# Bridging silos on a budget: how interprofessional education shapes collaborative attitudes across low-and middle-income countries - a systematic review

## TL;DR

This review finds that interprofessional education can improve teamwork attitudes among health students in low-and middle-income countries, but more rigorous research is needed.

## Contribution

The study synthesizes limited evidence on IPE's impact in LMICs, highlighting contextual factors and methodological gaps.

## Key findings

- Four of five studies showed significant positive changes in collaborative attitudes after IPE interventions.
- Positive outcomes were most common in clinically embedded and small-group IPE settings.
- Methodological limitations like lack of control groups and small samples reduced evidence certainty.

## Abstract

Interprofessional education (IPE) enables health-profession students from different disciplines to learn together, fostering teamwork, communication, and collaborative practice. Although widely implemented in high-income countries (HICs), evidence from low-and middle-income countries (LMICs) is limited and scattered. This systematic review synthesized quantitative evidence on the impact of IPE interventions on students’ collaborative attitudes in LMIC contexts, and explored intervention characteristics, methodological quality, and evidence gaps.

Following PRISMA (2020) guidance, we searched PubMed, Scopus, and Embase (January 2010-August 2025) and screened grey literature. Eligible studies included undergraduate or pre-licensure health-profession students from at least two disciplines in LMICs, exposed to structured IPE interventions, with pre- and post-measurement of attitudes using validated or described quantitative instruments. Two reviewers independently screened, extracted data, and assessed risk of bias using the Joanna Briggs Institute checklist for quasi-experimental studies. Certainty of evidence was rated with GRADE. Heterogeneity precluded meta-analysis; findings were synthesized narratively using the SWiM vote-count approach.

Five studies (Brazil, Iran, India, Lebanon, Pakistan; total baseline N = 396) met inclusion criteria. All used uncontrolled pre-post designs; three employed validated scales (IEPS, IPAS, RIPLS). Four studies reported statistically significant positive changes in overall attitudes: particularly in domains such as teamwork, role understanding, and communication. One reported a decline in a single patient-centeredness domain. Interventions ranged from single-day workshops to semester-long courses, delivered in classroom, blended, or clinical settings. Positive shifts were most common when IPE was embedded in authentic clinical environments and small-group learning. Risk of bias was moderate to serious, mainly due to lack of control groups, attrition, and reliance on self-report. Certainty of evidence was low.

Structured IPE in LMIC undergraduate settings can improve collaborative attitudes, particularly when clinically embedded and professionally diverse. However, evidence is constrained by methodological limitations, small samples, and short follow-up. Future research should adopt controlled designs, harmonized outcome measures, and longer-term evaluation to assess sustainability and practice impact.

The online version contains supplementary material available at 10.1186/s12909-025-08203-6.