Identifying costs in health professions education: a scoping review protocol.

INTRODUCTION: Profound changes in the healthcare sector and the growing, global shortage of healthcare workers are driving the demand to update and scale-up health professions education (HPE). At the same time, educational institutions are faced with increasing resource scarcity and decisions of where and how to allocate resources must be made conscious of costs. However, costs are known to be inaccurately and incompletely identified in HPE research. Therefore, to improve rigour in cost evidence and enable its use in decision-making, it is necessary to have a better understanding of the costs, stakeholders and cost identification methods being used in HPE research. This protocol has been developed to outline the rationale and methods for a scoping review of the literature intended to map the current state of cost and cost identification evidence in HPE. METHODS AND ANALYSIS: This protocol is developed in accordance with the Joanna Briggs Institute Manual for Evidence Synthesis. PubMed, ERIC, CINAHL and PsycInfo will be scoped for all types of English language publications from 2012 to 2022 that investigate costs associated with the education of health professionals. Two independent reviewers will assess publications for eligibility. Data will be extracted on the educational topic and context, the costs, cost types, perspectives and methods of cost identification as represented in the literature. ETHICS AND DISSEMINATION: No human participants are involved in this scoping review. All evidence for this study are sourced from public databases; therefore, ethical approval was not required. Final results will be disseminated through peer-reviewed publications and presented at conferences. TRIAL REGISTRATION NUMBER: A preliminary version of this protocol was prospectively registered on Open Science Framework (OSF) on 13 June 2022 and is available at https://doi.org/10.17605/OSF.IO/ET4XB.

Understanding effort regulation: Comparing 'Pomodoro' breaks and self-regulated breaks.

BACKGROUND: During self-study, students need to monitor and regulate mental effort to replete working memory resources and optimize learning results. Taking breaks during self-study could be an effective effort regulation strategy. However, little is known about how breaktaking relates to self-regulated learning. AIMS: We investigated the effects of taking systematic or self-regulated breaks on mental effort, task experiences and task completion in real-life study sessions for 1 day. SAMPLE: Eighty-seven bachelor's and master's students from a Dutch University. METHODS: Students participated in an online intervention during their self-study. In the self-regulated-break condition (n = 35), students self-decided when to take a break; in the systematic break conditions, students took either a 6-min break after every 24-min study block (systematic-long or 'Pomodoro technique', n = 25) or a 3-min break after every 12-min study block (systematic-short, n = 27). RESULTS: Students had longer study sessions and breaks when self-regulating. This was associated with higher levels of fatigue and distractedness, and lower levels of concentration and motivation compared to those in the systematic conditions. We found no difference between groups in invested mental effort or task completion. CONCLUSIONS: Taking pre-determined, systematic breaks during a study session had mood benefits and appeared to have efficiency benefits (i.e., similar task completion in shorter time) over taking self-regulated breaks. Measuring how mental effort dynamically fluctuates over time and how effort spent on the learning task differs from effort spent on regulating break-taking requires further research.

Factors Influencing Professional Identity Construction in Fourth-Year Pharmacy Students.

Objectives. To explore the key factors that influence professional identity construction in fourth-year pharmacy students enrolled in a Doctor of Pharmacy program.Methods. A single-site instrumental case study of current fourth-year pharmacy students from the Leslie Dan Faculty of Pharmacy, University of Toronto, was used. Thirteen students participated in semistructured interviews. Poststructural social identity theories were used to analyze the data and identify themes that influence identity construction in pharmacy students.Results. Data analysis identified five overarching themes that influence pharmacy student professional identity construction: path to pharmacy, curriculum, environment, preceptors, and patient interactions. The Leslie Dan Faculty of Pharmacy curriculum prioritized the health care provider identity, which influenced the students desire to "become" clinicians. Based on their internalized health care provider identity, they rejected preceptors and practice environments that negatively impacted their ability to embody this identity.Conclusion. The findings of this study suggest that pharmacy students align themselves strongly with health care provider identities at the cost of other potentially relevant identities. Pharmacy education programs may benefit from curricular reforms that incorporate and legitimize multiple pharmacist identities to ensure a strong pharmacy workforce for the future.

Detection and localization of early- and late-stage cancers using platelet RNA.

