Promoting Speaking Up Through Interprofessional Identity Triggers in a Mixed-Profession Simulation Scenario: Two Group Double-Blinded Pre-Test-Only Design.

Background: Speaking up can manifest in various forms, such as raising concerns or sharing ideas. While conceptual overlap exists within its behavioural dimensions, distinctions remain, including context-dependent social risks. Regarding the assurance of quality and safety in patient care, speaking up is paramount, particularly in mixed-profession groups. Speaking up requires specific competencies and depends on individuals' motivation to do so. Interprofessional identity (IPI) is a specific source of intrinsic motivation for interprofessional collaboration (IPC). Little is known about its relationship with speaking up. This study aims to investigate whether conversational topics act as triggers of IPI affecting speaking-up behaviour, and whether the strength of their influence varies across different conversational topics. Methods: Participants of this study were 41 dental bachelor and 43 dental hygiene students. IPI was measured using the Extended Professional Identity Scale (EPIS) eight weeks prior to a simulation session (not a training). Students were assigned into weak or strong identity conditions based on EPIS scores. Small mixed-profession groups with four to five members were formed based on their identity condition and in alphabetic order. Every mixed-profession group discussed eight conversational topics. Groups listed up to ten ideas per topic. The number of ideas generated per topic in each group was used to measure speaking up. A higher idea percentage in the strong IPI group indicated activated IPI, reflecting identity-congruent behaviour. Results: Mixed-profession groups with relatively strong IPI showed more speaking up than groups with weak identifiers. Conversational topics can trigger IPI to varying degrees, reflected in differing levels of speaking up. Conclusion: Some topics raise awareness of IPI, boosting speaking up in groups with relatively strong IPI. Using Extended Professional Identity Theory (EPIT) and effective IPI triggers in simulations helps trigger this behaviour. Moreover, reflective debriefing is likely to further support IPI and encourage speaking up.