Nursing and medical students' attitudes and perceptions towards interprofessional education during clinical training in Uganda

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Despite its recognized benefits, IPE remains underutilized in many medical and nursing schools. This study aimed to evaluate the attitudes and perceptions of medical and nursing students toward interprofessional collaboration in the clinical learning environment. Methods A cross-sectional, questionnaire-based study was conducted from April to August 2022 at the Faculty of Health Sciences, Busitema University, and the College of Health Sciences, Makerere University. The study used the 27-item Interprofessional Attitude Scale (IPAS) to assess teamwork, patient-centeredness, inter-professional biases, diversity and ethics, and community-centeredness. Undergraduate students in years 3 to 5 from medical and nursing programs were sampled consecutively. Descriptive and inferential analyses were performed. Results A total of 467 students participated, including 404 (86.5%) medical and 63 (13.5%) nursing students. The majority (74.5%) were from Makerere University. Only 17.8% had prior IPE exposure. Despite this, students demonstrated a strong willingness to engage in interprofessional learning. Nursing students scored higher in patient-centeredness (p = 0.0467) and inter-professional biases (p = 0.0160). Busitema University students had higher scores in teamwork, diversity and ethics, and community-centeredness (p < 0.05). Female students scored significantly higher in teamwork, patient-centeredness, and community-centeredness (p < 0.05). Conclusion Although formal IPE exposure was limited, students showed positive attitudes toward interprofessional collaboration. These findings highlight the need to integrate structured IPE activities in clinical training to enhance teamwork, reduce professional silos, and improve patient care. 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F1000Research 2026, 15 :556 ( https://doi.org/10.12688/f1000research.168153.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Nursing and medical students' attitudes and perceptions towards interprofessional education during clinical training in Uganda [version 1; peer review: 1 approved] Rebecca Nekaka https://orcid.org/0000-0002-9199-7197 1,2 , Firdouza Waggie https://orcid.org/0000-0003-1977-3073 3 , Scovia Nalugo Mbalinda 4 , [...] Ezekiel Mupere https://orcid.org/0000-0002-8746-9009 1 , Ian Munabi 5 , Mubuuke Aloysius G 6 , Sarah Kiguli 1 Rebecca Nekaka https://orcid.org/0000-0002-9199-7197 1,2 , Firdouza Waggie https://orcid.org/0000-0003-1977-3073 3 , [...] Scovia Nalugo Mbalinda 4 , Ezekiel Mupere https://orcid.org/0000-0002-8746-9009 1 , Ian Munabi 5 , Mubuuke Aloysius G 6 , Sarah Kiguli 1 PUBLISHED 18 Apr 2026 Author details Author details 1 Department of Pediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences, Kampala, Central Region, 256, Uganda 2 Department of Community and Public Health, Faculty of Health Sciences, Busitema University, Tororo, Eastern Region, 256, Uganda 3 Department of Health Professions Education, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, Western Cape, South Africa 4 Department of Nursing, School of Health Sciences, Makerere University College of Health Sciences, Kampala, Central Region, Uganda 5 Department of Anatomy School of Health Sciences, Makerere University College of Health Sciences, Kampala, Central Region, Uganda 6 Department of Radiology, School of Medicine,, Makerere University College of Health Sciences, Kampala, Central Region, Uganda Rebecca Nekaka Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Firdouza Waggie Roles: Formal Analysis, Investigation, Methodology, Supervision, Validation, Visualization, Writing – Review & Editing Scovia Nalugo Mbalinda Roles: Formal Analysis, Funding Acquisition, Investigation, Methodology, Supervision, Writing – Review & Editing Ezekiel Mupere Roles: Formal Analysis, Investigation, Methodology, Resources, Supervision, Validation, Visualization, Writing – Review & Editing Ian Munabi Roles: Data Curation, Formal Analysis, Funding Acquisition, Methodology, Resources, Software, Supervision, Visualization, Writing – Review & Editing Mubuuke Aloysius G Roles: Data Curation, Formal Analysis, Funding Acquisition, Methodology, Resources, Supervision, Visualization, Writing – Review & Editing Sarah Kiguli Roles: Data Curation, Funding Acquisition, Methodology, Resources, Supervision, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Introduction Interprofessional Education (IPE) fosters the knowledge, skills, and attitudes necessary for collaborative practice in complex clinical settings. Despite its recognized benefits, IPE remains underutilized in many medical and nursing schools. This study aimed to evaluate the attitudes and perceptions of medical and nursing students toward interprofessional collaboration in the clinical learning environment. Methods A cross-sectional, questionnaire-based study was conducted from April to August 2022 at the Faculty of Health Sciences, Busitema University, and the College of Health Sciences, Makerere University. The study used the 27-item Interprofessional Attitude Scale (IPAS) to assess teamwork, patient-centeredness, inter-professional biases, diversity and ethics, and community-centeredness. Undergraduate students in years 3 to 5 from medical and nursing programs were sampled consecutively. Descriptive and inferential analyses were performed. Results A total of 467 students participated, including 404 (86.5%) medical and 63 (13.5%) nursing students. The majority (74.5%) were from Makerere University. Only 17.8% had prior IPE exposure. Despite this, students demonstrated a strong willingness to engage in interprofessional learning. Nursing