Cross-cultural adaptation of the professional version of the Readiness for Interprofessional Learning Scale (RIPLS) in Japanese

Evaluation of the elements of interprofessional education for end-of-life care among homecare nurses, care managers, and head care workers: A cluster-randomized controlled trial

Our group developed an interprofessional education (IPE) program for home-based end-of-life (EOL) care among health and welfare professionals, with the purpose of understanding professional roles in EOL care and promoting mutual respect among team members. This study aimed to verify the understanding and awareness of the elements of IPE. Seven districts in a city in Japan were cluster-randomized into an education group or a control group. A questionnaire survey using original items to evaluate two purposes of the IPE program was conducted before the IPE workshop and seven months later. In total, 291 professionals participated in the study: 64 homecare nurses, 129 care managers, and 98 head care workers. Care managers and care workers in the education group significantly understood their own and other professional roles in EOL care (p= .01, p < .0001, respectively) and gained confidence in collaboration among health and welfare professionals (p = .02, p < .0001, respectively). Care workers in the education group felt respect for team members (p = .02). For homecare nurses, no significant effects were observed. The IPE was more effective for welfare professionals who had difficulty cooperating in end-of-life care.

Current status of interprofessional competency among healthcare professions in Japan: A cross-sectional web-based survey

Background

Self-assessment of professionals' interprofessional competency is meaningful for benchmarking oneself and helping to identify training needs. We aimed to clarify differences in self-assessment of interprofessional competency in Japan by profession and type of facility.

Methods

We conducted a cross-sectional study using a web survey among primary healthcare providers in Japan, especially members of the Japan Primary Care Association, between June and October 2020. After sampling using the e-mail list, we used an exponential nondiscriminative snowball method as purposive sampling through key professional informants between November 2020 and February 2021. The questionnaire covered items including participant demographics (age, gender, years of experience as professionals, years of experience working at the current institution, attendance type (regular or part-time work), administrative experience, profession, and facility type) and included the Japanese version of the Self-assessment Scale of Interprofessional Competency (JASSIC). Differences between healthcare professions (physician, nurse, pharmacist, rehabilitation therapist, and social worker) and between types of facility (university hospital, medium-sized hospital, small hospital, and clinics) were compared using the Kruskal-Wallis test.

Results

A total of 593 people responded to the survey. Their mean age was 41.2 ± 11.3 years, and 312 (52.6%) were female. JASSIC scores of physicians and social workers were significantly higher than those of rehabilitation therapists (p < 0.01). Concerning facilities, professionals working in clinics rated themselves higher than those in medium-sized hospitals (p < 0.01).

Conclusions

We revealed that self-assessment of interprofessional competency in Japan varied by profession and type of facility.

Italian Translation and Validation of the Readiness for Interprofessional Learning Scale (RIPLS) in an Undergraduate Healthcare Student Context

Interprofessional education requires that two or more professionals learn from and with each other to allow effective collaboration and improve health outcomes. Thus far, the interprofessional collaboration of healthcare students might be assessed using the Readiness for Interprofessional Learning Scale (RIPLS), which is currently not available in its Italian version. This study aimed to provide the intercultural adaptation of the RIPLS in Italian (I-RIPLS) and assess its validity and reliability. A two-phase validation study was performed in 2020, using a single-centre approach in students enrolled in the medical degree, physiotherapy, nursing, and dentistry courses at an Italian-speaking university in Albania. The first phase of the study determined the cross-cultural adaptation of the items by involving two translators who followed a forward and backward translation process. In the second phase, a sample of 414 students was enrolled. The preliminary corrected item-total correlations showed that five items did not show significant item-to-total correlations. Even if their deletion was not mandatory for generating a suitable correlation matrix for factor analysis, the advantages of keeping only items contributing to a more stable measurement with a shorter scale represented the rationale for removing items with non-significant item-to-total correlation from the correlation matrix before testing the dimensionality of the I-RIPLS with factor analysis. The answers from the first 50% of responders (n = 207) were used to determine the most plausible dimensionality of the I-RIPLS by employing an exploratory factor analysis (EFA), and the second 50% were used to cross-validate the most plausible dimensionality derived from EFA by employing confirmatory factor analysis (CFA) models. The most plausible dimensionality from EFA, by acknowledging the interpretation of the scree plot, the eigenvalues greater than 1, a parallel analysis, and the previous theoretical dimensions of the tool had two factors with adequate internal consistency. The CFA confirmed the two-factor solutions and the internal consistency for each domain. The I-RIPLS has 14 items with adequate evidence of validity and reliability. Future research should revise the tool for pursuing cross-cultural multigroup measurement invariance.

