Confronted with the real world: how final-year medical students experience interprofessional collaboration in clinical practice.

backgroundInterprofessional education (IPE) is increasingly embedded in undergraduate medical curricula, yet little is known about how students encounter interprofessional collaboration (IPC) in real-world clinical practice.

methodsThis longitudinal qualitative study analyzed written diaries from eight final-year medical students at one institution (blinded) to explore IPC experiences during clerkships without formal IPE. Deductive coding used an interprofessional learning framework with four domains: "Roles, Hierarchy, and Power Dynamics," "Team Inclusion, Collaboration, and Silos," "Communication Patterns," and "Navigation of Conflicts."

resultsStudents reported contrasting experiences with professional roles and power dynamics. Supportive environments with clear delegation facilitated learning and participation, whereas rigid hierarchies fostered hostility. Formal communication channels promoted coordination, while informal interactions fostered inclusion and trust. Conflict was infrequent and generally avoided.

conclusionsThese real-world accounts illustrate how traditional cultural norms and local team dynamics shape medical students' interprofessional interactions in ways that are difficult to reproduce in classroom or simulation settings. To bridge this gap, IPE should be extended into authentic workplace learning as a socially situated process influenced by local practices and expectations. Targeted strategies to strengthen team communication and clarify roles are particularly needed when these elements are weak and especially during transitional phases such as clerkships.