The Student Health Service, known in France as the Service Sanitaire, occupies a unique position in the landscape of health professional education. Introduced as a compulsory component of French health curricula, it requires students from six distinct disciplines to work side by side on prevention projects aimed at communities, schools, and other beneficiary populations. According to the study’s authors, it is the only mandatory and universal interprofessional training experience embedded in French health education. That universality makes it an unusually powerful natural laboratory: unlike voluntary electives or single-institution pilots, the program reaches essentially every health student in a given region, allowing researchers to assess skill development across an entire cohort rather than a self-selected sample of enthusiasts.

To quantify the change, the research team turned to a validated instrument called the Interprofessional Collaborative Competency Attainment Survey, or ICCAS. The tool asks respondents to rate their own competence across the domains of interprofessional collaboration, including roles and responsibilities, teamwork, communication, and collaborative patient- or client-centered practice. The French version was used with written permission from Professor Douglas Archibald, with a minor contextual adaptation: references to the patient or family were reworded to refer to the beneficiary of the preventive action, matching the prevention-focused mission of the Student Health Service. The survey uses a seven-point scale, and the study’s primary endpoint was the change in mean score between a retrospective pre-program rating and a post-program rating collected at the same time.

That retrospective pre-post design deserves a technical note, because it is both the study’s methodological strength and a source of interpretive caution. Rather than asking students to rate their skills before the program and then again afterward, the researchers collected both the before and after ratings simultaneously once the program was complete. This approach, widely used in educational research, is thought to reduce response-shift bias, the phenomenon in which participants’ internal standards shift during an intervention, making their earlier self-assessments incomparable with later ones. By anchoring both judgments to a common frame of reference at a single moment, the retrospective design attempts to isolate genuine perceived growth from mere changes in how students understand the rating scale itself.

The scale of the data collection was ambitious. All 1,141 students completing their Student Health Service during the 2024–2025 academic year in the departments of Maine-et-Loire, Mayenne, and Sarthe were eligible. Of these, 943 received the questionnaire, 638 responded, and 553 questionnaires met the predefined completion criterion and entered the final analysis. The results were striking in their consistency. The mean ICCAS score rose from 5.81 before the program to 6.37 afterward, a statistically significant mean improvement of 0.55 points with a p-value below 0.001. In practical terms, students moved from a self-assessment comfortably above the scale’s midpoint to one approaching its upper range, and every one of the ICCAS domains showed significant improvement.

The distribution of individual responses adds texture to the headline numbers. A decisive majority, 86.6 percent of students, reported an improvement in their self-perceived interprofessional skills. A small fraction, 9.9 percent, reported no change, and 3.4 percent actually reported a decrease. The researchers also ran exploratory analyses to see whether the size of the gain varied by field of study, by department, or by the prevention topic students worked on. No significant differences emerged, although the authors caution that some subgroups were small, limiting the statistical power of those comparisons. The apparent uniformity of benefit across professions is itself notable: it suggests the program’s effect is not driven by one discipline’s curriculum or one region’s implementation but appears to operate broadly across the interprofessional mix.

One of the study’s most intriguing findings came from its sensitivity analysis, which compared paper-based questionnaires with digital ones. Students who completed the survey on paper reported a mean improvement of 0.586 points, while those using the digital format reported a mean gain of only 0.251 points, a difference that was itself statistically significant at p below 0.001. The authors do not overinterpret this gap, but it raises genuine methodological questions for anyone designing self-assessment research. Response formats can influence how people recall and evaluate their own past states, and the nearly threefold difference between modalities suggests that survey delivery is not a neutral technical choice. Future evaluations of interprofessional education may need to account for, or standardize, the medium through which self-perception is measured.

Why does a mandatory prevention placement move the needle on collaboration skills at all? The theoretical answer lies in the architecture of interprofessional education itself. Decades of research have argued that health professions students learn in silos, absorbing the norms, vocabularies, and hierarchies of their own discipline while rarely practicing the negotiation of roles that real clinical teamwork demands. The Student Health Service forces that negotiation early. Because prevention projects require students to define who does what, communicate across professional boundaries, and center the needs of a shared beneficiary, they create authentic opportunities to exercise exactly the competencies the ICCAS measures. The study’s findings are consistent with the idea that collaborative competence is not an abstract attitude but a practical skill that develops through structured, repeated, real-world interaction with other professions.

