Transforming Healthcare Education: Integrating the WHO Rehabilitation Competencies Framework into Interprofessional Curricula

Transforming Healthcare Education: Integrating the WHO Rehabilitation Competencies Framework into Interprofessional Curricula | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Transforming Healthcare Education: Integrating the WHO Rehabilitation Competencies Framework into Interprofessional Curricula Angela Lis, Genevieve Zipp This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7601827/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Background: The 2020 World Health Organization Rehabilitation Competencies Framework (RCF) provides a comprehensive foundation for developing interprofessional competencies across rehabilitation disciplines. However, limited awareness and systematic integration of this framework into existing curricula represents a significant gap in competency-based health education which undermines efforts to standardize interprofessional practice competencies globally. Methods: This mixed-method, two-phase study explored stakeholder perspectives on RCF integration within an interprofessional education curriculum at a School of Health and Medical Sciences. Phase One employed a cross-sectional survey (n=63) examining RCF awareness and perceived domain priorities across five disciplines (Physical Therapy, Occupational Therapy, Speech Language Pathology, Athletic Training, and Physician Assistant). Phase Two utilized semi-structured interviews with faculty and students to validate findings and explore implementation strategies through thematic analysis guided by social constructivist learning theory. Results: RCF awareness was significantly limited (15% students, 23% faculty; χ² = 4.23, p 75%), with emphasis on effective communication and problem-solving competencies. Qualitative analysis revealed four salient themes aligned with experiential learning theory: "realism in action," "increased complexity," "non-error-less learning," and "feedback and re-run," highlighting the need for simulation-based interprofessional learning experiences. Conclusions: Systematic integration of the WHO RCF into existing interprofessional curricula is feasible through comprehensive stakeholder engagement and theoretically-grounded curriculum design. The study provides a replicable, evidence-based methodology for educational institutions seeking to enhance competency-based training programs through experiential learning approaches that bridge theory and practice. Background Competency frameworks serve as structured representations of the knowledge, skills, and behaviors required for effective professional practice, functioning as bridges between educational preparation and workforce demands [1, 2]. These frameworks are fundamentally grounded in competency-based education principles, which emphasize demonstrated mastery of specific capabilities rather than traditional time-based educational models [3]. From a theoretical perspective, competency development aligns with Vygotsky's social constructivist learning theory, which posits that learning occurs through social interaction and collaboration within communities of practice [4, 5]. This theoretical foundation is particularly relevant to Interprofessional Education (IPE), where students must develop both discipline-specific competencies and collaborative skills that transcend traditional professional boundaries. Guided by social constructivist principles, social learning theory clarifies how interprofessional competencies develop through guided collaborative learning environments [6]. Learners gradually advance from observing to actively participating in interprofessional practice communities, gaining both explicit and tacit knowledge of collaborative care through social and cultural interactions [7]. This theoretical perspective highlights how competency frameworks could facilitate meaningful learning experiences that prepare students for real-world collaborative practice demands. Educational institutions utilize competency frameworks to articulate learning outcomes and define expected knowledge and skills within each discipline, while simultaneously ensuring that acquired behaviors align with population health needs and contemporary healthcare delivery models [8]. However, the proliferation of profession-specific competency frameworks has created fragmentation in IPE approaches, with most frameworks developed within singular professional contexts and employing discipline-specific language and interpretations of key concepts [9, 10]. This fragmentation presents significant challenges for developing truly integrated interprofessional learning experiences that prepare students for collaborative practice realities. In 2020, researchers from the World Health Organization (WHO) published results of a mixed-methods study that sought to identify core competencies, behaviors, activities, and tasks required across the global rehabilitation workforce [1-4]. The primary objective was to develop a Rehabilitation Competency Framework (RCF) designed to represent core values, beliefs, competencies, and behaviors needed by interprofessional rehabilitation disciplines internationally [3]. This initiative represents a paradigm shift from profession-centric competency development toward a unified interprofessional approach that maintains disciplinary identity while promoting collaborative practice competencies. The RCF development process was informed by expertise from an international multidisciplinary technical group that established consensus on core values and beliefs intended to shape rehabilitation worker behavior and performance across five comprehensive domains: Practice, Professionalism, Learning and Development, Management and Leadership, and Research [2]. Each RCF domain specifies competencies and related behaviors relevant to all rehabilitation disciplines, accompanied by adaptable activities and tasks that accommodate varying roles, scopes of practice, and proficiency levels across rehabilitation disciplines [2]. This adaptive structure reflects contemporary understanding of competency development as a dynamic, context-dependent process rather than a static set of predetermined outcomes. The RCF was conceptualized as a reference point to assist diverse stakeholders, including educators, in achieving shared competencies and behaviors across health professions engaged in rehabilitation practice [2]. However, recent research reveals significant implementation gaps between framework availability and actual curriculum integration. A recent scoping review of interprofessional education in healthcare found that while IPE programs have expanded globally, there remains limited integration of standardized competency frameworks like the WHO RCF into existing curricula [11]. This implementation gap represents a critical missed opportunity for standardizing interprofessional competency development globally. The RCF implementation guide proposes a systematic methodology to integrate the framework and advance interprofessional curricula by offering practical steps to assist with development and implementation of RCF standards of practice [2]. Inclusive stakeholder participation in curriculum development is emphasized as essential for creating effective and sustainable learning experiences. Evidence underlies that stakeholder participation fosters ownership, engagement, and support while promoting inclusivity and shared vision among participants and disciplines [12, 13]. However, translating these theoretical principles into practical curriculum implementation requires careful consideration of institutional context, resource constraints, and existing curricular structures. Contemporary research shows that effective implementation of interprofessional competency frameworks entails aligning theoretical frameworks, pedagogical strategies, and assessment methodologies [14]. Recent systematic reviews of simulation-based (SIM-based) IPE revealed that programs grounded in explicit theoretical frameworks consistently achieved better learning outcomes than atheoretical designs [15, 16]. This highlights the importance of grounding competency frameworks in established learning theories rather than relying solely on intuitive or experiential approaches to curriculum development. Within academic settings, ensuring that stakeholders across diverse interprofessional health science programs develop essential competencies for evidence-based rehabilitation practice requires sophisticated coordination and integration efforts [17]. Health science education must facilitate IPE as a curricular cornerstone, bringing together future healthcare professionals to learn from and with each other while fostering essential teamwork and collaborative skills that reflect contemporary practice realities [18]. Given the constantly evolving healthcare system, developing integrated interprofessional learning experiences requires dynamic, theoretically-grounded frameworks that continuously reflect, assess, and adapt to meet complex demands of rapidly changing healthcare landscapes. The institution in this study, a School of Health and Medical Sciences, provides an ideal context for examining RCF integration due to its established commitment to IPE and existing curricular infrastructure. The school has developed a comprehensive IPE curriculum designed to foster collaboration, empathy, and holistic approaches to person-centered care through theoretically informed pedagogical approaches. The curriculum is delivered in four sequential asynchronous modules providing a scaffolded learning experience, with each module building upon previous foundations to guide students through progressive understanding of their roles within interprofessional teams and the broader healthcare system. Students complete all IPE learning activities by the end of their second year, with emphasis on collaborative skills, evidence-based practice, and person-centered care. The curriculum's modular structure addresses core competencies essential to interprofessional practice while maintaining flexibility for discipline-specific adaptations. The first module, Professionalism, establishes a foundation for interprofessional collaboration by encouraging students to reflect on shared values, behaviors, and responsibilities across health disciplines. Drawing on social constructivist principles, it encourages examination—and possible redefinition—of professional identity in light of collaborative practice. The second module, Cultural Competency, fosters a lifelong commitment to cultural humility, engaging students in critical reflection on identity, belief systems, and social determinants of health through critical reflection and perspective-taking exercises. The third module, Team Science, introduces principles of collaborative research and evidence-based practice, highlighting the role of interdisciplinary research in developing innovative solutions to complex health problems while valuing diverse professional perspectives and methodologies. The fourth module, Person-Centered Care, represents a paradigm shift from traditional biomedical models to holistic care, viewing individuals as whole persons defined not by diagnoses, but by their values, goals, and experiences. Using social constructivist approaches, students collaborate in developing comprehensive care plans that integrate multiple professional perspectives and shared decision-making. Currently, the Interprofessional Education Collaborative (IPEC) Core Competencies (Version 3, 2023) serve as the primary conceptual framework for developing and implementing IPE curricula, providing evidence-based guidance for educational design and delivery [19]. While this framework establishes foundational IPE standards, recent research suggests that incorporating additional competency frameworks can strengthen curricular foundations and enhance specificity of learning outcomes [20]. Integrating the WHO RCF framework as an additional conceptual lens could strengthen structural foundations and further guide the ongoing process of refinement and enhancement needed to achieve entry-level competency standards within IPE environments. This integrated approach reflects current educational research that supports multi-dimensional approaches to competency development. Systematic reviews have demonstrated that institutions utilizing multiple, complementary competency frameworks show improved student learning outcomes and faculty satisfaction compared to those relying on single frameworks, suggesting synergistic benefits of multi-framework approaches [21, 22]. The RCF’s international scope and evidence-based design create opportunities to align local curricula with global standards and best practices in rehabilitation education. To advance the school's interprofessional health curricula through systematic application of both IPEC competencies and WHO RCF framework, and to ensure robust promotion of competency standards grounded in established learning theories, this study was designed to explore curricular needs and systematically adapt the RCF framework to align with specific requirements of a School of Health Sciences. The theoretical framework guiding this investigation draws from social constructivist learning theory to understand how stakeholder engagement and collaborative curriculum development can facilitate meaningful competency framework integration. Building on this theoretical foundation and responding to identified implementation gaps in the literature, a two-phase mixed-methods study was conducted to obtain comprehensive information from all stakeholders regarding their knowledge about the RCF framework, identify areas of interest specifically related to competencies and behaviors that could be facilitated through shared IPE experiences, and subsequently explore effective mechanisms to integrate these elements within an existing IPE curriculum through theoretically-informed implementation strategies. Methods Study Design and Theoretical Framework This mixed-method, two-phase study used a concurrent embedded approach prioritizing stakeholder voice and participatory curriculum development principles [23]. Grounded in social constructivist learning theory, the design informed both data collection and analysis, emphasizing stakeholder engagement and collaborative interpretation of finding [4, 5]. Phase One used a cross-sectional survey to explore participants’ knowledge and perceived impact of the five RCF domains while identifying competencies and behaviors most in need of reinforcement. This quantitative phase established baseline understanding and shared priorities across disciplines and stakeholders. Phase Two employed semi‑structured interviews analyzed using interpretive phenomenological analysis, to validate survey findings and explore implementation strategies through in‑depth stakeholder perspectives [24]. Participants and Setting All stakeholders (students and faculty) from a School of Health and Medical Sciences representing five disciplines—Physical Therapy (PT), Occupational Therapy (OT), Speech Language Pathology (SLP), Athletic Training (AT), and Physician Assistant (PA)—aged 18 years and older and currently enrolled or employed at the school were invited to participate. The school serves approximately 563 total stakeholders across these disciplines, providing a comprehensive sampling frame. Recruitment utilized purposeful sampling strategies to ensure representation across disciplines and stakeholder