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NURS FPX 6030 Assessment 2 Problem Statement (PICOT)

NURS FPX 6030 Assessment 2 Problem Statement (PICOT)

Name

Capella university

NURS-FPX 6030 MSN Practicum and Capstone

Prof. Name

Date

Problem Statement (PICOT)

The NCLEX, an acronym for the National Council Licensure Examination, is developed for nursing graduates in the United States and Canada to successfully pass the computerized test to receive a license for practicing in clinical areas as Practical Nurses (PN) or Registered Nurses (RN). The NCLEX-PN/RN is a test to measure the essential competencies of newly graduated nurses to provide safe and effective care in patient care areas. For this purpose, organizations continuously strive to improve their learning strategies and processes. This assessment investigates the details of a problem statement using the PICOT approach: “Does a blended learning approach to LPN education, compared to a traditional in-person program, lead to improved NCLEX pass rates over 12 months.” 

 Need Assessment 

Improving the passing rates of the NCLEX exam among LPN students is the pivotal need that this project revolves around. Specifically, the project is investigating if a blended learning approach (a combination of both online and classroom learning modalities) will be valuable compared to traditional classroom learning to improve the performance of concerned students in passing their licensure exams. There are several reasons behind the importance of clearing NCLEX for nursing students; these include ensuring patient safety and expanding the healthcare workforce.

Licensed practice nurses (LPNs) play a crucial role in healthcare by providing direct care to the patients at the frontline and maintaining patient safety (Vaismoradi et al., 2020). Their competency is indicated through the NCLEX passing rates. Furthermore, high NCLEX passing rates will eventually expand the frontline workforce, addressing nursing shortages nationwide. Thus, there is a pressing need to improve NCLEX pass rates using different educational modalities. 

Assumptions of Analysis

This need assessment analysis is based on the assumption that NCLEX is vital for nurses in clinical areas. This assumption is observed in most nursing schools where the administration strives to improve NCLEX pass rates for first-timers. A study also supports this assumption, explaining that NCLEX pass rates ensure that nurses are competent in their knowledge of nursing practices, and it helps to maintain patient safety and improve the quality of care. Lastly, it indicates that educational programs are effective, and further resources should be invested to introduce other educational modalities to enhance the licensure exam passing rates (Loftin et al., 2020). 

Population and Setting 

Through this capstone project, I will target LPN students presently enrolled in nursing education programs. The goal is to apply the intervention (blended learning) to observe the passing rates of NCLEX for 12 months. Career growth and development is one reason that signifies the need to improve the licensure exam passing rates within my project population. Since LPN students are future healthcare providers, completing and passing licensure exams is necessary. If proven to be an effective learning approach, blended learning will help the targeted population become qualified and licensed to provide care, which is essential for their career growth and development.

Moreover, there is diversity among the LPN students from different backgrounds and working in various sectors. Such diversity advocates the need for a blended learning approach where education and curriculum are tailored to individual needs. Simultaneously, the targeted setting in this capstone project is Chippewa Valley Technical College (CVTC), where a one-year Practical Nursing (LPN) diploma program is established. This program helps students learn basic nursing skills to help and support other healthcare providers (physicians, nurses, and nurse practitioners) in healthcare settings.

The delivery method of this program is face-to-face; thus, a blended learning approach is planned to be introduced in the college through this capstone project. Since LPN programs are developed to prepare students to work in patient care areas, increasing licensure exam passing rates is imperative. Addressing the need through our proposed intervention is significant to identify the quality of the education, consequently preparing nurses for providing safe and effective care. Moreover, high NCLEX passing rates are essential for the organization to seek accreditation and retain a positive reputation. 

Quality Improvement Method

The quality improvement method used in our project is the PDSA (plan-do-study-act) cycle, also called Deming’s cycle. It is a four-stage, repetitive QI method focusing on continuous progress in quality improvement projects (Chen et al., 2021). In our project’s “planning” phase, we will select a batch of nursing students who will act as an interventional group. Further, we will identify the need to address NCLEX exam rates by analyzing test pass rates in the past three years and a short and long-term goal is decided; for instance, the goal of our project is to improve NCLEX passing rates by 20% within the first six months and by 50% at the end of the year.