The implications extend beyond France. Health systems globally face workforce shortages, rising chronic disease burdens, and mounting evidence that fragmented care harms patients, all of which have pushed interprofessional education to the top of curricular reform agendas. Yet rigorous evaluations of mandatory, large-scale interprofessional programs remain scarce, partly because few countries have made such training universal. The Angers study, covering six professions across three departments in a single academic year, provides a template for how such evaluations can be conducted: a validated self-assessment instrument, a retrospective pre-post design, and a completion criterion applied before analysis. Its conclusion that the program strengthened interprofessional training in French health curricula gives policymakers empirical support for maintaining and expanding the model.

The authors are careful about the limits of what self-report can show. Self-perceived competence is not the same as objectively measured competence, and students may overestimate or underestimate their actual collaborative abilities. The study’s own recommendation points the way forward: further research should explore the relationship between self-perceived and objectively measured interprofessional competencies, ideally through observational measures, standardized assessments, or longitudinal follow-up into professional practice. There is also the question of durability, whether gains measured immediately after the program persist once students enter clinical rotations and, eventually, the workforce. Still, the core message stands. When a thousand-plus students across medicine, nursing, midwifery, pharmacy, and the therapies were required to collaborate on real prevention work, nearly nine in ten came away believing they had become better team members, and the numbers behind that belief were statistically robust. For a field long criticized for teaching teamwork in lecture halls, that is evidence worth taking seriously.

Subject of Research: Changes in self-perceived interprofessional collaborative skills among health students after a mandatory student health service program

Article Title: Changes in students’ self-perceived interprofessional collaborative skills following participation in the student health service program

Article References: Donat, T., De Roquefeuil, E., Busson, A., Baglin, I., Poiroux, L., Ramond-Roquin, A., Ammi, M., & Levaillant, M. (2026). Changes in students’ self-perceived interprofessional collaborative skills following participation in the student health service program. BMC Medical Education. https://doi.org/10.1186/s12909-026-10479-1

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10479-1

Keywords: interprofessional education, interprofessional collaboration, Student Health Service, ICCAS, self-assessment, health professions students, medical education, teamwork, preventive care, France, BMC Medical Education, curriculum evaluation

The research, led by Teresa M. Cochran of the University of Nebraska Medical Center’s College of Allied Health Professions, together with colleagues at Creighton University, the University of Nebraska-Lincoln, and the University of Nebraska at Kearney, tested what the team calls a longitudinal tele-team model. Thirty-two health professions students from four disciplines—physical therapy, occupational therapy, medical nutrition, and speech-language pathology—were organized into small interprofessional teams. Each team met six times over a sustained period with community-dwelling stroke survivors, conducting sessions remotely via telehealth. The design deliberately paired the authenticity of real patient relationships with the accessibility of virtual delivery, allowing students in different programs and locations to collaborate without the logistical barriers that often doom interprofessional education initiatives.

What makes the study methodologically interesting is that it did not rely on a single measure of success. The researchers used a convergent mixed methods design, combining quantitative surveys with qualitative focus groups to capture both the magnitude and the texture of change. Students completed the Interprofessional Collaborative Competency Attainment Survey, or ICCAS, as a retrospective pre-post instrument, meaning they rated their own competencies before and after the experience in a single sitting—a technique that reduces the response bias that can arise when learners’ understanding of a concept shifts during training. Team-level functioning was tracked with the Relational Coordination Survey, administered after each of the six sessions, providing a session-by-session trajectory rather than a single endpoint snapshot.

Relational coordination is a concept borrowed from organizational sociology that describes how work groups coordinate through shared goals, shared knowledge, and mutual respect, communicated through frequent, timely, accurate, and problem-solving exchanges. In health care, high relational coordination has been linked to better patient outcomes and lower staff burnout, but it is rarely measured in educational settings. By collecting RCS data after every session, the Nebraska team could model how coordination developed over time rather than assuming it appeared fully formed. Stroke survivors added a third perspective, completing the Patient Insights and Views Observing Team survey, known as PIVOT, at the midpoint and end of the program—an unusually direct way of asking patients whether the students were actually functioning as a team.