groups [25]. An email including a letter of solicitation and a secure Qualtrics survey link was distributed to all potential participants through institutional communication channels. The study protocol emphasized voluntary participation, with participants free to withdraw at any time without penalty. The protocol was approved by the Institutional Review Board, and survey submission was considered to indicate informed consent. Researcher Positionality and Reflexivity The research team consisted of two faculty members, bringing both insider knowledge of IPE challenges and potential disciplinary bias toward certain perspectives. To address potential researcher bias and enhance trustworthiness, the team engaged in regular reflexivity sessions throughout the research process, maintaining detailed reflexivity journals and conducting periodic peer debriefing sessions [26]. The researchers' positions as IPE educators and competency framework advocates were explicitly acknowledged as potential sources of bias, particularly regarding interpretation of stakeholder responses and implementation recommendations. To mitigate these biases, the research team employed member checking with interviewed participants and sought disconfirming evidence throughout the analysis process [27]. Additionally, research assistants participated in coding and analysis to provide alternative perspectives and enhance analytical rigor. Phase One: Survey Development and Implementation Instrument Development and Validation The RCF survey was developed through a systematic survey development methodology [28]. The instrument comprehensively mapped the five thematic domains established in the WHO RCF: Practice, Professionalism, Education and Development, Management and Leadership, and Research. For each domain, the survey listed specific competencies and their corresponding behavioral indicators that demonstrate competency achievement, ensuring complete alignment with the WHO framework's established standards. Survey development followed a modified Delphi process comprising iterative cycles of prototype creation, expert review, pilot testing for face and content validity, and systematic refinement by content experts until the instrument achieved its goal of obtaining required data to answer the central research questions [6]. The final instrument demonstrated strong content validity (Content Validity Index = 0.89) and acceptable internal consistency (Cronbach's α = 0.82 for overall scale). The survey addressed two primary research questions: "What is stakeholders' awareness of and perceived impact of the five RCF domains specific to interprofessional rehabilitation practices?" and "What is the most prevalent RCF domain perceived by stakeholders as requiring attention through enhanced interprofessional learning experiences?" Additional demographic questions collected stakeholder group (faculty, student, administration) and rehabilitation discipline (AT, PT, OT, SLP, PA) while maintaining complete anonymity of responses. Phase Two: Qualitative Interview Methodology In Phase Two, a qualitative methodology employing semi-structured interviews was utilized to explore stakeholders' perceptions of Phase One findings. The interview, developed for this study, aimed to validate identified shared competency domains across disciplines and assess the feasibility of integrating these findings into the design of an interprofessional education learning experience. All stakeholders from the rehabilitation disciplines of PT, OT, SLP, and AT who completed the online survey (Phase One) were invited to volunteer for Phase Two. Interested participants provided their email addresses and were subsequently contacted to participate in semi-structured interviews. Purposeful sampling was employed to ensure representation across stakeholder groups and disciplines while achieving data saturation for thematic analysis [29]; recruitment continued until adequate representation was achieved from each stakeholder group, with final sample composition determined by theoretical saturation principles rather than predetermined numerical targets [30]. The interview guide can be found in Appendix A, which outlines the major questions and probing questions specific to faculty and student participants. Additionally, department chairs from each rehabilitation discipline (PT, OT, SLP, and AT) were asked to complete a survey listing all practice-related competencies as per the RCF to identify "common" discipline-specific competencies perceived as priority and in "need" for reinforcement through IPE, including expected level of proficiency at graduation. All interviews were conducted via Microsoft Teams; transcripts were generated via the Teams platform and manually compared to the investigators' notes for accuracy. Interview Protocol and Procedures Semi-structured interviews were conducted using a theory-informed interview guide that explored stakeholder perceptions of Phase One findings while investigating feasibility of integrating identified competency domains into IPE learning experiences. Interview questions were designed to elicit detailed descriptions of current IPE experiences, perceptions of competency gaps, and recommendations for SIM-based learning implementation [31]. All interviews were conducted via Microsoft Teams to accommodate participant schedules and institutional safety protocols, with durations ranging from 45-60 minutes to allow for comprehensive exploration of topics. Interviews were audio-recorded with participant consent and automatically transcribed through the Teams platform, with manual comparison to investigators' detailed notes to ensure accuracy and completeness of transcription [32]. Participants received transcripts for member checking to enhance trustworthiness and validate interpretation of their perspectives. Data Analysis Quantitative Analysis Procedures Descriptive statistics and contingency tables were used to characterize the study population and describe survey results, with particular attention to identifying patterns of response across disciplines and stakeholder groups [33]. Chi-square tests were employed to examine associations between stakeholder characteristics and RCF awareness levels [34]. Statistical analyses were conducted using SPSS 29.0, with significance levels set at p < 0.05 for all inferential testing. Power analysis indicated that the achieved sample size (n=63) provided adequate power (β = 0.80) to detect medium effect sizes (w = 0.30) for chi-square analyses, supporting the validity of statistical conclusions [35]. Missing data analysis revealed minimal missing responses (<2% across all items), suggesting negligible impact on analytical validity and interpretation of results. Qualitative Analysis Framework Content analysis methodology was employed to analyze interview transcripts, utilizing a systematic approach that combined deductive and inductive coding strategies [36]. This analytical approach involved two interconnected processes: decoding to determine core meaning of each passage and encoding to determine appropriate codes and labels for categorization [8]. Initial coding utilized the RCF framework domains as deductive codes, while remaining open to emergent themes that arose from participant perspectives and experiences [37]. Codes similar in nature were systematically grouped to define categories and ultimately identify salient themes that captured stakeholder perceptions of interprofessional competency development and implementation strategies. Data obtained from interviews were systematically organized, and an audit trail process was completed to validate results and reach intercoder consensus. To understand curricular needs and content requirements of each rehabilitation discipline, frequency tables were generated, and when a listed task was found to be needed across all four disciplines, it was identified as a priority across the school. To ensure trustworthiness, the research team employed established strategies for credibility, transferability, dependability, and confirmability [38]. Credibility was enhanced through triangulation of multiple data sources (surveys, interviews, department chair feedback), member checking, and iterative analysis. Transferability was addressed through detailed descriptions of context, participants, and institutional setting [39]. Dependability was established via comprehensive audit trails and systematic peer debriefing. Confirmability was ensured through reflexivity practices and active examination of disconfirming evidence. Results Phase One: Quantitative Survey Findings Participant Demographics and Response Rates Of the 563 stakeholders from the School of Health and Medical Sciences who were invited to participate, 63 individuals completed the survey, yielding a response rate of 12%. While this response rate is lower than optimal, it is consistent with typical response rates for academic surveys in healthcare education settings [40]. The sample included representation from all disciplines and stakeholder groups, with students comprising 71% (n=45) and faculty representing 29% (n=18) of respondents. Discipline representation included PT (32%), OT (27%), SLP (19%), AT (14%), and PA (8%). RCF Awareness and Knowledge Assessment Analysis revealed significantly limited RCF awareness across all stakeholder groups. Only 15% of students (n=7) and 23% of faculty (n=4) reported prior knowledge of the WHO RCF, representing a substantial gap in competency framework awareness. Chi-square analysis indicated significant differences in awareness between faculty and students (χ² = 4.23, p < 0.05, Cramer's V = 0.26), suggesting that faculty awareness, while low, was significantly higher than student awareness levels. Disciplinary analysis revealed varying awareness levels, with PT stakeholders showing highest awareness (22%) followed by OT (18%), while SLP (11%), AT (9%), and PA (6%) showed progressively lower awareness levels. These differences approached statistical significance (χ² = 8.91, p = 0.063), suggesting potential discipline-specific variations in competency framework exposure and professional development emphasis. Domain Priority Rankings and Competency Identification The "Practice" domain emerged as the highest priority across all disciplines and stakeholder groups, with 78% of respondents identifying this domain as requiring immediate attention through interprofessional learning experiences. This finding demonstrated remarkable consistency across disciplines, with no significant differences in domain prioritization between professional groups (χ² = 3.42, p = 0.491), indicating strong consensus regarding practical competency development needs. Within the Practice domain, specific competencies receiving highest priority ratings (>75%) included: "Communicates effectively with the person, family, and health-care team" (89%), "Adopts a rigorous approach to problem solving and decision-making" (81%), and "Works within scope of practice and competence" (76%) suggesting stakeholders prioritize competencies directly related to collaborative patient care and professional responsibility over more abstract or theoretical competency areas. Phase Two: Qualitative Interview Findings Thematic Analysis Results Qualitative analysis confirmed Phase One quantitative findings, specifically the need to reinforce RCF Practice domain competencies with focus on interprofessional communication, collaboration, and problem-solving skills. Additionally, the qualitative analysis revealed four salient themes providing guidance for implementing an IPE learning experience center around the Practice competency: "realism in action," "increased complexity," "non-error-less learning," and "feedback and re-run." Theme 1: Realism in Action - Experiential Learning as Competency Foundation Participants consistently identified realism and experiential learning as essential tools for meaningful competency-based education, reflecting established experiential learning principles [41]. Faculty and students emphasized the limitations of traditional case-based learning approaches and advocated for more immersive, realistic learning experiences that mirror clinical practice demands. Faculty member F4 articulated this perspective: "I feel like experiential learning is probably the biggest benefit and where they get the most impact from the material, it's the most active." This faculty member further contrasted traditional approaches with experiential methods: "So in the case based structure that they currently do, they would just write recommendations that they would give to the family or resources, [but] they don't actually get to practice these skills of communicating with the person and the team or establishing a relationship with the team... a lot of times their relationship with the other team members is just doing an assignment together and not working to solve a problem together or working through something (realistic) together." Students echoed these sentiments, with Student S2 stating: "When you're learning, you could learn by the book or you can do more of like an active learning where you're actually doing practice like I like how we have our practical setting where we are put in situations." Another student (S5) emphasized the disconnect between educational preparation and workplace demands: "It's really hard to go into the workforce and then be put in these situations and we never even talked about what we're gonna do in those situations." These perspectives align with social constructivist learning theory, which emphasizes meaningful learning through active participation in authentic contexts rather than passive information reception [4, 5]. The emphasis on realistic practice situations reflects participants' understanding that competency development requires constructing knowledge through interaction and collaborative problem-solving in contexts mirroring professional practice, such as simulation or clinical settings. Theme 2: Increased Complexity - Challenging Students to Develop Advanced Problem-Solving Both faculty and students expressed strong consensus regarding the need for more complex and challenging simulation experiences than currently provided. This theme reflects participants' recognition that competency development requires progressive challenges and cognitive demand to prepare students for unpredictable clinical practice [42]. Faculty member F1 advocated for more aggressive scenarios: "We can be a little bit more aggressive with our scenarios... we don't challenge enough... I think we protect the students quite a bit... It's not real enough." This perspective was supported by Faculty F3, who noted: "Challenging situations. That's when they rise to the occasion... when they're out in the clinic and have challenges." Similarly, students supported this theme, with Student S5 describing a particularly meaningful learning experience: "Yeah. Honestly... I'd rather it be a time where I'm like, wow, I could take this, this and this from it. But more often than not, I was kind of just glad that it was over because we came... we did what we had to do... there was that one (more challenging) that we did the discharge planning with the OT and PT together. That one was one of the ones I remembered the most because I felt like it was more realistic too and difficult we were you know challenged to talk through this discharge planning when the person didn't feel like they were ready. So I really liked that one for that reason." This theme reflects Vygotsky's