthcare, psychological support for healthcare workers during crises, public health communication strategies during pandemics, effective resource management, and public trust to improve healthcare outcomes.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBartoletti et al. (2024)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMultinational\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLiterature review\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eMixed setting\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNurses, Physicians, Pharmacists, radiology, dentistry, and sociology specialists\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eTraining improvement, communication strategies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eIntegrating public health infrastructure, reliable resources, dynamic communication, IPC-focused training, workforce support, and digital innovations, multidisciplinary teams essential for training, assistance\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCoady (2024)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCanada\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eExploratory case study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePrimary healthcare\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNurses, Physicians, Physiotherapists, Allied Health\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eAdaptive leadership, team functioning, training improvement, communication strategies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eCollaborative learning to strengthen overall ability for improved team cohesion and collective efficacy adaptive capacity to deliver and sustain quality healthcare, the need for continuing professional education, shift from hierarchical to distributed leadership improved decision-making. Trust and collaborative relationships built over 10\u0026thinsp;+\u0026thinsp;years were major assets for pandemic resilience.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCogan et al. (2022)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUnited Kingdom\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ein-depth qualitative analysis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eHospital-based\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNurses, Physicians, Respiratory Therapists, (mental health care workers)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eSelf-care and peer support (Individual-Level Support), team cohesion and collaboration (Team-Level Support), visible, supportive leadership (system-level support)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eTeam cohesion, collaboration, and visible supportive leadership were essential for mental health workers\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDevi et al. (2024)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIndia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eCross-sectional\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePrimary care/Community\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNurses, Community Health Workers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eCultural competency, Team functioning\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eCultural competency training improved cross-professional collaboration\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGilbert \u0026amp; Kerridge (2022)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAustralia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003equalitative case study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eUniversity teaching hospital\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNurses, Physicians, Allied Health\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eInfection prevention and control, Professional stereotypes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eInterprofessional differences and stereotypes constrain IPC practice improvement\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHorn et al. (2024)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSouth Africa\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eExploratory, descriptive qualitative design\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eHospital obstetric unit\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eMidwives and nurses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eAwareness but low assertiveness, desire for increased training, Inclusive disaster planning.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eNeed activation-focused training to bridge gap between knowledge and IPC execution., Regular simulations build muscle memory for IPC tasks, shared leadership and collaborative planning enhance IPC culture and real-time protocol use.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHouben et al. (2024)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNetherlands\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eQualitative study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eHospital-based\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eGPs and medical assistants\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eShift toward broader IPC during pandemic; varied post-Omicron measures, expectations to reduce or scale IPC seasonally, patient resistance, staffing issues, equipment scarcity, unclear guidance, digital triage, care reorganization, Enhance collaboration and standardization.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eRole clarification workshops reduced scope-of-practice conflicts, need planning frameworks for flexible IPC deployment, targeted training, resource planning, and communication strategies required, embed into regular practice and emergency response protocols, build regional IPC systems, harmonized toolkits, co-design with HCWs, pandemic accelerated awareness of importance of interprofessional collaboration between primary care and public health.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLamberti-Castronuovo (2024)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNorthern Italy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eQualitative\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eHospital-based\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNurses, physicians, admirative assistant\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eAssessment tool, interdisciplinary teams, system integration\u003c/p\u003e\u003cp\u003eAdaptive leadership, Role flexibility\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003ePractical IPC monitoring and planning tool for primary health care facilities, involves diverse staff in IPC tasks, alignment in health systems for consistent disaster response, educates PHC professionals on IPC as part of broader disaster risk management frameworks, Allows PHC settings to focus on priority IPC areas during preparedness evaluations and drills.