 

In the “doing” stage, the planned intervention (blended learning approach) is implemented. After implementation, pre- and post-intervention passing rates will be assessed in the “studying” phase, along with gathering feedback from faculty and students on our intervention. In the last stage (acting phase), the continuous improvement process will begin by analyzing the results. The approach will be scaled up on positive results, and further improvements will be made on receiving negative results. 

Potential Challenges 

There are some potential challenges that I observed in my concerned population and setting. Students of LPN programs need more access to technology and need to be educated about digital utilization. These challenges are eventually hindering their learning process. Another challenge is time consumption, explicitly affecting the faculty of Chippewa Valley Technical College. A study claims that creating blended learning modules and courses is more time-consuming than creating face-to-face interaction (Alvarez Jr, 2020). The challenges I observed in the project setting are related to technical problems like poor connectivity and lack of resources. These are disrupting the effectiveness of learning and development. To address these challenges, it is imperative to ensure adequate resources, student and faculty training, improvising technological infrastructure in the organization, and allocating incentives for faculty on their extra efforts. 

Intervention Overview

Several educational interventions can be applied to improve the NCLEX passing rates. However, our project focuses on using a blended learning approach to address the identified need among LPN students at CVT College. I would use the “flipped classroom model,” where students will be engaged through online courses before attending in-person classes for the central part of their education. Along with this, the curriculum would include weekly online modules, biweekly online quiz completions, and online simulatory learning per month. The flipped classroom model improves the quality of education as it promotes in-class active learning.

This exercise helps gauge student’s engagement and prepares them for critical thinking and problem-solving abilities. Such an approach is essential for students to pass NCLEX exams successfully. Similarly, blended learning provides flexible learning times and develops skills for independent study (Shang & Liu, 2018), which is why it is the best fit for LPN students due to their diverse schedules and responsibilities. Moreover, it is an appropriate intervention for CVT College as the faculty and administration are always welcoming to improving the quality of their education. However, there are some weaknesses in the flipped classroom model that require attention.

Since the flipped classroom model is a blended approach, it requires the availability of technological resources. Organizations with limited technological infrastructure and limited investment finances may have difficulty in implementing. Another weakness of the flipped classroom model is learners’ ability to utilize these blended teaching methods effectively. Limited accessibility and digital illiteracy may act as the weaknesses of the blended learning approach; therefore, assessing students’ readiness to change and tailoring the program according to their preferences is imperative. Additionally, a budget must be allocated for adequate technological resources within the campus that students can utilize for learning purposes. 

Comparison of Approaches 

Alternative approaches to education that can directly or indirectly impact the need of the project (improving NCLEX passing rates) are interprofessional education and clinical preceptorships. The interprofessional approaches are significant to achieve our project outcomes. The comparison of the approaches is presented as follows: 

  • Interprofessional Education (IPE): When learning together, students from various healthcare backgrounds, such as nursing, medicine, and pharmacy, can foster a collaborative environment and improve healthcare practices in clinical areas (Zechariah et al., 2019). Compared to the flipped classroom model, this approach will encourage LPN students to connect with students from other domains and expose them to diverse perspectives and skills, enabling them to perform interprofessional care. However, IPE does not have a direct impact on NCLEX passing rates as a flipped classroom model. Yet, the positives of the IPE are that it will motivate the students to perform well in their licensure exams to provide efficient care to the patients in clinical areas. On the other hand, there are some weaknesses of this approach. Firstly, conducting IPE can be resource-intensive and may become inappropriate for organizations with limited resources, such as our project setting. Secondly, analyzing the effects of IPE on NCLEX pass rates is a complicated process, as there is an indirect impact of the approach on NCLEX rates. Thus, there is a need to address these weaknesses before applying the alternative approach.

NURS FPX 6030 Assessment 2 Problem Statement (PICOT)

  • Clinical Preceptorships: The relationship of preceptee and preceptor in clinical areas is an effective method of learning and education for nursing students. These preceptorships expose students to real healthcare settings and interprofessional teams, enabling them to observe and participate in care. The experience helps nursing students enhance their proficiencies in nursing skills and practices to contribute to patient care. It is an appropriate approach for CVT College as the institution already arranges clinical mentorships for nursing students. Thus, the learning modality is already in place in the organization. Literature supports clinical preceptorships as it helps to expand practical wisdom among nurses, eventually improving NCLEX pass rates as this approach enhances practical skills and helps nursing students learn from the experiences of their preceptors, directly contributing to their readiness for the NCLEX and their ability to provide safe and effective patient care (Dube & Rakhudu, 2021). However, the weakness of this approach is the need for more support from faculty members. An article presents that some faculty may need more support in clinical areas, become negligent, and not supervise their students. This disconnection of educational settings with clinical areas may lead to a disruption in students’ learning outcomes (Mhango et al., 2021). 