students scored higher in patient-centeredness (p = 0.0467) and inter-professional biases (p = 0.0160). Busitema University students had higher scores in teamwork, diversity and ethics, and community-centeredness (p < 0.05). Female students scored significantly higher in teamwork, patient-centeredness, and community-centeredness (p < 0.05). Conclusion Although formal IPE exposure was limited, students showed positive attitudes toward interprofessional collaboration. These findings highlight the need to integrate structured IPE activities in clinical training to enhance teamwork, reduce professional silos, and improve patient care. READ ALL READ LESS Keywords Interprofessional Education, Collaborative Practice Corresponding Author(s) Rebecca Nekaka ( [email protected] ) Close Corresponding author: Rebecca Nekaka Competing interests: No competing interests were disclosed. Grant information: This research was supported by the Forgarty International Center of the National Institute of Health, US Department of state Office of the U.S, Global AIDS Coordinator and Health Diplomacy(S/GAC), and President’s Emergency Plan for AIDS Relief (PEPFAR) under award number 1R25TW011213 The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Copyright: © 2026 Nekaka R et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Nekaka R, Waggie F, Nalugo Mbalinda S et al. Nursing and medical students' attitudes and perceptions towards interprofessional education during clinical training in Uganda [version 1; peer review: 1 approved] . F1000Research 2026, 15 :556 ( https://doi.org/10.12688/f1000research.168153.1 ) First published: 18 Apr 2026, 15 :556 ( https://doi.org/10.12688/f1000research.168153.1 ) Latest published: 18 Apr 2026, 15 :556 ( https://doi.org/10.12688/f1000research.168153.1 ) Introduction Interprofessional Education (IPE) is an educational approach where students from two or more healthcare or social care professions engage in learning with, from, and about each other. 1 This collaborative learning process fosters a deeper understanding, mutual respect, and shared values across different healthcare roles, equipping students with the necessary competencies to work effectively in interprofessional healthcare teams that prioritize patient-centred care. 1 By bringing together students from various health disciplines, IPE enhances their ability to share skills and knowledge, fostering teamwork that improves healthcare delivery. The integration of IPE into healthcare training is widely recognized as a critical strategy for strengthening teamwork and improving health outcomes. A systematic review by Berger-Estilita et al. (2020) emphasized the importance of introducing IPE early in health professional curricula, ensuring that students internalize the core values of interprofessional collaboration before entering clinical practice. 2 The goal is to develop a team-based, interprofessional approach that enhances patient outcomes and the overall quality of care. Globally, and particularly within Africa, reducing medical errors and improving patient outcomes have become central healthcare priorities. 3 The Commission on the Education of Health Professions for the 21st Century advocates for promoting interprofessional and trans-professional education, which breaks down professional silos and fosters collaborative, non-hierarchical relationships within effective teams. 4 There is compelling evidence that IPE leads to better collaborative practice, enhanced healthcare service delivery, stronger health systems, and improved patient outcomes. 5 , 6 In contrast, poor inter-professional collaboration and ineffective communication among healthcare professionals have been linked to preventable patient harm, as documented in numerous studies. 7 – 9 In Uganda, healthcare training programs face challenges in incorporating IPE into clinical education. These challenges include the prioritization of discipline-specific competencies over collaborative practice in clinical training settings. The backbone of Uganda’s healthcare workforce, nursing and medical students often train in silos, which perpetuates role boundaries and communication gaps. Furthermore, resource constraints, including overcrowded classrooms and inadequate monitoring, limit opportunities for interprofessional engagement during clinical placements. The lack of official IPE policies and structured courses in many Ugandan institutions exacerbates these issues, leaving students unprepared for the collaborative work required in demanding clinical environments. The success of IPE largely depends on students’ attitudes and perceptions toward collaboration. 7 Research shows that improved student attitudes lead to greater cooperation and better patient outcomes. 9 , 10 However, conflicting opinions often arise, especially in settings where traditional hierarchical structures dominate. For instance, medical students may undervalue nursing roles, while nursing students may perceive disparities in decision-making power. Although the importance of IPE is increasingly recognized, few studies in Uganda have examined the attitudes and perceptions of nursing and medical students during their clinical training. Most existing literature focuses on classroom-based IPE or postgraduate teamwork, overlooking the formative clinical phase where interprofessional dynamics are most pronounced. 