Patient care is not possible without cooperation between the different professions in the health care system. In order to improve care and ensure good cooperation between professions, learners from different professions should be brought together in education (Wissenschaftsrat, 2012). The focus of research is mostly on the learners, with the role of the teacher less well studied (Reeves et al., 2016). However, they are the ones who are responsible for teaching, planning and implementing. For inter-professional education (IPE) in Germany, learners from different education can come together - from technical colleges, universities of applied sciences and universities (Cichon and Klapper, 2018). The entry requirements for teachers to be allowed to teach are very different in the institutions. The basis for teaching at universities is the Framework Act for Higher Education (2019). It is explicitly stated that university lecturers perform their tasks in science, art, research, teaching and further education independently (Hochschulrahmengesetz, 2019). No information is given on the qualifications that a university lecturer should possess. At universities, further training in didactics and pedagogy is only partially required (Strauss et al., 2020).

Thus, the scope for deciding which persons with which existing or non-existing qualifications are employed in teaching is relatively large. For technical colleges and universities of applied sciences, there are no uniform federal specifications, which is why there are considerable differences. In most cases, however, not only professional competences in the sense of the professional title are required for teaching, but also pedagogical competences (MPhG - Masseur- und Physiotherapeutengesetz, 1994; PflBG - Pflegeberufegesetz, 2017; Zusatzqualifikation von mind - Deutscher Verband für Physiotherapie, 2018). What exactly is meant by this varies from region to region. It should be noted that pedagogical competencies are at least considered in technical colleges and universities of applied sciences, but are not mentioned in the university setting according to the Higher Education Framework Act (2019).

In the university setting, the assumption of teaching for lecturers usually comes suddenly. In the university setting, it is assumed that lecturers can teach even if they have previously worked exclusively in the practical setting, for example. They are often inexperienced and are not prepared for the new challenges. From the management level it is assumed that teaching teaching occurs naturally (Böss-Ostendorf et al., 2014). Individual, non-mandatory programs show that quality improvement in teaching through professionalization offers are advertised and accepted by teachers (Babbe et al., 2020). However, knowing about teaching competence or acquiring it are two different aspects. Moreover, the development from novice to teaching professional is not automatic. Winteler and Batscherer (2004) outline five phases of development that are occur in the best case: The first phase is characterized by ‘survival’, the teacher is preoccupied with him/herself and his/her own role. In the second phase, the teacher is still uncertain, but recognizes that the learners are interested in the lesson content. In the third phase, the teacher focuses more on the content rather than the learners. If the teachers perceive and reflect on their fixations on the lesson content, they can enter the fourth phase. If this self-fixation cannot be abandoned, they remain in the third phase. In the fourth phase, the teacher focuses on the learners and the learning process and is able to adjust the content and teaching style accordingly. In the fifth phase, the teacher adapts the variety of methods and the use of media to the learners, as he or she recognizes that they are more likely to retain what they have worked out for themselves. These developmental stages show that teaching is fraught with challenges. If pedagogical and/or didactic competencies are lacking, it does not become easier for the teacher to navigate the classroom.

In uniprofessional teaching, one teacher is responsible, so there is no need to cooperate with other teachers. However, this ability to cooperate is an important element in interprofessional education (Crow and Smith, 2003). It is about thinking as a team, planning and implementing lessons together. Through collaborative competence, teachers can engage in reflective dialogue with colleagues and plan, deliver, and evaluate teaching together (Feldmann, 2005). Team teaching is more than the existence of another teacher. The goal should be to become communicative and cooperative team players and to turn away from individualism and lone wolf existence (Rohr et al., 2016). To be able to collaborate across professions, it is necessary to work together at eye level and to overcome silo thinking (Sottas et al., 2013). Cooperation at eye level can be made more difficult if teachers also pursue a research interest in addition to their teaching activities. Research interests are competitive and joint teaching places its emphasis on good cooperation. Combining this could be a big challenge for IPE teachers (Viebahn, 2009). If a central point of interprofessional teaching is togetherness and the logic of research is a competitive one, the question may be raised how a well-functioning togetherness in teaching can be realized.