While both approaches are supported by literature, they are different from blended learning, as the primary target of our intervention is to improve NCLEX pass rates. Comparatively, these learning modalities focus on enhancing teamwork and interprofessional collaboration. This will not directly but indirectly impact NCLEX passing rates. Thus, assessing the project setting, infrastructure, and stakeholders’ readiness to adapt to the changes is imperative before implementing the interventions. 

Initial Outcome Draft 

The outcome that I want to achieve through this project is to increase the percentage of NCLEX passing rates among LPN students within 12 months. Enhancing students’ learning, education process, and readiness to pass NCLEX is directly interlinked with our outcome and intervention’s goal. By increasing the number of students passing their licensure exam, the project aims to determine the effectiveness of blended learning in improving LPN students’ academic performance, confidence, and knowledge. The criteria to evaluate the achievement of outcomes is based on the seamless transition of LPN students into their roles as practical nurses. Consequently, the results of the NCLEX passing rates, the quality of safe and efficient patient care, and patient satisfaction levels will be evaluated using several evaluation methods such as interviewing and feedback of students and faculty, questionnaires and surveys, analyzing dashboard metrics within the organization, patient feedback and data analysis on improved outcomes using Electronic Health Records System (EHR).

Time Estimate 

The estimated time for intervention development would range from 3 to 6 months. This time is needed to design the course, develop an application, and prepare resources for PBLs. Thus, it is realistic for the faculty and the organization. However, particular challenges may hinder the smooth processes. They may extend the timeline by securing necessary funds and resources, coordinating with the faculty to schedule their extra responsibilities, and aligning with the educational regulatory requirements.

On the other hand, an estimated time frame for implementation can vary between 6 months to a year. This includes the rollout of the blended learning modalities, training for faculty, and overcoming students’ limited access and knowledge about technological mediums. During the implementation phase, a one-year record of NCLEX passing rates will be analyzed to find an answer to our PICOT question. However, some uncertainties of project implementation that can impact the time frame are the faculty and students’ readiness to change, unavailability of resources at the required time, and unforeseen situations such as technological issues, resource constraints, and lack of support from leadership. These may exceed the timeline and would require urgent addressing. 

Literature Review 

Several studies in the literature are focused on advocating for the need to improve NCLEX passing rates among nursing students. 

    • An article by Hanson-Zalot et al. (2019), presents a recent decline of 7% in NCLEX passing rates for first-timers. This significant decline encourages organizations to modify their education curriculum and delivery methods to improve the statistics of students passing NCLEX. This article discusses the challenges students face during the exam and how important it is for faculty to provide support and resources. This information is relevant to my project to improve NCLEX exam rates in LPN students because it provides insights into how nursing schools can help their students succeed. For example, the article suggests nursing schools can provide students access to practice questions and review courses through online mediums. Such a strategy is connected to our project of introducing a blended learning approach. 
    • Another study by Cosper et al. (2023), found that academic factors (such as GPA and exam scores) and non-academic factors (poor study skills, personal matters, prioritizing studies, and unexpected job demands) play a role in NCLEX-RN success. These findings highlighted the importance of modification in curriculum, test methods, instruction methods, and teachers’ support. This study is connected to my project as it provides an understanding of the factors contributing to success on the NCLEX-RN exam, which can be used to develop targeted interventions to support LPN students. Moreover, it explains the importance of a blended learning approach to alleviate the effect of non-academic factors. 
    • A study explains the effectiveness of a blended learning approach to address some factors that may impact nursing students’ efficiency in learning. The study demonstrates that the blended learning approach provides flexible learning times, where students can arrange their schedules according to their responsibilities. It also develops skills for independent research, improving their understanding and knowledge according to their pace (Shang & Liu, 2018). Such an approach enhances understanding of the curriculum and eventually increases exam passing rates. Since the study is about blended learning and its effectiveness in nursing education, it is connected to the primary intervention of my project. 
    • Almasloukh et al. (2023), review several studies to conclude that it is imperative to improve NCLEX success rate among nursing students through modifying educational strategies. They suggested some strategies, out of which one that is relevant to my project is simulation as an active learning strategy. This strategy encourages students to engage with the curriculum in a meaningful and practical way rather than simply memorizing it. The blended learning approach planned to be introduced through this project has similar benefits. Thus, the study and the information outsourced from this study are essential for the project