11 This gap hinders the creation of contextually relevant IPE systems that align with Uganda’s unique healthcare needs. Based on the Interprofessional Education Collaborative (IPEC) 2016 competencies, this study aims to address this gap by exploring the attitudes and perceptions of nursing and medical students during their clinical training, providing valuable insights to guide the integration of IPE in resource-limited environments. Methods Study Design and Setting : This cross-sectional (quantitative) study was conducted at Makerere University College of Health Sciences (MakCHS) and Busitema University Faculty of Health Sciences (BUFHS) from April 2022 to August 2022. Uganda has 11 public universities, including Makerere University and Busitema University, both of which offer competency-based curricula in health sciences. Makerere University College of Health Sciences, one of the largest medical schools in the country, has an enrolment of approximately 2,000 students. Medical training at Makerere and Busitema follows a structured pathway: a five-year Bachelor of Medicine and Bachelor of Surgery (MBChB) program, with three years focused on basic sciences followed by two years of clinical training. The nursing program spans four years, with the first two years dedicated to basic sciences and the final two years to clinical training. Current status of implementation of IPE: The implementation of interprofessional education (IPE) in Ugandan medical schools is gradually gaining traction but is not yet universally integrated. Efforts are underway to introduce collaborative learning approaches involving multiple healthcare disciplines to enhance professionals’ teamwork, communication, and mutual understanding. Various institutions have begun incorporating IPE elements into their curricula, fostering joint learning experiences among medical, nursing, and pharmacy students. However, implementation varies due to resource constraints, curriculum alignment, faculty readiness, and institutional support. Partnerships between universities, professional bodies, and healthcare organizations are gradually advancing IPE, emphasizing the importance of collaborative practices for improving patient care outcomes in Uganda’s healthcare system. Study population and sample : The study population comprised third- and fourth-year nursing students and fourth- and fifth-year medical students at Makerere and Busitema public medical schools. The sample size was determined using the Kish Leslie formula for cross-sectional studies. 12 The sample size calculation assumed a 95% confidence level, a standard normal deviation of 1.96, and an expected proportion of positive attitudes towards IPE of 50% with a margin of error of 5%. This yielded a required sample size of 427 students. The final sample size was 467 due to additional eligible students consenting to participate. The response rate and justification for increased inclusion are detailed in the results section. Consecutive sampling was used for participant selection. Data collection tools A validated Interprofessional Attitudes Scale (IPAS) was used. 13 The IPAS assesses attitudes related to the 2011 Core Competencies for Interprofessional Collaborative Practice. The items are based on an existing tool, the Readiness for Interprofessional Learning Scale (RIPLS), and the four domains of the 2011 IPEC Core Competencies for Interprofessional Collaborative Practice. The IPAS was one of the first scales to focus on these core competencies. It consists of 27 items in five subscales: Teamwork, Roles, and Responsibilities; Patient-Centeredness; Interprofessional Biases; Diversity and Ethics; and Community-Centeredness. All items were assessed using a 5-point Likert scale (from “strongly disagree” 1 to “strongly agree” 5 ). Additionally, demographic details (age, sex, program of study, and prior IPE experience) were collected. This tool is particularly relevant for evaluating students’ preparedness for interprofessional education in diverse learning environments. Given that Makerere University and Busitema University have not yet implemented structured interprofessional programs, the IPAS provides a robust framework to measure students’ perspectives on interprofessional collaboration and teamwork. The validity and reliability of the IPAS questionnaire were checked for the Ugandan context before administration. Expert review ensured content validity, while internal consistency reliability was assessed using Cronbach’s alpha. Data collection process: The researcher trained all research assistants on administering the questionnaire and familiarized them with the instrument. Research assistants received information sheets, consent forms, and survey tools to distribute to clinical students after training. The questionnaire was self-administered, with research assistants available to clarify any queries. Research assistants approached students in classrooms or hospital wards during break times to distribute the questionnaire. The researcher was available to address any challenges during data collection. Data analysis: Data from the IPAS tool were captured and analysed using STATA 15 software (StataCorp, College Station, TX, USA). Initially, data were cleaned and organized to ensure accurate recording. Descriptive statistics, such as mean and median values, provided an overview of the attitude distribution. Frequencies and percentages of Likert-scale responses were analysed to assess the distribution of attitudes. Measures of variability, such as standard deviation, indicated the degree of consensus among participants. IPAS scoring and derivation of mean scores This study utilized a structured questionnaire based on the Interprofessional Attitudes Scale (IPAS), which consists of multiple items organized under key thematic domains: Teamwork, Roles, and Responsibilities; Patient-Centeredness; Inter-professional Biases; Diversity and Ethics; and Community-Centeredness. Each item was rated using a five-point Likert scale, where 5 represents “Strongly Agree,” 4 represents “Agree,” 3 represents “Neutral (Not Decided),” 2 represents “Disagree,” and 1 represents “Strongly Disagree.” Derivation of mean scores: To derive the mean score for each