From learning to practice: A theory-informed qualitative study of why interprofessional collaboration remains difficult to enact

INTRODUCTION: Interprofessional collaboration (IPC) is essential for high-quality, integrated care, and interprofessional education (IPE) aims to prepare future health professionals for collaborative practice. However, positive educational experiences and attitudes towards teamwork do not necessarily translate into collaboration in clinical practice. A theory-informed understanding of the determinants shaping this translation is needed to better align interprofessional learning with the realities of healthcare practice. We explore the determinants of IPC among senior health professions students and recent graduates using a theory-informed qualitative approach. METHODS: This qualitative study formed the first phase of a sequential mixed-methods project. Eight focus group discussions were conducted with 37 senior students and recent graduates from medicine, pharmacy, dental medicine, and health sciences at Qatar University. Data were analysed using a hybrid deductive-inductive thematic analysis, with codes mapped to the Theoretical Domains Framework (TDF) and iteratively refined into higher-order themes. RESULTS: Nine themes were identified across seven TDF domains, represented through six analytic groupings, with Knowledge and Skills combined for reporting. Participants generally expressed positive intentions towards collaboration, but IPC in practice was constrained by hierarchical relationships, unclear professional roles, limited opportunities to collaborate, and inconsistent reinforcement. Participants described closer collaboration in high-acuity settings, whereas hierarchical norms appeared more pronounced in lower-complexity settings. Facilitators and preceptors were perceived as influential in reinforcing or discouraging collaborative behaviour. DISCUSSION: IPC is shaped by interacting individual, social, and environmental determinants. Although prelicensure IPE can foster readiness for collaboration, participants may struggle to enact this learning when educational preparation does not reflect practice realities. Strengthening IPC requires alignment between curriculum design, assessment, faculty development, and clinical practice environments, alongside continued interprofessional learning beyond qualification.