Psychometric validity of the interprofessional professionalism assessment assessment instrument in nursing education: Short report

Abstract

The demand for valid and reliable instruments to assess behaviors in interprofessional education (IPE) opportunities coincides with the recent shift in nursing education toward competency-based education (CBE). The purpose of the proposed study is to validate the Interprofessional Professionalism Assessment (IPA) instrument within the context of nursing education. The IPA instrument is used to assess individual interprofessional professionalism (IPP) in IPE and consists of 26 items clustered across six subscales: Accountability, Altruism and Caring, Communication, Ethics, Excellence, and Respect. The proposed study will be among the first to involve psychometric testing of the IPA instrument among the health professions and the first in nursing education, building upon the foundational work of the Interprofessional Professionalism Collaborative. The aim is to fill the gap in robust assessment tools that measure professionalism within IPE opportunities in a CBE framework. Potential participants for this study include clinical instructors overseeing prelicensure nursing students in the final year of their programs, ensuring a diverse representation of nursing students. The study will have a non-experimental, cross-sectional, and correlational design involving a web-based survey created with Qualtrics to validate the IPA instrument and explore the relationship between the IPA instrument and the Individual Teamwork Observation and Feedback Tool (i-TOFT). Confirmatory factor analysis will reveal the interrelationships among the items of the IPA instrument by investigating factor retention.

Keywords

Interprofessional education / Interprofessional professionalism / Interprofessional Professionalism Assessment

References

[1] Berwick DM, Nolan TW, Whittington J. The triple aim: care, health, and cost. Health Aff (Millwood). 2008; 27(3): 759-69. PMid:18474969 https://doi.org/10.1377/hlthaff.27.3.759

[2] Kindig D, Stoddart G. What is population health? Am J Public Health. 2003; 93(3): 380-3. PMid:12604476 https://doi.org/10.2105/AJPH.93.3.380

[3] Kindig DA. Understanding population health terminology. Milbank Q. 2007; 85(1): 139-61. PMid:17319809 vhttps://doi.org/10.1111/j.1468-0009.2007.00479.x

[4] Patel H, Perry S, Badu E, et al. A scoping review of interprofessional education in healthcare: evaluating competency development, educational outcomes and challenges. BMC Med Educ. 2025; 25(1): 409. PMid:40114152 https://doi.org/10.1186/s12909-025-06969-3

[5] Swarthout M, Bishop MA. Population health management: review of concepts and definitions. Am J Health Syst Pharm. 2017; 74(18): 1405-11. PMid:28887342 https://doi.org/10.2146/ajhp170025

[6] Healthy people: Centers for Disease Control and Prevention; 2020. Available from: https://www.cdc.gov/nchs/healthy_people/hp2020.htm

[7] Homeyer S, Hoffmann W, Hingst P, et al. Effects of interprofessional education for medical and nursing students: enablers, barriers and expectations for optimizing future interprofessional collaboration - a qualitative study. BMC Nurs. 2018; 17(1): 13. Mid:29643742 https://doi.org/10.1186/s12912-018-0279-x

[8] O’Leary N, Salmon N, Clifford AM. ‘It benefits patient care’: the value of practice-based IPE in healthcare curriculums. BMC Med Educ. 2020; 20(1): 424. PMid:33183276 https://doi.org/10.1186/s12909-020-02356-2

[9] Oudbier J, Verheijck E, van Diermen D, et al. Enhancing the effectiveness of interprofessional education in health science education: a state-of-the-art review. BMC Med Educ. 2024; 24(1): 1492. PMid:39696195 https://doi.org/10.1186/s12909-024-06466-z

[10] Interprofessional Education Collaborative. IPEC core competencies for interprofessional collaborative practice: Version 3. Washington, DC: Interprofessional Education Collaborative, 2023.

[11] Interprofessional Education Collaborative Expert Panel. IPEC core competencies for interprofessional collaborative practice:report of an expert panel. Washington, DC: Interprofessional Education Collaborative, 2011.

[12] Interprofessional Professionalism Collaborative. IPEC core competencies for interprofessional collaborative practice: Version 2. Washington, DC: Interprofessional Education Collaborative, 2016.

