In the chronic obstructive pulmondary disease (COPD) module, Group A (intervention group) will go through the ER COPD scenario with group discussion. The tuberculosis (TB) module launched after three weeks of washout period, Group A (control group) will go through the TB scenario using problem based learning approach.

In the chronic obstructive pulmonary disease (COPD) module, Group B (control group) will go through the COPD scenario using problem based learning approach. The tuberculosis (TB) module launched after three weeks of washout period, Group B (intervention group) will go through the ER TB scenario with group discussion.

To prepare health discipline students for effective interdisciplinary learning in a global learning environment, a novel pedagogical innovation is proposed in this project - using an interactive 'Escape Room ER' that encompasses situational and cultural awareness to enhance the delivery of appropriate prioritized care for community people in home setting. 'Escape room' is a game-based learning that shows evidence in motivating and engaging students in the learning process.

The online rooms will be designed by the interdisciplinary teachers of involved institutions collaboratively, based on the concept of situational awareness that includes perception of the elements in the environment, comprehension of the situation, and projection of future status. To achieve the overall goal of developing prioritization skills and cultural competence skills of participating students, they will be empowered in mastering generative AI (ChatGPT) to acquire answers that pertain to specific scenarios.

The SPICE-R instrument contains ten items and three factors dedicated to interprofessional teamwork and team-based practice (items 1, 5, 6, & 8-10), roles/responsibilities for collaborative practice (items 2 & 7), and patient outcomes from collaborative practice (items 3 & 4). The SPICE-R instrument demonstrated reliability and construct validity. The instrument demonstrated validity according to multiple established criteria, and the composite reliability of the overall instrument (i.e., all ten items evaluated together) was high at 0.84.

The questionnaire comprised four factors, namely skills engagement (e.g., taking good notes over readings), emotional engagement (e.g., finding ways to make the course interesting to me), participation engagement (e.g., participating actively in small group discussion forums), and performance engagement (e.g., getting a good grade). The Online Student Engagement (OSE) covered 19 items that measured students' behaviours, thoughts, or feelings regarding the online courses. The items were scored using a 5-point Likert scale. The OSE requires approximately 10-15 min to complete. The maximum possible engagement score was 95, and the maximum scores in the domains of skills engagement, emotional engagement, participation engagement and performance engagement were 30, 25, 30 and 10 respectively. A mean item score of ≥3.5 (total score of ≥66.5) represents a highly engaged student. The OSE exhibited face and concurrent validity and had a Cronbach's Alpha of 0.91.

The mCAS is a four-factor measure of cultural awareness, and it possesses satisfactory internal consistency. The Cronbach's alpha value was 0.88 for the total scale and ranged from 0.7 ("cognitive awareness") to 0.9 ("general educational and research experience") for the four subscales. The four factors explained 43.4% of the total variance. All items had a factor loading > 0.3. Factor 1, "general education and research experience," included 15 items and was the strongest factor (16.87% of the total variance). Factor 2, "behaviours/comfort with interactions," included eight items. Factor 3, "cognitive awareness," and factor 4, "clinical issues", included 7 and 5 items. Results support the use of the modified CAS as a generic tool to measure cultural awareness among students in higher education within the health and social care fields.