Abstract:

Background and objectives:
Curricular fragmentation limits students’ ability to integrate competences from different disciplines into cohesive professional tasks. Health Education (HE) project design offers a natural context for inter-subject coordination, yet empirical comparisons between coordinated and single-subject models remain scarce in health sciences education. This study compared two instructional models for HE project design in the Physiotherapy Degree at CSEU La Salle – Universidad Autónoma de Madrid: an inter-subject coordination model integrating Public Health and Preventive and Community Physiotherapy (intervention group, n = 68), and a single-subject model using only Preventive Physiotherapy (comparison group, n = 14).
The objectives were:
(a) to compare academic outcomes between models;
(b) to analyse digital participation, emotional climate and student appraisal as complementary process indicators; and
(c) to explore competences developed and difficulties perceived through individual reflections.

Methods:
A quasi-experimental design with a non-equivalent comparison group was implemented over five weeks (November–December 2025) with 82 second-year Physiotherapy students organised in 12 project teams. Both groups designed HE projects with identical deliverable structures, phases and digital tools (Microsoft Teams), and completed peer assessment processes. The key difference was that the intervention group integrated evaluation criteria from both subjects (epidemiological analysis + educational design), while the comparison group was assessed exclusively from Preventive Physiotherapy. Given non-normal distributions (Shapiro-Wilk, p < 0.05) and the small comparison group, Mann-Whitney U tests (two-tailed) were used for between-group comparisons, supplemented by Cohen’s d as effect size estimator and Fisher’s exact test for pass rates. Emotional climate was monitored through five Microsoft Reflect check-ins, and qualitative data were gathered from individual student reflections.

Results:
The coordinated model yielded significantly higher HE project scores (M = 7.64 vs. 6.26; U = 745.5; p < 0.001; d = 1.26) and final course grades (M = 7.12 vs. 6.54; U = 639.0; p = 0.045; d = 0.70). Digital participation was statistically equivalent between groups (U = 449.0; p = 0.744), reinforcing the attribution of academic differences to the coordination model rather than to overall engagement levels. Conversely, peer assessment scores were significantly higher in the comparison group (M = 9.18 vs. 7.94; U = 189.0; p < 0.001; d = 0.81), possibly due to smaller team sizes (3–4 members) increasing individual contribution visibility. The pass rate difference (98.5% vs. 85.7%) did not reach statistical significance (Fisher’s exact test, p = 0.074). Emotional climate remained positive across both groups (> 94% favourable in all check-ins), with final motivation at 98.4% and task appraisal at 90.5% positive. Qualitative analysis of reflections revealed development of planning, teamwork, leadership and educational design competences.

Conclusions:
Inter-subject coordination enhances academic performance and competence integration without increasing perceived emotional burden or reducing digital engagement. The unequal group sizes (68 vs. 14) and non-random assignment limit generalisability; replication with balanced samples and standardised instruments is recommended.

Keywords:

Inter-subject coordination, Health Education, project-based learning, quasi-experimental study, physiotherapy.