[13] Blue AV, Chesluk BJ, Conforti LN, et al. Assessment and evaluation in interprofessional education: exploring the field. J Allied Health. 2015; 44(2): 73-82.

[14] Brandt BF, Stumpf Kertz J, Arenson C. National Center for Interprofessional Practice and Education 2023: reflecting back, looking forward. J Interprof Care. 2023; 37(sup1): S4-s14. PMid:37073117 https://doi.org/10.1080/13561820.2023.2197939

[15] American Association of Colleges of Nursing. The essentials: core competencies for professional nursing education. American Association of Colleges of Nursing; 2021.

[16] Anema MG, McCoy JL. Competency-based nursing education: guide to achieving outstanding learner outcomes: Springer Publishing; 2009.

[17] Lenburg C. The framework, concepts and methods of the Competency Outcomes and Performance Assessment (COPA) model. Online Journal of Issues in Nursing. 1999; 4. https://doi.org/10.3912/OJIN.Vol4No02Man02

[18] Wittmann-Price RA, Gittings KK. Fast facts about competency-based education in nursing. 1 ed. Glasgow MES, Wittmann-Price RA, editors. New York: Springer Publishing Company; 2020. https://doi.org/10.1891/9780826136633

[19] Albarqouni L, Hoffmann T, Straus S, et al. Core competencies in evidence-based practice for health professionals: consensus statement based on a systematic review and Delphi survey. JAMA Netw Open. 2018; 1(2): e180281-e. PMid:30646073 https://doi.org/10.1001/jamanetworkopen.2018.0281

[20] The ACGME common program requirements: Accreditation Council for Graduate Medical Education; 2023. Available from: https://www.acgme.org/programs-and-institutions/programs/common-program-requirements

[21] Shrader S, Farland MZ, Danielson J, et al. A systematic review of assessment tools measuring interprofessional education outcomes relevant to pharmacy education. Am J Phar Educ. 2017; 81(6): 119. PMid:28970620 https://doi.org/10.5688/ajpe816119

[22] Acceditation standards for nursing education programs. National League for Nursing Commission for Nursing Education Acceditation. Washington, DC National League for Nursing; 2021. p. 49.

[23] Standards for acceditation of baccalaureate and graduate nursing programs. Commission on Collegiate Nursing Education; 2024.

[24] Acceditation NCfNE. Standards for Nursing Education Programs. National League of Nursing; 2021.

[25] Durkin AE, Feinn RS. Traditional and accelerated baccalaureate nursing students’ self-efficacy for interprofessional learning. Nurs Educ Perspect. 2017; 38(1). PMid:29194239 https://doi.org/10.1097/01.NEP.0000000000000101

[26] Hall LW, Zierler BK. Interprofessional education and practice guide no. 1: developing faculty to effectively facilitate interprofessional education. Journal Interprof Care. 2015; 29(1): 3-7. PMid:25019466 https://doi.org/10.3109/13561820.2014.937483

[27] Speakman E. Creating an infrastructure and culture of empowerment. Clin Scholars Rev. 2014; 7(2): 90-1. https://doi.org/10.1891/1939-2095.7.2.90

[28] Committee for Assessing Progress on Implementing the Recommendations of the Institute of Medicine Report The Future of Nursing:Leading Change Advancing Health, Institute of Medicine, National Academies of Sciences Engineering and Medicine. Assessing progress on the Institute of Medicine report:the future of nursing. Altman SH, Butler AS, Shern L, editors. Washington (DC): National Academies Press (US); 2016.