      NURS FPX 6030 Assessment 2 Problem Statement (PICOT) 

  • Another research article by Shatto et al. (2019), examines the effectiveness of active learning methods in improving student performance on the NCLEX-RN. Initially, the article presents the importance of enhancing NCLEX success rate, followed by explaining the efficiency of active learning, which is mainly about switching from traditional to student-focused learning methods. These include blended learning, problem-based learning, case studies, and simulation. This article is related to my project as it provides a comprehensive understanding of the need identified within the project and the targeted intervention proposed. Insights from this article helped in developing effective interventions. 
  • Another study explains that since nursing education is full of complexities, utilizing a blended learning approach through online modules and simulations have effectively improved student outcomes and interaction with the learning management systems (Sáiz-Manzanares et al., 2020). This study is beneficial for my project as it advocates for utilizing a blended learning approach within the course to improve student learning outcomes and critical thinking ability, which is an essential aspect of NCLEX, as the exam is based on testing critical thinking and manipulations rather than memorized content. 
  • A review article by McNally et al. (2019), highlighted the importance of supporting diversity in nursing education. It emphasized the need to make ongoing efforts to help students from different backgrounds (social, economic, cultural, and occupational) to be part of nursing schools. My project also caters to the population of LPN students from various backgrounds and occupational settings. Therefore, this review article supports my project’s target population. 

NURS FPX 6030 Assessment 2 Problem Statement (PICOT)

  • A study examines the effectiveness of the online flipped classroom model, stating that the model has been effective, especially in COVID, for remote studying. This model has resulted in higher pass rates similar to the traditional teaching method, with some limitations (Du et al., 2023). This article is related to my project as the model is student-centered, so it can improve student outcomes, including NCLEX pass rates. Moreover, the flipped classroom model gives leverage for students to study at their own pace, regardless of their multiple commitments. 
  • A systematic review by Özbay and Çınar (2021), presents the effectiveness of flipped classroom teaching methods in nursing education. The review found that such methods are essential to improve or maintain academic performance, enhance student satisfaction, and augment their clinical skills and capabilities. This article is connected to my project to improve NCLEX success rates, as the interest of educators is to improve student performance, which is one of the outcomes of flipped classrooms, as per the review. Secondly, the critical success measure of NCLEX pass rates is enhanced clinical competencies, another significant outcome of the flipped classroom model as per the review. Thus, this review is helpful in the development of my interventional plan. 
  • Another article that supports the impact of flipped classrooms presents some other outcomes of this teaching methodology. It mentions that along with improved academic performance, the flipped classroom model is impactful for increasing problem-solving and critical thinking abilities (Lelean & Edwards, 2020). Such outcomes are essential for my project as one of the purposes of the NCLEX exam is to test students’ ability to solve clinical issues using critical thinking. This article is vital for my project as it supports both the need addressed and the intervention planned. 

NURS FPX 6030 Assessment 2 Problem Statement (PICOT)

My PICOT project is supported by credible evidence. The relevance, credibility, and trustworthiness of these pieces of evidence can be assessed using CRAAP criteria – currency, relevance, authority, accuracy, and purpose. The CRAAP criteria are developed for researchers to find authentic resources that fall under the current date of publication (within five years), relevant to the topic of the research, adequately authorized by reliable authors and journals/websites, claims are accurately supported, and the purpose of the study revolves around the purpose of the research (Fielding, 2019). 