individual item, the numerical values assigned to each response were averaged across all participants. This provided a summary measure of the level of agreement or disagreement with each statement, with higher mean scores indicating stronger agreement and more positive attitudes toward the construct being measured. Domain-level mean scores: For each domain, the item-level scores were first summed for each respondent. The total domain score for each respondent was then averaged across all participants to obtain the domain-level mean score and the corresponding standard deviation (SD). The composite mean score for each domain reflects respondents’ overall attitudes toward that specific dimension of interprofessional practice. For example, a high mean score in the “Teamwork, Roles, and Responsibilities” domain suggests a strong value placed on interprofessional collaboration. Conversely, a lower mean score in domains such as “Inter-professional Biases” indicates more neutral or negative perceptions toward collaboration with professionals from other disciplines. Inferential statistics were used to identify significant differences in attitudes based on gender and program of study. Mann–Whitney test was used to compare mean scores between groups, while chi-square tests assessed associations between categorical variables. A p-value of <0.05 was considered statistically significant. Further exploratory and inferential analyses were conducted. Descriptive statistics, including frequency distributions and measures of central tendency (mean, median), were used to summarize demographic data and attitudes toward interprofessional learning. Ethical considerations : Participation in the study was voluntary. Written consent was obtained from all students before they received the questionnaire. Students were assigned ID numbers to maintain confidentiality, and no identifying data were collected. Ethical approval was obtained from the Makerere University College of Health Sciences, School of Medicine Research and Ethics Committee (Mak-SOMREC-2021-188). Administrative clearance was sought and received from the respective school deans before data collection. Results A total of 467 medical (404) and nursing (63) trainees responded to the survey, with a response rate of >100%. Of these hundred and fifteen (67.5%) were males, and 152 (15.2%) were females. Most (93.8%) of the patients were between 20 and 34 years of age. Three hundred forty-eight (74.5%) were from Makerere University College of Health Sciences and nineteen (25.5%) were from Busitema University Faculty of Health Sciences. Eighty-three students (17.8%) had previous experience in Interprofessional Education ( Table 1 ). Table 1. Demographic characteristics of the participants. Variable Median IQR Frequency n = 467 Percentage (%) Age years (median) 24 3 Institution Busitema university 119 25.5 Makerere university 348 74.5 Your discipline Bachelor of Medicine and Bachelor of Surgery 404 86.5 Bachelor of Science in Nursing 63 13.5 Gender Female 152 32.5 Male 315 67.5 Year of study III 125 26.8 IV 199 42.6 V 123 26.3 Completed the IPAS questionnaire before 39 8.4 Had previous experience of inter-professional learning Overall 83 17.8 Makerere university 24 28.9 Busitema university 59 71.1 Table 2 ( https://doi.org/10.17605/OSF.IO/736J8 ) shows the mean scores for each item of the IPAS. The highest mean score was obtained for several statements, including ‘Shared learning before graduation will help me become a better team worker’, ‘Shared learning will help me think positively about other professionals’, and ‘establishing trust with my patients is important to me.’ Students obtained the lowest mean score for the statement, ‘ I have prejudices or make assumptions about health professionals/students from other disciplines.’ As shown in Table 2 ( https://doi.org/10.17605/OSF.IO/736J8 ), the Medicine and Nursing students generally had a positive attitude towards interprofessional education and collaborative practice. Domain comparisons Comparison of overall mean scores by institution The comparison of overall mean scores between Busitema and Makerere University students revealed significant differences in several variables ( Table 3 ). Teamwork, roles, and responsibilities had a higher mean score at Busitema (41.9 ± 3.1) than Makerere (40.6 ± 4.4), with a significant p-value of 0.0054. Similarly, patient centeredness was significantly higher at Busitema (23.9 ± 1.5) than Makerere (23.4 ± 2.4, p = 0.0184). Diversity and ethics also showed a significant difference (p = 0.0027), with Busitema students scoring higher (17.6 ± 0.9) than their Makerere counterparts (17.3 ± 1.3). Additionally, community-centeredness was significantly higher at Busitema (28.0 ± 2.3) than Makerere (27.3 ± 3.0, p = 0.0496). However, no significant difference was observed in inter-professional biases (p = 0.0652). These findings suggest that students at Busitema University may have stronger competencies in teamwork, patient-centeredness, diversity, and community engagement compared to those at Makerere University. Table 3. Comparison of overall mean scores (Busitema and Makerere University). Variable All sample mean (SD) Busitema university mean (SD) Makerere university mean (SD) Prob >|z| Teamwork, Roles, and Responsibilities 41.0(4.1) 41.9(3.1) 40.6(4.4) 0.0054 Patient centeredness 23.6(2.1) 23.9(1.5) 23.4(2.4) 0.0184 Inter-professional Biases 10.1(2.9) 9.7(3.0) 10.2(2.9) 0.0652 Diversity and Ethics 17.3(1.2) 17.6(0.9) 17.3(1.3) 0.0027 Community – Centeredness 27.5(2.8) 28.0(2.3) 27.3(3.0) 0.0496 Comparison of overall mean scores by course The comparison of overall mean scores between Bachelor of Medicine and Bachelor of Surgery (MBChB) and Bachelor of Science in Nursing (BScN) students revealed significant differences