Psychometric appraisal of the Readiness for Interprofessional Learning Scale (RIPLS) Arabic-version

Interprofessional education within healthcare has been shown to have many benefits, however, it is a relatively new educational concept within the Arabic setting. Although the Readiness for Interprofessional Learning Scale is a commonly utilised tool to examine student attitudes, there is a lack of evidence for use of an Arabic translated version. The aim of this study was to develop and psychometrically evaluate an Arabic language version of the Readiness for Interprofessional Learning Scale with Saudi nurses. Two independent translators, proficient in both English and Arabic languages, completed a forward-backward translation of the original English version of the Readiness for Interprofessional Learning Scale. Subsequently, this Readiness for Interprofessional Learning Scale-Arabic version was used to collect data from undergraduate nursing students enrolled at a number of Saudi Arabian universities. Exploratory and Confirmatory Factor Analyses were then performed on the scale. Six hundred and fifty-two participants were recruited. Exploratory Factor Analysis of the Readiness for Interprofessional Learning Scale-Arabic version resulted in a 15-item, three-factor model. Subsequent analysis with Confirmatory Factor Analysis and the resultant final 13-item model demonstrated a poor fit between the hypothesized model and the data. Although our three-factor model is supported by previous studies, the proposed model did not perform well on Confirmatory Factor Analysis assessment. This suggests that there may be issues of applicability of the Readiness for Interprofessional Learning Scale-Arabic version within the current cohort. The present study of the Readiness for Interprofessional Learning Scale-Arabic version has demonstrated some psychometric inadequacies and thus it is possible that this scale may not be appropriate for use with Saudi nurses. However further research with different professional groups is suggested to fully explore its utility within the Saudi setting.

Japanese medical learners' achievement emotions: Accounting for culture in translating Western medical educational theories and instruments into an asian context

Medical learners' achievement emotions during educational activities have remained unexamined in Asian cultural contexts. The Medical Emotion Scale (MES) was previously developed to assess achievement emotions experienced by North American medical learners during learning activities. The goal of this study was to create and validate a Japanese version of the Medical Emotion Scale (J-MES). We translated the MES into Japanese and conducted two initial validation studies of the J-MES. In the first pilot study, we asked five, native-Japanese, second-year medical students to assess their emotions with the J-MES during a computer-based clinical reasoning activity. Each participant was then interviewed to assess the clarity and suitability of the items. In a second, larger study, 41 Japanese medical students were recruited to assess the psychometric properties of the J-MES. We also conducted individual, semi-structured interviews with ten of these participants to explore potential cultural features in the achievement emotions of Japanese students. The first pilot study demonstrated that the J-MES descriptions were clear, and that the scale captured an appropriate range of emotions. The second study revealed that the J-MES scale's profiles and internal structure were largely consistent with control-value theory. The achievement emotions of pride, compassion, and surprise in the J-MES were found to be susceptible to cultural differences between North American and Japanese contexts. Our findings clearly demonstrated the scoring capacity, generalizability, and extrapolability of the J-MES.

Development of a Japanese version of the Self-assessment Scale of Interprofessional Competency (JASSIC)

This study aimed to develop a Japanese version of the Self-assessment Scale of Interprofessional Competency (JASSIC), which consists of six domains: Patient-/Client-/Family-/Community-Centered, Interprofessional Communication, Role Contribution, Facilitation Relationship, Reflection, and Understanding of Others. Validity of JASSIC was confirmed through a four-step process consisting of expert discussion, cognitive debriefing, feasibility, and statistical analysis. Confirmatory factor analysis (CFA) was performed by testing the correlation between the sum scores of JASSIC and the Assessment of Interprofessional Team Collaboration Scale-II(AITCS-II). First, 24 items were created through discussions among physicians, a nurse, a medical educator, and an information sociologist. Second, the items were modified by cognitive debriefing of a physician, nurse, pharmacist, occupational therapist, and social worker. Third, we provided the developed JASSIC for professionals at Hospital X (n = 139) and revised the wording and composition of the items. Finally, CFA among professionals at Hospital Y (n = 153) identified a 6-domain structure (GFI: 0.847, AGFI: 0.782, RMSEA: 0.088). Cronbach's alpha was 0.92, and the correlation coefficient with AITCS-II was 0.72. Ongoing research into JASSIC will promote effective interprofessional collaborative practice not only in Japan but also other countries which share a similar culture and system.

