The Gordian Knot That Is Patient and Public Involvement in Interprofessional Education

The combination of patient and public involvement (PPI) and interprofessional education (IPE) is promising to help students delineate roles based on real patients' needs; however, their integration in practice remains limited. Although the individual concepts have been studied, little is known about how stakeholders perceive PPI in IPE, leaving gaps in designing effective educational strategies. Therefore, this study aims to explore the experiences and perspectives of key stakeholders - students, academic staff members, and patient representatives - on the feasibility, (intended) learning outcomes, and requirements for the successful implementation of PPI in IPE in undergraduate healthcare education.

We qualitatively explored the experiences and perspectives of each stakeholder group in separate focus groups. In total, 15 focus groups were conducted across four European countries, involving 27 academic staff members, 27 students, and 24 patient representatives, all with diverse backgrounds. Data were analyzed using thematic analysis.

Themes were structured by organizational levels within educational institutions to optimize uptake in practice. As for strategic considerations (align), participants noted compounded organizational complexity, which may lead to inertia - especially without institutional support. At the same time, PPI in IPE should be valued equally compared to biomedical subjects. With respect to educational design considerations, PPI in IPE helped students bridge theory and practice and decreased hierarchy. Lastly, regarding operational considerations (execute), the compounding complexity of organizing patient involvement in interprofessional education also holds true for facilitating it, as facilitators must role-model both person-centered communication and interprofessional collaboration. According to participants, learning from PPI in IPE is about unifying what cannot be separated.

Despite strong rhetorical endorsement, a lack of institutional support persists. Our findings suggest PPI in IPE as a powerful means of addressing epistemic injustice by promoting epistemic symmetry between future professionals and patients, reducing interprofessional hierarchies, and grounding interprofessional learning in real-world experiences. Strategic use of these levers may unlock the necessary institutional resources, acting as Alexander's sword to overcome barriers and ultimately slice through the Gordian knot.