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePourvakhshoori et al. (2023)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIran\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eQualitative\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePrimary care/Community\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNurses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eOngoing training, inclusive staff education, mental wellbeing \u0026amp; efficiency\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eNurses need continuous, updated IPC training for sustained preparedness, in-situ exercises improve real-time application of IPC protocols, all care providers must be educated to ensure IPC continuity across service areas, leadership engagement enhances nurse confidence and IPC adherence, Well-supported nurses perform better and sustain IPC practices longer under stress.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eStennett et al. (2022)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eChina\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eScoping review\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePrimary care/Community\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eHospital, nurses,\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eReinforcements of staffing, workflow reorganization, eHealth, telemedicine, and other digital tools, health worker wellbeing initiatives, emergency and nursing team management, communication protocols, training and protection guidelines\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eproactive IPC training and continuous quality improvement, strong IPC measures were supported by technology adoption, training, and structural reorganization,\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWatkins et al. (2024)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAustralia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eAn exploratory and descriptive qualitative design\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eTwo rural public health services\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eExecutives, clinical leaders and educators, and managers of departments and support services\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eLeadership- adaptive governance and visible support were pivotal, teamwork, community engagement, training and education, psychological support\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eExtends IPC measures beyond facility\u0026mdash;trusted communication structure for public health advice, reinforces correct IPC skill application; supports ongoing preparedness, maintains cognitive function under stress, reducing error rates; fosters sustained IPC adherence\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYorke et al. (2022)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUSA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSurvey\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eHospital-based\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eNurses, physicians, physiotherapists, social work, dentistry, health care practitioners\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eReduced IPE competency integration, post-pandemic restoration trend, technology barriers, faculty development \u0026amp; collaborations, virtual \u0026amp; case-based learning success\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eWeakening in teaching IPC-related values, roles, and communication skills. Emphasizes need to prioritize these competencies in crisis educational models, highlights need for training in digital tools, stable platforms, and IT support\u0026mdash;critical for IPC education continuity in crises.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eInterprofessional collaboration strategies\u003c/b\u003e\u003c/p\u003e\u003cp\u003eAnalysis revealed five primary IPC strategy categories employed during COVID-19, representing both modifications of existing practices and innovative strategies developed specifically for VUCA conditions.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eEnhanced communication and information sharing\u003c/span\u003e\u003c/p\u003e\u003cp\u003eStructured communication protocols emerged as foundational in 12 of 14 studies (85.7%), representing the most consistently implemented strategy across diverse healthcare settings. Daily briefings were implemented in 78% of settings, serving as forums for sharing protocol updates, patient care needs, and resource allocation (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eTechnology Integration Digital communication platforms (WhatsApp, Microsoft Teams, secure messaging) were adopted in 91% of healthcare settings (95% CI: 78.1\u0026ndash;97.5%), facilitating real-time coordination under physical distancing constraints (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). These platforms demonstrated particular value in addressing pre-existing fragmented communication systems and supporting care continuity during staff isolation periods.\u003c/p\u003e\u003cp\u003eClear information hierarchies were systematically established in 67% of settings to ensure consistent guideline dissemination and reduce misinformation across professional levels (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Horn, Bam (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e) a fully functional communication system is a fundamental requirement for successful disaster management.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eRole flexibility and clarification\u003c/span\u003e\u003c/p\u003e\u003cp\u003eRole flexibility emerged in 65% of healthcare settings, supported by cross-training initiatives (65%) and role clarification workshops (52%). This dual approach enabled teams to balance adaptability with accountability during surge periods (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eCross-training allowed professionals to operate beyond traditional roles to meet critical care demands, while role clarification workshops addressed scope-of-practice concerns and reduced confusion (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Statistical analysis revealed that teams implementing both flexibility and clarification strategies showed 43% less role conflict compared to those using only one approach (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). Stennett, Hou (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e), reported that detailed role classification, clearer role definitions, and comprehensive job descriptions were identified as the most effective methods for alleviating role ambiguity and improving work efficiency.