[29] Cooper J, Courtney-Pratt H, Fitzgerald M. Key influences identified by first year undergraduate nursing students as impacting on the quality of clinical placement: A qualitative study. Nurse Educ Today. 2015; 35(9): 1004-8. PMid:25828091 https://doi.org/10.1016/j.nedt.2015.03.009

[30] Leighton K, Kardong-Edgren S, McNelis AM, et al. Traditional clinical outcomes in prelicensure nursing education: an empty systematic review. J Nurs Educ. 2021; 60(3): 136-42. PMid:33657230 https://doi.org/10.3928/01484834-20210222-03

[31] Oates M, Davidson M. A critical appraisal of instruments to measure outcomes of interprofessional education. Med Educ. 2015; 49(4): 386-98. PMid:25800299 https://doi.org/10.1111/medu.12681

[32] Billings DM, Halstead JA. Teaching in nursing: a guide for faculty. 7th ed: Elsevier; 2024.

[33] Oermann MH, Shellenbarger T, Gaberson KB. Clinical teaching strategies in nursing: Springer; 2022.

[34] Kavanagh JM, Szweda C. A crisis in competency: the strategic and ethical imperative to assessing new graduate nurses’ clinical reasoning. Nurs Educ Perspect. 2017; 38(2). PMid:29194297 https://doi.org/10.1097/01.NEP.0000000000000112

[35] Amicucci B. What nurse faculty have to say about clinical grading. Teach Learn Nurs. 2012; 7(2): 51-5. https://doi.org/10.1016/j.teln.2011.09.002

[36] Heaslip V, Scammell JME. Failing underperforming students: the role of grading in practice assessment. Nurse Educ Pract. 2012; 12(2): 95-100. PMid:21907621 https://doi.org/10.1016/j.nepr.2011.08.003

[37] Lewallen LP, Van Horn ER. The state of the science on clinical evaluation in nursing education. Nurs Educ Perspect. 2019; 40(1). PMid:30095729 https://doi.org/10.1097/01.NEP.0000000000000376

[38] Scanlan JM, Care WD, Gessler S. Dealing with the unsafe student in clinical practice. Nurse Educ. 2001; 26(1): 23-7. PMid:16372451 https://doi.org/10.1097/00006223-200101000-00013

[39] Tanicala ML, Scheffer BK, Roberts MS. Defining pass/fail nursing student clinical behaviors phase I: moving toward a culture of safety. Nurs Educ Perspect. 2011; 32(3): 155-61. PMid:21834376 https://doi.org/10.5480/1536-5026-32.3.155

[40] Lapkin S, Levett-Jones T, Gilligan C. A systematic review of the effectiveness of interprofessional education in health professional programs. Nurse Educ Today. 2013; 33(2): 90-102. PMid:22196075 https://doi.org/10.1016/j.nedt.2011.11.006

[41] Burrell G, Morgan G. Sociological paradigms and organisational analysis: elements of the sociology of corporate life: Heinemann; 1979.

[42] Comte A. A genderal view of positivism: Cambridge University Press; 1865.

[43] Durkheim E. The rules of sociological method: The MacMillan Press Ltd; 1982. https://doi.org/10.1007/978-1-349-16939-9

[44] Evetts J.The management of professionalism: a contemporary paradox. 2005.

[45] Khalili H, Hall J, DeLuca S. Historical analysis of professionalism in western societies: implications for interprofessional education and collaborative practice. J Interprof Care. 2014; 28(2): 92-7. PMid:24383410 https://doi.org/10.3109/13561820.2013.869197

[46] Zemlak J, Rodney T, Mangano E, et al. Professionalism in prelicensure nursing education: Core values, didactic coursework and clinical training. J Clin Nurs. 2024; 33(2): 702-9. PMid:37941319 https://doi.org/10.1111/jocn.16926

[47] Frenk J, Chen L, Bhutta ZA, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet. 2010; 376(9756): 1923-58. PMid:21112623 https://doi.org/10.1016/S0140-6736(10)61854-5

[48] Al-Hamdan Z, Dalky H, Al-Ramadneh J. Nurses’ professional commitment and its effect on patient safety. Glob J Health Sci. 2018; 10: 111-9. https://doi.org/10.5539/gjhs.v10n1p111

[49] Charania NAMA, Ferguson DL, Bay E, et al. A professionalism and safety code of conduct designed for undergraduate nursing students. J Prof Nurs. 2017; 33(6): 460-3. PMid:29157576 https://doi.org/10.1016/j.profnurs.2017.06.006

[50] The ICN code of ethics for nurses. Geneva, Switzerland: ICN - International Council of Nurses, 2012.

