BACKGROUND
Challenge
The ability to measure professionalism within any discipline is not an easy endeavor given the breadth and depth of concepts associated with professionalism, how professionalism may change over time with experience and clinical mastery, and the ability to adequately define valid and reliable measures that incorporate behaviors, values, and attitudes. Other professions are confronted by the challenge of assessing and measuring professionalism for the purpose of admissions, student professional educational preparation, and clinical practice for practitioners. The assessment of professionalism is a challenging area that many professions are wrestling with at this time.
Purpose
The Interprofessional Professionalism Collaborative (IPC) was created to
- Develop a definition of interprofessional professionalism,
- Design and pilot an interprofessional professionalism assessment (IPA) instrument focused on health professions’ entry into practice, and
- Develop educational resources for use in teaching to further interprofessional professionalism (IPP).
About the IPC
Overlapping Concepts
Interprofessional professionalism overlaps conceptually with broad definitions of professionalism; builds upon research on team functioning, interprofessional education, interprofessional care, and relational coordination.
IPA Development Process
Interprofessional professionalism (IPP) focuses on observable behaviors that illustrate the elements of professionalism uniquely relevant to collaborations across a variety of health professionals. To develop an instrument to measure interprofessional professionalism, the IPC first conducted a review of the literature, created a conceptual definition of IPP, and defined 80+ observable IPP behaviors.
The IPC refined 43 interprofessional professionalism behaviors based on feedback from a 2009 survey disseminated to a broad cohort of healthcare professions. Eighty-three (83) percent of responders to the survey indicated that the 43 behaviors were sufficiently comprehensive and distinct from one another. More than 73 percent responded they could measure these observable behaviors in their professional students, professional students from other health professions, and other practicing professionals.*
Based on this feedback, an Interprofessional Professionalism Assessment (IPA) form was drafted. The IPC created the IPA for use by preceptors/supervisors, so they may rate how well students/trainees under their supervision demonstrate the IPP behaviors when interacting with other health professionals.
Following modifications of the initial IPA, cognitive interviews were conducted with preceptors/supervisors of diverse health professions who oversee students. The purpose of these interviews was to further assess the IPA instrument with a sample representing “typical” potential users of the instrument from across a broad range of health professions to determine whether they could interpret and potentially evaluate a student on the draft items. Content experts from different health professions then reviewed the IPA instrument, including the conceptualization of IPP, the IPA content, instructions, and format. Modifications based on feedback from these interviews resulted in the finalized 26 behavioral-item assessment instrument for pilot testing that included directions for use, definitions, and a rating scale.
The University of Mississippi granted IRB approval to John Bentley, the primary investigator (PI), in 2013 to conduct a pilot study of the IPA across multiple health professions, academic institutions, and clinical settings. The IPA pilot study was launched in September 2013 and the data collection process concluded in December 2015. The study assessed the instrument's integrity and psychometric properties with learners in their final year prior to graduation from multiple health professions from multiple academic institutions. The IPC analyzed the results of the pilot and submitted a related manuscript to the Journal of Interprofessional Care in 2017, which was accepted and published in 2018.
The IPC refined 43 interprofessional professionalism behaviors based on feedback from a 2009 survey disseminated to a broad cohort of healthcare professions. Eighty-three (83) percent of responders to the survey indicated that the 43 behaviors were sufficiently comprehensive and distinct from one another. More than 73 percent responded they could measure these observable behaviors in their professional students, professional students from other health professions, and other practicing professionals.*
Based on this feedback, an Interprofessional Professionalism Assessment (IPA) form was drafted. The IPC created the IPA for use by preceptors/supervisors, so they may rate how well students/trainees under their supervision demonstrate the IPP behaviors when interacting with other health professionals.
Following modifications of the initial IPA, cognitive interviews were conducted with preceptors/supervisors of diverse health professions who oversee students. The purpose of these interviews was to further assess the IPA instrument with a sample representing “typical” potential users of the instrument from across a broad range of health professions to determine whether they could interpret and potentially evaluate a student on the draft items. Content experts from different health professions then reviewed the IPA instrument, including the conceptualization of IPP, the IPA content, instructions, and format. Modifications based on feedback from these interviews resulted in the finalized 26 behavioral-item assessment instrument for pilot testing that included directions for use, definitions, and a rating scale.
The University of Mississippi granted IRB approval to John Bentley, the primary investigator (PI), in 2013 to conduct a pilot study of the IPA across multiple health professions, academic institutions, and clinical settings. The IPA pilot study was launched in September 2013 and the data collection process concluded in December 2015. The study assessed the instrument's integrity and psychometric properties with learners in their final year prior to graduation from multiple health professions from multiple academic institutions. The IPC analyzed the results of the pilot and submitted a related manuscript to the Journal of Interprofessional Care in 2017, which was accepted and published in 2018.
About the IPA Pilot Study
The interprofessional professionalism assessment (IPA) pilot study was launched in September 2013 and data collection was completed on December 31, 2015. The 26-item online IPA instrument was designed to be used with students who are completing their final practice experiences prior to the attainment of their professional degree (eg, final or close to final clerkship, practicum, internship, rotation, etc. – not residents or postgraduates).