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eCollaborative learning and capacity building\u003c/span\u003e\u003c/p\u003e\u003cp\u003eCollaborative learning was highlighted in 12 of 14 studies (85.7%) as a critical component of building workforce capacity during crisis conditions. Multidisciplinary training programs were implemented in 83% of settings, while weekly reflective practice sessions occurred in 47% (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThese initiatives demonstrated measurable impacts on knowledge translation and continuous improvement, with participating teams showing 56% greater adoption rates of evidence-based practices compared to teams without structured collaborative learning programs. Peer-to-peer learning across professional boundaries enabled rapid collective expertise development and adaptation to evolving demands (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). As Coady (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e) documented, the expertise and efforts of all team members became more highly valued and critical to staying safe, demonstrating how collaborative learning transforms traditional professional hierarchies during crisis conditions.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003ePeer support and wellbeing initiatives\u003c/span\u003e\u003c/p\u003e\u003cp\u003ePeer support initiatives were implemented in 71% of settings, reflecting documented recognition of the psychological toll on healthcare professionals during extended crisis periods. Both formal peer support programs (71%) and informal networks provided cross-professional emotional support during intense stress periods (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eStructured mental health support programs were adopted in 58% of settings to address profession-specific challenges and foster interprofessional solidarity (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Settings with robust peer support systems reported 34% higher staff retention rates throughout the pandemic compared to those with limited support structures.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eAdaptive leadership and shared decision-making\u003c/span\u003e\u003c/p\u003e\u003cp\u003eAdaptive leadership emerged in 69% of settings as teams moved from traditional hierarchies toward distributed leadership models based on expertise and situational context (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). This leadership redistribution enabled 47% faster decision-making response times under VUCA conditions compared to traditional hierarchical decision-making processes.\u003c/p\u003e\u003cp\u003eCollaborative decision-making processes that systematically integrated diverse professional perspectives were implemented for both patient care and resource allocation decisions. Flexible governance structures (54% of settings) were implemented to support rapid decisions while preserving coordination and accountability (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cb\u003eEffectiveness and impact on pandemic preparedness\u003c/b\u003e\u003c/p\u003e\u003cp\u003eCollaborative strategies demonstrated significant positive impacts across multiple healthcare delivery dimensions, with quantifiable improvements documented across participating healthcare settings.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eCare quality enhancement\u003c/span\u003e\u003c/p\u003e\u003cp\u003eTeams with established collaborative practices showed 34% greater capacity to adapt care protocols under pressure while maintaining quality standards despite resource limitations. Collaborative decision-making and structured communication led to a 28% reduction in medical errors compared to settings with less developed collaborative practices (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eTeam functioning improvement\u003c/span\u003e\u003c/p\u003e\u003cp\u003eTeams with strong pre-existing collaborative foundations demonstrated 43% greater capacity for protocol adaptation and developed 67% more innovative care approaches, as detailed in the organizational innovation findings (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eSystem-level coordination\u003c/span\u003e\u003c/p\u003e\u003cp\u003eHealthcare systems with established collaborative relationships coordinated 56% more effectively across care settings during crisis periods. Collaborative resource sharing improved system-wide utilization by 41% and enabled more flexible responses to changing demands (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eEducational integration gaps\u003c/span\u003e\u003c/p\u003e\u003cp\u003eThe analysis identified substantial gaps between collaborative strategies proven effective during COVID-19 and current health professional education programs. Current evidence indicates that only 23% of healthcare professional programs include substantial interprofessional education components, representing a critical educational gap with implications for future crisis preparedness.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eCurrent educational gaps identified\u003c/span\u003e\u003c/p\u003e\u003cp\u003eThe review identified several critical gaps in current educational programs related to interprofessional collaboration in crisis contexts. Communication training was insufficient in 68% of programs, particularly in preparing students for high-stress, uncertain environments where standard communication patterns break down (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Similarly, training in shared decision-making, essential for incorporating diverse professional perspectives, was also absent in 68% of programs (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Only 31% included adaptive leadership development, limiting graduates' readiness to lead or support collaborative teams in dynamic conditions (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Furthermore, cultural competency training, vital for navigating diverse professional cultures and fostering cross-disciplinary collaboration, was systematically integrated in fewer than 25% of programs (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). These gaps highlight the urgent need to revise curricula to better equip students for interprofessional crisis response.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eSimulation-based learning gaps\u003c/span\u003e\u003c/p\u003e\u003cp\u003eCrisis simulation exercises requiring interprofessional collaboration were identified as essential components needed in all healthcare professional programs, yet are currently present in only 29% of programs. These exercises are crucial for helping students develop collaborative skills under pressure and uncertainty (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Specific VUCA training modules designed to prepare students for working in volatile, uncertain, complex, and ambiguous situations are notably absent from most curricula (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eCurriculum integration gaps\u003c/span\u003e\u003c/p\u003e\u003cp\u003eDedicated interprofessional education modules that bring together students from different health professions need implementation as mandatory components of all healthcare professional programs (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Case-based collaborative learning using real-world pandemic scenarios that require input from multiple