Modeling interprofessional collaboration: an instrumental case study of interprofessional co-facilitation in simulation-based team training

Interprofessional simulation-based team training (ISBTT) aims to improve collaboration and teamwork in healthcare. Ideally, ISBTT sessions are co-facilitated by facilitators with different professional backgrounds who model collaborative behaviors for learners. However, co-facilitation is uncommon, and guidelines for preparing facilitators are limited. This instrumental case study examined how implementing structured guidelines for interprofessional co-facilitation in a preexisting ISBTT program influenced interactions between physician and nurse facilitators, using observations of ISBTT sessions and interviews with facilitators. Prior to guideline implementation, physician facilitators dominated the conversation while nurse facilitators were hesitant to contribute. After implementation, physician and nurses routinely co-facilitated sessions, valued each other's contributions, and endorsed benefits of interprofessional co-facilitation. Some physician facilitators continued to dominate the conversation, especially with nurse co-facilitators who were less experienced or felt uncertain about the guidelines. In those situations, nurse facilitators tended to defer to physicians, thereby enabling physician dominance. These findings suggest that interprofessional co-facilitation is feasible and can enhance modeling of collaborative practice but sustaining it may require ongoing facilitator support and additional strategies to address entrenched hierarchies.