Cancer patients benefit from early tumor detection since treatment outcomes are more favorable for less advanced cancers. Platelets are involved in cancer progression and are considered a promising biosource for cancer detection, as they alter their RNA content upon local and systemic cues. We show that tumor-educated platelet (TEP) RNA-based blood tests enable the detection of 18 cancer types. With 99% specificity in asymptomatic controls, thromboSeq correctly detected the presence of cancer in two-thirds of 1,096 blood samples from stage I-IV cancer patients and in half of 352 stage I-III tumors. Symptomatic controls, including inflammatory and cardiovascular diseases, and benign tumors had increased false-positive test results with an average specificity of 78%. Moreover, thromboSeq determined the tumor site of origin in five different tumor types correctly in over 80% of the cancer patients. These results highlight the potential properties of TEP-derived RNA panels to supplement current approaches for blood-based cancer screening.

When theory joins practice: A design-based research approach for leader identity development.

INTRODUCTION: Inclusive educational leaders promote teacher team functioning. To support leader inclusiveness, we designed and implemented a faculty development programme focusing on leader identity formation. We investigated (1) how participants' leader identity developed throughout the programme and (2) how the design principles contributed to this process, according to participants. METHODS: A design-based research approach was followed. Participants were 7 course coordinators, leading an interdisciplinary teacher team. To study leader identity development, participants repeatedly filled out a validated questionnaire. To investigate how design principles contributed, observational field notes, facilitator debriefings, a programme evaluation questionnaire and a semi-structured focus group were used. Thematic analysis was applied for qualitative data. RESULTS: Participants gained broader views on leadership, moving from individual dominance towards engaging team members. Most participants initially experienced a deconstruction of their former leader identity and became motivated to improve leadership qualities. Competence-building, reflecting and receiving feedback on workplace experiences, and practicing in a safe environment were perceived to be key for identity development. CONCLUSIONS: We developed and evaluated a leader identity programme which can convert teachers' classic leadership views towards views incorporating social interactions and relationships. We demonstrated how social interactions provide opportunities to learn from pe.ers in the work environment.

The Analysis of Platelet-Derived circRNA Repertoire as Potential Diagnostic Biomarker for Non-Small Cell Lung Cancer.

Tumor-educated Platelets (TEPs) have emerged as rich biosources of cancer-related RNA profiles in liquid biopsies applicable for cancer detection. Although human blood platelets have been found to be enriched in circular RNA (circRNA), no studies have investigated the potential of circRNA as platelet-derived biomarkers for cancer. In this proof-of-concept study, we examine whether the circRNA signature of blood platelets can be used as a liquid biopsy biomarker for the detection of non-small cell lung cancer (NSCLC). We analyzed the total RNA, extracted from the platelet samples collected from NSCLC patients and asymptomatic individuals, using RNA sequencing (RNA-Seq). Identification and quantification of known and novel circRNAs were performed using the accurate CircRNA finder suite (ACFS), followed by the differential transcript expression analysis using a modified version of our thromboSeq software. Out of 4732 detected circRNAs, we identified 411 circRNAs that are significantly (p-value < 0.05) differentially expressed between asymptomatic individuals and NSCLC patients. Using the false discovery rate (FDR) of 0.05 as cutoff, we selected the nuclear receptor-interacting protein 1 (NRIP1) circRNA (circNRIP1) as a potential biomarker candidate for further validation by reverse transcription-quantitative PCR (RT-qPCR). This analysis was performed on an independent cohort of platelet samples. The RT-qPCR results confirmed the RNA-Seq data analysis, with significant downregulation of circNRIP1 in platelets derived from NSCLC patients. Our findings suggest that circRNAs found in blood platelets may hold diagnostic biomarkers potential for the detection of NSCLC using liquid biopsies.

The effects of standing in tutorial group meetings on learning: A randomized controlled trial.

BACKGROUND: Standing desks have been brought into the education environment to reduce sedentary behavior among students. The current study explored the effects of standing in tutorial group meetings on learning among undergraduate students. METHODS: Ninety-six participants were randomly allocated to a Sit or Stand group, with 2 h tutorial group meetings scheduled, once or twice per week, for nine weeks. Learning was analyzed using exam grades, concept maps, and tutorial interactions. RESULTS: Overall, the Sit and Stand groups did not differ from each other in terms of learning, measured through their exam, concept map, and the use of learning-oriented interactions. CONCLUSION: Standing in tutorial group meetings neither enhanced nor compromised learning. Considering the health risks associated with prolonged sedentary behavior, offering standing tutorial group meetings to undergraduate students is a recommended solution to break up prolonged sedentary behavior and encourage more physical activity, while maintaining the learning performance of students.