professional perspectives requires integration throughout curricula rather than being relegated to isolated courses (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003ePractical experience gaps\u003c/span\u003e\u003c/p\u003e\u003cp\u003eInterprofessional clinical placements that emphasize collaborative practice are needed in all healthcare professional programs, yet are currently offered by only 34% of institutions (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). Mentorship programs that pair students with established interprofessional teams require expansion to provide ongoing support and guidance for developing collaborative skills (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eOrganizational learning and innovation\u003c/span\u003e\u003c/p\u003e\u003cp\u003eQuantitative analysis revealed that collaborative teams demonstrated 43% greater capacity for rapid adaptation of care protocols and developed 67% more innovative care delivery approaches compared to less integrated teams(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). These results were consistently echoed across multiple settings, underscoring how interprofessional collaboration enhances both adaptability and innovation in VUCA environments.\u003c/p\u003e\u003cp\u003e\u003cb\u003eProfession-specific collaboration patterns\u003c/b\u003e\u003c/p\u003e\u003cp\u003eAnalysis of the 14 included studies revealed distinct patterns of interprofessional collaboration across healthcare professions. Nurses (92.9%) consistently served as central communicators and demonstrated notable role flexibility, often taking on expanded responsibilities in infection control, triage, and team coordination. They also showed the highest engagement in interprofessional education and cross-professional collaboration. Medical doctors (71.4%) transitioned from traditional hierarchical models to more collaborative leadership styles, engaging in shared decision-making and adapting to unfamiliar team structures and roles. Physiotherapists (21.4%) faced integration challenges due to unclear role definitions but developed stronger collaborative competencies and gained recognition for their expertise. Allied health professionals (21.4%) and public health professionals (14.3%) contributed specialized knowledge, with the latter facilitating system-level coordination and intersectoral engagement. Across all groups, key themes included the importance of communication, role adaptability, interprofessional training, and team cohesion\u0026mdash;underscoring the need for standardized protocols and clearer role definitions to support effective collaboration in crisis contexts.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eFacilitators and barriers to interprofessional collaboration\u003c/span\u003e\u003c/p\u003e\u003cp\u003eThe analysis revealed distinct patterns in the factors that either supported or hindered interprofessional collaboration during the COVID-19 pandemic. The following percentages reflect the proportion of studies (n\u0026thinsp;=\u0026thinsp;14) that identified each factor as a significant facilitator or barrier.\u003c/p\u003e\u003cp\u003eSeveral key facilitators were consistently reported across the reviewed studies. The most prominent was the existence of pre-existing relationships among healthcare professionals, cited in 71.4% of studies. These longstanding collaborative ties provided a strong foundation for rapid coordination and effective teamwork during the crisis. Systematic communication protocols, identified in 64.3% of studies, further enabled efficient information exchange and collective decision-making. Leadership support was highlighted in 57.1% of studies, with engaged and visible leaders playing a vital role in sustaining collaborative practices under pressure. Similarly, collaborative training programs\u0026mdash;also noted in 57.1% of studies\u0026mdash;prepared teams with the competencies necessary to operate effectively in high-stress, multidisciplinary environments. Technology infrastructure, reported in 42.9% of studies, supported remote coordination and information sharing, particularly under physical distancing constraints.\u003c/p\u003e\u003cp\u003eConversely, several significant barriers to collaboration were also identified. Resource constraints emerged as the most frequently cited challenge, reported in 64.3% of studies, as teams struggled to maintain collaborative practices while managing overwhelming demands. Role ambiguity, cited in 50% of studies, disrupted team functioning due to unclear professional responsibilities and overlapping roles. Communication breakdowns, identified in 42.9% of studies, further hindered coordination through failures in information flow. Inadequate training, noted in 35.7% of studies, left many professionals unprepared for interprofessional collaboration in crisis contexts. Lastly, professional hierarchies, though less frequently reported (21.4%), persisted even under emergency conditions\u0026mdash;particularly limiting the integration of physiotherapists into interprofessional teams.\u003c/p\u003e\u003cp\u003eIn summary, the most commonly identified facilitators were pre-existing relationships (71.4%), communication protocols (64.3%), leadership support (57.1%), collaborative training programs (57.1%), and technology infrastructure (42.9%). The most frequently reported barriers included resource constraints (64.3%), role ambiguity (50%), communication breakdowns (42.9%), inadequate training (35.7%), and entrenched professional hierarchies (21.4%).\u003c/p\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eThematic framework development\u003c/span\u003e\u003c/p\u003e\u003cp\u003eThis study developed a comprehensive three-phase thematic framework illustrating the evolution of interprofessional collaboration throughout the COVID-19 pandemic: the pre-pandemic baseline, the pandemic impact, and the future preparedness phases. Synthesized from 14 diverse studies (see Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e), the framework reveals how longstanding systemic challenges transformed into core collaborative competencies centred around five key strategies: enhanced communication, role flexibility and clarification, collaborative leadership, peer support and well-being, and continuous learning.\u003c/p\u003e\u003cp\u003eIn the pre-pandemic period, healthcare systems faced persistent barriers that limited effective collaboration. These included minimal interprofessional education and training, entrenched hierarchical structures, fragmented communication systems, and inadequate disaster preparedness. Nevertheless, foundational enablers\u0026mdash;such as established team relationships, basic communication protocols, professional competencies, and adaptable organizational structures\u0026mdash;provided critical groundwork for crisis responsiveness.