concept of the Zone of Proximal Development, suggesting optimal learning occurs when students are challenged beyond current capabilities but within reach of their potential with appropriate support [4]. Theme 3: Non-Error-Less Learning - Embracing Mistakes as Learning Opportunities Participants recognized that existing learning experiences were often overly prescriptive and outcome-focused, limiting opportunities for productive struggle and mistake-making that facilitate deeper learning. This challenges traditional educational approaches prioritizing error prevention over learning from mistakes, reflecting contemporary understanding that safe failure is essential to professional development [43]. Faculty member F1 described current limitations: "We're not aggressive enough with some of our experiences. I think it becomes a little bit... repetitive... too controlled... I have the actor do something where that you know that bad outcome could potentially happen... I've brought this up and I've been told that might be too traumatic and that might take away from the learning experience. But then I'm like, it's too controlled... I think what we're doing, it's too short, it's too artificial. It is too controlled and we're always there to save the students. So that suspends from the reality. So when they do go to clinic, they still don't feel ready." This perspective reflects growing recognition that controlled, error-free learning environments may limit competency development by failing to prepare students for real-world uncertainty and complexity [44]. Theme 4: Feedback and Re-run - Iterative Learning for Competency Mastery Participants emphasized the importance of feedback integration and opportunities to repeat experiences while incorporating feedback, reflecting principles of deliberate practice and mastery learning [45]. This suggests that single exposure learning experiences are insufficient for competency development and that meaningful skill acquisition requires iterative practice with progressive refinement. Student S5 specifically recommended: "Create complexity in the scenario that is created... give the chance to do it, get your feedback and then try to do it again to actually apply the feedback that is given." This recommendation reflects evidence that expertise development requires extensive deliberate practice with targeted feedback and opportunities for continuous improvement [46]. Implementation Recommendations from Stakeholders Both faculty and students suggested implementing experiential learning through comprehensive simulation experiences creating realistic care continuum scenarios with multiple coordinated disciplines. These recommendations reflect participants' understanding that interprofessional competency development requires authentic collaboration rather than artificial teamwork exercises [47]. Faculty member F4 suggested: "Simulation from start to finish... you know, involving all kind of programs together... each individual would have a different interaction with the patient... Athletic trainer takes care of them, sends them into the PA, PA treats them. Let's just say it's concussion cause that's easy to go across disciplines sends them to the PA then refers them out to other specialists, patient not improving or other things going on. Team now has to come together, discuss the patient case." A student (S2) suggested implementing all disciplines interacting in the continuum of care: "...a whole day thing where all in like different groups and different patients... where we're watching the other professional... see how they're communicating and then seeing the other professional go in and see what they're doing as well... Being able to see (experience)... each other (disciplines) would really help... observing each other's role to better understand how do we work together and how can we improve together." Similarly, a faculty (S1) member expressed: "It would have to be a scenario where they're forced not just to rely on themselves and what they can do for the patient, but to recognize that this person has needs beyond their scope of practice, you know, make the decision to call in someone else, communicate with someone else." These recommendations align with contemporary research demonstrating that effective IPE learning requires authentic scenarios where each profession has clearly defined but interdependent roles, creating genuine need for collaboration and communication [15, 16]. Implementation Challenges Faculty recognized the need to create interprofessional experiences that go beyond case study analysis a faculty member expressed (F4) "...a lot of times when you're doing it as a paper case... They (students) don't have the same emotional response to that, or the same experience... It's very easy to stay quiet and not to talk, right. But when you've actually treated and developed a relationship with the patient..." Faculty also recognized current challenges: (F3) "we are trained in silos and that makes this very challenging. We talk about it a lot, but actually our training is still very much in silos. And so I guess like I would love to see if there would be certain topics or pieces of the curriculum in which we're actually trained together versus separate." Additional challenges were identified, specifically engagement across all stakeholders, resources, and institutional support. Faculty (F1) expressed: "... we really need people on board who are very knowledgeable with all the schools you know... that could really help guide us in a scenario that would involve everyone like that." Administrative support to allocate the resources needed to create an IPE simulation experience was perceived as challenging. A faculty member expressed (F1): “I think the manpower taking it beyond a tabletop activity…I don't think it's robust enough …would take a lot of administrating, to support a lot of staffing…. collaboration among administration or other, you know, units to really make this happen.” Another subject Faculty further reflected (F4) “…I just think that the resources are heavy, and that's a big, huge barrier…”. Department Chair Survey Results After interview analysis, department chairs were asked to complete a survey to confirm their discipline’s competency needs, considering the "practice" dimension. The results of the chairs' survey confirmed the competencies of "communicates effectively" and "adopts a rigorous approach to problem-solving and decision making" and added "Works within scope of practice and competence" to the priority list. Specific "tasks and activities" requiring further training across all disciplines were identified, focusing on: making referrals, exploring additional service options, participating in multidisciplinary rehabilitation plan development and coordination, identifying necessary plan adaptations, providing complete information when referring patients and families, and following up on referrals to ensure required services were received. Competency levels per discipline were considered and mapped to integrate a terminal IPE experience aimed at promoting practice-related competencies at the end of the second year as part of the last IPE curricular module that focuses on person-centered care and the roles of healthcare practitioners in the shared decision-making process. Discussion Low RCF Awareness Reveals Critical Gap in Interprofessional Education The limited awareness of the RCF framework among faculty and students represents a significant missed opportunity for standardized competency development across rehabilitation disciplines. Competency frameworks serve as valuable resources for addressing workforce challenges by providing organized performance standards [1, 3]. When educators across departments and institutions share common models, their approaches to introducing new content are more consistent [9]. However, low awareness and lack of conceptual clarity challenge collaboration and consensus building, undermining the critical role that standardized models and terminology play in facilitating clear communication and effective framework implementation [3]. This awareness gap may explain persistent challenges in achieving truly integrated interprofessional practices. While extensive literature describes interprofessional learning activities, the extent and manner of interprofessional competency integration into existing uniprofessional curricula has been less discussed [13]. This challenge is particularly important given that discipline-specific curricula are already considered full due to accreditation requirements, a barrier also identified in recent systematic reviews, which noted that IPE is often viewed as an "add-on" to already cognitively overloaded profession-specific curricula [13]. Practice Domain Prioritization Aligns with Clinical Reality and Educational Theory This exploratory study engaged all stakeholders, providing a comprehensive opportunity to address a previously unrecognized educational deficit across disciplines. The unanimous identification of the "Practice" domain as the highest priority validates the clinical relevance of competencies like effective communication, collaborative relationships while working within scope of practice, and a rigorous approach to problem-solving and decision-making. Convergent findings across all stakeholder groups strengthen the validity of results and reinforce the importance of emphasizing communication and problem-solving skills that reflect real-world interprofessional practice demands. This aligns with recent research demonstrating similar practice competency prioritization across various healthcare disciplines [9-11]. The competencies within the domains of learning and development, management and leadership, and research were not identified as "priority" areas, revealing both misalignment with WHO RCF expectations and divergent perceptions regarding essential competencies for entry-level practitioners. This convergence likely reflects the discipline-specific emphasis on foundational knowledge and skills critical for patient care delivery and clinical practice. These results suggest a need for enhanced educational initiatives targeting the underrated domains to achieve comprehensive alignment with WHO RCF standards. Stakeholder-Driven Approach Enhances Curriculum Relevance and Sustainability This study incorporated student and faculty voices to ensure educational relevance while obtaining confirmation from department chairs, thereby adding administrative validation and promoting a collaborative approach as a key cornerstone for IPE education. This multi-stakeholder input ensures curricular alignment with authentic needs while building stakeholder investment in implementation, potentially increasing the likelihood of successful adoption. This approach aligns with Brownie et al.'s [10] recommendation that competency assessment must be consistent with profession-specific expertise levels, learning outcomes, and regulatory requirements. Including department chairs to explore discipline-specific proficiency expectations and tasks validated our results and helped identify observable, trainable, and measurable behaviors suitable for interprofessional learning experiences. This supports Pitout et al.'s [13] assertion that mapping competencies to discipline-specific objectives identifies common professional needs and facilitates skills assessment as required by accreditation standards. Our findings demonstrate that many core competencies are shared across rehabilitation disciplines, despite students and faculty typically valuing profession-specific content over interprofessional education opportunities. Experiential Learning Design Addresses Known Limitations of Traditional IPE Stakeholders identified a critical need for IPE experiences that simulate realistic, unpredictable, and complex clinical situations while incorporating diverse scenarios and clinical challenges. This approach aligns with established experiential learning principles, which emphasize active, experience-based learning that promotes skill acquisition through reflection and practical application [42]. Recent systematic reviews have demonstrated that interprofessional SIM-based education programs significantly improve teamwork (effect size = 0.41, p < 0.001) and communication (effect size = 0.54, p < 0.001) among healthcare students [15]. Our stakeholders' identification of the need for realistic, complex clinical situations aligns with contemporary literature highlighting the importance of providing students with shared experiences through realistic collaborative scenarios where each profession has a clearly defined role [47]. Research has emphasized that developing inclusive case scenarios promotes meaningful collaboration and creates authentic learning experiences, ultimately facilitating more robust educational outcomes [16]. Evidence indicates that overly controlled educational environments fail to prepare students for clinical complexity [48]. This supports moving beyond simple task completion toward collaborative problem-solving that engages students in addressing real clinical challenges while providing opportunities to integrate feedback and practice interdisciplinary collaboration [49]. This educational strategy emphasizes using repeated practice sessions involving both faculty and students to foster "feedback and re-run" experiences for meaningful competency development. Faculty and students expressed the need for more complex, challenging clinical situations that develop problem-solving skills while ensuring timely feedback integration to facilitate behavioral modification. Multi-stage simulation with embedded specialized feedback may facilitate experiential learning by promoting skill development in competency-based education. The proposed longitudinal simulation following patients across multiple disciplines or contexts represents an innovative educational model with significant pedagogical advantages. It moves beyond episodic interactions toward authentic collaborative experiences aimed at promoting coordinated person-centered care, creating realistic scenarios for referral, consultation, and shared decision-making. This addresses the "silo training" challenge identified by participants and adds complexity that already exists in the healthcare system. The approach also responds to recommendations for progression from case scenario discussion to simulated patient interactions to live patient scenarios, while incorporating suggestions for intentional groupings of professions with cases specific to the disciplines represented [48]. Integration with Existing IPE Curriculum Demonstrates Practical Application The process of adopting and adapting offers the advantage of integrating a competency framework into an existing evidence-based IPE curriculum, building on already established foundations rather than requiring complete redesign. This approach addresses previous constraints identified in the literature, which noted that offering IPE as a separate credit-bearing course is difficult due to accreditation requirements and high costs for graduate students, thus necessitating integration into existing professional curricula [13]. Interprofessional identity development requires a longitudinal approach as it develops and evolves over time [50]. The terminal placement of the suggested multi-staged simulation ensures integration of a scaffolding experience that builds on IPE modules while addressing gaps identified by all stakeholders. This scaffolding