1. Dawn LaBarbera PhD, PA-C
Assessment of Health Professions Students’ Perceptions of Interprofessional Education
Mary Kiersma PharmD, PhD Deb Poling PhD, RN, FNP-BC, CNE
Dawn LaBarbera PhD, PA-C

2. Learning Objectives
Explain the Theory of Planned Behavior and its relationship to students’ perceptions of interprofessional education and collaborative practice
Describe the application of a new interprofessional assessment tool based upon the Theory of Planned Behavior
Evaluate uses of the new interprofessional assessment tool at your institution

3. Interprofessional education (IPE) Background
Recommended by:
Pew Health Professions Commission
Institute of Healthcare Improvement
Institute of Medicine
Accrediting organizations in healthcare education
Linked to reduced deaths, sentinel events and health care costs
an essential component of teamwork and collaboration

4. FWAIPEC Faculty
University of Saint Francis: Physician Assistant, Nursing MSN and Family Nurse Practitioner
Indiana University-Purdue University Fort Wayne: Nursing MS and Nurse Practitioner
Indiana University: School of Medicine
Fort Wayne Medical Education Program: Family Practice Residency Program
Manchester University: Doctor of Pharmacy
Graduate Health Care Education
Created August 2011
Common interest of accreditation criteria

6. Seminar Series Activities
Three-session series AY 13-14
Introductory Exercise
BATHE Model of Psychosocial Interviewing
Root Cause Analysis
Materials available through MEDEdPORTAL
RIPLS did not work
Scores not congruent w qualitative data

7. Theory of Planned Behavior
Attitude
Subjective Norm
Intention
Behavior
The theory of planned behavior is the theoretical framework used for this study. This theory has been used in previous studies examining health behaviors and pharmacists’ intentions to provide patient-centered services. The theory of planned behavior was developed to assist in predicting and explaining human behavior in specific circumstances and combines the effects of attitude, subjective norm, and perceived behavioral control on the individual’s intention in executing a behavior. Attitude represents an individual’s personal evaluation of a behavior in terms of positive or negative feelings toward the performance of a behavior. Subjective norm refers to the perceived social pressure to perform or not perform a specific behavior. This perception can be affected by those influential to the individual. Perceived behavioral control refers to an individual’s perception of the ease or difficulty in performing the behavior while reflecting on past experience and anticipated obstacles. The theory of planned behavior incorporates attitudes, subjective norm, and perceived behavioral control which can aid in determining intentions toward and performance of specific behaviors. Therefore, the stronger the intention to engage in a behavior, the higher the probability the behavior will be performed.
An example of the relationship between the three components is counseling in the retail pharmacy setting. Some pharmacists are faced with multiple tasks to be completed quickly. A pharmacist may perceive time spent on counseling as a less important task and time should be allotted to other tasks to decrease the current workload and meet expectations of employers. Therefore, some pharmacists could have a pessimistic attitude toward counseling due to subjective norm conflicts of aspiring to meet the demands of employers. The perceived behavioral control of the pharmacists is influenced by the difficulty of performing counseling due to the tasks associated with their position such as time management and interruptions.
Perceived Behavioral Control
Theory of planned behavior (Ajzen, 1988)

9. Methods: Instrument Development
Theory of planned behavior questions
Attitude
Example: ABLE to evaluate team members in their verbal communication skills
Subjective Norm
Example: EXPECTED to collaborate with other healthcare professionals
Perceived Behavioral Control
Example: CAN apply the elements of the root cause analysis (RCA) model to real patient scenarios
5-point Likert scale:
5=strongly agree to 1=strongly disagree
The survey was constructed based a survey development guide for those utilizing the theory of planned behavior, as well as surveys previously used in related, published studies. The survey consisted of four sections including: measures of the theory of planned behavior; past behavior/work experience; professional commitment; and student demographics.
The theory of planned behavior section consisted of 27 questions pertaining to students’ attitudes, subjective norm, and perceived behavioral control concerning the professional role of the pharmacist. In a study by Lawrence and colleagues, pharmacy student perceptions were measured prior to and upon completion of a patient counseling course. The items were selected to represent pharmaceutical care activities a pharmacist would carry out in a variety of professional settings.
The questions were framed using specific verbs to illustrate the main constructs of the theory of planned behavior which include attitude (e.g. will, have), subjective norm (e.g. will be expected to), and perceived behavioral control (e.g. can) as recommended by the author of the theory of planned behavior. In most methodological applications of the theory of planned behavior, constructs are assessed by a 7-point Likert type scale (e.g. +3 to -3).

