From leadership research to district action: Cross-cultural and international barriers and enablers to medication safety and pharmacotherapy: insights from a World Café study on interprofessional education

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Evidence and transfer

Education-related source: verify which participants, institutions and outcomes were actually studied before district adoption. Source publication type: research-article. License and identity checks do not establish study quality or causality.

Original authors’ abstract, reproduced under the source license:

Introduction The prevalence of chronic illnesses and polypharmacy has made medication safety complex. While interprofessional collaboration has been proposed as a strategy to improve medication safety and pharmacotherapy, little is known about the barriers and enablers that influence its implementation in this context. This study aims to identify these barriers and enablers, using the Interprofessional Education for Collaborative Patient-Centred Practice (IECPCP) framework. Methods A World Café study was carried out at the All Together Better Health XI conference in Doha, Qatar, in November 2023. Participants engaged in discussions on four key themes related to interprofessional education in pharmacotherapy and medication safety. Data were analyzed using the IECPCP framework. Results Seventeen participants from seven countries identified 41 barriers and 75 enablers. Thematic analysis revealed six overarching domains: Culture and Attitude, Policy and Governance, Structure and Curriculum, Roles and Identity, Resources and Support, and Evaluation and Evidence. Key barriers included hierarchical norms and a lack of clarity about interprofessional roles at macro and meso levels, and interpersonal conflict and limited accountability at a micro level. Enablers included the promotion of open communication, leadership support, integration of interprofessional education into curricula, and the use of real-world examples to improve the relevance of training. Conclusion National laws, healthcare policies, and cultural hierarchies hinder interprofessional education in pharmacotherapy and medication safety, and strict legal rules and professional responsibilities concerning prescribing complicate collaboration. Stimulating open communication between different professionals may help improve interprofessional collaboration and create more supportive conditions for safe prescribing and medication safety. Supplementary Information The online version contains supplementary material available at 10.1007/s00228-026-04128-1.

Study methods

This World Café was organized at the All Together Better Health XI (ATBH XI) conference, an international conference held in Doha, Qatar in November 2023. The central theme of the conference was interprofessional education and collaborative practice (IPECP) and gave participants the opportunity to exchange ideas and best practices (ATBH XI | Interprofessional.Global). The international conference setting provided an opportunity to explore perspectives on interprofessional education in pharmacotherapy and medication safety across different healthcare and educational contexts.

Limitations

A key strength of this study is the diverse mix of participants, both internationally and professionally. They represented a range of cultural, professional, and educational backgrounds. The inclusion of both students and educators, especially those with experience in interprofessional education and pharmacotherapy, supported a broad range of perspectives during the discussions. The open and respectful atmosphere, combined with a clear structure and the use of the World Café method, encouraged everyone to contribute [31, 46]. The World Café is recognized as a suitable methodology to structure discussions on complex topics in a way that ensures inclusivity and equal participation, allowing all participants, including those less outspoken, to be heard and acknowledged. This study used a clear framework to explore the barriers and enablers of interprofessional education in pharmacotherapy and medication safety. By looking at factors at macro, meso, and micro levels, we gained a comprehensive and cross-cultural picture of how policies, institutions, and team dynamics affect interprofessional education in medication safety. The use of the IECPCP framework of Oandasan and D’Amour to structure our analysis strengthened this approach, as it offers a validated way to examine these levels. This made it easier to compare our findings with other areas of interprofessional education, showing where pharmacotherapy faces similar challenges and where it is different, and highlighting what is needed to improve interprofessional education across different healthcare topics. In addition, by combining this framework with thematic analysis, we were able to balance structure with openness. The framework ensured that barriers and enablers were systematically categorized at the macro, meso, and micro levels, while the inductive thematic analysis allowed new domains to emerge directly from the data. This hybrid approach improved both the transparency and the richness of the findings, making it possible to capture context-specific insights without losing comparability across interprofessional education research.

A 90-day district inquiry

Days 1–15 · Appraise. Read the source methods, recruitment, comparator, outcomes and limitations. Record how the study setting differs from your district and which claim the design can support.
Days 16–30 · Design. Choose one school improvement question with teachers. Protect a short shared planning cycle, agree an instructional change and use a common rubric for examining student work. Agree participation, privacy protections, baseline and stopping rules before starting.
Days 31–60 · Observe. Collect the pre-agreed measures, keep a log of implementation changes and invite confidential voluntary feedback. Preserve existing support for staff and learners.
Days 61–90 · Decide. Review implementation fidelity, teacher time and independently scored student work against a recorded baseline. Examine access differences and competing explanations before attributing changes to leadership. Make a dated decision to stop, revise or extend the inquiry.

Board decision brief

Present the local problem, source setting, evidence limits, intervention, responsible owner, total cost, measured changes and uncertainty. Separate staff perceptions, implementation measures and student learning outcomes.

Attribution and reuse

Rowan Sultan; Jan-Jaap Reinders; Michael O. Reumerman; Michiel A. van Agtmael; Milan C. Richir; Jelle Tichelaar. Cross-cultural and international barriers and enablers to medication safety and pharmacotherapy: insights from a World Café study on interprofessional education. European Journal of Clinical Pharmacology (2026-07-10). https://doi.org/10.1007/s00228-026-04128-1

Prepared 2026-11-07. Source authorship and DOI are preserved. The abstract and source passages are attributed extracts; this editorial guide is offered under the same CC BY 4.0 license.