Reeves et al. (2016) note that the research interest is more on learners and less on teachers. However, since teachers train and accompany learners on their way, they have a special task. The different institutional requirements for teachers make equal cooperation in teaching difficult. Therefore, an adapted preparation for interprofessional teaching is needed. According to Hattie, in order for good teaching to work, certain requirements must be fulfilled, which were compiled by Steffens and Höfer (2016):

Thus, adapted preparation for interprofessional teaching is needed. Our quantitative preliminary study (Schlicker and Ehlers, 2023) shows that of the 76 online respondents, 14 have an additional pedagogical qualification and seven have an interprofessional one. This indicates that there is currently no preparation that fits exactly. There are currently no special interprofessional training courses for teachers throughout Germany. Some institutions offer in-house training for their interprofessional staff, which is not accessible to outsiders. The content that is covered is not communicated to the outside world, so that it remains unclear which topics are being dealt with.

Since uniprofessional teaching formats differ from interprofessional ones, our research question is:

This research project focuses on the three professions of human medicine, nursing and physiotherapy, as they have a large overlap in the provision of care.

Openness in cooperation is important to the interviewees: To be open in order to recognize the expertise of other professions, to look at the fields of activity of other professions and thus to get to know them. This applies to the practical setting as well as to teaching.

For many of the interview partners, openness in the practical setting is expressed in the fact that they would like to accompany other professions in their work. They want to get to know the field of activity by looking over the shoulders of other professions in their everyday work, asking questions, discussing cases with them and, if possible, reflecting on them afterwards.

Other personal prerequisites mentioned are an empathetic approach, a willingness to engage with other professions, and a high degree of self-awareness through self-experience in order to be able to reflect on one’s own patterns of thought and action. If a discussion of the various topics only takes place on a theoretical level, the practical reference in dealing with people from other professions is missing.

A very important point mentioned for the design of interprofessional teaching is time. Each profession makes its own initial thoughts, which are then compiled. Thus, a first structure is created, which is adapted again and again in further steps. If the planners of the different professions see themselves as equals, appointments must be found that allow everyone to participate in the planning. This is a complex process due to different framework conditions. In addition to the planning of IPE events, the implementation of the teaching as well as a subsequent reflection is equally time-consuming.

Furthermore, the time is mentioned, which can be spent for the participation in a qualification course. This depends on many factors, such as course duration, work substitution, travel times and childcare. The tasks in the individual areas of activity are varied and complex, so that it is difficult for some to take or be able to take the time for further qualification.

On the one hand, the respondents find it difficult to take the time for a qualification course. On the other hand, repetition and continuity are important to them for implementation in practical everyday life and in terms of sustainability. These two poles reveal a certain discrepancy. A certain degree of continuity is desired for the implementation of a qualification course. Through the repetitions and the recurring confrontation with different topics, the probability is higher to be able to implement ideas into the daily work. IPE means to initiate changes in the facilities. Change takes time and practice. In order to be able to practice, topics must be regularly reflected upon and thought and action patterns must be adapted accordingly.

As a result of the Corona pandemic, many stakeholders have become accustomed to using online tools, which is seen as an opportunity in interprofessional work, but rather in the area of knowledge acquisition. The desire is expressed to make materials available online in order to be able to familiarize oneself thematically. An exchange in small groups is also seen as useful to get to know each other on a personal as well as professional level and to discuss and analyze cases.

The interviewees would like to see a theory-practice transfer. They want to get to know the field of activity of other professions, but also their practical field of work. This can be achieved through job shadowing, for example. The time for this should be provided by the qualification course and considered in the planning.

On the content level, good theory-practice transfer can be achieved through observation if the respective field of activity is experienced and explained in its many facets in a practical manner. The knowledge gained increases when the different professions exchange views on the cases during observation, bring in their own perspectives and discuss them.