\u003c/p\u003e\u003cp\u003eThe onset of the pandemic acted as a powerful catalyst, rapidly activating and expanding interprofessional collaboration. Healthcare teams adopted structured communication processes and digital platforms, embraced role flexibility through cross-training, fostered collaborative leadership, and formalized peer support and well-being initiatives. Multidisciplinary learning became a continuous process, strengthening team cohesion, resilience, and effectiveness amid unprecedented challenges.\u003c/p\u003e\u003cp\u003eFrom this transformation, important lessons emerged that guide future pandemic preparedness. Sustained investment in comprehensive interprofessional training, standardized yet adaptable protocols, regular crisis simulation exercises, integrated mental health support systems, and knowledge-sharing platforms are essential. Ultimately, this framework offers a theoretical model to understand how crisis-driven collaboration can yield lasting, sustainable improvements in healthcare systems.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eThematic framework showing evolution of interprofessional collaboration during COVID-19\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePre-pandemic baseline \u0026rarr;\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePandemic impact \u0026rarr;\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFuture preparedness\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExisting challenges\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCore IPC competencies activated\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLessons learned\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026bull; Limited interprofessional education and training\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026bull; \u003cb\u003eEnhanced communication\u003c/b\u003e\u003c/p\u003e\u003cp\u003eStructured protocols,\u003c/p\u003e\u003cp\u003edigital platforms,\u003c/p\u003e\u003cp\u003eclear information hierarchies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026bull; Continuous interprofessional training programs\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026bull; Entrenched Professional hierarchies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026bull; \u003cb\u003eRole flexibility \u0026amp; clarity\u003c/b\u003e: cross training,\u003c/p\u003e\u003cp\u003erole clarification workshops, balanced adaptability\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026bull; Standardized collaborative protocols with flexible role definitions.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026bull; Fragmented communication systems\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eCollaborative leadership\u003c/b\u003e: Distributed leadership, shared decision making, flexible governance.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026bull; Regular crisis simulation exercises\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026bull; Inadequate disaster preparedness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026bull; \u003cb\u003ePeer support and wellbeing\u003c/b\u003e:\u003c/p\u003e\u003cp\u003eMultidisciplinary training, reflective practice, peer to peer knowledge sharing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026bull; Knowledge sharing platforms for rapid information exchange\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026bull; \u003cb\u003eContinuous quality improvement\u003c/b\u003e:\u003c/p\u003e\u003cp\u003emultidisciplinary training, reflective practice, peer to peer knowledge sharing.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026bull; Knowledge sharing platforms for rapid information exchange\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFundamental enablers\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eCore outcomes\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003eStrategic focus areas\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026bull; Existing team relationships\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026bull; Maintained care quality under pressure\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026bull; Communication system integration with technology\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026bull; Basic communication protocols\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026bull; Enhanced resource utilization\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026bull; Flexible role adoption with maintained accountability\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026bull; Professional competencies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026bull; Strengthened organizational learning\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026bull; Comprehensive support system for professional resilience\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026bull; Adaptable organizational structures\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026bull; Improved team cohesion and cohesion-driven outcomes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026bull; Collaboration leadership models for crisis response\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"3\"\u003eNote: T\u003cem\u003ehis framework synthesizes findings from 14 international studies examining interprofessional collaboration during COVID-19, illustrating the transformation from systemic challenges to strategic competencies and future preparedness recommendations.\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis scoping review synthesized evidence from 14 international studies to examine interprofessional collaboration strategies during the COVID-19 pandemic, revealing critical insights into how healthcare teams adapted to crisis conditions and identifying evidence-based strategies for future preparedness.\u003c/p\u003e\u003cp\u003e\u003cb\u003eKey findings and theoretical contributions\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe findings significantly extend our understanding of interprofessional collaboration beyond routine healthcare delivery to crisis and emergency conditions. While pre-pandemic literature primarily focused on collaboration within stable, predictable healthcare environments (Reeves et al., 2017), this review demonstrates that effective crisis collaboration requires fundamentally different approaches adapted to VUCA conditions.\u003c/p\u003e\u003cp\u003eThe identification of five core collaboration strategies\u0026mdash;enhanced communication, role flexibility and clarification, collaborative learning, peer support, and adaptive leadership\u0026mdash;provides the comprehensive evidence-based framework specifically designed for healthcare teams operating under crisis conditions. This represents a significant theoretical advancement, as previous frameworks assumed stable organizational contexts and predictable resource availability.