This study evaluates the impact of a structured interprofessional training program on daily collaboration within the Cardiac Intensive Care Unit (CICU/UTIC) at the University Hospital of Parma. In high-intensity clinical settings, rapid and accurate coordination between physicians, nurses, and healthcare assistants is vital. Ineffective teamwork often leads to communication breakdowns, potentially compromising patient safety and care quality. This project investigates whether an interactive, scenario-based educational program can strengthen role clarity, communication, and shared decision-making.
The study seeks to determine if an active-learning program using interactive branching scenarios improves interprofessional collaboration more effectively than traditional methods. The researchers hypothesize that this simulation-based approach will significantly enhance professional outcomes, including self-efficacy, shared decision-making, and commitment to both the team and the profession.
The study utilizes a convenience sample (approx. 5 physicians, 30 nurses, 8 healthcare assistants, and 10 students). Eligible participants include staff and students currently or recently active in the Parma CICU who provide informed consent.
The intervention is delivered via a Moodle-based platform featuring case-based simulations. These scenarios replicate complex clinical pathways, such as:
Cath-lab and Electrophysiology procedures.
Heart failure management.
TAVI (Transcatheter Aortic Valve Implantation) preparation.
As participants navigate these scenarios, they must make critical decisions and receive immediate feedback designed to reinforce collaborative best practices.
Data Collection and Timeline
Data is gathered at three intervals: T0 (Baseline), T1 (Post-training), and T2 (6-month follow-up). Validated questionnaires measure:
Attitudes toward physician-nurse collaboration.
Perceived daily collaboration and decision-making satisfaction.
Professional commitment and work-related self-efficacy.
The training phase spans six months, with a subsequent six-month follow-up, totaling a 24-month project duration.
Ethics and Privacy Risks are minimal, primarily involving the time required for participation. The primary benefit is the development of skills that foster safer, more coordinated patient care. Privacy is strictly maintained through pseudo-anonymization, with data access restricted to the research team.
Healthcare professionals (physicians, nurses and healthcare assistants/OSS) employed in the Cardiac Intensive Care Unit (UTIC) of the University Hospital of Parma.
Healthcare professionals who have completed the training pathway and are still working in the unit at the time of the six-month follow-up.
Medical and nursing students who have carried out or are carrying out a clinical placement within the UTIC.
Ability to use a computer or mobile device, essential for participating in the online training activities (e.g. Moodle, H5P).
Healthcare professionals who do not work in the cardiology setting or who are not employed in the UTIC of the AOU Parma.
Inability to participate in the training activities or assessment sessions for logistical, organisational or clinical reasons (e.g. planned prolonged absences during the study period).
Refusal or inability to provide informed consent.
Single group
The training phase of the project consists of an interactive course aimed at healthcare professionals (physicians, nurses and OSS) to improve their ability to recognise and enact effective collaborati
Other interventionThe branching scenarios replicate complex and common clinical situations that require effective interprofessional collaboration. Each scenario is carefully designed with detailed clinical and organisational elements, including the simulated patient's medical history and care pathway in the cath-lab and electrophysiology unit prior to a TAVI procedure, vital signs, diagnostic tests, available resources, clinical objectives, and potential critical issues. Scenarios are structured around a defined storyline and professional roles, and are divided into key phases with information, possible actions, and related consequences. Interactive elements allow learners to make decisions and engage with characters or objects, while meaningful feedback supports learning. Multiple pathways ensure a dynamic experience, supported by assessment criteria.
Name of the measurement: Change from Baseline in Mean Attitudes Toward Physician-Nurse Interprofessional Collaboration Score at 6 Months
Measurement tool: Jefferson Scale of Attitudes Toward Physician-Nurse Collaborative Relationship (JSAPNC); Unit of measure: Mean total score on the Jefferson Scale of Attitudes toward Physician-Nurse Collaboration;Attitudes toward physician-nurse interprofessional collaboration will be assessed using JSAPNC, a structured, self-administered questionnaire designed to evaluate attitudes toward collaborative relationships between physicians and nurses. JSAPNC assesses key aspects of physician-nurse collaboration, including mutual respect, shared responsibility, teamwork, and professional roles. Participants respond to a series of items using a standardized response scale, and item responses are combined to generate a total score representing overall attitudes toward physician-nurse interprofessional collaboration. Higher total scores indicate more positive attitudes toward collaboration. The outcome measure is defined as the change in mean JSAPNC total score from baseline to 6 months.
Name of the measurement: Change from Baseline in Mean Perceived Interprofessional Collaboration Score at 6 Months as Assessed by the Nurse-Physician Collaboration Scale (NPCS)
Measurement tool: Nurse-Physician Collaboration Scale (NPCS).Unit of measure: Mean total score on the Nurse-Physician Collaboration Scale (NPCS). Perceived interprofessional collaboration will be assessed using the Nurse-Physician Collaboration Scale (NPCS), a structured, self-administered questionnaire designed to evaluate nurses' and physicians' perceptions of interprofessional collaboration. The NPCS assesses key dimensions of nurse-physician collaboration, including communication, shared decision-making, coordination of care, and professional relationships. Participants respond to a series of items using a standardized response scale, and item responses are combined to generate a total score representing the overall level of perceived interprofessional collaboration. Higher total scores indicate greater perceived collaboration. The outcome measure is defined as the change in mean NPCS total score from baseline to 6 months.
Name of the measurement:Change from Baseline in Mean Collaboration and Satisfaction with Care Decisions (CSACD) Score at 6 Months. Measurement tool: Collaboration and Satisfaction with Care Decisions (CSACD) Scale
Unit of measure: Mean total score on the Collaboration and Satisfaction with Care Decisions (CSACD) scale. Perceived collaboration and satisfaction with care decisions will be assessed using the Collaboration and Satisfaction with Care Decisions (CSACD) Scale, a validated, structured, self-administered questionnaire. The CSACD includes 9 items, with a Collaboration subscale (7 items) and a Satisfaction subscale (2 items), rated on a 7-point Likert scale. Item responses are combined to generate a total score representing overall perceived collaboration and satisfaction with care decisions. The outcome measure is defined as the change in mean CSACD total score from baseline to 6 months.
Name of the measurement: Change from Baseline in Mean Professional and Team Commitment Scores at 6 Months as Assessed by the Professional and Team Commitment Questionnaire. Tool measurement: Professional and Team Commitment Questionnaire
Unit of measure: Mean subscale scores on the Professional Commitment scale (12 items; range 12-60) and the Team Commitment scale (5 items; range 5-25). Professional and team commitment will be assessed using the Professional and Team Commitment Questionnaire, a structured, self-administered questionnaire designed to evaluate levels of commitment to one's profession and to the interprofessional team. The questionnaire assesses key dimensions of professional and team commitment, including identification with professional roles, engagement in team activities, and commitment to collaborative work. Participants respond to a series of items using a standardized response scale, and item responses are combined to generate a total score representing overall professional and team commitment. Higher total scores indicate greater levels of professional and team commitment. The outcome measure is defined as the change in mean Professional and Team Commitment total score from baseline to 6 months.
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