The quantitative findings were consistent across all three instruments. On the ICCAS, students reported statistically significant improvements in every measured domain of interprofessional competency, with p-values below 0.05, spanning areas such as communication, role clarification, patient-centered care, and conflict management. The Relational Coordination Survey told a longitudinal story: linear mixed-effects modeling revealed a significant positive trajectory over the six sessions, with a beta coefficient of 0.06 per session (standard error 0.016, p < 0.001). That may sound like a small number, but in a model of repeated measures it indicates a steady, statistically robust climb in how well team members communicated and trusted one another as the weeks accumulated.

Perhaps the most revealing analysis came when the researchers correlated the two student-facing instruments. Higher relational coordination scores were moderately to strongly associated with higher self-assessed competencies, with correlation coefficients exceeding 0.62 for the domains of communication, patient-centered care, and conflict management. In plain terms, the students whose teams were knitting together socially and communicatively were the same students who felt they were mastering the collaborative skills that educators care about. This convergence suggests that individual competency and team-level coordination are not separate educational outcomes but intertwined processes, each reinforcing the other as a team matures.

Crucially, the patients agreed. Stroke survivors reported significant improvements in team functioning on the PIVOT survey, with a p-value of 0.031, indicating that the gains students and their teams perceived were visible to the people on the receiving end of care. That external validation matters, because self-report measures in education research are often criticized for capturing enthusiasm rather than ability. Here, three independent vantage points—student competency ratings, team communication scores, and patient observations—moved in the same direction.

The qualitative arm of the study filled in the why. Analysis of student focus groups yielded five themes: the value of learning from patient experience, role clarification, relationship-building, the importance of longitudinal engagement, and the feasibility of the tele-team model. Students described how hearing directly from stroke survivors about their daily challenges taught them things no textbook could, and how repeated sessions allowed them to move past the awkwardness of unfamiliar professional roles. The longitudinal structure appears to be doing heavy lifting here—six sessions gave teams time to develop the shared knowledge and mutual respect that relational coordination theory identifies as the foundation of effective collaboration, something a single simulation afternoon cannot supply.

The telehealth delivery model carries implications well beyond stroke rehabilitation education. Rural communities, which the study’s funding from the American Heart Association’s Mission Lifeline Rural Stroke Innovators Grant implicitly acknowledges, often lack access to interprofessional rehabilitation services and to the training pipelines that produce them. A tele-team format lets students from different universities and disciplines participate without travel, and lets patients contribute from their own homes, where the realities of living with stroke are most visible. The authors describe the approach as scalable, and the study’s structure—small teams, scheduled sessions, standardized surveys—lends itself to replication in other regions and other patient populations.

There are, of course, limits to what one study can establish. The sample of thirty-two students is modest, the ICCAS relies on self-assessment even in its retrospective format, and the educational program was evaluated as a quality improvement activity rather than registered as human subjects research, as the University of Nebraska Medical Center Institutional Review Board determined. The authors also note that the version of the article shared ahead of final publication remains subject to editorial completion. Still, the convergent evidence—quantitative trajectories, cross-measure correlations, patient confirmation, and rich qualitative themes—makes a compelling case that the field’s evaluation toolkit should expand. Combining an individual competency measure like the ICCAS with a team-level measure like the RCS, the researchers argue, gives educators a far more complete picture of how collaborative capacity actually develops. If the findings hold up across larger and more diverse cohorts, the humble video call, repeated week after week with a real patient at the center, may prove to be one of the most effective classrooms interprofessional education has ever had.

Subject of Research: Interprofessional education through longitudinal telehealth student teams caring for stroke survivors

Article Title: Improving interprofessional competencies and relational coordination through longitudinal tele-teams: a mixed methods study

Article References: Cochran, T. M., Kennel, V., Beam, E. L., Jensen, L. E., Volkman, K. G., McKelvey, M., & Jensen, G. M. (2026). Improving interprofessional competencies and relational coordination through longitudinal tele-teams: a mixed methods study. BMC Medical Education. https://doi.org/10.1186/s12909-026-10472-8

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10472-8

Keywords: interprofessional education, telehealth, relational coordination, stroke rehabilitation, health professions education, teamwork, mixed methods, ICCAS, patient-centered care, longitudinal learning, medical education, collaborative practice