#48
Education Abstract Format
PROJECT NAME: Interprofessional education in
safety and quality. Does it influence student attitude
toward patient safety?
Institution: UTHSCSA
Primary Author: Deborah Kendall-Gallagher, PhD, JD, RN
Secondary Author: Jan Patterson, MD
Project Category: Education
Background: Interprofessional teamwork and patient safety behaviors are core competencies
identified by the Institute of Medicine as critical for health professionals in providing safe, quality
care. Interprofessional education is a key intervention for teaching pre-licensure health
professions students the skills and knowledge that foster safe practice. A positive attitude
toward interprofessional practice and patient safety is a prerequisite for effective teamwork
needed to reduce patient harm.
Purpose: To determine if completion of an undergraduate interprofessional (IPE) course
affects student attitude towards interprofessional learning and patient safety behaviors.
Setting: UTHSCSA, with pilot grant support from the Institute of Healthcare Improvement (IHI)
Open School and the Josiah Jr. Macy Foundation, began offering an interprofessional course
(IPE) on quality improvement (QI) and patient safety (PS) for undergraduate medical and
nursing students in 2009. The course provides experiential learning activities that facilitate
students’ translation of teamwork and patient safety concepts into practice. Students are
assigned to interprofessional teams and work through a QI case study over 8 weeks.
Subjects: Second year medical and junior level first year nursing students enrolled in spring
2012 IPE course (n=219). Participation was voluntary and anonymous with a $5 gift card
incentive.
Intervention: Institutional review board approval was obtained. Student attitude toward patient
safety behaviors was assessed pre and post course using the Attitudes to Patient Safety
Questionnaire (APSQ) validated previously for medical students (Cronbach’s α = .73). Minor
modifications to APQS were made, with permission, to ensure questions were disciplineappropriate. APQS measures five constructs: error perception, error causation, error reporting,
improvement strategies, and learning environment. One group pre and post course test design
guided analysis (control group not feasible).
Results: Seventy-one percent (71%) of eligible participants completed the questionnaire
pre and post course (medical = 64, nursing = 93). Data were analyzed using independent t-test
set at 5% significance level. Reliability coefficients for subscales pre and post revealed an
increase for error causation (α=.57 to α=.71), error perception (α=.47 to α=.76), error reduction
(α=.63 to α=.74), and learning/teaching (α=.72 to α=.85) and a decrease for error reporting
(α=.81, α=.63). For medical students, APQS mean subscales pre and post were significant for
error perception (5.34 to 6.05), learning/teaching (3.60 to 5.05), and error reporting (5.13 to
4.80) on a 7-point Likert scale ranging from strongly disagree (1) to strongly agree (7) plus NA
(8). APQS results for nursing students demonstrated a similar pattern, error perception (5.67 to
6.06), learning and teaching (4.81 to 5.42), error reduction (6.01 to 6.38), and error reporting
(5.75 to 5.31) (Table 1). Inability to match pre to post-test responses due to anonymity limited
study findings.
Conclusions: This educational study provides preliminary evidence that an undergraduate IPE
course in quality and safety taught to medical and nursing students may increase student
awareness of safety and team-related issues that can impact quality of care. The one group,
pre and post test design cannot conclusively demonstrate that observed changes are due to the
IPE course. Additional validation of APQS in an interprofessional context is recommended.
Table 1. APQS Significant Findings Independent T-Tests
Pre-to Post-Test APSQ Mean
Pre-Test
Post-Test
Subscale Comparisons for
Medical Students
Error Perceptions
5.34
6.05
Learning/Teaching
3.60
5.05
Error Reporting
5.13
4.80
Pre-Test
Post-Test
Error Perceptions
5.67
6.06
Error Reduction
6.01
6.38
Learning/Teaching
4.81
5.42
Error Reporting
5.75
5.31
Pre-to Post-Test APSQ Mean
Subscale Comparisons for
Nursing Students