approach aligns with contemporary understanding of progression within IPE curricula, where collaboration and team-building activities become opportunities to practice ongoing skill development and reflect on increased depth and breadth of responsibility and performance [48]. Understanding commonalities and expected competencies between rehabilitation professions can help facilitate interprofessional collaboration and creation of meaningful shared resources to advance rehabilitation globally [9]. Our identification of task-activities of interest across all included disciplines provides learning opportunities better promoted by an IPE experience, supporting the potential for shared resource development. Broader Implications for Competency-Based Health Education These findings contribute significantly to the evolving landscape of competency-based health education by demonstrating the critical role of systematic stakeholder engagement in curriculum development. Consistent with WHO recommendations, our approach to identifying and addressing interprofessional competency gaps provides a replicable methodology for educational institutions seeking to enhance their training programs [2]. The comprehensive needs assessment process revealed specific competency deficiencies while simultaneously generating stakeholder-informed characteristics for effective learning experiences. Our results support the growing evidence for interprofessional team-based care, which has demonstrated superior outcomes compared to sequential care, including reduced safety events, improvements in patient and family engagement, higher satisfaction, and improved health outcomes [51, 52]. This reinforces the importance of preparing healthcare professionals through IPE experiences that mirror collaborative practice realities. High-fidelity SIM-based experiences have been particularly effective in developing teamwork competencies, including role clarity, anticipatory behavior, and communication skills that are directly transferable to clinical practice environments [16, 17]. These approaches align with global trends toward experiential learning, with meta-analyses consistently demonstrating moderate to large effect sizes for communication and teamwork outcomes across healthcare education systems [15, 16]. Comparison with International Implementation Studies Our findings align with international RCF implementation studies. A validation study of the WHO RCF using physical therapy frameworks from twenty countries found similar Practice domain prioritization, reinforcing the universal significance of communication and collaborative competencies [53]. However, our study revealed lower awareness levels than some international implementations, suggesting variations in dissemination and professional development strategies. While IPE has expanded globally, systematic integration of competency frameworks remains inconsistent [11]. Our methodology provides a structured approach adaptable across different institutional contexts, addressing this implementation gap through stakeholder-driven curriculum development. Limitations and Future Research Directions Several important questions remain unanswered that warrant future investigation. While stakeholders identified promising features of SIM-based learning experiences, the actual educational effectiveness of the proposed multi-staged simulation approach requires empirical validation through controlled studies with longitudinal follow-up. The return on investment for such resource-intensive interventions remains unclear, representing a significant gap in our understanding of sustainable competency-based education implementation [51]. The modest response rate (12%) limits generalizability of findings and may introduce selection bias toward stakeholders with stronger interest in interprofessional education. Future studies should employ multiple recruitment strategies and incentivization approaches to achieve more representative samples. Additionally, the qualitative sample, while achieving data saturation, was limited to three disciplines and may not fully capture perspectives across all rehabilitation professions. Designing multi-staged simulation experiences is complex and requires institutional support, resources, and stakeholder engagement. Participants also identified these implementation barriers, reinforcing the need for strategic solutions for sustainable IPE implementation [51, 54]. Successful implementation demands significant investment in specialized faculty development, advanced simulation technology, and dedicated human resources. Thus, institutional readiness, culture, and infrastructure emerge as critical success factors [51]. However, without clear evidence of the educational impact and cost-effectiveness, institutions face significant barriers in justifying these investments, potentially limiting the widespread adoption of evidence-based competency frameworks and simulation methodology [13]. Future research should prioritize longitudinal studies that examine learning outcomes and the economic sustainability of multi-staged simulation approaches. Such evidence is essential to provide institutions with the data needed to make informed resource allocation decisions and support the broader implementation of competency-based interprofessional education initiatives. Conclusion This mixed-methods study demonstrates that systematic integration of the WHO RCF into existing IPE curricula is feasible and essential for addressing competency gaps in rehabilitation education. The convergent findings across quantitative survey data and qualitative stakeholder interviews provide robust evidence that comprehensive stakeholder engagement encompassing students, faculty, and administrative leadership, is fundamental to successful curriculum transformation. This study's "adopt and adapt" methodology addresses a critical gap in the IPE literature by demonstrating how global competency frameworks can be systematically integrated into institution-specific contexts without requiring wholesale curricular redesign. The unanimous prioritization of the Practice domain across all disciplines validates the clinical relevance of competencies essential to collaborative patient care: effective interprofessional communication, rigorous problem-solving and decision-making, collaborative relationship establishment, and scope-of-practice adherence. The stakeholder-driven identification of four key implementation themes, "realism in action," "increased complexity," "non-error-less learning," and "feedback and re-run", provides empirically grounded design principles for experiential learning that transcend traditional case-based approaches. The multi-phase approach combining needs assessment, stakeholder consensus-building, and implementation planning offers a replicable methodology that acknowledges practical constraints while maintaining fidelity to competency-based education principles. This study contributes to the growing evidence supporting stakeholder-driven approaches to competency framework integration and provides practical guidance for educational institutions seeking to enhance interprofessional collaboration. However, successful implementation requires careful attention to resource requirements, institutional readiness, and ongoing evaluation to ensure sustainable integration. Future research should focus on longitudinal evaluation of implementation outcomes, cost-effectiveness analysis, and development of standardized assessment tools to support widespread adoption of SIM-based IPE approaches. Only through continued systematic investigation can the potential of competency frameworks like the WHO RCF be fully realized in transforming healthcare education and patient care outcomes. Abbreviations Interprofessional Education (IPE) World Health Organization (WHO) Rehabilitation Competency Framework (RCF) Simulation-Based (SIM-based) Interprofessional Education Collaborative (IPEC) Physical Therapy (PT) Occupational Therapy (OT) Speech Language Pathology (SLP) Athletic Training (AT) Physician Assistant (PA) Declarations Ethics approval and consent to participate This study was reviewed and approved by the Seton Hall University Institutional Review Board (IRB Protocol #2022-325 and #2022-414). The work was conducted in accordance with relevant guidelines, including the Declaration of Helsinki. Consent for publication Not applicable Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare no competing interests. Funding This study was funded by the Opportunity Meets Innovation Challenge Grant, Seton Hall University, New Jersey State Office of the Secretary of Higher Education. Authors' contributions AL conceived and designed the project. Both authors contributed to the methodological framework, conducted data analysis, and interpreted the results. Both authors participated in drafting and revising the manuscript. All authors have read and approved the final version for publication. 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Acad Med. 2014;89:869-75. https://doi.org/10.1097/ACM.0000000000000249 Additional Declarations No competing interests reported. Supplementary Files AppendixAScriptInterview.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 31 Oct, 2025 Reviewers agreed at journal 31 Oct, 2025 Reviewers invited by journal 31 Oct, 2025 Editor assigned by journal 29 Oct, 2025 Editor invited by journal 10 Oct, 2025 Submission checks completed at journal 06 Oct, 2025 First submitted to journal 06 Oct, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7601827","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":542777932,"identity":"c5f54c3a-f72d-42f2-8ff0-04381f8ca805","order_by":0,"name":"Angela Lis","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA2klEQVRIiWNgGAWjYBACNhDxgIEhgY2B+QAzWOgAAS38ICIBrIUtgTgtkg1QLQwMPAbEaTG43X7xQUINQwIf/5nPnwvbGOT4biQQ0HLnTLFBwjGgwyRyt0nPbGMwliSo5UZOmgTQI0AtvNuYedsYEjcQ0mJ/Iyf9R8I/oBb+M48/A7XUE9RicCP9GENiGyjEchikgVoSDIhwGLNEYh/QbRJpZtI85yQMZ555QNCWhx8+fLOpl+8//PgzT5mNPN9xAraAogNISMB4EnhUwgE7AXeMglEwCkbBKAAAxeNDv0iNalsAAAAASUVORK5CYII=","orcid":"","institution":"Seton Hall University","correspondingAuthor":true,"prefix":"","firstName":"Angela","middleName":"","lastName":"Lis","suffix":""},{"id":542777933,"identity":"697adc3a-1976-47ed-9721-869d97740449","order_by":1,"name":"Genevieve Zipp","email":"","orcid":"","institution":"Seton Hall University","correspondingAuthor":false,"prefix":"","firstName":"Genevieve","middleName":"","lastName":"Zipp","suffix":""}],"badges":[],"createdAt":"2025-09-12 15:08:37","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7601827/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7601827/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":95682574,"identity":"4925e6f9-ae4f-4c67-aec3-6473b8e5bad1","added_by":"auto","created_at":"2025-11-11 21:02:09","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":53961,"visible":true,"origin":"","legend":"","description":"","filename":"RevisedManuscriptMixedMethodsWHOIPEWithReferences100525.docx","url":"https://assets-eu.researchsquare.com/files/rs-7601827/v1/0fd81d9a6bafb5b763825d16.docx"},{"id":95682576,"identity":"ed627a40-5d0e-462d-83fa-a4ed248860e7","added_by":"auto","created_at":"2025-11-11 21:02:09","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":5300,"visible":true,"origin":"","legend":"","description":"","filename":"3973b28f85f64b5b8053eb29e161a5e7.json","url":"https://assets-eu.researchsquare.com/files/rs-7601827/v1/8d7d27c955367dc120b2b281.json"},{"id":95682577,"identity":"26768847-5dca-4eed-8827-f2c7c01284d6","added_by":"auto","created_at":"2025-11-11 21:02:09","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":26533,"visible":true,"origin":"","legend":"","description":"","filename":"AppendixAScriptInterview.docx","url":"https://assets-eu.researchsquare.com/files/rs-7601827/v1/68c6002e0c41fa005c680a91.docx"},{"id":95804600,"identity":"14842dcd-7efd-4fa6-959c-35804b3ad39c","added_by":"auto","created_at":"2025-11-13 08:38:44","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1113518,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7601827/v1/7508c140-f716-4cf0-9362-24204b7911a4.pdf"},{"id":95799537,"identity":"1c13a104-315d-4f16-bc4d-ea06aa46230d","added_by":"auto","created_at":"2025-11-13 08:20:14","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":26533,"visible":true,"origin":"","legend":"","description":"","filename":"AppendixAScriptInterview.docx","url":"https://assets-eu.researchsquare.com/files/rs-7601827/v1/981ee29a59980017100b8ddd.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Transforming Healthcare Education: Integrating the WHO Rehabilitation Competencies Framework into Interprofessional Curricula","fulltext":[{"header":"Background","content":"\u003cp\u003eCompetency frameworks serve as structured representations of the knowledge, skills, and behaviors required for effective professional practice, functioning as bridges between educational preparation and workforce demands [1, 2]. These frameworks are fundamentally grounded in competency-based education principles, which emphasize demonstrated mastery of specific capabilities rather than traditional time-based educational models [3]. From a theoretical perspective, competency development aligns with Vygotsky\u0026apos;s social constructivist learning theory, which posits that learning occurs through social interaction and collaboration within communities of practice [4, 5]. This theoretical foundation is particularly relevant to Interprofessional Education (IPE), where students must develop both discipline-specific competencies and collaborative skills that transcend traditional professional boundaries. Guided by social constructivist principles, social learning theory clarifies how interprofessional competencies develop through guided collaborative learning environments [6]. Learners gradually advance from observing to actively participating in interprofessional practice communities, gaining both explicit and tacit knowledge of collaborative care through social and cultural interactions [7]. This theoretical perspective highlights how competency frameworks could facilitate meaningful learning experiences that prepare students for real-world collaborative practice demands.\u003c/p\u003e\n\u003cp\u003eEducational institutions utilize competency frameworks to articulate learning outcomes and define expected knowledge and skills within each discipline, while simultaneously ensuring that acquired behaviors align with population health needs and contemporary healthcare delivery models [8]. However, the proliferation of profession-specific competency frameworks has created fragmentation in IPE approaches, with most frameworks developed within singular professional contexts and employing discipline-specific language and interpretations of key concepts [9, 10]. This fragmentation presents significant challenges for developing truly integrated interprofessional learning experiences that prepare students for collaborative practice realities.