11. Demographics Variable Category N (%) Health Profession Gender Male
Pharmacy Student
71 (55.0)
Nurse practitioner student
29 (22.5)
Physician assistant student
25 (19.4)
Family practice resident
2 ( 1.6)
Nursing student, undergraduate
Gender
Male
37 (28.9)
Female
91 (71.1)
Ethnicity
Caucasian
79 (61.2)
African American
11 (8.5)
Asian/Pacific Islander
20 (15.5)
Other
19 (14.7)
We wanted to give you an overview of the demographics that were collected.
Multiple health professions participated including family practice residents, medical students, physician assistant students, and nursing students that included undergraduate, graduate and nurse practitioners students.
The majority of participants were Caucasian and female.

12. Attitude Questions Question Median (IQR) I am ABLE to: Pre Post
I am ABLE to:
Pre
Post
p-value
Explain why interprofessionalism is important for patient-centered care
4 (4-5)
5 (4-5)
0.000
Evaluate team members in their verbal communication skills
4 (3-5)
14. Demonstrate principle and values of team dynamics to function in various teach roles
0.004
25. Collaborate with other healthcare professions
35. Apply the elements of the root cause analysis (RCA) model to real patient scenarios
3 (2-4)
Scale: 1= Strongly Disagree, 5= Strongly Agree *= Not significant

13. Subjective Norm Questions
Median (IQR)
I am EXPECTED to:
Pre
Post
p-value
Collaborate with other healthcare professionals
5 (4-5)
0.708*
13. Employ therapeutic communication skills within an interprofessional team to convey necessary information
4 (4-5)
0.001
16. Be able to explain why interprofessionalism is important for patient-centered care
18. Collaborate with other healthcare professionals
0.039
Scale: 1= Strongly Disagree, 5= Strongly Agree *= Not significant

14. Perceived Behavioral Control Questions
Median (IQR)
I CAN:
Pre
Post
p-value
23. Explain why interprofessionalism is important for patient-centered care
4 (4-5)
5 (4-5)
0.000
26. Discuss how healthcare professionals and patients can understand the role of other healthcare providers
4 (3-5)
29. Apply the elements of the root cause analysis model to real patient scenarios
3 (2-5)
36. Identify problems in a patient scenario using a fishbone diagram
37. Collaborate with other healthcare professionals
Scale: 1= Strongly Disagree, 5= Strongly Agree *= Not significant

15. Scale Reliability (Cronbach’s Alpha)
TPBAT Pre-Test
TPBAT Post-Test
 Profession N α
Pharmacy 71
0.963
0.975
Nursing 29
0.969 27
0.763
Physician Assistant 25
0.983
Total
127
0.967
125
0.919

16. Domain Reliability (Cronbach’s Alpha)
Number of Items
Pre-Test
Post-Test N α
Attitude 15
0.913
0.949
Subjective Norm 9
0.871
0.892
Perceived Behavioral Control 14
0.948
0.950

17. Discussion Strongly agreed: collaboration of healthcare professionals
Collaboration: beneficial in respective fields
Interprofessionalism
Important for patient-centered care
Leads to providing the best care to their patients
Reduce costs
Evidence that students strongly agreed in the collaboration of healthcare professionals (reminder of Cronbach’s alpha and p-values say that evidence is strong)
Students understand that collaboration is beneficial in their respective fields
Students strongly agreed that they were expected to explain why interprofessionalism is important for patient-centered care
Interprofessionalism will lead to the primary goal of providing the best care to their patients

18. Limitations Unequal distribution: Small sample size
Age groups
Professions
Small sample size
Completion of assessments

19. Conclusions/Implications
Potential new tool
Theory of Planned Behavior
Engagement in interprofessional education activities and future collaboration
Measures of perception could assist faculty in the design and development of interprofessional education activities

20. QUESTIONS?