in inter-professional biases (p = 0.0160) and total score (p = 0.0346). Nursing students had higher mean scores for inter-professional biases (10.8 ± 2.8) compared to medical students (10.0 ± 2.9), suggesting potential differences in perceptions of inter-professional interactions. Similarly, nursing students scored higher on total score (121.8 ± 6.8) than medical students (119.1 ± 9.5). No significant differences were observed in teamwork, roles, and responsibilities (p = 0.1082), patient-centeredness (p = 0.0574), diversity and ethics (p = 0.2482), and community-centeredness (p = 0.5430), indicating comparable competencies in these areas between the two student groups ( see Table 4 ). Table 4. Comparison of overall mean scores (Medicine and nursing students). Variable Total Bachelor of medicine and bachelor of surgery Bachelor of science in nursing P-value Mean (SD) Median (IQR) Mean (SD) Median (IQR) Mean (SD) Median (IQR) Teamwork, Roles, and Responsibilities 41.0(4.2) 41.0(5) 40.8(4.3) 41(5) 41.8(3.1) 42(5) 0.1082 Patient centeredness 23.6(2.2) 24(2) 23.5(2.3) 24(2) 24.1(1.3) 25(2) 0.0574 Inter-professional Biases 10.1(2.9) 10(4) 10.0(2.9) 10(4) 10.8(2.8) 11(4) 0.0160 Diversity and Ethics 17.3(1.2) 18(1) 17.3(1.2) 18(1) 17.5(1.0) 18(1) 0.2482 Community – Centeredness 27.6(2.8) 28(4) 27.5(2.9) 28(4) 27.6(2.2) 28(4) 0.5430 Total score 119.4(9.2) 121(12) 119.1(9.5) 120(12) 121.8(6.8) 123(10) 0.0346 Comparison of overall mean scores by gender The comparison of overall mean scores by gender revealed significant differences in several variables ( Table 5 ). Female students scored significantly higher than male students in teamwork, roles, and responsibilities (41.7 ± 3.4 vs. 40.6 ± 4.5, p = 0.0074), patient centeredness (23.8 ± 2.1 vs. 23.5 ± 2.2, p = 0.0192), community-centeredness (27.9 ± 2.5 vs. 27.3 ± 2.9, p = 0.0482), and total score (120.6 ± 8.5 vs. 118.9 ± 9.5, p = 0.0345). No significant differences were observed in inter-professional biases (p = 0.3471) and diversity and ethics (p = 0.1785), suggesting that attitudes and perceptions in these areas were similar between male and female students. These findings indicate that female students demonstrated stronger competencies in teamwork, patient-centeredness, and community engagement compared to their male counterparts. Table 5. Comparison of overall mean scores (By Gender). Variable Female Male P-value Mean (SD) Median (IQR) Mean (SD) Median (IQR) Teamwork, Roles, and Responsibilities 41.7(3.4) 42(6) 40.6(4.5) 41(6) 0.0074 Patient centeredness 23.8(2.1) 25(2) 23.5(2.2) 24(2) 0.0192 Inter-professional Biases 9.9(3.0) 10(4) 10.2(2.9) 10(4) 0.3471 Diversity and Ethics 17.4(1.1) 18(1) 17.3(1.2) 18(1) 0.1785 Community – Centeredness 27.9(2.5) 29(4) 27.3(2.9) 28(4) 0.0482 Total score 120.6(8.5) 122.5(12) 118.9(9.5) 120(13) 0.0345 Comparison of overall mean score- Years of study The comparison of overall mean scores across years of study revealed significant differences in inter-professional biases (p = 0.0024), with Year IV students scoring lower, and community-centeredness (p = 0.0329), where Year IV had the highest mean score ( Table 6 ). No significant differences were observed in teamwork, roles, and responsibilities, patient centeredness, and diversity and ethics (p > 0.05). These findings suggest that inter-professional biases may decrease in Year IV, while community-centeredness improves, whereas other competencies remain relatively stable across the clinical years of study. Table 6. Comparison of overall mean scores (Year of study). Variable Year of study Prob >|z| III Mean (SD) IV Mean (SD) V Mean (SD) Teamwork, Roles, and Responsibilities 41.1(3.5) 41.3(3.5) 40.3(5.6) 0.7249 Patient centeredness 23.5(1.6) 23.8(2.0) 23.3(2.9) 0.0900 Inter-professional Biases 10.5(2.7) 9.6(2.8) 10.4(3.2) 0.0024 Diversity and Ethics 17.2(1.1) 17.4(1.1) 17.3(1.4) 0.1521 Community – Centeredness 27.1(2.6) 27.9(2.4) 27.3(3.5) 0.0329 Discussion This study examined the interprofessional attitudes and perceptions of healthcare students at Makerere and Busitema Universities, with particular focus on variations based on year of study, university, academic discipline, and gender. The findings underscore the importance of structured interprofessional education (IPE) in clinical settings, where students develop practical collaboration skills critical for patient-centered care. Interprofessional competencies across years of study The results show significant differences in inter-professional biases and community-centeredness across the years of study. Specifically, Year IV students exhibited lower inter-professional biases and higher community-centeredness compared to those in Years III and V. These findings suggest that fourth-year students, who likely have more exposure to interprofessional learning in clinical settings, have developed more positive attitudes toward collaboration. However, the decline in scores among fifth-year students may reflect a shift toward professional identity formation, which often reinforces discipline-specific roles, a pattern that has been observed in studies from the United States and across other countries. 14 – 16 This shift could indicate that students begin to prioritize their professional identities as they near graduation, which may limit their openness to interprofessional collaboration. To maintain positive attitudes toward teamwork and reduce professional silos, IPE activities should be integrated consistently throughout clinical rotations. These activities should encourage ongoing interaction across disciplines, not just in the early stages of training. By ensuring that IPE evolves alongside students throughout their programs, the training will remain relevant and impactful, strengthening interprofessional collaboration as students advance in their clinical years. 