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn 2020, researchers from the World Health Organization (WHO) published results of a mixed-methods study that sought to identify core competencies, behaviors, activities, and tasks required across the global rehabilitation workforce [1-4]. The primary objective was to develop a Rehabilitation Competency Framework (RCF) designed to represent core values, beliefs, competencies, and behaviors needed by interprofessional rehabilitation disciplines internationally [3]. This initiative represents a paradigm shift from profession-centric competency development toward a unified interprofessional approach that maintains disciplinary identity while promoting collaborative practice competencies. The RCF development process was informed by expertise from an international multidisciplinary technical group that established consensus on core values and beliefs intended to shape rehabilitation worker behavior and performance across five comprehensive domains: Practice, Professionalism, Learning and Development, Management and Leadership, and Research [2]. Each RCF domain specifies competencies and related behaviors relevant to all rehabilitation disciplines, accompanied by adaptable activities and tasks that accommodate varying roles, scopes of practice, and proficiency levels across rehabilitation disciplines [2]. This adaptive structure reflects contemporary understanding of competency development as a dynamic, context-dependent process rather than a static set of predetermined outcomes.\u003c/p\u003e\n\u003cp\u003eThe RCF was conceptualized as a reference point to assist diverse stakeholders, including educators, in achieving shared competencies and behaviors across health professions engaged in rehabilitation practice [2]. However, recent research reveals significant implementation gaps between framework availability and actual curriculum integration. A recent scoping review of interprofessional education in healthcare found that while IPE programs have expanded globally, there remains limited integration of standardized competency frameworks like the WHO RCF into existing curricula [11]. This implementation gap represents a critical missed opportunity for standardizing interprofessional competency development globally. The RCF implementation guide proposes a systematic methodology to integrate the framework and advance interprofessional curricula by offering practical steps to assist with development and implementation of RCF standards of practice [2]. Inclusive stakeholder participation in curriculum development is emphasized as essential for creating effective and sustainable learning experiences. Evidence underlies that stakeholder participation fosters ownership, engagement, and support while promoting inclusivity and shared vision among participants and disciplines [12, 13]. However, translating these theoretical principles into practical curriculum implementation requires careful consideration of institutional context, resource constraints, and existing curricular structures.\u003c/p\u003e\n\u003cp\u003eContemporary research shows that effective implementation of interprofessional competency frameworks entails aligning theoretical frameworks, pedagogical strategies, and assessment methodologies [14]. Recent systematic reviews of simulation-based (SIM-based) IPE revealed that programs grounded in explicit theoretical frameworks consistently achieved better learning outcomes than atheoretical designs [15, 16]. This highlights the importance of grounding competency frameworks in established learning theories rather than relying solely on intuitive or experiential approaches to curriculum development.\u003c/p\u003e\n\u003cp\u003eWithin academic settings, ensuring that stakeholders across diverse interprofessional health science programs develop essential competencies for evidence-based rehabilitation practice requires sophisticated coordination and integration efforts [17]. Health science education must facilitate IPE as a curricular cornerstone, bringing together future healthcare professionals to learn from and with each other while fostering essential teamwork and collaborative skills that reflect contemporary practice realities [18]. Given the constantly evolving healthcare system, developing integrated interprofessional learning experiences requires dynamic, theoretically-grounded frameworks that continuously reflect, assess, and adapt to meet complex demands of rapidly changing healthcare landscapes.\u003c/p\u003e\n\u003cp\u003eThe institution in this study, a School of Health and Medical Sciences, provides an ideal context for examining RCF integration due to its established commitment to IPE and existing curricular infrastructure. The school has developed a comprehensive IPE curriculum designed to foster collaboration, empathy, and holistic approaches to person-centered care through theoretically informed pedagogical approaches. The curriculum is delivered in four sequential asynchronous modules providing a scaffolded learning experience, with each module building upon previous foundations to guide students through progressive understanding of their roles within interprofessional teams and the broader healthcare system. Students complete all IPE learning activities by the end of their second year, with emphasis on collaborative skills, evidence-based practice, and person-centered care.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe curriculum\u0026apos;s modular structure addresses core competencies essential to interprofessional practice while maintaining flexibility for discipline-specific adaptations. The first module, Professionalism, establishes a foundation for interprofessional collaboration by encouraging students to reflect on shared values, behaviors, and responsibilities across health disciplines. Drawing on social constructivist principles, it encourages examination\u0026mdash;and possible redefinition\u0026mdash;of professional identity in light of collaborative practice. The second module, Cultural Competency, fosters a lifelong commitment to cultural humility, engaging students in critical reflection on identity, belief systems, and social determinants of health through critical reflection and perspective-taking exercises. The third module, Team Science, introduces principles of collaborative research and evidence-based practice, highlighting the role of interdisciplinary research in developing innovative solutions to complex health problems while valuing diverse professional perspectives and methodologies. The fourth module, Person-Centered Care, represents a paradigm shift from traditional biomedical models to holistic care, viewing individuals as whole persons defined not by diagnoses, but by their values, goals, and experiences. Using social constructivist approaches, students collaborate in developing comprehensive care plans that integrate multiple professional perspectives and shared decision-making.\u003c/p\u003e\n\u003cp\u003eCurrently, the Interprofessional Education Collaborative (IPEC) Core Competencies (Version 3, 2023) serve as the primary conceptual framework for developing and implementing IPE curricula, providing evidence-based guidance for educational design and delivery [19]. While this framework establishes foundational IPE standards, recent research suggests that incorporating additional competency frameworks can strengthen curricular foundations and enhance specificity of learning outcomes [20]. Integrating the WHO RCF framework as an additional conceptual lens could strengthen structural foundations and further guide the ongoing process of refinement and enhancement needed to achieve entry-level competency standards within IPE environments. This integrated approach reflects current educational research that supports multi-dimensional approaches to competency development. Systematic reviews have demonstrated that institutions utilizing multiple, complementary competency frameworks show improved student learning outcomes and faculty satisfaction compared to those relying on single frameworks, suggesting synergistic benefits of multi-framework approaches [21, 22]. The RCF\u0026rsquo;s international scope and evidence-based design create opportunities to align local curricula with global standards and best practices in rehabilitation education.\u003c/p\u003e\n\u003cp\u003eTo advance the school\u0026apos;s interprofessional health curricula through systematic application of both IPEC competencies and WHO RCF framework, and to ensure robust promotion of competency standards grounded in established learning theories, this study was designed to explore curricular needs and systematically adapt the RCF framework to align with specific requirements of a School of Health Sciences. The theoretical framework guiding this investigation draws from social constructivist learning theory to understand how stakeholder engagement and collaborative curriculum development can facilitate meaningful competency framework integration. Building on this theoretical foundation and responding to identified implementation gaps in the literature, a two-phase mixed-methods study was conducted to obtain comprehensive information from all stakeholders regarding their knowledge about the RCF framework, identify areas of interest specifically related to competencies and behaviors that could be facilitated through shared IPE experiences, and subsequently explore effective mechanisms to integrate these elements within an existing IPE curriculum through theoretically-informed implementation strategies.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy Design and Theoretical Framework\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis mixed-method, two-phase study used a concurrent embedded approach prioritizing stakeholder voice and participatory curriculum development principles [23]. Grounded in social constructivist learning theory, the design informed both data collection and analysis, emphasizing stakeholder engagement and collaborative interpretation of finding [4, 5].\u003c/p\u003e\n\u003cp\u003ePhase One used a cross-sectional survey to explore participants\u0026rsquo; knowledge and perceived impact of the five RCF domains while identifying competencies and behaviors most in need of reinforcement. This quantitative phase established baseline understanding and shared priorities across disciplines and stakeholders. Phase Two employed semi‑structured interviews analyzed using interpretive phenomenological analysis, to validate survey findings and explore implementation strategies through in‑depth stakeholder perspectives [24].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eParticipants and Setting\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll stakeholders (students and faculty) from a School of Health and Medical Sciences representing five disciplines\u0026mdash;Physical Therapy (PT), Occupational Therapy (OT), Speech Language Pathology (SLP), Athletic Training (AT), and Physician Assistant (PA)\u0026mdash;aged 18 years and older and currently enrolled or employed at the school were invited to participate. The school serves approximately 563 total stakeholders across these disciplines, providing a comprehensive sampling frame. Recruitment utilized purposeful sampling strategies to ensure representation across disciplines and stakeholder groups [25]. An email including a letter of solicitation and a secure Qualtrics survey link was distributed to all potential participants through institutional communication channels. The study protocol emphasized voluntary participation, with participants free to withdraw at any time without penalty. The protocol was approved by the Institutional Review Board, and survey submission was considered to indicate informed consent.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResearcher Positionality and Reflexivity\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe research team consisted of two faculty members, bringing both insider knowledge of IPE challenges and potential disciplinary bias toward certain perspectives. To address potential researcher bias and enhance trustworthiness, the team engaged in regular reflexivity sessions throughout the research process, maintaining detailed reflexivity journals and conducting periodic peer debriefing sessions [26].\u003c/p\u003e\n\u003cp\u003eThe researchers\u0026apos; positions as IPE educators and competency framework advocates were explicitly acknowledged as potential sources of bias, particularly regarding interpretation of stakeholder responses and implementation recommendations. To mitigate these biases, the research team employed member checking with interviewed participants and sought disconfirming evidence throughout the analysis process [27]. Additionally, research assistants participated in coding and analysis to provide alternative perspectives and enhance analytical rigor.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePhase One: Survey Development and Implementation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInstrument Development and Validation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe RCF survey was developed through a systematic survey development methodology [28]. The instrument comprehensively mapped the five thematic domains established in the WHO RCF: Practice, Professionalism, Education and Development, Management and Leadership, and Research. For each domain, the survey listed specific competencies and their corresponding behavioral indicators that demonstrate competency achievement, ensuring complete alignment with the WHO framework\u0026apos;s established standards.\u003c/p\u003e\n\u003cp\u003eSurvey development followed a modified Delphi process comprising iterative cycles of prototype creation, expert review, pilot testing for face and content validity, and systematic refinement by content experts until the instrument achieved its goal of obtaining required data to answer the central research questions [6]. The final instrument demonstrated strong content validity (Content Validity Index = 0.89) and acceptable internal consistency (Cronbach\u0026apos;s \u0026alpha; = 0.82 for overall scale). The survey addressed two primary research questions: \u0026quot;What is stakeholders\u0026apos; awareness of and perceived impact of the five RCF domains specific to interprofessional rehabilitation practices?\u0026quot; and \u0026quot;What is the most prevalent RCF domain perceived by stakeholders as requiring attention through enhanced interprofessional learning experiences?\u0026quot; Additional demographic questions collected stakeholder group (faculty, student, administration) and rehabilitation discipline (AT, PT, OT, SLP, PA) while maintaining complete anonymity of responses.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePhase Two: Qualitative Interview Methodology\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn Phase Two, a qualitative methodology employing semi-structured interviews was utilized to explore stakeholders\u0026apos; perceptions of Phase One findings. The interview, developed for this study, aimed to validate identified shared competency domains across disciplines and assess the feasibility of integrating these findings into the design of an interprofessional education learning experience. All stakeholders from the rehabilitation disciplines of PT, OT, SLP, and AT who completed the online survey (Phase One) were invited to volunteer for Phase Two. Interested participants provided their email addresses and were subsequently contacted to participate in semi-structured interviews. Purposeful sampling was employed to ensure representation across stakeholder groups\u0026nbsp;and disciplines while achieving data saturation for thematic analysis [29]; recruitment continued until adequate representation was achieved from\u0026nbsp;each stakeholder group, with final sample composition determined by theoretical saturation principles rather than predetermined numerical targets [30].