Advanced Cardiac Life Support Training in Interprofessional Teams of Undergraduate Nursing and Medical Students Using Mannequin-Based Simulation


We developed an interprofessional advanced cardiac life support (ACLS) course for final-year undergraduate nursing and medical students, aiming to increase technical resuscitation and non-technical teamwork skills. We studied the effects of the course using mixed methods, comprising the Readiness for Interprofessional Learning Scale (RIPLS), a questionnaire, and focus groups. Over eight full days, 188 students participated—comprising 59 nursing and 129 medical students (representing 69 and 68% of the total year’s cohorts, respectively). Overall RIPLS scores increased pre- to post-course by 2.13 points (from 76.41 to 78.54, p < 0.001)—being largely due to medical students’ scores (increasing by 2.50 points, p < 0.001). The study questionnaire showed agreement or strong agreement that non-technical course objectives had been achieved, and the analysis of focus group transcripts identified five themes involving communication, teamwork, leadership, value and realism, and professional roles. Both student groups reported specific insights into the skills and roles of each other. Nursing students were identified by medical students as better at drawing up drugs, setting up intravenous drips, and keeping records. Nursing students identified medical students as better at diagnosis, patient care planning, and intervention tasks such as needle insertion during pneumothorax. Both groups reported that such insights would not have occurred during uniprofessional simulation, felt that the course better prepared them for work in the clinical context, and agreed that more undergraduate interprofessional teaching using simulation should occur. Our results were instrumental in the adoption of the interprofessional ACLS course as a permanent part of our university’s undergraduate curriculum.

This is a preview of subscription content, access via your institution.


  1. 1.

    Manser T. Teamwork and patient safety in dynamic domains of healthcare: a review of the literature. Acta Anaesthesiol Scand. 2009;53(2):143–51.

    Article  Google Scholar 

  2. 2.

    Thistlethwaite J. Interprofessional education: a review of context, learning and the research agenda. Med Educ. 2012;46(1):58–70.

    Article  Google Scholar 

  3. 3.

    Oates M, Davidson MA. Critical appraisal of instruments to measure outcomes of interprofessional education. Med Educ. 2015;49(4):386–98.

    Article  Google Scholar 

  4. 4.

    Weller JM, Barrow M, Gasquoine S. Interprofessional collaboration among junior doctors and nurses in the hospital setting. Med Educ. 2011;45(5):478–87.

    Article  Google Scholar 

  5. 5.

    Bondoc S, Wall T. Interprofessional educational experience to assist in student readiness toward neurorehabilitation. Occup Ther Health Care. 2015;29(2):153–64.

    Article  Google Scholar 

  6. 6.

    Kohn LT, Corrigan JM, Donaldson MS. To err is human: building a safer health system. Washington: National Academy Press; 1999.

    Google Scholar 

  7. 7.

    Reid R, Bruce D, Allstaff K, McLernon D. Validating the readiness for Interprofessional learning scale (RIPLS) in the postgraduate context: are health care professionals ready for IPL? Med Educ. 2006;40(5):415–22.

    Article  Google Scholar 

  8. 8.

    Reeves S, Lewin S, Espin S, Zwarenstein M. Interprofessional teamwork for health and social care. Singapore: Wiley-Blackwell; 2010.

    Google Scholar 

  9. 9.

    Weller JM, Frengley R, Torrie J, Webster CS, Tomlinson S, Henderson K. Change in attitudes and performance of critical care teams after a multi-disciplinary simulation-based intervention. Int J Med Educ. 2012;3:124–31.

    Article  Google Scholar 

  10. 10.

    Hammick M, Freeth D, Koppel I, Reeves S, Barr HA. Best evidence systematic review of interprofessional education: BEME guide no. 9. Med Teach. 2007;29(8):735–51.

    Article  Google Scholar 

  11. 11.

    Buckley S, Hensman M, Thomas S, Dudley R, Nevin G, Coleman J. Developing interprofessional simulation in the undergraduate setting: experience with five different professional groups. J Interprof Care. 2012;26(5):362–9.

    Article  Google Scholar 

  12. 12.

    Thistlethwaite J, Moran M. Learning outcomes for interprofessional education (IPE): literature review and synthesis. J Interprof Care. 2010;24(5):503–13.

    Article  Google Scholar 

  13. 13.

    Palaganas JC, Brunette V, Winslow B. Prelicensure simulation-enhanced Interprofessional education: a critical review of the research literature. Simul Healthc. 2016;11(6):404–18.

    Article  Google Scholar 

  14. 14.

    Parsell G, Bligh J. The development of a questionnaire to assess the readiness of health care students for interprofessional learning (RIPLS). Med Educ. 1999;33(2):95–100.

    Article  Google Scholar 

  15. 15.

    McFadyen AK, Webster V, Strachan K, Figgins E, Brown H, McKechnie J. The readiness for Interprofessional learning scale: a possible more stable sub-scale model for the original version of RIPLS. J Interprof Care. 2005;19(6):595–603.

    Article  Google Scholar 

  16. 16.

    Norman G. Likert scales, levels of measurement and the “laws” of statistics. Adv Health Sci Educ Theory Pract. 2010;15(5):625–32.

    Article  Google Scholar 

  17. 17.

    Saldaña J. The coding manual for qualitative researchers. London: Sage; 2013.

    Google Scholar 

  18. 18.

    Thomas DR. A general inductive approach for analysing qualitative evaluation data. Am J Eval. 2006;27(2):237–46.

  19. 19.

    Hertweck ML, Hawkins SR, Bednarek ML, Goreczny AJ, Schreiber JL, Sterrett SE. Attitudes toward interprofessional education: comparing physician assistant and other health care professions students. J Physician Assist Educ. 2012;23(2):8–15.

