Revisiting the attitudes toward health care teams scale: Developing a short version for graduate health care education

ABSTRACT

As interprofessional education (IPE) becomes more common in student training programs, reliable and valid scales are needed to measure students’ perceptions of the experience. The Attitudes Toward Health Care Teams Scale (ATHCTS) was developed to measure students’ attitudes toward IPE programs using 14 items loaded on two factors. In this paper, we used the ATHCTS scale to assess the effects of a three-semester long health care IPE program on three cohorts of nurse practitioner, occupational therapy, and physical therapy graduate students with three measurement points across two university sites (N = 367). Confirmatory factor analysis on the baseline data of the first cohort revealed unacceptable fit indices; in addition, not all items were applicable, some items had double or low factor loadings, and positively and negatively worded items loaded on separate factors, indicating potential answering bias, and both factors were highly correlated. We thus conducted further item analyses and propose a short version of the ATHCTS using six items with one reverse coded item, describing the quality of interprofessional care in a more parsimonious way. The factor structure of the six-item version was tested using confirmatory factor analysis on the baseline data of cohort 2 and 3. Results were compared to the 14-item version, and fit indices confirmed a better fit to the data than the old version. Using the shortened scale, student attitudes were compared over the course of the program and between both sites. Results showed that site 2 students’ attitudes remained very positive over time, while site 1 students’ attitudes declined significantly. We suggest this finding is related to the consistency of team membership at site 2 and discuss the implications for IPE program design.

KEYWORDS:

• Interprofessional education
• health care education assessment
• attitudes toward health care team scale

Acknowledgments

We dedicate this paper to our friend, colleague and co-author Dr. Ann L. Shortridge who passed away unexpectedly in May 2019. Ann’s dedication to interprofessional research and her persistence in sharing the findings were instrumental to the success of this project.

We would like to thank our reviewers and the editors for their helpful suggestions and comments. Special thanks to: Geraldine Ellison, Ph.D, Professor Emeritus, Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Science Center and Mark Fox, MD, Ph.D, MPH, Associate Dean and Center Director, Indiana University School of Medicine, South Bend, former Medical Director of OU Physicians Wayman Tisdale Specialty Health Clinic – Tulsa, OK.

Declaration of interest

The authors report no conflict of interest. The authors alone are responsible for the content and writing of this paper.

Additional information

Funding

This project is supported by funds from the Bureau of Health Professions (BHPr), Health Resources and Services Administration (HRSA), Department of Health and Human Services (DHHS) under grant number D09HP25024, Use of Technology in Educating Advanced Practice Nursing and Allied Health Students in Team Based Care in the amount of $1,116,906 over three years. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by the BHPr, HRSA, DHHS or the U.S. Government.

Notes on contributors

Brigitte Steinheider

Brigitte Steinheider, PhD MBA is an Associate Professor in Psychology at the University of Oklahoma in Tulsa where she teaches in the Organizational Dynamics Masters’ program. Her research focuses on interdisciplinary collaborations and knowledge sharing processes as well as interprofessional education in health care teams. Other interests include organizational climate, organizational behavior and using team-based learning to improve training and teaching effectiveness.

Ann Shortridge

Ann Shortridge EdD was an Instructional Designer for the University of Oklahoma Health Sciences College of Nursing before her death. She earned her EdD in Curriculum and Instructional Technology with her key areas of expertise in e-learning, hybrid and experiential learning, including simulation, needs assessment and task analysis, technology system adoption analysis, and outcomes evaluation.

Vivian Hoffmeister

Vivian Hoffmeister, MBA MA was a Graduate Research Assistant in the Organizational Dynamics Graduate Program at the University of Oklahoma in Tulsa. She now works as the Learning, Development and Evaluation Director at City Year Tulsa.

Ken Randall

Ken Randall, PT, PhD, MHR is Associate Dean in the University of Oklahoma’s College of Allied Health, is a Professor in its Department of Rehabilitation Sciences, and is co-Director of the OU-Tulsa Office of Community Engagement.  He has been involved in interprofessional education for twenty-one years and has published numerous articles in international journals as well as in both Allied Health Education and Physical Therapy, the flagship journals of his profession.

Carrie Ciro

Carrie Ciro, PhD, OTR/L, FAOTA is an Associate Professor and Elam-Plowman Chair of Rehabilitation Sciences in the OUHSC College of Allied Health. Her 30 year career in occupational therapy has spanned an interest in keeping older adults functional, safe and in their own homes, through clinical care, teaching and research with a foci on people with Alzheimer’s disease and related dementias.