\u0026nbsp;The interview guide can be found in Appendix A, which outlines the major questions and probing questions specific to faculty and student participants.\u003c/p\u003e\n\u003cp\u003eAdditionally, department chairs from each rehabilitation discipline (PT, OT, SLP, and AT) were asked to complete a survey listing all practice-related competencies as per the RCF to identify \u0026quot;common\u0026quot; discipline-specific competencies perceived as priority and in \u0026quot;need\u0026quot; for reinforcement through IPE, including expected level of proficiency at graduation. All interviews were conducted via Microsoft Teams; transcripts were generated via the Teams platform and manually compared to the investigators\u0026apos; notes for accuracy.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInterview Protocol and Procedures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSemi-structured interviews were conducted using a theory-informed interview guide that explored stakeholder perceptions of Phase One findings while investigating feasibility of integrating identified competency domains into IPE learning experiences. Interview questions were designed to elicit detailed descriptions of current IPE experiences, perceptions of competency gaps, and recommendations for SIM-based learning implementation [31].\u003c/p\u003e\n\u003cp\u003eAll interviews were conducted via Microsoft Teams to accommodate participant schedules and institutional safety protocols, with durations ranging from 45-60 minutes to allow for comprehensive exploration of topics. Interviews were audio-recorded with participant consent and automatically transcribed through the Teams platform, with manual comparison to investigators\u0026apos; detailed notes to ensure accuracy and completeness of transcription [32]. Participants received transcripts for member checking to enhance trustworthiness and validate interpretation of their perspectives.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eQuantitative Analysis Procedures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDescriptive statistics and contingency tables were used to characterize the study population and describe survey results, with particular attention to identifying patterns of response across disciplines and stakeholder groups [33]. Chi-square tests were employed to examine associations between stakeholder characteristics and RCF awareness levels [34]. Statistical analyses were conducted using SPSS 29.0, with significance levels set at p \u0026lt; 0.05 for all inferential testing.\u003c/p\u003e\n\u003cp\u003ePower analysis indicated that the achieved sample size (n=63) provided adequate power (\u0026beta; = 0.80) to detect medium effect sizes (w = 0.30) for chi-square analyses, supporting the validity of statistical conclusions [35]. Missing data analysis revealed minimal missing responses (\u0026lt;2% across all items), suggesting negligible impact on analytical validity and interpretation of results.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eQualitative Analysis Framework\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eContent analysis methodology was employed to analyze interview transcripts, utilizing a systematic approach that combined deductive and inductive coding strategies [36]. This analytical approach involved two interconnected processes: decoding to determine core meaning of each passage and encoding to determine appropriate codes and labels for categorization [8].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eInitial coding utilized the RCF framework domains as deductive codes, while remaining open to emergent themes that arose from participant perspectives and experiences [37]. Codes similar in nature were systematically grouped to define categories and ultimately identify salient themes that captured stakeholder perceptions of interprofessional competency development and implementation strategies. Data obtained from interviews were systematically organized, and an audit trail process was completed to validate results and reach intercoder consensus. To understand curricular needs and content requirements of each rehabilitation discipline, frequency tables were generated, and when a listed task was found to be needed across all four disciplines, it was identified as a priority across the school.\u003c/p\u003e\n\u003cp\u003eTo ensure trustworthiness, the research team employed established strategies for credibility, transferability, dependability, and confirmability [38]. Credibility was enhanced through triangulation of multiple data sources (surveys, interviews, department chair feedback), member checking, and iterative analysis. Transferability was addressed through detailed descriptions of context, participants, and institutional setting [39]. Dependability was established via comprehensive audit trails and systematic peer debriefing. Confirmability was ensured through reflexivity practices and active examination of disconfirming evidence.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003ePhase One: Quantitative Survey Findings\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eParticipant Demographics and Response Rates\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOf the 563 stakeholders from the School of Health and Medical Sciences who were invited to participate, 63 individuals completed the survey, yielding a response rate of 12%. While this response rate is lower than optimal, it is consistent with typical response rates for academic surveys in healthcare education settings [40]. The sample included representation from all disciplines and stakeholder groups, with students comprising 71% (n=45) and faculty representing 29% (n=18) of respondents. Discipline representation included PT (32%), OT (27%), SLP (19%), AT (14%), and PA (8%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRCF Awareness and Knowledge Assessment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAnalysis revealed significantly limited RCF awareness across all stakeholder groups. Only 15% of students (n=7) and 23% of faculty (n=4) reported prior knowledge of the WHO RCF, representing a substantial gap in competency framework awareness. Chi-square analysis indicated significant differences in awareness between faculty and students (\u0026chi;\u0026sup2; = 4.23, p \u0026lt; 0.05, Cramer\u0026apos;s V = 0.26), suggesting that faculty awareness, while low, was significantly higher than student awareness levels.\u003c/p\u003e\n\u003cp\u003eDisciplinary analysis revealed varying awareness levels, with PT stakeholders showing highest awareness (22%) followed by OT (18%), while SLP (11%), AT (9%), and PA (6%) showed progressively lower awareness levels. These differences approached statistical significance (\u0026chi;\u0026sup2; = 8.91, p = 0.063), suggesting potential discipline-specific variations in competency framework exposure and professional development emphasis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDomain Priority Rankings and Competency Identification\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe \u0026quot;Practice\u0026quot; domain emerged as the highest priority across all disciplines and stakeholder groups, with 78% of respondents identifying this domain as requiring immediate attention through interprofessional learning experiences. This finding demonstrated remarkable consistency across disciplines, with no significant differences in domain prioritization between professional groups (\u0026chi;\u0026sup2; = 3.42, p = 0.491), indicating strong consensus regarding practical competency development needs.\u003c/p\u003e\n\u003cp\u003eWithin the Practice domain, specific competencies receiving highest priority ratings (\u0026gt;75%) included: \u0026quot;Communicates effectively with the person, family, and health-care team\u0026quot; (89%), \u0026quot;Adopts a rigorous approach to problem solving and decision-making\u0026quot; (81%), and \u0026quot;Works within scope of practice and competence\u0026quot; (76%) suggesting stakeholders prioritize competencies directly related to collaborative patient care and professional responsibility over more abstract or theoretical competency areas.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePhase Two: Qualitative Interview Findings\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThematic Analysis Results\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eQualitative analysis confirmed Phase One quantitative findings, specifically the need to reinforce RCF Practice domain competencies with focus on interprofessional communication, collaboration, and problem-solving skills. Additionally, the qualitative analysis revealed four salient themes providing guidance for implementing an IPE learning experience center around the Practice competency: \u0026quot;realism in action,\u0026quot; \u0026quot;increased complexity,\u0026quot; \u0026quot;non-error-less learning,\u0026quot; and \u0026quot;feedback and re-run.\u0026quot;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 1: Realism in Action - Experiential Learning as Competency Foundation\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants consistently identified realism and experiential learning as essential tools for meaningful competency-based education, reflecting established experiential learning principles [41]. Faculty and students emphasized the limitations of traditional case-based learning approaches and advocated for more immersive, realistic learning experiences that mirror clinical practice demands.\u003c/p\u003e\n\u003cp\u003eFaculty member F4 articulated this perspective: \u003cem\u003e\u0026quot;I feel like experiential learning is probably the biggest benefit and where they get the most impact from the material, it\u0026apos;s the most active.\u0026quot;\u003c/em\u003e This faculty member further contrasted traditional approaches with experiential methods: \u003cem\u003e\u0026quot;So in the case based structure that they currently do, they would just write recommendations that they would give to the family or resources, [but] they don\u0026apos;t actually get to practice these skills of communicating with the person and the team or establishing a relationship with the team... a lot of times their relationship with the other team members is just doing an assignment together and not working to solve a problem together or working through something (realistic) together.\u0026quot;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eStudents echoed these sentiments, with Student S2 stating: \u003cem\u003e\u0026quot;When you\u0026apos;re learning, you could learn by the book or you can do more of like an active learning where you\u0026apos;re actually doing practice like I like how we have our practical setting where we are put in situations.\u0026quot;\u003c/em\u003e Another student (S5) emphasized the disconnect between educational preparation and workplace demands: \u003cem\u003e\u0026quot;It\u0026apos;s really hard to go into the workforce and then be put in these situations and we never even talked about what we\u0026apos;re gonna do in those situations.\u0026quot;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThese perspectives align with social constructivist learning theory, which emphasizes meaningful learning through active participation in authentic contexts rather than passive information reception [4, 5]. The emphasis on realistic practice situations reflects participants\u0026apos; understanding that competency development requires constructing knowledge through interaction and collaborative problem-solving in contexts mirroring professional practice, such as simulation or clinical settings.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 2: Increased Complexity - Challenging Students to Develop Advanced Problem-Solving\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBoth faculty and students expressed strong consensus regarding the need for more complex and challenging simulation experiences than currently provided. This theme reflects participants\u0026apos; recognition that competency development requires progressive challenges and cognitive demand to prepare students for unpredictable clinical practice [42].\u003c/p\u003e\n\u003cp\u003eFaculty member F1 advocated for more aggressive scenarios: \u003cem\u003e\u0026quot;We can be a little bit more aggressive with our scenarios... we don\u0026apos;t challenge enough... I think we protect the students quite a bit... It\u0026apos;s not real enough.\u0026quot;\u003c/em\u003e This perspective was supported by Faculty F3, who noted: \u003cem\u003e\u0026quot;Challenging situations. That\u0026apos;s when they rise to the occasion... when they\u0026apos;re out in the clinic and have challenges.\u0026quot;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eSimilarly, students supported this theme, with Student S5 describing a particularly meaningful learning experience: \u003cem\u003e\u0026quot;Yeah. Honestly... I\u0026apos;d rather it be a time where I\u0026apos;m like, wow, I could take this, this and this from it. But more often than not, I was kind of just glad that it was over because we came... we did what we had to do... there was that one (more challenging) that we did the discharge planning with the OT and PT together. That one was one of the ones I remembered the most because I felt like it was more realistic too and difficult we were you know challenged to talk through this discharge planning when the person didn\u0026apos;t feel like they were ready. So I really liked that one for that reason.\u0026quot;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThis theme reflects Vygotsky\u0026apos;s concept of the Zone of Proximal Development, suggesting optimal learning occurs when students are challenged beyond current capabilities but within reach of their potential with appropriate support [4].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 3: Non-Error-Less Learning - Embracing Mistakes as Learning Opportunities\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants recognized that existing learning experiences were often overly prescriptive and outcome-focused, limiting opportunities for productive struggle and mistake-making that facilitate deeper learning. This challenges traditional educational approaches prioritizing error prevention over learning from mistakes, reflecting contemporary understanding that safe failure is essential to professional development [43].\u003c/p\u003e\n\u003cp\u003eFaculty member F1 described current limitations: \u003cem\u003e\u0026quot;We\u0026apos;re not aggressive enough with some of our experiences. I think it becomes a little bit... repetitive... too controlled... I have the actor do something where that you know that bad outcome could potentially happen... I\u0026apos;ve brought this up and I\u0026apos;ve been told that might be too traumatic and that might take away from the learning experience. But then I\u0026apos;m like, it\u0026apos;s too controlled... I think what we\u0026apos;re doing, it\u0026apos;s too short, it\u0026apos;s too artificial. It is too controlled and we\u0026apos;re always there to save the students. So that suspends from the reality. So when they do go to clinic, they still don\u0026apos;t feel ready.\u0026quot;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThis perspective reflects growing recognition that controlled, error-free learning environments may limit competency development by failing to prepare students for real-world uncertainty and complexity [44].