Students Attitudes to Health Professionals before and after their interprofessional learning (IPL) Dr Susanne Lindqvist Senior Lecturer in Interprofessional Practice Talk given at the Faculty of Health Research Colloquium 24 th April 2009

Poor attitudes amongst healthcare professionals can negatively influence interprofessional working in healthcare settings, which may ultimately impact unfavourably on patient care… Interprofessional learning (IPL) is thought to encourage the development of positive attitudes between healthcare professionals and improve teamworking in practice.

Was formed in 2002 Has since then developed an IPL programme with two arms of activity: 1)the post-registration IPL programme (working with clinical and inter-agency teams) 2)the pre-registration IPL programme (involving all healthcare students at UEA from 9 different programmes, ~ 1500 students) Centre for Interprofessional Practice

Interprofessional learning (IPL) programme IPL1 IPL2 IPL3 Classroom based introduction to IPL. Integration into practice including shadowing of other healthcare professionals. One Day Student Conference – working alongside service users and practitioners to discuss interprofessional working practices and the impact on patient care. IPL4 Involvement of service users in half-day topic based workshops. Centre for Interprofessional Practice

The aim of the IPL programme is to foster the knowledge, skills, attitudes and behaviour that facilitate effective interprofessional teamworking In order to measure students attitudes, before and after IPL, the Centre developed the Attitudes to Health Professionals Questionnaire (AHPQ)

The AHPQ can be used to assess differences in attitudes between healthcare professional groups attitudinal change over time The term attitudes in the title of this measure, is defined as an indicator of how people make sense of their experience (Eiser, 1997)

The AHPQ comprises different sections, for each profession. Each section contains 20 items (a pair of opposites). Each part of the item serves as verbal anchors for each end of a visual analogue scale. Two main components emerged from principal components analysis: caring and subservient 10 0 Assertive Non-assertive X 10 0 Thoughtful Not thoughtful X

Caring items Subservient items Caring/ non-caring Empathetic/ non-empathetic Approachable/ non-approachable Values teamwork/ does not value teamwork Sympathetic/ non-sympathetic Thoughtful/ not thoughtful Flexible/ not flexible Patient-centred/ not patient-centred Not self-centred/ self-centred Gentle/ rough Not arrogant/ arrogant Practical/ theoretical Conciliatory/ not conciliatory Vulnerable/ confident Non-assertive/ assertive Does not value autonomy/ values autonomy Not technically focused/ technically focused Not independent/ independent Poorly paid/ well paid Not confrontational/ confrontational

Lets have a look at it… Copyright © July 2006, Centre for Interprofessional Practice, University of East Anglia. All rights reserved.

Subservient Caring PHA MED PT MID OT NUR Students views before the IPL programme Students views after the IPL programme Principal Component Score Students views before and after IPL

Caring dimension PharmOTMedicNursePT Profession Principal component score Before and After IPL1 comparing 2004 datawith 2009

Subservient dimension PharmOTMedicNursePT Profession Principal Component Score Before and After IPL1 comparing 2004 datawith 2009

Caring dimension PharmOTMedicNursePT Principal component score Students entering that profession Other healthcare students

Subservient dimension PharmOTMedicNursePT Principal Component Score Students entering that profession Other healthcare students

Negative attitudes can affect team performance in healthcare; IPL is thought to encourage the development of positive interprofessional attitudes; The AHPQ has been developed for the purpose of assessing attitudes. It measures two dimensions of interprofessional attitudes, which we have labelled caring and subservient ; Healthcare students arrive at UEA with views of their own and other healthcare professions. Data suggest that students entering UEA now are more caring than those starting their training five years ago; These attitudes/views – whatever the baseline - change over the course of students working together in IPL; IPL may have a direct impact on the direction of these attitudinal changes; To fully understand the underlying factors determining these changes and their implication on teamworking and patient care in practice, quantitative data need to be complemented with qualitative data. In Conclusion

is in a unique position to carry out this research Thank you for your attention – any questions? Dr Susanne Lindqvist Senior Lecturer in Interprofessional Practice