17 , 18 Institutional differences in IPE exposure Significant differences were also noted between students from Makerere and Busitema Universities. Busitema students scored higher in areas such as teamwork, patient-centeredness, diversity and ethics, and community-centeredness. These differences may be attributed to variations in clinical training environments. Busitema University’s emphasis on community-based learning contrasts with the more hospital-centric training at Makerere University, where discipline-specific hierarchies are more pronounced. Similar findings have been reported in the United Kingdom, United States and Saudi Arabia, where students engaged in community-based training programs demonstrated stronger interprofessional competencies compared to those trained in hospital settings. 4 , 5 , 19 , 20 Therefore, expanding IPE in hospital environments through structured clinical mentorship and interprofessional ward rounds could help address the disparities between the two institutions. 21 Additionally, incorporating more community-based placements into Makerere’s curriculum could help foster a more inclusive and collaborative learning environment, similar to what is observed at Busitema. Discipline-Specific variations in attitudes and perceptions towards IPE Interprofessional attitudes varied significantly between medical and nursing students, particularly in inter-professional biases and overall scores. Nursing students scored higher in both areas, which suggests that they may have heightened awareness of interprofessional dynamics, possibly due to their experiences in settings where medical professionals are dominant. This increased awareness of interprofessional biases could reflect the hierarchical nature of clinical environments, where medical professionals often take center stage, leading to perceptions of power imbalances in teamwork. 21 This finding aligns with other studies that show nursing students are often more aware of power imbalances in clinical teamwork. 11 , 22 , 23 Addressing these imbalances through interdisciplinary clinical learning experiences such as interprofessional ward rounds, case discussions, and shared clinical assessments could help promote more balanced perceptions of teamwork and improve role recognition across disciplines. Furthermore, integrating these collaborative activities earlier in training may help students enter clinical environments that emphasize collaboration over hierarchy. 24 , 25 Gender differences in IPE competencies Emerging evidence suggests that gender influences the development of IPE competencies and collaborative practices. 26 IPE aims to challenge traditional hierarchical roles and encourage equitable team dynamic. 27 However, cultural norms may still affect how students view and participate in interprofessional education. In this study, female students demonstrated significantly higher scores in teamwork, patient-centeredness, and community-centeredness than their male counterparts. This finding is consistent with previous research indicating that female students in IPE settings often display better communication and teamwork skills. 24 , 26 Female students tend to engage more actively in decision-making, consult other professionals, and adopt a collaborative approach, which may be reflective of societal expectations that encourage women to take on more relational roles. 28 In contrast, male students often use more directive communication techniques, which align with traditional gender roles that emphasize assertiveness and leadership. 29 , 30 The non-significant differences observed in inter-professional biases and diversity and ethics suggest that gender does not strongly affect perceptions of interprofessional collaboration in these areas. However, recognizing gender differences in communication and teamwork can help tailor IPE strategies to ensure both male and female students develop strong collaborative skills. 29 Future IPE interventions should consider these gendered dynamics and create an environment where all students, regardless of gender, feel equally empowered to participate in collaborative healthcare teams. 29 Implications for IPE The differences observed across student groups highlight the need for intentional IPE strategies that can be adapted to the diverse needs of students. Research has demonstrated that structured IPE programs improve teamwork, reduce professional biases, and enhance patient-centered care. 9 , 31 , 32 The higher community-centeredness scores in Year IV students and those from Busitema University suggest that community-based education plays a significant role in strengthening students’ ability to engage with communities. These findings align with similar studies in Uganda, where community-based education has been linked to improved collaborative competencies. 33 Integrating community-based learning into clinical training at both universities could enhance students’ sense of responsibility for community health and reinforce the value of collaboration in achieving broader health goals. Moreover, the observed gender and discipline-based differences underscore the importance of designing IPE interventions that foster collaboration, mutual respect, and teamwork across gender and professional lines. The higher inter-professional biases among nursing students suggest that interdisciplinary training should specifically address role perceptions and promote more equitable collaboration. Additionally, targeted strategies should be implemented to strengthen teamwork and community engagement among male students, ensuring that all students, regardless of discipline or gender, develop the necessary competencies for effective interprofessional collaboration. Limitations The cross-sectional and exploratory design of this