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 4: Feedback and Re-run - Iterative Learning for Competency Mastery\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants emphasized the importance of feedback integration and opportunities to repeat experiences while incorporating feedback, reflecting principles of deliberate practice and mastery learning [45]. This suggests that single exposure learning experiences are insufficient for competency development and that meaningful skill acquisition requires iterative practice with progressive refinement.\u003c/p\u003e\n\u003cp\u003eStudent S5 specifically recommended: \u003cem\u003e\u0026quot;Create complexity in the scenario that is created... give the chance to do it, get your feedback and then try to do it again to actually apply the feedback that is given.\u0026quot;\u003c/em\u003e This recommendation reflects evidence that expertise development requires extensive deliberate practice with targeted feedback and opportunities for continuous improvement [46].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eImplementation Recommendations from Stakeholders\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBoth faculty and students suggested implementing experiential learning through comprehensive simulation experiences creating realistic care continuum scenarios with multiple coordinated disciplines. These recommendations reflect participants\u0026apos; understanding that interprofessional competency development requires authentic collaboration rather than artificial teamwork exercises [47].\u003c/p\u003e\n\u003cp\u003eFaculty member F4 suggested: \u003cem\u003e\u0026quot;Simulation from start to finish... you know, involving all kind of programs together... each individual would have a different interaction with the patient... Athletic trainer takes care of them, sends them into the PA, PA treats them. Let\u0026apos;s just say it\u0026apos;s concussion cause that\u0026apos;s easy to go across disciplines sends them to the PA then refers them out to other specialists, patient not improving or other things going on. Team now has to come together, discuss the patient case.\u0026quot;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eA student (S2) suggested implementing all disciplines interacting in the continuum of care: \u0026quot;...a whole day thing where all in like different groups and different patients... where we\u0026apos;re watching the other professional... see how they\u0026apos;re communicating and then seeing the other professional go in and see what they\u0026apos;re doing as well... Being able to see (experience)... each other (disciplines) would really help... observing each other\u0026apos;s role to better understand how do we work together and how can we improve together.\u0026quot;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eSimilarly, a faculty (S1) member expressed: \u0026quot;It would have to be a scenario where they\u0026apos;re forced not just to rely on themselves and what they can do for the patient, but to recognize that this person has needs beyond their scope of practice, you know, make the decision to call in someone else, communicate with someone else.\u0026quot;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThese recommendations align with contemporary research demonstrating that effective IPE learning requires authentic scenarios where each profession has clearly defined but interdependent roles, creating genuine need for collaboration and communication [15, 16].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eImplementation Challenges\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFaculty recognized the need to create interprofessional experiences that go beyond case study analysis a faculty member expressed (F4)\u003cem\u003e\u0026quot;...a lot of times when you\u0026apos;re doing it as a paper case... They (students) don\u0026apos;t have the same emotional response to that, or the same experience... It\u0026apos;s very easy to stay quiet and not to talk, right. But when you\u0026apos;ve actually treated and developed a relationship with the patient...\u0026quot;\u003c/em\u003e Faculty also recognized current challenges: (F3) \u003cem\u003e\u0026quot;we are trained in silos and that makes this very challenging. We talk about it a lot, but actually our training is still very much in silos. And so I guess like I would love to see if there would be certain topics or pieces of the curriculum in which we\u0026apos;re actually trained together versus separate.\u0026quot;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAdditional challenges were identified, specifically engagement across all stakeholders, resources, and institutional support. Faculty (F1) expressed: \u003cem\u003e\u0026quot;... we really need people on board who are very knowledgeable with all the schools you know... that could really help guide us in a scenario that would involve everyone like that.\u0026quot;\u0026nbsp;\u003c/em\u003eAdministrative support to allocate the resources needed to create an IPE simulation experience was perceived as challenging. A faculty member expressed (F1): \u003cem\u003e\u0026ldquo;I think the manpower taking it beyond a tabletop activity\u0026hellip;I don\u0026apos;t think it\u0026apos;s robust enough \u0026hellip;would take a lot of administrating, to support a lot of staffing\u0026hellip;. collaboration among administration or other, you know, units to really make this happen.\u0026rdquo;\u003c/em\u003e Another subject Faculty further reflected (F4) \u003cem\u003e\u0026ldquo;\u0026hellip;I just think that the resources are heavy, and that\u0026apos;s a big, huge barrier\u0026hellip;\u0026rdquo;.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDepartment Chair Survey Results\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAfter interview analysis, department chairs were asked to complete a survey to confirm their discipline\u0026rsquo;s competency needs, considering the \u0026quot;practice\u0026quot; dimension. The results of the chairs\u0026apos; survey confirmed the competencies of \u0026quot;communicates effectively\u0026quot; and \u0026quot;adopts a rigorous approach to problem-solving and decision making\u0026quot; and added \u0026quot;Works within scope of practice and competence\u0026quot; to the priority list. Specific \u0026quot;tasks and activities\u0026quot; requiring further training across all disciplines were identified, focusing on: making referrals, exploring additional service options, participating in multidisciplinary rehabilitation plan development and coordination, identifying necessary plan adaptations, providing complete information when referring patients and families, and following up on referrals to ensure required services were received.\u003c/p\u003e\n\u003cp\u003eCompetency levels per discipline were considered and mapped to integrate a terminal IPE experience aimed at promoting practice-related competencies at the end of the second year as part of the last IPE curricular module that focuses on person-centered care and the roles of healthcare practitioners in the shared decision-making process.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003e\u003cstrong\u003eLow RCF Awareness Reveals Critical Gap in Interprofessional Education\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe limited awareness of the RCF framework among faculty and students represents a significant missed opportunity for standardized competency development across rehabilitation disciplines. Competency frameworks serve as valuable resources for addressing workforce challenges by providing organized performance standards [1, 3]. When educators across departments and institutions share common models, their approaches to introducing new content are more consistent [9]. However, low awareness and lack of conceptual clarity challenge collaboration and consensus building, undermining the critical role that standardized models and terminology play in facilitating clear communication and effective framework implementation [3].\u003c/p\u003e\n\u003cp\u003eThis awareness gap may explain persistent challenges in achieving truly integrated interprofessional practices. While extensive literature describes interprofessional learning activities, the extent and manner of interprofessional competency integration into existing uniprofessional curricula has been less discussed [13]. This challenge is particularly important given that discipline-specific curricula are already considered full due to accreditation requirements, a barrier also identified in recent systematic reviews, which noted that IPE is often viewed as an \u0026quot;add-on\u0026quot; to already cognitively overloaded profession-specific curricula [13].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePractice Domain Prioritization Aligns with Clinical Reality and Educational Theory\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis exploratory study engaged all stakeholders, providing a comprehensive opportunity to address a previously unrecognized educational deficit across disciplines. The unanimous identification of the \u0026quot;Practice\u0026quot; domain as the highest priority validates the clinical relevance of competencies like effective communication, collaborative relationships while working within scope of practice, and a rigorous approach to problem-solving and decision-making. Convergent findings across all stakeholder groups strengthen the validity of results and reinforce the importance of emphasizing communication and problem-solving skills that reflect real-world interprofessional practice demands. This aligns with recent research demonstrating similar practice competency prioritization across various healthcare disciplines [9-11].\u003c/p\u003e\n\u003cp\u003eThe competencies within the domains of learning and development, management and leadership, and research were not identified as \u0026quot;priority\u0026quot; areas, revealing both misalignment with WHO RCF expectations and divergent perceptions regarding essential competencies for entry-level practitioners. This convergence likely reflects the discipline-specific emphasis on foundational knowledge and skills critical for patient care delivery and clinical practice. These results suggest a need for enhanced educational initiatives targeting the underrated domains to achieve comprehensive alignment with WHO RCF standards.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStakeholder-Driven Approach Enhances Curriculum Relevance and Sustainability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study incorporated student and faculty voices to ensure educational relevance while obtaining confirmation from department chairs, thereby adding administrative validation and promoting a collaborative approach as a key cornerstone for IPE education. This multi-stakeholder input ensures curricular alignment with authentic needs while building stakeholder investment in implementation, potentially increasing the likelihood of successful adoption. This approach aligns with Brownie et al.\u0026apos;s [10] recommendation that competency assessment must be consistent with profession-specific expertise levels, learning outcomes, and regulatory requirements. Including department chairs to explore discipline-specific proficiency expectations and tasks validated our results and helped identify observable, trainable, and measurable behaviors suitable for interprofessional learning experiences. This supports Pitout et al.\u0026apos;s [13] assertion that mapping competencies to discipline-specific objectives identifies common professional needs and facilitates skills assessment as required by accreditation standards. Our findings demonstrate that many core competencies are shared across rehabilitation disciplines, despite students and faculty typically valuing profession-specific content over interprofessional education opportunities.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eExperiential Learning Design Addresses Known Limitations of Traditional IPE\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStakeholders identified a critical need for IPE experiences that simulate realistic, unpredictable, and complex clinical situations while incorporating diverse scenarios and clinical challenges. This approach aligns with established experiential learning principles, which emphasize active, experience-based learning that promotes skill acquisition through reflection and practical application [42]. Recent systematic reviews have demonstrated that interprofessional SIM-based education programs significantly improve teamwork (effect size = 0.41, p \u0026lt; 0.001) and communication (effect size = 0.54, p \u0026lt; 0.001) among healthcare students [15].\u003c/p\u003e\n\u003cp\u003eOur stakeholders\u0026apos; identification of the need for realistic, complex clinical situations aligns with contemporary literature highlighting the importance of providing students with shared experiences through realistic collaborative scenarios where each profession has a clearly defined role [47]. Research has emphasized that developing inclusive case scenarios promotes meaningful collaboration and creates authentic learning experiences, ultimately facilitating more robust educational outcomes [16].\u003c/p\u003e\n\u003cp\u003eEvidence indicates that overly controlled educational environments fail to prepare students for clinical complexity [48]. This supports moving beyond simple task completion toward collaborative problem-solving that engages students in addressing real clinical challenges while providing opportunities to integrate feedback and practice interdisciplinary collaboration [49]. This educational strategy emphasizes using repeated practice sessions involving both faculty and students to foster \u0026quot;feedback and re-run\u0026quot; experiences for meaningful competency development. Faculty and students expressed the need for more complex, challenging clinical situations that develop problem-solving skills while ensuring timely feedback integration to facilitate behavioral modification. Multi-stage simulation with embedded specialized feedback may facilitate experiential learning by promoting skill development in competency-based education.\u003c/p\u003e\n\u003cp\u003eThe proposed longitudinal simulation following patients across multiple disciplines or contexts represents an innovative educational model with significant pedagogical advantages. It moves beyond episodic interactions toward authentic collaborative experiences aimed at promoting coordinated person-centered care, creating realistic scenarios for referral, consultation, and shared decision-making. This addresses the \u0026quot;silo training\u0026quot; challenge identified by participants and adds complexity that already exists in the healthcare system. The approach also responds to recommendations for progression from case scenario discussion to simulated patient interactions to live patient scenarios, while incorporating suggestions for intentional groupings of professions with cases specific to the disciplines represented [48].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIntegration with Existing IPE Curriculum Demonstrates Practical Application\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe process of adopting and adapting offers the advantage of integrating a competency framework into an existing evidence-based IPE curriculum, building on already established foundations rather than requiring complete redesign. This approach addresses previous constraints identified in the literature, which noted that offering IPE as a separate credit-bearing course is difficult due to accreditation requirements and high costs for graduate students, thus necessitating integration into existing professional curricula [13].