Health Policy, Healthcare Technologies, and Other Communications

  • The Title VIII Nursing Workforce Development Act is the policy relevant to our identified need to improve NCLEX passing rates among LPN students. This act is developed to provide adequate funding to organizations providing high-quality nursing education to expand the nursing workforce (Craig & Hewitt, 2020). This act is impacting my identified need as one of the reasons to improve NCLEX passing rates is to bring qualified nurses to clinical areas for safe and effective patient care. Further, the funding resources available under this act can impact my intervention (blended learning) to address the identified need as various blended learning methods can be introduced for LPN students, consequently affecting their NCLEX passing rates. 
  • Simultaneously, Virtual Reality (VR) and Telehealth platforms will impact the blended learning approach in my project as VR devices can be used as a blended learning method to make students practice real-life scenarios and achieve immersive learning experiences (Lange et al., 2020). Furthermore, telehealth platforms could be used in blended learning programs through virtual consultations with expert support from senior clinical nurses. This will help students learn from specialists and get the support they need to succeed in their licensure exams. Additionally, these technological mediums can be used for simulation as part of my intervention plan, which can incorporate student practice skills (Lister et al., 2018). The article explains that telehealth mediums used for simulation help students learn at their own pace, addressing the factors of diverse responsibilities, prioritization issues, different study timings, and geographical barriers. This study is related to my project as the purpose of the project is to improve NCLEX pass rates by integrating blended and self-paced learning approaches.

NURS FPX 6030 Assessment 2 Problem Statement (PICOT)

  • Other communications from NCSBN and the American Association of Colleges of Nursing (AACN) can be utilized for effectively addressing the need to improve NCLEX pass rates. We can integrate the resources published by these bodies, such as the standards of nursing practice and educational material. These resources and accreditation standards can be integrated into blended learning programs to improve the efficacy of education, enhancing licensure exam passing rates and generating a competent workforce for clinical areas. 

However, more information is required related to the analysis. Students’ needs and preferences play a crucial role in designing the educational approach. Thus, addressing this knowledge gap will impact our choice of modalities and may require modifications in education delivery methods. Moreover, the analysis of current technological infrastructure in the organization is essential. This analysis will guide faculty and administrators to either expand the availability of technologies or modify the teaching and learning methods. The information gap about the eligibility of LPN students for the funds provided under the Title VIII Nursing Workforce Development Act. Such information will become a directive to improvise the approach in a way that it can become cost-effective for both the target students as well the target setting. 

Conclusion 

This assessment concludes our PICOT question, where the identified need is to improve NCLEX passing rates among the targeted population of Licensed Practical Nursing students in the targeted setting of Chippewa Valley Technical College. The proposed intervention is a blended learning approach compared to traditional in-person teaching. This intervention will be based on a flipped classroom model, including weekly online modules, biweekly quizzes, and monthly online simulations. The outcome is to increase the number of students passing NCLEX in one year.

Several literature evidence present the importance of the identified need and support the blended learning approach as an effective method in nursing education. Furthermore, the health policy of VIII Nursing Workforce Development Act supports blended learning and NCLEX passing rates through monetary resources. Other technological mediums and standard guidelines can be fused into our interventional plan to accomplish desired outcomes. Overall, the PICOT research aims to improve NCLEX passing rates, subsequently evolving a competent workforce for augmenting quality of care and patient safety. 

References

Almasloukh, K. B., Miner, M., Phillips, K., & Evans, M. (2023). Educational strategies and nursing theory to prepare learners for NCLEX‐RN. Nursing Open, 10(11), 7144–7153. https://doi.org/10.1002/nop2.1998 

Alvarez Jr, A. V. (2020). Learning from the problems and challenges in blended learning: Basis for faculty development and program enhancement. Asian Journal of Distance Education, 15(2), 112–132. https://files.eric.ed.gov/fulltext/EJ1285361.pdf 

Chen, Y., VanderLaan, P. A., & Heher, Y. K. (2021). Using the model for improvement and plan‐do‐study‐act to effect smart change and advance quality. Cancer Cytopathology, 129(1), 9–14. https://doi.org/10.1002/cncy.22319 

Cosper, S. M., Callan, R. S., & Anderson, L. S. (2023). Investigating student and faculty perspectives related to predictors of NCLEX-RN success: A mixed methods approach. Teaching and Learning in Nursing, 18(3), 360–365. https://doi.org/10.1016/j.teln.2023.02.002 

NURS FPX 6030 Assessment 2 Problem Statement (PICOT)

Craig, G., & Hewitt, S. (2020). Federal legislative agenda: ANA focuses on key workplace and workforce issues. American Nurse Journal, 15(3), 34–36. https://go.gale.com/ps/i.do?p=AONE&sw=w&issn=19305583&v=2.1&it=r&id=GALE%7CA623791393&sid=googleScholar&linkaccess=abs 