How pharmacists perceive their professional identity: a scoping review and discursive analysis.

OBJECTIVES: The objectives of this scoping review were to (a) explore how pharmacists perceive their professional roles and identities and (b) describe factors impacting which professional roles or identities pharmacists embody in different pharmacy practice settings. METHODS: A scoping review using a deductive approach was undertaken for this study. Systematic searches were conducted in five databases: Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO, EBSCO Cumulative Index to Nursing and Allied Health and Scopus (Elsevier). Key words searched included pharmacist, identity, professional role and one variations of these. Results were double-blind screened for relevance by two authors. Data extraction was facilitated by the web-based software platform COVIDENCE. Foucauldian critical discourse analysis was used to deconstruct how pharmacists perceive their professional roles and identities. KEY FINDINGS: In total, 21 701 articles were retrieved in the search. Following de-duplication and screening, 23 studies from 11 different countries were included. Five major identity themes were identified: Clinician, Dispenser, Business Person, Patient Counsellor and Physician Supporter. The dispenser identity was the most widespread, but it was viewed by many pharmacists as undesirable. The clinician identity also had a strong presence but was viewed as an identity that pharmacists aspire to embody. CONCLUSIONS: This scoping review illustrates that pharmacists do not uniformly perceive themselves to be clinicians. A significant gap exists between the profession's desired identity and that embodied by practicing pharmacists. The resulting dissonance may be a contributing factor to the lack of wide-scale practice change that the profession has been seeking for decades.

When Feedback Backfires: Influences of Negative Discrepancies Between Physicians' Self and Assessors' Scores on Their Subsequent Multisource Feedback Ratings.

INTRODUCTION: With multisource feedback (MSF) physicians might overrate their own performance compared with scores received from assessors. However, there is limited insight into how perceived divergent feedback affects physicians' subsequent performance scores. METHODS: During 2012 to 2018, 103 physicians were evaluated twice by 684 peers, 242 residents, 999 coworkers, and themselves in three MSF performance domains. Mixed-effect models quantified associations between the outcome variable "score changes" between first and second MSF evaluations, and the explanatory variable "negative discrepancy score" (number of items that physicians rated themselves higher compared with their assessors' scores) at the first MSF evaluation. Whether associations differed across assessor groups and across a physician's years of experience as a doctor was analyzed too. RESULTS: Forty-nine percent of physicians improved their total MSF score at the second evaluation, as assessed by others. Number of negative discrepancies was negatively associated with score changes in domains "organization and (self)management" (b = -0.02; 95% confidence interval [CI], -0.03 to -0.02; SE = 0.004) and "patient-centeredness" (b = -0.03; 95% CI, -0.03 to -0.02; SE = 0.004). For "professional attitude," only negative associations between score changes and negative discrepancies existed for physicians with more than 6-year experience (b6-10yearsofexperience = -0.03; 95% CI, -0.05 to -0.003; SE = 0.01; b16-20yearsofexperience = -0.03; 95% CI, -0.06 to -0.004; SE = 0.01). DISCUSSION: The extent of performance improvement was less for physicians confronted with negative discrepancies. Performance scores actually declined when physicians overrated themselves on more than half of the feedback items. PA score changes of more experienced physicians confronted with negative discrepancies and were affected more adversely. These physicians might have discounted feedback due to having more confidence in own performance. Future work should investigate how MSF could improve physicians' performance taking into account physicians' confidence.

Platelets as messengers of early-stage cancer.

Platelets have an important role in tumor angiogenesis, growth, and metastasis. The reciprocal interaction between cancer and platelets results in changes of several platelet characteristics. It is becoming clear that analysis of these platelet features could offer a new strategy in the search for biomarkers of cancer. Here, we review the human studies in which platelet characteristics (e.g., count, volume, protein, and mRNA content) are investigated in early-stage cancer. The main focus of this paper is to evaluate which platelet features are suitable for the development of a blood test that could detect cancer in its early stages.

Enhancing Team Learning through Leader Inclusiveness: A One-Year Ethnographic Case Study of an Interdisciplinary Teacher Team.