study presents certain limitations. Since data were collected from only two universities, the findings provide a snapshot of attitudes toward IPE but may not be fully generalizable to other institutions, particularly private universities with different educational models. Private universities often have varied curricular structures, funding models, and clinical training environments, which could influence students’ perceptions of IPE differently. Future research should incorporate a broader range of institutions to enhance the study’s generalizability. Conclusions Despite limited prior exposure to IPE, students exhibited a positive attitude and readiness for interprofessional collaboration. The findings provide valuable insights for faculty at Makerere and Busitema Universities to enhance IPE integration within their curricula. The differences in attitudes between medical and nursing students, as well as gender-related variations, highlight the need for tailored educational strategies that foster teamwork and mutual respect among healthcare students. Additionally, as students progress through their programs, their increasing recognition of the importance of teamwork suggests that IPE interventions should be introduced early and reinforced throughout their education. Recommendations 1. Curriculum Integration: IPE should be systematically incorporated into all healthcare professional programs to promote collaborative skills and teamwork in a multidisciplinary setting. 2. Faculty Training: Educators should be equipped with the knowledge and skills to facilitate interprofessional learning effectively. 3. Addressing Biases: Structured interprofessional learning experiences should be designed to reduce professional stereotypes and enhance teamwork among healthcare students. 4. Gender Considerations: Gender differences in attitudes toward IPE should be acknowledged when developing collaborative learning strategies. 5. Longitudinal Studies: Future research should explore how attitudes toward IPE evolve over time, incorporating multiple institutions to provide a comprehensive understanding of IPE readiness among healthcare students. 6. Alignment with IPEC Competencies: The updated Interprofessional Education Collaborative (IPEC) competencies should be considered in designing and implementing IPE curricula to ensure alignment with best practices in interprofessional learning. Consent for publication Not required. Availability of data and materials All the relevant data (Identifier: DOI https://doi.org/10.17605/OSF.IO/736J8 ). Extended data OSF: Attitudes and perceptions of health professional students towards Interprofessional Education and Collaborative Practice in a clinical Learning environment https://doi.org/10.17605/OSF.IO/736J8 . 34 This project contains the following extended data: - Supplementary Table 2 - DATA COLLECTION TOOLS - DATA COLLECTION TOOLS- IPECP BECKY - Questionnaire. Data are available under the terms of the Creative Commons Zero “No rights reserved” data waiver ( CC0 1.0 Public domain dedication ). Acknowledgment We thank the Dean’s Office of the Busitema University Faculty of Health Sciences and Makerere University School of Medicine for granting administrative clearance for this study. Additionally, we thank all the research assistants, JIS, EK, AO, and LS for facilitating the distribution of the IPAS survey to students during clinical rotations. 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Nekaka R: Attitudes and perceptions of health professional students towards Interprofessional Education and Collaborative Practice in a clinical Learning environment.2026, March 12. Publisher Full Text Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 18 Apr 2026 ADD YOUR COMMENT Comment Author details Author details 1 Department of Pediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences, Kampala, Central Region, 256, Uganda 2 Department of Community and Public Health, Faculty of Health Sciences, Busitema University, Tororo, Eastern Region, 256, Uganda 3 Department of Health Professions Education, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, Western Cape, South Africa 4 Department of Nursing, School of Health Sciences, Makerere University College of Health Sciences, Kampala, Central Region, Uganda 5 Department of Anatomy School of Health Sciences, Makerere University College of Health Sciences, Kampala, Central Region, Uganda 6 Department of Radiology, School of Medicine,, Makerere University College of Health Sciences, Kampala, Central Region, Uganda Rebecca Nekaka Roles: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing Firdouza Waggie Roles: Formal Analysis, Investigation, Methodology, Supervision, Validation, Visualization, Writing – Review & Editing Scovia Nalugo Mbalinda Roles: Formal Analysis, Funding Acquisition, Investigation, Methodology, Supervision, Writing – Review & Editing Ezekiel Mupere Roles: Formal Analysis, Investigation, Methodology, Resources, Supervision, Validation, Visualization, Writing – Review & Editing Ian Munabi Roles: Data Curation, Formal Analysis, Funding Acquisition, Methodology, Resources, Software, Supervision, Visualization, Writing – Review & Editing Mubuuke Aloysius G Roles: Data Curation, Formal Analysis, Funding Acquisition, Methodology, Resources, Supervision, Visualization, Writing – Review & Editing Sarah Kiguli Roles: Data Curation, Funding Acquisition, Methodology, Resources, Supervision, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information This research was supported by the Forgarty International Center of the National Institute of Health, US Department of state Office of the U.S, Global AIDS Coordinator and Health Diplomacy(S/GAC), and President’s Emergency Plan for AIDS Relief (PEPFAR) under award number 1R25TW011213 The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Article Versions (1) version 1 Published: 18 Apr 2026, 15:556 https://doi.org/10.12688/f1000research.168153.1 Copyright © 2026 Nekaka R et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Nekaka R, Waggie F, Nalugo Mbalinda S et al. Nursing and medical students' attitudes and perceptions towards interprofessional education during clinical training in Uganda [version 1; peer review: 1 approved] . F1000Research 2026, 15 :556 ( https://doi.org/10.12688/f1000research.168153.