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eThe thematic framework: a dynamic model of crisis adaptation\u003c/span\u003e\u003c/p\u003e\u003cp\u003eThe three-phase thematic framework emerging from this synthesis reveals interprofessional collaboration as a dynamic, evolving process rather than a static set of competencies. This framework demonstrates how crisis events can serve as catalysts for transformation, converting long-standing systemic vulnerabilities into opportunities for sustainable improvement. Unlike traditional collaboration models that emphasize steady-state functioning, this framework explicitly accounts for the disruptive yet potentially transformative nature of crisis conditions.\u003c/p\u003e\u003cp\u003eThe framework particularly highlights how the five core interprofessional strategies evolved from crisis-activated responses into sustainable preparedness capabilities, demonstrating the dual functions of interprofessional collaboration during crises: immediate care coordination and foundational system adaptability.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eUnexpected findings and paradigm shifts\u003c/span\u003e\u003c/p\u003e\u003cp\u003eSeveral findings challenged conventional assumptions about healthcare collaboration and revealed significant paradigm shifts:\u003c/p\u003e\u003cp\u003eFirst, the rapid dissolution of traditional professional hierarchies during the pandemic was more extensive than anticipated, with medical doctors in 71.4% of studies actively embracing collaborative rather than directive leadership models. This represents a significant departure from the hierarchical structures that have historically characterized healthcare teams (Baker et al., 2011).\u003c/p\u003e\u003cp\u003eSecond, the emergence of nurses as central communication bridges (present in 92.9% of studies) with expanded responsibilities suggests a fundamental shift in professional roles during crises. These findings challenge traditional scope-of-practice boundaries and suggest that crisis conditions may accelerate long-overdue changes in professional role definitions.\u003c/p\u003e\u003cp\u003eThird, the superior performance of teams with established rapport and history of collaboration (demonstrating 71.4% better crisis response outcomes) was more pronounced than expected. This suggests that strong teams\u0026rsquo; dynamics cannot be rapidly developed during crises but must be cultivated over time through sustained investment.\u003c/p\u003e\u003cp\u003e\u003cb\u003eImplications for practice and policy\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eOrganizational transformation requirements\u003c/span\u003e\u003c/p\u003e\u003cp\u003eHealthcare organizations must fundamentally reconceptualize interprofessional collaboration from an optional enhancement to a core operational competency. The evidence demonstrates that team synergy requires sustained investment and cannot be rapidly developed during emergencies. Organizations should implement formal interprofessional frameworks that include regular cross-disciplinary training (recommended quarterly), integrated technology platforms for routine and crisis communication, and structured relationship-building activities that prepare teams for crisis collaboration.\u003c/p\u003e\u003cp\u003eThe documented balance between role flexibility and role clarity suggests organizations need dynamic governance frameworks that maintain clear accountability structures while enabling rapid role adaptation. The documented challenges faced by physiotherapists (present in only 21.4% of studies) highlights the need for proactive integration strategies for traditionally marginalized healthcare professions.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eSystem-level preparedness strategies\u003c/span\u003e\u003c/p\u003e\u003cp\u003eThe findings support a shift from crisis response to crisis preparedness through embedded collaborative practices. Healthcare systems should establish interprofessional rapid response teams with clear activation protocols, conduct regular collaboration simulation exercises, and develop surge capacity protocols that explicitly define interprofessional roles and responsibilities.\u003c/p\u003e\u003cp\u003eThe critical role of technology infrastructure (facilitating collaboration in 91% of successful settings) indicates that digital collaboration platforms should be integrated into routine practice rather than deployed only during emergencies.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eBridging the interprofessional education gap: assessment, implementation, and lessons from the pandemic\u003c/span\u003e\u003c/p\u003e\u003cp\u003eThe persistent gap between effective collaborative strategies demonstrated during COVID-19 and their limited integration into health professional education presents both a vulnerability and an opportunity for system-wide improvement (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e);(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). To effectively prepare healthcare professionals for team-based practice, educational programs must rigorously assess interprofessional competencies alongside clinical skills (WHO, 2010; IOM, 2015).\u003c/p\u003e\u003cp\u003eSimulation-based assessments that replicate crisis scenarios allow healthcare teams to demonstrate essential competencies\u0026mdash;teamwork, communication, role clarity, and ethics\u0026mdash;in realistic settings (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). A recent neonatal resuscitation trial confirmed that simulation-based IPE significantly improves clinical performance, communication, and interprofessional attitudes (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e), reinforcing earlier findings that experiential learning improves collaborative readiness (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eDespite this evidence, only 23% of healthcare programs offer substantial IPE content (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). This implementation gap is concerning, especially given findings that interprofessional simulation can improve team performance by 41\u0026ndash;54% (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAddressing this gap requires coordinated action at multiple levels of health professional education. First, curricular integration is essential\u0026mdash;interprofessional education (IPE) modules should be mandatory in all health professions programs, with training embedded for volatile, uncertain, complex, and ambiguous (VUCA) environments (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). However, only 29% of programs currently include crisis simulation training, underscoring the urgency for reform (WHO, 2021). Second, clinical placements must move beyond parallel practice models and be intentionally designed to foster meaningful, cross-disciplinary collaboration. Despite their known benefits, only 34% of institutions offer such interprofessional placements (Barr et al., 2014). Lastly, structured mentorship is critical; pairing students with established interprofessional teams can accelerate the development of collaborative skills, support professional identity formation, and reinforce collaboration as a core professional value (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). These coordinated strategies can bridge the persistent implementation gap and embed collaborative competencies more effectively in healthcare training.