During the pilot study, the IPC collected data from preceptor and student pairs. The preceptor assessed students using the IPA and the students self-assessed using IPA. Assessments were made at the conclusion of each practice experience/rotation/practicum based on observations of the student’s behavior throughout the practice experience.
The IPC involved many different preceptors from a variety of healthcare professions and academic institutions in the pilot project. Given a target group of respondents consisting of preceptor-students pairs, with students currently completing their final practice experiences prior to attainment of a professional degree, respondents were generally between the ages of 21 and 65.
Preceptor-student dyads were asked to complete a 26 behavioral-item assessment instrument designed to measure IPP. Preceptor responses were asked about their student, while student responses were in the form of a self-assessment. Students and preceptors answered demographic questions. Preceptors answered questions concerning their experiences with, and evaluation of, the IPA instrument. Student responses were anonymous, but preceptor responses were not. Only the principal investigator had access to identifiable preceptor data. Results were reported only in the aggregate. Individual preceptor responses were not reported.
The IPC developed a manuscript about the pilot study that was accepted for publication and has made IPA instrument available for wide use by communities of interest.
During the pilot study, the IPC collected data from preceptor and student pairs. The preceptor assessed students using the IPA and the students self-assessed using IPA. Assessments were made at the conclusion of each practice experience/rotation/practicum based on observations of the student’s behavior throughout the practice experience.
The IPC involved many different preceptors from a variety of healthcare professions and academic institutions in the pilot project. Given a target group of respondents consisting of preceptor-students pairs, with students currently completing their final practice experiences prior to attainment of a professional degree, respondents were generally between the ages of 21 and 65.
Preceptor-student dyads were asked to complete a 26 behavioral-item assessment instrument designed to measure IPP. Preceptor responses were asked about their student, while student responses were in the form of a self-assessment. Students and preceptors answered demographic questions. Preceptors answered questions concerning their experiences with, and evaluation of, the IPA instrument. Student responses were anonymous, but preceptor responses were not. Only the principal investigator had access to identifiable preceptor data. Results were reported only in the aggregate. Individual preceptor responses were not reported.
The IPC developed a manuscript about the pilot study that was accepted for publication and has made IPA instrument available for wide use by communities of interest.
IPC Milestones
- Compiled key resources and research from the different professions.
- Identified and defined terms associated with professionalism applicable to all involved professions.
- Collaborated on the development of a mechanism to measure interprofessional professionalism (IPP) behaviors,
- Launched the IPC website to facilitate discussion across the health professions, provide participants with an opportunity to provide feedback about the IPP behaviors, and promote communication about the IPA pilot study.
- Provided multiple panel presentations to the various representative professions at national conferences.
- Completed the IPA pilot study.
- Analyzed the results of the IPA pilot study.
- Published 3 articles, including the most recent in the Journal of Interprofessional Care.
- Released the IPA Instrument for public use.
Dates
2006: Creation of the IPC committee instigated by the APTA. Discussions of Professionalism as defined by various health professions
2007: Identification of and defining professionalism from the lens of an interprofessional team
2008-2009: Describing and drafting observable interprofessional professionalism behaviors across health care teams; national and international presentations to solicit feedback on draft instrument; online survey created for feedback
2010: Revised the instrument based on feedback; sent next draft to content reviewers
Based on feedback from content expert reviewers’ revisions, conducted IPA cognitive interviews with preceptors from 11 health professions
2011: Second revision and conducted cognitive interviews from sample of end users – qualitative research and receive feedback on observable behaviors
2012: Ready to pilot the project. Recruitment for participation. From various academic health centers
Interprofessional Professionalism Assessment pilot to assess instrument integrity and psychometric properties.
Publications, presentations, and the development of training materials.
2013-2015: In preparation for the pilot project, recruitment of sites and IRB approval pilot project launched. Collection of data; continued presentations; designing of training materials
2015: Finished data collection.
2016: Data analysis and manuscript preparation
2017: Fall manuscript submission
2017-2018: Developed case scenario videos and tool kit materials to be used in conjunction with the IPA instrument
2018: IPC article published in the Journal of Interprofessional Care and released the IPA instrument for public use
2007: Identification of and defining professionalism from the lens of an interprofessional team
2008-2009: Describing and drafting observable interprofessional professionalism behaviors across health care teams; national and international presentations to solicit feedback on draft instrument; online survey created for feedback
2010: Revised the instrument based on feedback; sent next draft to content reviewers
Based on feedback from content expert reviewers’ revisions, conducted IPA cognitive interviews with preceptors from 11 health professions
2011: Second revision and conducted cognitive interviews from sample of end users – qualitative research and receive feedback on observable behaviors
2012: Ready to pilot the project. Recruitment for participation. From various academic health centers
Interprofessional Professionalism Assessment pilot to assess instrument integrity and psychometric properties.
Publications, presentations, and the development of training materials.
2013-2015: In preparation for the pilot project, recruitment of sites and IRB approval pilot project launched. Collection of data; continued presentations; designing of training materials
2015: Finished data collection.
2016: Data analysis and manuscript preparation
2017: Fall manuscript submission
2017-2018: Developed case scenario videos and tool kit materials to be used in conjunction with the IPA instrument
2018: IPC article published in the Journal of Interprofessional Care and released the IPA instrument for public use