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 1 VERSION 1 PUBLISHED 18 Apr 2026 Views 0 Cite How to cite this report: Akbar MA. Reviewer Report For: Nursing and medical students' attitudes and perceptions towards interprofessional education during clinical training in Uganda [version 1; peer review: 1 approved] . F1000Research 2026, 15 :556 ( https://doi.org/10.5256/f1000research.185318.r480232 ) The direct URL for this report is: https://f1000research.com/articles/15-556/v1#referee-response-480232 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 09 May 2026 M Agung Akbar , Universitas Indonesia, Depok, Indonesia Approved VIEWS 0 https://doi.org/10.5256/f1000research.185318.r480232 Title : title does not explicitly state the study design. Since this is a cross-sectional study, the title should mention “cross-sectional study” abstract: abstract should more clearly mention the sampling method, introduction: The gap ... Continue reading READ ALL Title : title does not explicitly state the study design. Since this is a cross-sectional study, the title should mention “cross-sectional study” abstract: abstract should more clearly mention the sampling method, introduction: The gap should be supported with more specific Uganda-based evidence or previous local studies. Methods: 1.inclusion and exclusion criteria should be described more 2. pls reported Cronbach's alpha from IPAS 3.The authors should provide a participant flow: eligible students, approached students, consenting students, completed questionnaires, and analyzed questionnaires. 4.the authors should explain the rationale for choosing non-parametric tests and whether normality was assessed. Results: Participant characteristics are presented in Table 1. However, there is an error in the text: it states “hundred and fifteen (67.5%) were males” and “152 (15.2%) were females,” whereas Table 1 shows 315 males and 152 females. Reference: the reference list should be checked for formatting consistency, completeness, and accuracy. Some references appear incomplete or inconsistently formatted. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes References 1. Akbar M, Sahar J, Rustina Y, Rekawati E, et al.: Interprofessional Collaboration in Primary Care: Concept Analysis. Journal of Caring Sciences . 2025; 14 (4): 267-277 Publisher Full Text Competing Interests: No competing interests were disclosed. Reviewer Expertise: Interprofessional collaboration I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Akbar MA. Reviewer Report For: Nursing and medical students' attitudes and perceptions towards interprofessional education during clinical training in Uganda [version 1; peer review: 1 approved] . F1000Research 2026, 15 :556 ( https://doi.org/10.5256/f1000research.185318.r480232 ) The direct URL for this report is: https://f1000research.com/articles/15-556/v1#referee-response-480232 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 18 Apr 2026 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 Version 1 18 Apr 26 read M Agung Akbar , Universitas Indonesia, Depok, Indonesia Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2026 Akbar M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 09 May 2026 | for Version 1 M Agung Akbar , Universitas Indonesia, Depok, Indonesia 0 Views copyright © 2026 Akbar M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Title : title does not explicitly state the study design. Since this is a cross-sectional study, the title should mention “cross-sectional study” abstract: abstract should more clearly mention the sampling method, introduction: The gap should be supported with more specific Uganda-based evidence or previous local studies. Methods: 1.inclusion and exclusion criteria should be described more 2. pls reported Cronbach's alpha from IPAS 3.The authors should provide a participant flow: eligible students, approached students, consenting students, completed questionnaires, and analyzed questionnaires. 4.the authors should explain the rationale for choosing non-parametric tests and whether normality was assessed. Results: Participant characteristics are presented in Table 1. However, there is an error in the text: it states “hundred and fifteen (67.5%) were males” and “152 (15.2%) were females,” whereas Table 1 shows 315 males and 152 females. Reference: the reference list should be checked for formatting consistency, completeness, and accuracy. Some references appear incomplete or inconsistently formatted. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes References 1. Akbar M, Sahar J, Rustina Y, Rekawati E, et al.: Interprofessional Collaboration in Primary Care: Concept Analysis. Journal of Caring Sciences . 2025; 14 (4): 267-277 Publisher Full Text Competing Interests No competing interests were disclosed. Reviewer Expertise Interprofessional collaboration I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Akbar MA. Peer Review Report For: Nursing and medical students' attitudes and perceptions towards interprofessional education during clinical training in Uganda [version 1; peer review: 1 approved] . F1000Research 2026, 15 :556 ( https://doi.org/10.5256/f1000research.185318.r480232) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. 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