    Article  Google Scholar 

  20. 20.

    Hood K, Cant R, Baulch J, Gilbee A, Leech M, Anderson A, et al. Prior experience of interprofessional learning enhances undergraduate nursing and healthcare students’ professional identity and attitudes to teamwork. Nurse Educ Pract. 2014;14(2):117–22.

    Article  Google Scholar 

  21. 21.

    Bradley P, Cooper S, Duncan FA. Mixed-methods study of interprofessional learning of resuscitation skills. Med Educ. 2009;43(9):912–22.

    Article  Google Scholar 

  22. 22.

    Lapkin S, Levett-Jones T, Gilligan C. The effectiveness of interprofessional education in university-based health professional programs: a systematic review. JBI Libr Syst Rev. 2011;9(46):1917–70.

    Google Scholar 

  23. 23.

    Yu T-C, Webster CS, Weller JM. Simulation in the medical undergraduate curriculum to promote interprofessional collaboration for acute care: a systematic review. BMJ Sim Tech Enhanced Learning. 2016;2:90–6.

    Article  Google Scholar 

  24. 24.

    Dreier-Wolfgramm A, Homeyer S, Beyer A, Kirschner S, Oppermann RF, Hoffmann W. Impact of interprofessional education for medical and nursing students using simulation training and a training ward: a German pilot study. J Health Educ Res Dev. 2016;4(04):200.

    Google Scholar 

  25. 25.

    Thannhauser J, Russell-Mayhew S, Scott C. Measures of interprofessional education and collaboration. J Interprof Care. 2010;24(4):336–49.

    Article  Google Scholar 

  26. 26.

    Coster S, Norman I, Murrells T, Kitchen S, Meerabeau E, Sooboodoo E, et al. Interprofessional attitudes amongst undergraduate students in the health professions: a longitudinal questionnaire survey. Int J Nurs Stud. 2008;45(11):1667–81.

    Article  Google Scholar 

  27. 27.

    Wilhelmsson M, Ponzer S, Dahlgren L, Timpka T, Faresjö T. Are female students in general and nursing students more ready for teamwork and interprofessional collaboration in healthcare? BMC Med Educ. 2011;11(1):15. Available from

    Article  Google Scholar 

  28. 28.

    Horsburgh M, Lamdin R, Williamson E. Multiprofessional learning: the attitudes of medical, nursing and pharmacy students to shared learning. Med Educ. 2001;35(9):876–83.

    Article  Google Scholar 

  29. 29.

    Horsburgh M, Perkins R, Coyle B, Degeling P. The professional subcultures of students entering medicine, nursing and pharmacy programmes. J Interprof Care. 2006;20(4):425–31.

    Article  Google Scholar 

  30. 30.

    Kozmenko V, Johnson Bye E, Simanton E, Lindemann J, Schellpfeffer SE. The optimal time to institute interprofessional education in the medical school curriculum. Med Sci Educ. 2017;27(2):259–66.

    Article  Google Scholar 

  31. 31.

    Gunaldo TP, Andrieu SC, Garbee D, Giovingo LK, Mercante DE, Tortu S, et al. Student perceptions about interprofessional education after an elective course. J Interprof Care. 2015;29(4):370–1.

    Article  Google Scholar 

  32. 32.

    Williams B, Boyle M, Brightwell R, McCall M, McMullen P, Munro G, et al. A cross-sectional study of paramedics' readiness for interprofessional learning and cooperation: results from five universities. Nurse Educ Today. 2013;33(11):1369–75.

    Article  Google Scholar 

  33. 33.

    Merry AF, Weller JM. Teamwork and minimizing error. In: Alston RP, Myles PS, Ranucci M, editors. Oxford textbook of cardiothoracic anaesthesia. Oxford: Oxford University Press; 2015.

    Google Scholar 

  34. 34.

    Gunaldo TP, Mangum SW. Providing interprofessional continuing education promotes continuing competence in health providers. Med Sci Educ. 2013;23(S3):559–61.

    Article  Google Scholar 

  35. 35.

    Virant-Young D, Forrest K, McCaskey S, Smith C, Saadeh C, Gudakunst J, et al. Faculty development in interprofessional education—designing and implementing a successful program. Med Sci Educ. 2014;24(4):401–7.

    Article  Google Scholar 

  36. 36.

    Acquavita SP, Lewis MA, Aparicio E, Pecukonis E. Student perspectives on interprofessional education and experiences. J Allied Health. 2014;43(2):e31–6.

    Google Scholar 

Download references


We would like to thank the following people from the University of Auckland, New Zealand, for their support and assistance: Warwick Bagg, Head of the Medical Programme; Abbey Gundesen and Brenda Knowles from the Simulation Centre for Patient Safety; Heather Baker, Dianne Marshall, Deborah Somerville, Michelle Adams, and Michael Crossan from the School of Nursing; and Tim Skinner, Simon Mitchell, and Jonathon Webber from the Department of Anaesthesiology. Thank you also to Carmen Skilton (CS) for conducting the independent check of our data by re-coding a subset of focus group transcripts, and to Tanisha Jowsey for assistance with the qualitative analysis.

Author information



Corresponding author

Correspondence to Craig S. Webster.

Ethics declarations

This study was approved by the University of Auckland Human Participants Ethics Committee (reference 9073). All participants gave written informed consent.

Conflict of Interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Webster, C.S., Hallett, C., Torrie, J. et al. Advanced Cardiac Life Support Training in Interprofessional Teams of Undergraduate Nursing and Medical Students Using Mannequin-Based Simulation. Med.Sci.Educ. 28, 155–163 (2018).

Download citation


  • Undergraduate education
  • Interprofessional learning
  • Life support training
  • Simulation
  • Nursing and medical students
  • Mixed-methods evidence