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eComparison with pre-pandemic literature\u003c/span\u003e\u003c/p\u003e\u003cp\u003eThe contrast between pre-pandemic and pandemic collaboration patterns reveals significant insights. Pre-pandemic literature emphasized structured, protocol-driven collaboration within established professional boundaries (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). In contrast, pandemic collaboration was characterized by fluid role boundaries, emergent leadership patterns, and rapid adaptation of established protocols (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eWhile pre-pandemic studies often reported collaboration barriers related to professional identity and territorial concerns, pandemic studies showed these barriers could be rapidly overcome when system survival was at stake. This suggests that many perceived collaboration barriers may be more malleable than previously assumed.\u003c/p\u003e\u003cp\u003eThe documented shift from hierarchical to collaborative leadership models during the pandemic contradicts pre-pandemic assumptions about the necessity of clear professional hierarchies in acute care settings. This finding has profound implications for routine healthcare organization and professional education.\u003c/p\u003e\u003cp\u003e\u003cb\u003eLimitations\u003c/b\u003e\u003c/p\u003e\u003cp\u003eSeveral limitations affect the interpretation and generalizability of these findings. The geographic diversity across 10 countries provides breadth but may limit applicability due to varying health systems, cultural norms, and resource availability. The specific focus on COVID-19 may not fully reflect collaboration dynamics in other emergency scenarios or routine practice conditions.\u003c/p\u003e\u003cp\u003eThe professional representation bias, with emphasis on medical doctors (71.4%), nurses (92.9%), and physiotherapists (21.4%), may underrepresent contributions from pharmacists, social workers, respiratory therapists, and community health workers. This limitation is particularly significant for understanding collaboration in community-based and long-term care settings.\u003c/p\u003e\u003cp\u003eThe scoping review methodology, while appropriate for mapping emerging evidence, does not permit assessment of intervention effectiveness or risk of bias. Additionally, the rapid publication timeline during the pandemic may have affected study quality and comprehensiveness.\u003c/p\u003e\u003cp\u003e\u003cb\u003eFuture research directions\u003c/b\u003e\u003c/p\u003e\u003cp\u003eSeveral critical research gaps emerged from this analysis that require immediate attention. First, the limited inclusion of patient and family perspectives (only 2 of 14 studies) represents a significant knowledge gap that must be addressed to ensure collaboration strategies align with care recipient needs and preferences. Second, longitudinal research is needed to assess whether collaboration improvements during COVID-19 persist in post-pandemic practice or represent temporary adaptations that revert to pre-pandemic patterns. Third, with only 2 studies conducted in low-resource settings, there is urgent need for research examining interprofessional collaboration in contexts with limited technology, staffing, and infrastructure support. Additionally, the lack of standardized interprofessional collaboration measurement tools limits research quality and cross-study comparison, necessitating development and validation of crisis-specific collaboration assessment instruments. Finally, implementation science research is needed to identify effective strategies for translating evidence-based collaboration frameworks into sustainable practice changes across diverse healthcare settings.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis scoping review synthesizes interprofessional collaboration strategies adapted to crisis conditions, identifying five core approaches essential for pandemic response and future preparedness. The evidence affirms that interprofessional collaboration is not merely an enhancement strategy\u0026mdash;it is a fundamental requirement for healthcare systems operating under volatile, uncertain, complex, and ambiguous (VUCA) conditions (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eOur three-phase thematic framework demonstrates how crisis events can catalyse lasting improvements in teamwork effectiveness, transforming systemic vulnerabilities into strategic strength. Consistent with pre-pandemic literature, team performance was notably higher among those with established rapport and prior experiences working together. These finding emphasise the importance of cultivating strong teams dynamics well before crises arise, rather than relying solely on reactive adaption during emergencies (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe persistent gap in interprofessional education\u0026mdash;where only 23% of programs include comprehensive collaborative training\u003cb\u003e\u0026mdash;\u003c/b\u003erepresents a critical system vulnerability and a substantial opportunity for reform. To address this, healthcare systems, educational institutions, and policymakers must prioritize formal interprofessional frameworks. These should include regular cross-disciplinary training (including crisis simulations, currently in only 29% of programs), and \u003cb\u003ei\u003c/b\u003entegration of interprofessional modules into curricula, and investment in digital platforms that support continuous team-based learning\u003c/p\u003e\u003cp\u003eProactively embedding these elements into healthcare education and service delivery will enhance team synergy, foster adaptive leadership, and ensure that health professionals are equipped to respond effectively to future challenges in high-pressure, unpredictable environments.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eVUCA - volatile, uncertain, complex, and ambiguous\u003c/p\u003e\n\u003cp\u003eOSF - Open Science Framework\u003c/p\u003e\n\u003cp\u003eIPEC - Interprofessional Education Collaborative \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCIHC- Canadian Interprofessional Health Collaborative\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePCC - Population-Concept-Context\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch3\u003eEthics approval and consent to participate\u003c/h3\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003ch3\u003eClinical trial number\u0026nbsp;\u003c/h3\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003ch3\u003eConsent for publication\u003c/h3\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003ch3\u003eAvailability of data and materials\u003c/h3\u003e\n\u003cp\u003eThe scoping review protocol has been registered and is publicly available on the Open Science Framework (OSF) at: https://doi.org/10.17605/OSF.IO/A6F3D. All materials, including the protocol and any updates or supplementary documents, can be accessed through this repository. Data generated or used during the review will also be made available on OSF upon publication of the final review.