Determinants of Health Professions Students' Engagement with Interprofessional Education: A Theory-Informed Systematic Review Using the Theoretical Domains Framework.

内容摘要

Engagement with interprofessional education (IPE) is essential to prepare health professions students for collaborative practice, yet the behavioral determinants shaping students' active participation remain insufficiently understood. This review conceptualizes engagement as a proximal behavioral construct reflecting students' cognitive, affective, and behavioral involvement in IPE activities. We employed the Theoretical Domains Framework (TDF) as it synthesizes behavior-change constructs into modifiable domains, enabling systematic identification of determinants and theory-informed targets for intervention. We searched six databases (PubMed®, Medline®, EMBASE®, CINAHL®, ProQuest®, and ERIC) for articles published between January 2010 and October 2024, with updates conducted to January 2026. Two reviewers independently screened studies, extracted data, and assessed methodological quality using the Crowe Critical Appraisal Tool. We synthesized reported enablers and barriers influencing student engagement using deductive content analysis and mapped them to TDF domains. We included 30 studies. We identified determinants of student engagement with IPE across 12 of the 14 TDF domains. The most commonly identified enabler was Social/Professional Role and Identity, particularly through role clarification, understanding of professional responsibilities, and recognition of complementary contributions within teams. Other frequently represented enablers included Environmental Context and Resources (e.g., structured clinical exposure, immersive placements, simulation, and repeated opportunities for interaction), Social Influences (e.g., facilitator support, peer relatedness, mentoring, and encouragement), Knowledge, Skills, Beliefs about Consequences, and Beliefs about Capabilities. We mapped barriers to nine TDF domains, with Social Influences emerging as the most common barrier, particularly through hierarchy, dominance of some professional groups, isolation, and lack of authority to speak up. Other common barriers included Environmental Context and Resources (e.g., limited time, scheduling conflicts, short placement duration, and workload pressures), Emotions (e.g., anxiety, defensiveness, and embarrassment), Knowledge (e.g., unclear expectations and limited understanding of other professional roles), and Beliefs about Capabilities (e.g., low self-confidence in contributing to interprofessional discussions). Student engagement with IPE is shaped by modifiable cognitive, affective, and contextual determinants. Mapping these influences through the TDF clarifies the behavioral mechanisms underpinning engagement and identifies theory-informed targets for the design and delivery of IPE interventions.