Further wishes include a teaching of didactic skills. These relate to teaching methods for the classroom - Which methods are particularly useful in interprofessional teaching? - but also preparation on a human level - How do I give appreciative feedback? How do I accept appreciative feedback? How do I really engage with others? These questions also reflect the desire to be prepared on a personal level. What does it take for me to be able to deal with other people in a way that is as free of hierarchy as possible, as free of prejudice as possible, and as sensitive to discrimination as possible? The interviewees mention terms such as openness, appreciation and reflection. However, these must be filled with content.

One’s own attitude towards interprofessional work is relevant for cooperation. Questions about the voluntary nature of teaching, the choice of topics, the view of other professions, teamwork and conflict management should be answered by each person individually, because for interprofessional work to be fruitful, “everyone must be behind it.

Interprofessional teaching means working together, relying on each other and designing teaching together.

The interviewees mentioned openness on different levels as an important concept for them in the cooperation with other professions. Cooperation is characterized by the internalization of stereotypes, which in turn have an influence on attitudes and behavior (Petersen and Six, 2008). Since the term stereotype tends to have a negative meaning in everyday life, disdainful behaviors are assumed as a consequence. Since stereotypical patterns are mostly automated, the consequences on the level of one’s own thought and action patterns are unconscious (Schmid Mast and Krings, 2008). Attitudes and perceptions are already developed at an early stage of training through profession-specific socialization and form the basis for later interaction (Sottas et al., 2016). This can be counteracted by the job shadowing mentioned by the interviewees (Monahan et al., 2018). In the practical setting, previously negative assumptions about other professions can be revised by accompanying them in their everyday work. Experiencing what tasks other professions have, what expertise they possess, what their everyday work looks like in all its facets, can change the empathy and the view of these professions. It is possible to form one’s own picture and to enter into a targeted exchange with the actors. In most cases, job shadowing is arranged on an individual basis, and there are few opportunities in the health care system to get to know other professions in this way. The Charité Universitätsmedizin Berlin (2023) offers a “Hospitationswoche im klinischen Qualitäts- und Risikomanagement” (Hospitalization week in clinical quality and risk management). Since this week is not remunerated and an application is required, it is questionable how many people have the possibilities and resources to accept this offer. Teaching observations also help the respondents to better understand other professions.

There are fears of contact between the teachers due to their different educational backgrounds. The idea of being observed by other teachers in their own lessons is described as unusual (Arens, 2017). In addition, the norm in teaching is to give lessons alone, which is why teachers are not used to working in a team (Feldmann, 2005). By observing other teachers in the teaching context, insights can be gained and implemented in one’s own teaching (Burgsteiner, 2014). A joint reflection afterwards can be beneficial for observers and teachers, as difficulties and questions can be discussed from different perspectives. It is essential that the observer expresses criticism constructively and that the teacher accepts it as well (Zankel-Pichler, 2014). Since interprofessionality thrives on cooperation, teaching should also be done in a team (Sottas et al., 2013). Through the preparation and implementation of joint teaching, the various professions get to know each other on a variety of levels - from the content of the training courses to practical activities and teaching skills. By working together as a team, individuals are relieved, lone wolves are reduced and silo thinking can be overcome (Arbeitsstab Forum Bildung, 2001; Sottas et al., 2013). Professional practice is characterized by an ambivalence between what the actors say and what they show. The joint cooperation is seen as quite important, which indicates a positive basic attitude of the persons. In practical everyday life, however, this attitude is less visible. Kerres et al. (2022) outline this using the example of interprofessional rounds. A ward round in which several professions are involved does not necessarily mean that interprofessional exchange takes place and ideas, suggestions, feedback and impulses are accepted respectfully.