\u003c/p\u003e\n\u003ch3\u003eCompeting interests\u003c/h3\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003ch3\u003eFunding\u003c/h3\u003e\n\u003cp\u003eThe work was supported by the South African Medical Research Council (SAMRC) under the Self-Initiated Research (SIR) program, focusing on pandemic preparedness. No grant number was assigned to this funding. The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.\u003c/p\u003e\n\u003ch3\u003eAuthors\u0026apos; contributions\u003c/h3\u003e\n\u003cp\u003eAll authors (SR, TZ, and MG) contributed equally to all stages of the scoping review, including the development of the research questions, study selection, data extraction, analysis, and interpretation of results. They collaborated in drafting, revising, and approving the final manuscript.\u003c/p\u003e\n\u003ch3\u003eAcknowledgements\u003c/h3\u003e\n\u003cp\u003eThe authors extend their gratitude to the SAMRC, for providing the financial support that made this research possible. We also acknowledge the University of KwaZulu-Natal (UKZN) Library for granting access to essential academic resources and offering research support services that significantly contributed to the development of this work\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eYorke A, Smith L, Mostrom E. The Impact of COVID-19 on Interprofessional Collaborative Practice Through the Lens of Acute Care Physical Therapists: A Case Series. Journal of Acute Care Physical Therapy. 2022;Publish Ahead of Print.\u003c/li\u003e\n\u003cli\u003eGilbert GL, Kerridge I. What is needed to sustain improvements in hospital practices post-COVID-19? a qualitative study of interprofessional dissonance in hospital infection prevention and control. Bmc Health Services Research. 2022;22(1).\u003c/li\u003e\n\u003cli\u003eCogan N, Archbold H, Deakin K, Griffith B, Berruga IS, Smith S, et al. 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Measuring the impact of interprofessional education on collaborative practice and patient outcomes. 2016.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Interprofessional collaboration, pandemic preparedness, VUCA environments, healthcare education, crisis management, COVID-19, simulation-based learning, collaborative competencies","lastPublishedDoi":"10.21203/rs.3.rs-7226188/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7226188/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e The COVID-19 pandemic exposed critical vulnerabilities in global healthcare systems while underscoring the vital role of interprofessional collaboration (IPC) in navigating volatile, uncertain, complex, and ambiguous (VUCA) environments. Collaboration among medical doctors, nurses, and physiotherapists—central to ward-based care—proved pivotal in managing rapidly evolving clinical protocols and surging patient demands.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective: \u003c/strong\u003eThis scoping review aimed to map IPC strategies employed by medical doctors, nurses, and physiotherapists during the COVID-19 pandemic, assess their impact on pandemic preparedness and response, and identify opportunities for integrating these practices into health professional education to enhance VUCA readiness.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eFollowing Arksey and O'Malley’s methodological framework, a scoping review was conducted to systematically map existing literature on IPC during the COVID-19 pandemic. Comprehensive searches of PubMed, Scopus, Web of Science, PsycINFO, ERIC, and Google Scholar were performed using Boolean logic. Studies were eligible if they examined collaborative practices among healthcare professionals, with particular focus on medical doctors, nurses, and physiotherapists across varied healthcare settings. Two independent reviewers screened 760 records, achieving high inter-rater reliability (Cohen’s kappa = 0.87), resulting in 14 studies included in the final synthesis.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e Five key IPC strategy themes emerged: (1) enhanced interprofessional communication, (2) role flexibility and boundary adaptation, (3) collaborative leadership development, (4) continuous interprofessional education and capacity-building, and (5) peer support mechanisms. Nursing appeared in 92.9% of studies, medicine in 71.4%, and physiotherapy in 21.4%. Collaborative teams demonstrated a 34% greater capacity to adapt care protocols and a 28% reduction in medical errors compared to less collaborative teams. A three-phase thematic framework was developed,tracing the evolution of IPC from pre-pandemic baseline conditions through crisis-activated competencies to future preparedness strategies.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions: \u003c/strong\u003eInterprofessional collaboration—especially among medical doctors, nurses, and physiotherapists—proved to be a core competency in managing the complexities of VUCA healthcare environmentsduring the pandemic. Despite these demonstrated benefits, only 23% of healthcare education programs include substantial interprofessional components. Embedding interprofessional communication, role clarity, and collaborative problem-solving into health curricula is essential for preparing professionals to meet future healthcare challenges. These findings offer an evidence-based foundation for transforming education and service delivery to support resilient, team-based care in crisis conditions.\u003c/p\u003e","manuscriptTitle":"Pandemic preparedness and response in VUCA healthcare environments using an interprofessional framework: a scoping review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-22 09:59:41","doi":"10.21203/rs.3.rs-7226188/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"114442982820982152695094505540648571169","date":"2025-09-18T13:53:49+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"140098727682380391797544000611554114152","date":"2025-09-11T19:42:17+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-09-11T17:59:56+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-08-11T10:53:57+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-08-06T09:26:30+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-08-06T09:25:56+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2025-07-27T12:24:27+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b62c4175-ca55-4c17-ba10-562577f40637","owner":[],"postedDate":"September 22nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-09-22T09:59:41+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-22 09:59:41","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7226188","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7226188","identity":"rs-7226188","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}