Spanish version of the readiness for interprofessional learning scale (RIPLS) in an undergraduate health sciences student context

The Readiness for Interprofessional Learning Scale (RIPLS) has been widely used to measure students' and professionals' attitudes toward interprofessional learning. However, inconsistencies have been reported concerning its validity and reliability. This study aimed to translate, adapt, and validate the RIPLS questionnaire to be applied to Spanish-speaking health sciences students in Chile. Content and construct validity evidence of the newly created Spanish version of the RIPLS scale were analyzed. An exploratory (EFA) and confirmatory (CFA) analysis were conducted, determining goodness-of-fit indexes. Reliability was evaluated through Cronbach's Alpha Coefficient. We assessed sensitivity to change of the RIPLS scale by comparing pre- and post-interprofessional education workshop scores. The EFA showed that there were three factors. In the CFA, most of the standardized factor loadings were higher than 0.3. Regarding internal consistency, Cronbach's Alpha was 0.86. The differences between the total RIPLS scores before and after the workshops were statistically significant. The Spanish version of RIPLS showed evidence of validity and reliability for use amongst health sciences students. The construct was adequately measured and was shown that it could be used to assess the impact of interprofessional education workshops.

Has "The Ceiling" Rendered the Readiness for Interprofessional Learning Scale (RIPLS) Outdated?

PURPOSE

The present study aimed to investigate the preliminary effects of collaborative learning and simulation on readiness to engage in and attitudes toward future interprofessional learning activities. We translated into Norwegian and validated the original Readiness for Interprofessional Learning Scale (RIPLS) (part 1) to measure the efficacy and feasibility of a structured collaborative learning activity (part 2).

MATERIALS AND METHODS

Undergraduate social and health care professional students from five Norwegian universities (n = 307) participated in the validation stage of this study (part 1). A Norwegian version of the RIPLS was developed using forward and backward translation. An expert panel discussed discrepancies between the translations and professional concepts. We planned to conduct a principal component analysis to evaluate the structure, reliability, and internal consistency of the Norwegian version of the RIPLS, after investigating the skewness, kurtosis, and range of items included. One hundred fifty students participated in collaborative learning activities; 72 (48%) of these individuals answered the translated RIPLS questionnaire.

RESULTS

We found a substantial ceiling effect in the majority of items in the RIPLS, making it difficult to use the instrument as a measure of change. We evaluated the efficacy and feasibility of the collaborative activities based on the changes in the single items that had sufficient univariate normality and ultimately confirmed positive changes in two of these items.

CONCLUSION

Norwegian students appear ready for interprofessional learning; however, due to significant ceiling effects, the majority of items in the RIPLS no longer seem suitable for measuring and evaluating the effects of interprofessional learning (part 1). Single-item analysis revealed a potential effect of collaborative learning (part 2). A new questionnaire is needed where readiness is instead understood as self-efficacy in areas such as role awareness and interprofessional communication. Researchers should be aware that even previously validated questionnaires may lose their applicability over time and require revision. Demands for interprofessional learning and practice are continuously evolving, and evaluation methods should be adjusted accordingly.

Developing a Japanese version of the 'scale of attitudes toward pharmacist-physician collaboration'

There are many reports that pharmacotherapy has been optimized to ensure collaboration between physicians and pharmacists. Various scales assess the relationship between physicians and pharmacists as well as medical students and pharmacy students. The Scale of Attitudes Toward Physician-Pharmacist Collaboration (SATP²C) can be applied not only to the physician-pharmacist relationship but also to the medical-pharmacy student relationship. As there is no Japanese version of the SATP²C, we developed one and examined its psychometric properties. SATP²C scores were measured before and after interprofessional education (IPE) to verify responsiveness. The scale showed confirmed reliability: Cronbach's alphas were 0.79 for Responsibility and Accountability, 0.68 for Shared Authority, and 0.67 for Interdisciplinary Education. Pre and post-IPE, each mean subscale score increased: Responsibility and Accountability, 0.7 ± 0.4; Shared Authority, 0.2 ± 0.3; and Interdisciplinary Education, 0.3 ± 0.2. Although the total score increased (1.2 ± 0.7), this was non-significant. The Japanese version of the SATP²C can be considered, at least initially, to have reached an acceptable level of reliability and validity. The new measure is currently the only scale in Japan that can evaluate attitudes toward physician-pharmacist collaboration regarding IPE. Further studies are needed to confirm responsiveness pre- and post-IPE.