PHENOMENON: Developing modern medical curricula requires collaboration between different scientific and clinical disciplines. Consequently, institutions face the daunting task to engage colleagues from different disciplines in effective team collaboration. Two aspects that are vital to the success of such teamwork are "team learning behavior" by all team members and "leader inclusiveness behavior" by the team leader. Team members display team learning behavior when they share information, build upon and integrate each other's viewpoints. The team leader can promote such team learning by exhibiting inclusiveness behavior, which aims to encourage diversity and preserve individual differences for an inclusive workplace, nurturing engagement in teamwork. There is a paucity of in-depth research on leader inclusiveness behavior in the field of medical education. This case study aimed to offer unique insight into how leader inclusiveness behavior manifests itself in a successful interdisciplinary teacher team, demonstrating team learning behavior in undergraduate medical education. APPROACH: We conducted a qualitative, ethnographic case study using different but complementary methods, including observations, interviews and a documentary analysis of email communication. By means of purposive sampling, we selected an existing interdisciplinary teacher team that was responsible for an undergraduate medical course at Maastricht University, the Netherlands, and that was known to be successful. Chaired by a physician, the team included planning group members and tutors with medical, biomedical, and social sciences backgrounds as well as student-representatives. In the course of one academic year, 23 meetings were observed and recorded, informal interviews were conducted, and over 100 email conversations were collected. All data were submitted to a directed content analysis based on team learning and leader inclusiveness concepts. FINDINGS: Leader inclusiveness behavior became evident from verbal and non-verbal interactions between the team leader and team members. Leader inclusiveness behavior that facilitated team learning behavior manifested itself in five actions undertaken by the team leader: coordinating, explicating, inviting, connecting, and reflecting. Similarly, team members facilitated team learning behavior by participating actively, speaking up behavior, and mimicking leader inclusiveness behavior. These behaviors demonstrated engagement and feelings of inclusion, and reinforced leader inclusiveness behavior by creating additional opportunities for the leader to exhibit such behavior. INSIGHTS: This case study responds to the need for inclusive leadership approaches in medical education. Our findings build upon theoretical knowledge on team learning and leader inclusiveness concepts. By studying behaviors, interactions and documents we obtained in-depth information on leader inclusiveness. Our findings are unique in that they demonstrate how leader inclusiveness behavior manifests itself when leaders interact with their team members. This study provides health professionals who are active in education with practical suggestions on how to act as a successful and inclusive leader. Finally, the behaviors identified open up avenues for future professional development initiatives and future research on team leadership.Supplemental data for this article is available online at here.

The effects of standing tutorial meetings on physical activity behavior in undergraduates: A randomized controlled trial.

This study explored the effects of using standing desks in tutorial meetings on the physical activity behavior (PAB) of undergraduate students. Standing desks have been introduced to minimize the detrimental health effects of prolonged sedentary behavior (SB). The effectiveness of using standing desks has not been explored among undergraduate students - a population showing high SB. Ninety-six undergraduate students were randomly assigned to a sitting or standing tutorial group that ran for nine weeks, and their PAB was monitored using the activPAL3™ triaxial activity monitor. To check for potential compensatory or other covarying behaviors, the students' PAB was monitored on tutorial and non-tutorial days. PAB monitoring was conducted in week 4-5, and a follow-up measurement was conducted in week 9 to examine longer-term effects. In week 4-5, the stand group (n = 41) showed less SB (ß = -0.092, SE = 0.044, 95% CI: -0.179, -0.006) and more moderate-to-vigorous physical activity (ß = 0.320, SE = 0.160, 95% CI: 0.004, 0.635) compared to the sit group (n = 36). On tutorial days, the stand group showed more light physical activity (LPA) than the sit group (p < .001, d = 1.04). In week 9, there was an exam on the last day of that week. Nonetheless, the stand group (n = 37) showed less SB (p < .001, d = 0.378) and more LPA (p = .008, d = 0.725), while breaking up prolonged SB more frequently (p = .007, d = 0.696) on the tutorial day compared to the sit group (n = 32). Overall, undergraduates attending standing tutorial meetings showed less SB and more LPA than those attending conventional, seated tutorial meetings. Standing tutorial meetings can contribute to a more active lifestyle for undergraduates.

Working beyond disciplines in teacher teams: teachers' revelations on enablers and inhibitors.