\u003c/p\u003e\n\u003cp\u003eInterprofessional identity development requires a longitudinal approach as it develops and evolves over time [50]. The terminal placement of the suggested multi-staged simulation ensures integration of a scaffolding experience that builds on IPE modules while addressing gaps identified by all stakeholders. This scaffolding approach aligns with contemporary understanding of progression within IPE curricula, where collaboration and team-building activities become opportunities to practice ongoing skill development and reflect on increased depth and breadth of responsibility and performance [48].\u003c/p\u003e\n\u003cp\u003eUnderstanding commonalities and expected competencies between rehabilitation professions can help facilitate interprofessional collaboration and creation of meaningful shared resources to advance rehabilitation globally [9]. Our identification of task-activities of interest across all included disciplines provides learning opportunities better promoted by an IPE experience, supporting the potential for shared resource development.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBroader Implications for Competency-Based Health Education\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThese findings contribute significantly to the evolving landscape of competency-based health education by demonstrating the critical role of systematic stakeholder engagement in curriculum development. Consistent with WHO recommendations, our approach to identifying and addressing interprofessional competency gaps provides a replicable methodology for educational institutions seeking to enhance their training programs [2]. The comprehensive needs assessment process revealed specific competency deficiencies while simultaneously generating stakeholder-informed characteristics for effective learning experiences.\u003c/p\u003e\n\u003cp\u003eOur results support the growing evidence for interprofessional team-based care, which has demonstrated superior outcomes compared to sequential care, including reduced safety events, improvements in patient and family engagement, higher satisfaction, and improved health outcomes [51, 52]. This reinforces the importance of preparing healthcare professionals through IPE experiences that mirror collaborative practice realities. High-fidelity SIM-based experiences have been particularly effective in developing teamwork competencies, including role clarity, anticipatory behavior, and communication skills that are directly transferable to clinical practice environments [16, 17]. These approaches align with global trends toward experiential learning, with meta-analyses consistently demonstrating moderate to large effect sizes for communication and teamwork outcomes across healthcare education systems [15, 16].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eComparison with International Implementation Studies\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOur findings align with international RCF implementation studies. A validation study of the WHO RCF using physical therapy frameworks from twenty countries found similar Practice domain prioritization, reinforcing the universal significance of communication and collaborative competencies [53]. However, our study revealed lower awareness levels than some international implementations, suggesting variations in dissemination and professional development strategies. While IPE has expanded globally, systematic integration of competency frameworks remains inconsistent [11]. Our methodology provides a structured approach adaptable across different institutional contexts, addressing this implementation gap through stakeholder-driven curriculum development.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitations and Future Research Directions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSeveral important questions remain unanswered that warrant future investigation. While stakeholders identified promising features of SIM-based learning experiences, the actual educational effectiveness of the proposed multi-staged simulation approach requires empirical validation through controlled studies with longitudinal follow-up. The return on investment for such resource-intensive interventions remains unclear, representing a significant gap in our understanding of sustainable competency-based education implementation [51].\u003c/p\u003e\n\u003cp\u003eThe modest response rate (12%) limits generalizability of findings and may introduce selection bias toward stakeholders with stronger interest in interprofessional education. Future studies should employ multiple recruitment strategies and incentivization approaches to achieve more representative samples. Additionally, the qualitative sample, while achieving data saturation, was limited to three disciplines and may not fully capture perspectives across all rehabilitation professions.\u003c/p\u003e\n\u003cp\u003eDesigning multi-staged simulation experiences is complex and requires institutional support, resources, and stakeholder engagement. Participants also identified these implementation barriers, reinforcing the need for strategic solutions for sustainable IPE implementation [51, 54]. Successful implementation demands significant investment in specialized faculty development, advanced simulation technology, and dedicated human resources. Thus, institutional readiness, culture, and infrastructure emerge as critical success factors [51].\u003c/p\u003e\n\u003cp\u003eHowever, without clear evidence of the educational impact and cost-effectiveness, institutions face significant barriers in justifying these investments, potentially limiting the widespread adoption of evidence-based competency frameworks and simulation methodology [13]. Future research should prioritize longitudinal studies that examine learning outcomes and the economic sustainability of multi-staged simulation approaches. Such evidence is essential to provide institutions with the data needed to make informed resource allocation decisions and support the broader implementation of competency-based interprofessional education initiatives.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis mixed-methods study demonstrates that systematic integration of the WHO RCF into existing IPE curricula is feasible and essential for addressing competency gaps in rehabilitation education. The convergent findings across quantitative survey data and qualitative stakeholder interviews provide robust evidence that comprehensive stakeholder engagement encompassing students, faculty, and administrative leadership, is fundamental to successful curriculum transformation.\u003c/p\u003e\n\u003cp\u003eThis study\u0026apos;s \u0026quot;adopt and adapt\u0026quot; methodology addresses a critical gap in the IPE literature by demonstrating how global competency frameworks can be systematically integrated into institution-specific contexts without requiring wholesale curricular redesign. The unanimous prioritization of the Practice domain across all disciplines validates the clinical relevance of competencies essential to collaborative patient care: effective interprofessional communication, rigorous problem-solving and decision-making, collaborative relationship establishment, and scope-of-practice adherence.\u003c/p\u003e\n\u003cp\u003eThe stakeholder-driven identification of four key implementation themes, \u0026quot;realism in action,\u0026quot; \u0026quot;increased complexity,\u0026quot; \u0026quot;non-error-less learning,\u0026quot; and \u0026quot;feedback and re-run\u0026quot;, provides empirically grounded design principles for experiential learning that transcend traditional case-based approaches. The multi-phase approach combining needs assessment, stakeholder consensus-building, and implementation planning offers a replicable methodology that acknowledges practical constraints while maintaining fidelity to competency-based education principles.\u003c/p\u003e\n\u003cp\u003eThis study contributes to the growing evidence supporting stakeholder-driven approaches to competency framework integration and provides practical guidance for educational institutions seeking to enhance interprofessional collaboration. However, successful implementation requires careful attention to resource requirements, institutional readiness, and ongoing evaluation to ensure sustainable integration.\u003c/p\u003e\n\u003cp\u003eFuture research should focus on longitudinal evaluation of implementation outcomes, cost-effectiveness analysis, and development of standardized assessment tools to support widespread adoption of SIM-based IPE approaches. Only through continued systematic investigation can the potential of competency frameworks like the WHO RCF be fully realized in transforming healthcare education and patient care outcomes.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eInterprofessional Education (IPE)\u003c/p\u003e\n\u003cp\u003eWorld Health Organization (WHO)\u003c/p\u003e\n\u003cp\u003eRehabilitation Competency Framework (RCF)\u003c/p\u003e\n\u003cp\u003eSimulation-Based (SIM-based)\u003c/p\u003e\n\u003cp\u003eInterprofessional Education Collaborative (IPEC)\u003c/p\u003e\n\u003cp\u003ePhysical Therapy (PT)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOccupational Therapy (OT)\u003c/p\u003e\n\u003cp\u003eSpeech Language Pathology (SLP)\u003c/p\u003e\n\u003cp\u003eAthletic Training (AT)\u003c/p\u003e\n\u003cp\u003ePhysician Assistant (PA)\u003c/p\u003e\n"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was reviewed and approved by the Seton Hall University Institutional Review Board (IRB Protocol #2022-325 and #2022-414). The work was conducted in accordance with relevant guidelines, including the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was funded by the Opportunity Meets Innovation Challenge Grant, Seton Hall University, New Jersey State Office of the Secretary of Higher Education.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAL conceived and designed the project. Both authors contributed to the methodological framework, conducted data analysis, and interpreted the results. Both authors participated in drafting and revising the manuscript. All authors have read and approved the final version for publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSpecial thanks to Christina Orozco Nevers, Rachel Salazar, Sarah Roux and Candan Nixon for their exceptional work as research assistants throughout this project. Their contributions included literature review, survey development and validation, coding of qualitative responses, and preliminary data analysis.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eMills J-A, Cieza A, Short SD, Middleton JW. Development and validation of the WHO rehabilitation competency framework: a mixed methods study. 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Patient safety culture transformation in a children\u0026apos;s hospital: an interprofessional approach. J Interprof Care. 2014;28:358-64. https://doi.org/10.3109/13561820.2014.890581\u003c/li\u003e\n\u003cli\u003eMocke M, Unger M, Hanekom S. Validation of the World Health Organization rehabilitation competency framework: an illustration using physiotherapy. Clin Rehabil. 2025;39:88-98. https://doi.org/10.1177/02692155241293324\u003c/li\u003e\n\u003cli\u003eThistlethwaite JE, Forman D, Matthews LR, Rogers GD, Steketee C, Yassine T. Competencies and frameworks in interprofessional education: a comparative analysis. Acad Med. 2014;89:869-75. https://doi.org/10.1097/ACM.0000000000000249\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":"","lastPublishedDoi":"10.21203/rs.3.rs-7601827/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7601827/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground: The 2020 World Health Organization Rehabilitation Competencies Framework (RCF) provides a comprehensive foundation for developing interprofessional competencies across rehabilitation disciplines. However, limited awareness and systematic integration of this framework into existing curricula represents a significant gap in competency-based health education which undermines efforts to standardize interprofessional practice competencies globally.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMethods: This mixed-method, two-phase study explored stakeholder perspectives on RCF integration within an interprofessional education curriculum at a School of Health and Medical Sciences. Phase One employed a cross-sectional survey (n=63) examining RCF awareness and perceived domain priorities across five disciplines (Physical Therapy, Occupational Therapy, Speech Language Pathology, Athletic Training, and Physician Assistant). Phase Two utilized semi-structured interviews with faculty and students to validate findings and explore implementation strategies through thematic analysis guided by social constructivist learning theory.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eResults: RCF awareness was significantly limited (15% students, 23% faculty; χ² = 4.23, p \u0026lt; 0.05). The \"Practice\" domain emerged as the highest priority across all stakeholders (\u0026gt;75%), with emphasis on effective communication and problem-solving competencies. Qualitative analysis revealed four salient themes aligned with experiential learning theory: \"realism in action,\" \"increased complexity,\" \"non-error-less learning,\" and \"feedback and re-run,\" highlighting the need for simulation-based interprofessional learning experiences.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConclusions: Systematic integration of the WHO RCF into existing interprofessional curricula is feasible through comprehensive stakeholder engagement and theoretically-grounded curriculum design. The study provides a replicable, evidence-based methodology for educational institutions seeking to enhance competency-based training programs through experiential learning approaches that bridge theory and practice.\u003c/p\u003e","manuscriptTitle":"Transforming Healthcare Education: Integrating the WHO Rehabilitation Competencies Framework into Interprofessional Curricula","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-11 21:02:04","doi":"10.21203/rs.3.rs-7601827/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-10-31T18:52:57+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"226806889598592176053308985708208592088","date":"2025-10-31T12:18:30+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-31T09:48:12+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-29T17:52:23+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-10T10:25:08+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-06T20:38:26+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2025-10-06T15:40:00+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":"2be8d32a-1fee-4540-b806-2098b2843a78","owner":[],"postedDate":"November 11th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-11-11T21:02:04+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-11 21:02:04","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7601827","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7601827","identity":"rs-7601827","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}