Academic journal article American Journal of Pharmaceutical Education

Development and Validation of the Student Perceptions of Physician-Pharmacist Interprofessional Clinical Education (SPICE) Instrument

Academic journal article American Journal of Pharmaceutical Education

Development and Validation of the Student Perceptions of Physician-Pharmacist Interprofessional Clinical Education (SPICE) Instrument

Article excerpt


The use of interdisciplinary care teams has been promoted to improve health and safety outcomes for patients. (1-5) Several studies have characterized benefits associated with team-based healthcare delivery. (6-15) Specific examples include greater blood pressure control when care is delivered by a physician-pharmacist team, (8,12) increased patient satisfaction, (14) decreased healthcare costs, (14) and improved quality of care. (15) Despite this progress in the patient-care arena, consecutive Cochrane reviews performed within the last 10 years have neither consistently nor comprehensively established the benefits of the interdisciplinary model as it relates to healthcare education. (16,17) Authors of the most recent of these reviews cite the small number of studies, the heterogeneity of interventions, and methodological limitations as principal limitations and call for more rigorously designed studies to "provide better evidence of the impact of interprofessional education on professional practice and healthcare outcomes." (17)

To provide evidence of the impact of interprofessional education within healthcare disciplines, there have been efforts to produce, validate, and use measurement scales. (18-21) Specific instruments include the Readiness for Interprofessional Learning Scale (RIPLS), (18,21) the Interdisciplinary Education Perception Scale (IEPS), (21) the Attitudes Toward Health Care Teams Scale (ATHCTS), (21) and the Scale of Attitudes Toward Physician-Pharmacist Collaboration ([SATP.sup.2] C). (19,20) Since the reliability and validity of measurement instruments are contextually constrained, further development, refinement, and validation of measurement scales are warranted. (22)

This study entailed the development and validation of an instrument intended to measure student perceptions of physician-pharmacist interprofessional clinical education (SPICE). By formally establishing the psychometric properties of the instrument, research findings from its use in clinical education settings will be strengthened. Further, the development and validation of a measurement instrument can aid in assessing the impact of interprofessional education initiatives on students' perspectives regarding collaborative endeavors.

Physician and pharmacist faculty members practicing at the Texas Tech University Health Sciences Center (TTUHSC) Center for Family Medicine in Amarillo established a collaborative practice clinic in August 2011 to deliver Medicare's Annual Wellness Visit (AWV) benefit. (23,24) Prompted in part by the TTUHSC Quality Enhancement Plan for regional reaccreditation, which was designed to address perceived deficiencies in interprofessional teamwork, (25) these faculty members decided to include medical and pharmacy students in the AWV clinic to increase their exposure to interprofessional education. The AWV team investigated use of the aforementioned scales to assess changing perceptions of students toward interprofessional education following exposure to the AWV clinic but ultimately decided that a customized instrument was more desirable. The rationale for this decision was twofold. First, only 1 of the previously validated instruments was designed specifically for physician-pharmacist teamwork ([SATP.sup.2] C); physician-pharmacist teamwork was the delivery model for the AWV clinic. Additionally, in order to contribute maximally to the aforementioned Quality Enhancement Plan, the AWV team intended to generate more data specific to patient outcomes and educational preparedness for interprofessional education. SPICE was created out of this desire.


A structured process was followed to develop and refine the SPICE instrument. First, a pool of questions (items) was created using a 5-point Likert-type response system on which 5 = strongly agree, 4 = agree, 3 = neutral, 2 = disagree, and 1 = strongly disagree. Items were either derived from existing instruments or developed independently by the researchers. …

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