Du, J., Chen, X., Wang, T., Zhao, J., & Li, K. (2023). The effectiveness of the fully online flipped classroom for nursing undergraduates during the COVID‐19: Historical control study. Nursing Open, 10(8), 5766–5776. https://doi.org/10.1002/nop2.1757 

Dube, A., & Rakhudu, M. A. (2021). A preceptorship model to facilitate clinical nursing education in health training institutions in Botswana. Curationis, 44(1), 2182. https://doi.org/10.4102/curationis.v44i1.2182 

Fielding, J. A. (2019). Rethinking CRAAP: Getting students thinking like fact-checkers in evaluating web sources. College & Amp; Research Libraries News, 80(11), 620. https://doi.org/10.5860/crln.80.11.620

Hanson-Zalot, M., Gerolamo, A., & Ward, J. (2019). The voices of graduates: Informing faculty practices to establish best practices for readying NCLEX-RN applicants. Open Journal of Nursing, 9(2), 125–136. https://doi.org/10.4236/ojn.2019.9201 

Lange, A.-K., Koch, J., Beck, A., Neugebauer, T., Watzema, F., Wrona, K. J., & Dockweiler, C. (2020). Learning with virtual reality in nursing education: Qualitative interview study among nursing students using the unified theory of acceptance and use of technology model. JMIR Nursing, 3(1), e20249. https://doi.org/10.2196/20249

Lelean, H., & Edwards, F. (2020). The impact of flipped classrooms in nurse education: A literature review. Waikato Journal of Education, 25, 145–157. https://doi.org/10.15663/wje.v25i0.735 

Lister, M., Vaughn, J., Brennan-Cook, J., Molloy, M., Kuszajewski, M., & Shaw, R. J. (2018). Telehealth and telenursing using simulation for pre-licensure USA students. Nurse Education in Practice, 29, 59–63. https://doi.org/10.1016/j.nepr.2017.10.031

NURS FPX 6030 Assessment 2 Problem Statement (PICOT)

Loftin, C., Reyes, H., Hartin, V., & Rice, L. (2020). A closer look at first-time pass rates as the primary measure of program quality. Journal of Professional Nursing, 36(6), 707–711. https://doi.org/10.1016/j.profnurs.2020.09.011 

McNally, K., Metcalfe, S. E., & Whichello, R. (2019). Interventions to support diversity in nursing education. Journal of Nursing Education, 58(11), 641–646. https://doi.org/10.3928/01484834-20191021-05 

Mhango, L., Baluwa, M., & Chirwa, E. (2021). The challenges of precepting undergraduate nursing students in Malawi. Advances in Medical Education and Practice, 12, 557–563. https://doi.org/10.2147/AMEP.S306661 

Özbay, Ö., & Çınar, S. (2021). Effectiveness of flipped classroom teaching models in nursing education: A systematic review. Nurse Education Today, 102, 104922. https://doi.org/10.1016/j.nedt.2021.104922 

Sáiz-Manzanares, M. C., Escolar-Llamazares, M.-C., & Arnaiz González, Á. (2020). Effectiveness of blended learning in nursing education. International Journal of Environmental Research and Public Health, 17(5), 1589. https://doi.org/10.3390/ijerph17051589 

Shang, F., & Liu, C-Y. (2018). Blended learning in medical physiology improves nursing students’ study efficiency. Advances in Physiology Education, 42(4), 711–717. https://doi.org/10.1152/advan.00021.2018 

Shatto, B., Shagavah, A., Krieger, M., Lutz, L., Duncan, C. E., & Wagner, E. K. (2019). Active learning outcomes on nclex-rn or standardized predictor examinations: An integrative review. Journal of Nursing Education, 58(1), 42–46. https://doi.org/10.3928/01484834-20190103-07 

Vaismoradi, M., Tella, S., A. Logan, P., Khakurel, J., & Vizcaya-Moreno, F. (2020). Nurses’ adherence to patient safety principles: A systematic review. International Journal of Environmental Research and Public Health, 17(6), 2028. https://doi.org/10.3390/ijerph17062028 

Zechariah, S., Ansa, B. E., Johnson, S. W., Gates, A. M., & Leo, G. D. (2019). Interprofessional education and collaboration in healthcare: An exploratory study of the perspectives of medical students in the United States. Healthcare, 7(4), 117. https://doi.org/10.3390/healthcare7040117 

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