INTRODUCTION: Health professions education faces transitions from monodisciplinary to integrated education and from soloist teachers to interdisciplinary teacher teams. Interdisciplinary teamwork has been found complex and prone to conflict. Teachers' perceptions of why some teams work and learn as a real interdisciplinary team and others do not are lacking in this setting. We studied the factors that teachers perceive as enabling and/or inhibiting interdisciplinary team learning. METHODS: In this exploratory, qualitative study, we conducted 17 semi-structured, vignette-guided interviews with teachers recruited from diverse disciplines in undergraduate health professions programmes at Maastricht University, the Netherlands, through maximum variation sampling. Team learning research informed data collection and template analysis. RESULTS: We identified three themes representing the factors that teachers perceived to influence interdisciplinary team learning: 'alignment/misalignment with the educational philosophy' (regarding personal attributes, tendencies and motivation), 'leadership practices' (encompassing team vision, responsibility and reflection), and 'involvement in organisational processes' (covering organisational decision-making, support and learning opportunities). For interdisciplinary team learning in development of integrated education, teachers emphasised their personal ability to move beyond disciplinary boundaries. Shared team leadership enabled the creation of a shared vision, shared responsibility, and team reflection. Lastly, teacher involvement in educational management, peer support and learning was considered important. DISCUSSION: To work beyond disciplines in health professions education, teachers should take an interest in integrated education, share responsibility and work in an environment where people continuously learn from others. Organisations can facilitate this by involving teachers in decision-making processes and providing faculty development aimed to foster shared leadership and team reflection.

A Historical Discourse Analysis of Pharmacist Identity in Pharmacy Education.

Objective. To determine the discourses on professional identity in pharmacy education over the last century in North America and which one(s) currently dominate. Methods. A Foucauldian critical discourse analysis using archival resources from the American Journal of Pharmaceutical Education (AJPE) and commissioned education reports was used to expose the identity discourses in pharmacy education. Results. This study identified five prominent identity discourses in the pharmacy education literature: apothecary, dispenser, merchandiser, expert advisor, and health care provider. Each discourse constructs the pharmacist's professional identity in different ways and makes possible certain language, subjects, and objects. The health care provider discourse currently dominates the literature. However, an unexpected finding of this study was that the discourses identified did not shift clearly over time, but rather piled up, resulting in students being exposed to incompatible identities. Conclusion. This study illustrates that pharmacist identity constructs are not simple, self-evident, or progressive. In exposing students to incompatible identity discourses, pharmacy education may be unintentionally impacting the formation of a strong, unified healthcare provider identity, which may impact widespread practice change.

Academic Schedule and Day-to-Day Variations in Sedentary Behavior and Physical Activity of University Students.

Students starting at university tend to adopt unhealthy behaviors. With students expected to sit during classes, their academic schedule may be responsible for their activity patterns. The aim of the current study was to investigate the relationship between university students' academic schedule and day-to-day variations in sedentary behavior (SB) and physical activity (PA). The activity of 317 first-year undergraduate students (mean age 19.6 ± 1.4 years, 69.4% female, 30.0% male, and 0.6% other) was measured with the activPAL3™ triaxial monitor for seven consecutive days. Each class hour was found to be associated with 9.0 additional minutes of SB (95% CI [4.9, 13.1]), 54 additional seconds of moderate-to-vigorous PA (MVPA; 95% CI [12, 96]), and 12.2 min less time in bed (95% CI [-16.6, -7.8]). Active SB ratio (total duration of SB bouts < 30 min divided by total SB duration) decreased by 0.011 per hour of class scheduled for the students (95% CI [-0.016, -0.006]). Light PA (LPA) was not significantly associated with class duration. Students tend to cycle more on days with classes. Seated transportation was not significantly related to whether the students had classes or not. Overall, the academic schedule is associated with SB and PA in students.

Shaping a Culture for Continuous Quality Improvement in Undergraduate Medical Education.

