Longitudinal Assessment of Shared Pharmacy and Medical Student Learning Experiences Using the Interprofessional Attitudes Scale
Background: assessment tools for measurement of interprofessional education interventions are often deployed surrounding discrete learning activities, lacking baseline and longitudinal assessments. Pharmacy and medical students participated in three interprofessional learning experiences within the first two curricular years. Our specific aim was detection of longitudinal change of medical and pharmacy student responses at three time points between program years 1 and 2 using the validated 27 item Interprofessional Attitudes Scale (IPAS). The IPAS includes five subscales addressing teamwork, roles and responsibilities, community-centeredness, diversity & ethics, interprofessional biases, and patient centeredness.
Design: quasi-experimental design with a longitudinal cohort of pharmacy and medical students matriculating through pre-clinical curricula. The IPAS was completed early in the first year, again toward the end of the first year following delivery of fall and spring small group interactive interprofessional learning sessions, and mid-way through the second year following two simulated standardized outpatient encounters with one de-brief discussion. Students completed electronic survey responses to items on a scale from 1 (strongly disagree) to 7 (strongly agree). Data analysis used a repeated measure mixed model and p values < 0.05 indicated significant differences.
Results: baseline IPAS completion rates at the start of the first year were 93.1 and 74.3% for pharmacy and medical students, respectively. In general, overall level of agreement with IPAS survey items as measured by most subscales was highest at baseline and agreement trended down at the end of years 1 and 2, but was only significant for the subscale of teamwork, roles and responsibilities. The subscale of interprofessional biases was an exception, starting lower at baseline and trending significantly upward by program year 2 for both pharmacy and medical students.
Conclusion: baseline pharmacy and medical student perceptions in relation to interprofessional dynamics may reflect innate optimism or socially desirable responses, including incomplete appreciation for potential biases. The extent to which natural program progression, actual interprofessional learning experiences, or other factors contributed to changes seen is unclear. Further research including the impact of actual clinical learning experiences on IPAS responses should be investigated longitudinally with pharmacy and medical student matriculation.
Reflections: high baseline scores of interprofessional attitudes for students early in their programs which decline in relation to an educational intervention or natural matriculation may not necessarily indicate failure to achieve desirable outcomes. Gaining understanding of results for early, mid or late program IPAS survey administration should assist with appropriate timing to deploy validated measurement instruments.