Time is an essential factor for the interviewees in order to be able to adequately plan, carry out and reflect on joint teaching. In this context, it is not enough to talk about IPE. In order to be able to develop an understanding of the perspective of other professions, guidance for critical reflection is needed (Charles et al., 2010). To what extent the participants have time for this process of planning, implementation and critical reflection remains an open question. Interprofessional education in Germany is currently still carried out in few institutions (Schlicker and Ehlers, 2023) and teachers are rarely given additional time for this type of teaching. The reasons for this are manifold. Above all, the lack of support from the institution in terms of resources such as money, staff and rooms is mentioned. Co-teaching is often covered by dedicated staff. The problem does not only relate to time resources.

It is also difficult for interprofessional teachers to access interprofessional teaching-learning materials. Although the Robert Bosch Foundation with the program ‘Operation Team’ (Sottas, 2020) as well as the national model curriculum (IMPP, n.d.) are strongly committed to interprofessional education, there is relatively little material available for the planning of interprofessional courses (Kerres et al., 2022). Without the possibility of accessing existing material, time is again needed in addition to the methodological-didactic skills for planning.

Studies on how many interprofessional lecturers carry out joint teaching within the framework of their actual field of activity could not be found at present. If joint teaching, which is still the exception in Germany but common in international comparison (Crow and Smith, 2003; Cimino et al., 2022 Piper-Vallillo et al., 2023), is already performed as an additional task, the question can be asked what priority interprofessional continuing education has. The calendar of events of the Medical Association of Schleswig-Holstein (Aeksh De, n.d.) shows that the topic of “interprofessional training” is listed, but no training courses are currently offered. In many professions, continuing education credits must be earned in order to ensure medical quality. It is questionable what priority is given to training in interprofessional collaboration and to what extent it is offered. There is no central register for continuing education in which continuing education points can be acquired for the professions from the health care sector. And if, using the example of the medical profession, 250 continuing education points have to be acquired within five years and part of these must be subject-specific (Ärztefortbildungen.de, n.d.), it is questionable how much capacity the individual persons want to invest in interprofessional topics.

Since interprofessional teachers in Germany, in contrast to international comparisons (Paradis and Whitehead, 2019). Hardly have access to adequate teaching and learning material, they would like to see didactic skills taught in the context of a qualification course. This is aggravated by the fact that teachers at different institutions have considerable differences in their teaching skills (see introduction), which can lead to difficulties in cooperation. We can only speculate here about the reasons why things are done differently in Germany than internationally. IPE has only become an important topic here in recent years, so there is certainly still some catching up to do. Also the didactic training of lecturers in medicine has a much shorter tradition than in other countries. Positively, this opens up some possibilities to learn from other countries and to convey these learnings in newly designed courses.

Taking the two professions of human medicine and physiotherapy as an example, the practice in Germany is that physiotherapists provide therapy according to the doctor’s instructions. In the educational situation, teachers in physiotherapy colleges are expected to have “relevant professional qualifications and pedagogical aptitude” (MPhG - Masseur- und Physiotherapeutengesetz, 1994; Zusatzqualifikation von mind - Deutscher Verband für Physiotherapie, 2018), which is not the case for teachers in the university context. It has to be considered how the actors in the cooperation deal with the reversed roles. If the physiotherapy teacher has a higher pedagogical-didactic qualification for teaching, can the teacher from medicine, who may not have these qualifications, get involved? This is where the personal prerequisites mentioned by participants for a qualification course intertwine with what they want from a course in terms of content. Preparation on the human level seems to be an important aspect. Appreciative interaction is mentioned, as is reflection on one’s own attitudes. This joint preparation seems all the more important in view of the fact that, for example, the professional expertise of nurses is often not recognized by physicians (Dienhart et al., 2022). In the context of a qualification course, the aim should be for people to learn to relate to each other as human beings, to respect others in their field of activity, and to be able to give and accept feedback constructively. Thus, a course should not only cover the professional level of interprofessional cooperation, but rather bring the actors who work together in the practical setting for the patients together on a human level. To this end, it is essential to reflect on one’s own thought and action patterns vis-à-vis other professions and to critically question one’s own sensitivities, so that the WHO goal formulated as early as 1988 “Learn together to work together for health” (World Health Organization, 1988; p. 1) can already be achieved at the training level.