Interprofessional practices and readiness for interprofessional learning among health students and graduates in Rio Grande do Sul, Brazil: a cross-sectional study

This paper reports on a cross-sectional study performed with 370 students and graduates from 15 undergraduate health courses in a public university in Rio Grande do Sul, Brazil. The objective was to identify interprofessional education (IPE) curricular experiences and to evaluate the readiness for IPE among students and graduates who have attended a practical experience of IPE (Integrative Module) compared with undergraduate students who did not. The dimensionality and reliability of the Portuguese-validated expanded version of the Readiness for Interprofessional Learning Scale (RIPLS) with 40-items were also evaluated. This version of RIPLS was validated with 32 items. Cronbach's alpha values of the three factors of the scale were: Factor 1 α = 0.89, Factor 2 α = 0.47 and Factor 3 α = 0.83. IPE initiatives were identified in the undergraduate curricula mainly in the practical experience (Integrative Module) (47.5%), curricular placements (29.8%) and extracurricular activities (29.5%). Students and graduates who participated in the Integrative Module demonstrated greater readiness for IPE than students who did not attend. This study suggested that shared experiences among different undergraduate courses are associated with positive attitudes and greater availability of students and graduates for interprofessional learning and work. Future studies including the psychometric analysis of the Portuguese-validated expanded RIPLS are recommended.

Adaptation and reliability of the readiness for inter professional learning scale (RIPLS) in the Chinese health care students setting

BACKGROUND

Interprofessional collaboration (IPC) primarily aims to enhance collaborative skills and to improve the awareness of teamwork and collaborative competencies of health care students. The Readiness for Interprofessional Learning Scale (RIPLS) was used to assess such skills. The aim of this study was to adapt a Chinese version of the RIPLS among Chinese health care students and to test the psychometric properties of the modified instrument.

METHODS

The questionnaire was translated following a two-step process, comprising forward and backward translations and a pilot test. The Chinese version was tested on a group of students from various health care professions. Cronbach's α coefficients were calculated for each of the four factors and also for the entire questionnaire in order to evaluate the internal consistency of the Chinese version of the RIPLS.

RESULTS

Of the 295 health care students surveyed, 282 (96.5%) completed the questionnaire. Cronbach's α coefficient for the overall scale was 0.842. Internal consistencies within each factor were good (α > 0.70) except for the factor "Roles and Responsibilities", where α = 0.216. Confirmatory factor analysis showed that the data fit the four-factor structure.

CONCLUSION

The Chinese version of the RIPLS was an acceptable instrument for evaluating the attitudes of the health care students in China. The factor "Roles and Responsibilities" requires further scrutiny and development, at least in the Chinese context.

Educação interprofissional na graduação em Odontologia: experiências curriculares e disponibilidade de estudantes

Resumo Introdução Educação Interprofissional (EIP) é uma estratégia pedagógica que busca preparar o futuro profissional da saúde para o trabalho colaborativo. Objetivo Identificar experiências curriculares de EIP e avaliar a disponibilidade de estudantes/egressos da graduação em Odontologia para o aprendizado interprofissional. Material e método Estudo observacional transversal realizado em uma universidade pública da Região Sul do Brasil. Amostra foi constituída por estudantes e egressos de Odontologia que participaram da disciplina eletiva integradora dos cursos da saúde com foco na EIP e estudantes do último ano do curso que não a cursaram (N=172). Coleta de dados envolveu a aplicação online da versão validada para língua portuguesa e ampliada da Readiness for Interprofessional Learning Scale (RIPLS-40), acrescentando-se questões de perfil sociodemográfico dos participantes e experiências de EIP na graduação. Resultado Participaram do estudo 76 estudantes e 12 egressos de Odontologia (n=88). Atividades de EIP foram observadas nos estágios curriculares (20,4%), atividades extracurriculares diversas (17%), de extensão (13,6%) e pesquisa (7,6%). Entre os que cursaram a disciplina integradora, 89,1% a reconheceram como uma atividade de EIP. Resultados da RIPLS mostraram estudantes e egressos com atitudes positivas para EIP, ainda que não tenha sido verificada associação entre participação em atividades de EIP e maior disponibilidade para aprendizagem compartilhada. Conclusão Experiências curriculares pontuais de EIP na graduação em Odontologia foram observadas na Universidade investigada, especialmente em atividades eletivas e estágios curriculares. Para que sejam efetivas no desenvolvimento de competências colaborativas para o trabalho interprofissional em saúde, as experiências de EIP devem estar presentes ao longo da formação do cirurgião-dentista.