PURPOSE: This study sought to identify key features of an organizational quality culture and explore how these features contribute to continuous quality improvement of undergraduate medical education. METHOD: Between July and December 2018, researchers from Maastricht University in the Netherlands conducted a multicenter focus group study among 6 education quality advisory committees. Participants were 22 faculty and 18 student representatives affiliated with 6 medical schools in the Netherlands. The group interviews focused on quality culture characteristics in relation to optimizing educational development, implementation, evaluation, and (further) improvement. Template analysis, a stepwise type of thematic analysis, was applied to analyze the data. RESULTS: Five main themes resembling quality culture constituents to continuous educational improvement were identified: (1) fostering an open systems perspective, (2) involving stakeholders in educational (re)design, (3) valuing teaching and learning, (4) navigating between ownership and accountability, and (5) building on integrative leadership to overcome tensions inherent in the first 4 themes. A supportive communication climate (which can be fueled by the organization's leaders) contributes to and is integrated within the first 4 themes. CONCLUSIONS: The results call for a shift away from static quality management approaches with an emphasis on control and accountability toward more flexible, development-oriented approaches focusing on the 5 themes of a culture for continuous quality improvement. The study provides new insights in the link between theory and practice of continuous quality improvement. Specifically, in addition to quality management systems and structures, faculty's professional autonomy, collaboration with peers and students, and the valuing of teaching and learning need to be amplified.

Outcomes-Based Selection Into Medical School: Predicting Excellence in Multiple Competencies During the Clinical Years.

PURPOSE: Medical school selection committees aim to identify the best possible students and, ultimately, the best future doctors from a large, well-qualified, generally homogeneous pool of applicants. Constructive alignment of medical school selection, curricula, and assessment with the ultimate outcomes (e.g., CanMEDS roles) has been proposed as means to attain this goal. Whether this approach is effective has not yet been established. The authors addressed this gap by assessing the relationship between performance in an outcomes-based selection procedure and performance during the clinical years of medical school. METHOD: Two groups of students were compared: (1) those admitted into Maastricht University Medical School via an outcomes-based selection procedure and (2) those rejected through this procedure who were admitted into the program through a national, grade-point-average-based lottery. The authors compared performance scores of students from the 2 groups on all 7 CanMEDS roles, using assessment data gathered during clinical rotations. The authors examined data from 3 cohorts (2011-2013). RESULTS: Students admitted through the local, outcomes-based selection procedure significantly outperformed the initially rejected but lottery-admitted students in all years, and the differences between groups increased over time. The selected students performed significantly better in the CanMEDS roles of Communicator, Collaborator, and Professional in the first year of clinical rotations; in these 3 roles-plus Organizer-in the second year; and in 2 additional roles (Advocate and Scholar-all except Medical Expert) at the end of their clinical training. CONCLUSIONS: A constructively aligned selection procedure has increasing predictive value across the clinical years of medical school compared with a GPA-based lottery procedure. The data reported here suggest that constructive alignment of selection, curricula, and assessment to ultimate outcomes is effective in creating a selection procedure predictive of clinical performance.

How Teachers Meet in Interdisciplinary Teams: Hangouts, Distribution Centers, and Melting Pots.

PURPOSE: To explore team learning processes among interdisciplinary teacher teams in the development of integrated health professions education and to investigate students' perspectives on the quality of the educational courses. METHOD: Using an exploratory, sequential mixed-methods design, the first author conducted 17 vignette-guided, semistructured interviews with teachers originating from diverse disciplines. These teachers worked in different courses of integrated, undergraduate health professions programs at the Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands. The interview guide and vignettes were based on team learning research. The interviews sought to establish how interdisciplinary teacher team members work together on integrated curricula. The vignettes reflected constructs of team learning processes: sharing, co-construction, and constructive conflict. Data were collected between November 2017 and March 2018 and analyzed using template analysis. Sequentially, course evaluation data were used to provide a descriptive analysis of students' perspectives on educational quality (course organization, structure, learning effect, and alignment). RESULTS: Three team approaches were identified. In fragmented teams or "hangouts," teachers individually worked on tasks that they were interested in, leaving their disciplinary mark. Framework-guided teams or "distribution centers" aimed to work within the given frameworks and organizational expectations, striving for disciplinary balance. Integrated teacher teams or "melting pots" used an interdisciplinary approach on all topics and put students at the center. Integrated teams reflected high-level team learning processes and were most satisfied with their (team)work. In contrast, fragmented and framework-guided teams mainly reflected low-level team learning processes. Students evaluated courses of integrated teacher teams highest on all investigated quality items (course organization, structure, learning effect, and alignment). CONCLUSIONS: Successful interdisciplinary teacher teams are represented by an integrated approach with high-level team learning behavior and the best course evaluations. Therefore, health professions education management should actively encourage and facilitate integrated teacher teamwork.