[51] Cao H, Song Y, Wu Y, Du Y, et al. What is nursing professionalism? a concept analysis. BMC Nurs. 2023; 22(1): 34. PMid:36747180 https://doi.org/10.1186/s12912-022-01161-0

[52] Forouzadeh M, Kiani M, Bazmi S. Professionalism and its role in the formation of medical professional identity. Med J Islam Repub Iran. 2018; 32(1): 765-8. PMid:30815425 https://doi.org/10.14196/mjiri.32.130

[53] Owens RA, Kuhl LM, Hagopian CO, et al. Professionalism and professional identity. Amer Nurs J. 2024; 19(9): 14-9. https://doi.org/10.51256/ANJ092414

[54] Carter M, Hesselgreaves H, Burford B, et al. Professionalism in healthcare professionals. Health and Care Professionals Council: 2014.

[55] Stern DT. Measuring medical professionalism: Oxford University Press; 2005.

[56] Gilbert JH, Yan J, Hoffman SJ. A WHO report: framework for action on interprofessional education and collaborative practice. J Allied Health. 2010;39Suppl 1: 196-7.

[57] Holtman MC, Frost JS, Hammer DP, et al. Interprofessional professionalism: linking professionalism and interprofessional care. J Interprof Care. 2011; 25(5): 383-5. PMid:21732724 https://doi.org/10.3109/13561820.2011.588350

[58] Association AOT. Standards of Practice for Occupational Therapy. Amer J Occup Ther. 2021; 75(Supplement_3). PMid:34939642 https://doi.org/10.5014/ajot.2021.75S3004

[59] Care CoAfR. Acceditation standards for advanced practice programs in repiratory care. CoARC Advanced Practice Standards Commission on Accreditation for Respiratory Care; 2022.

[60] American Physical Therapy Association. Guide to physical therapist practice, 3rd ed. American Physical Therapy Association; 2020.

[61] Frost JS, Hammer DP, Nunez LM, et al. The intersection of professionalism and interprofessional care: development and initial testing of the Interprofessional Professionalism Assessment (IPA). J Interprof Care. 2019; 33(1): 102-15. PMid:30247940 https://doi.org/10.1080/13561820.2018.1515733

[62] Andrews C. Self-rated interprofessionalism between allied health professionals. Electronic Theses and Dissertations: East Tennessee State University; 2024.

[63] Tegzes JH, Frost JS. Alignment of selected veterinary education competencies with the Interprofessional Professionalism Assessment. Front Vet Sci. 2021; 8: 688633. Epub 20210709. PMid:34307528 https://doi.org/10.3389/fvets.2021.688633

[64] Frost JS. Interprofessional professionalism: Linking professionalism and interprofessional care [Paper presentation]. Establishing Transdisciplinary Professionalism for Health; 05/14/2013; Washington, DC, United States. 2013.

[65] Benner P, Stuphen M, Leonard V, et al. Educating nurses: a call for radical transformation. 2010. 183-4 p.

[66] American Board of Medical Specialties. ABMS guide to medical specialties, 11th ed.: American Board of Medical Specialties; 2023.

[67] American Pharmacists Association. Pharmacy practice in focus: Medication therapy management. American Pharmacists Association; 2022.

[68] American Physical Therapy Association. Core competencies of a physical therapy resident. American Physical Therapy Association; 2020.

[69] Reeves S, Xyrichis A, Zwarenstein M. Teamwork, collaboration, coordination, and networking: why we need to distinguish between different types of interprofessional practice. Journal Interprof Care. 2018; 32(1): 1-3. PMid:29131697 https://doi.org/10.1080/13561820.2017.1400150

[70] Havyer RD, Wingo MT, Comfere NI, Nelson DR, Halvorsen AJ, McDonald FS, et al. Teamwork assessment in internal medicine: a systematic review of validity evidence and outcomes. J Gen Intern Med. 2014; 29(6): 894-910. PMid:24327309 https://doi.org/10.1007/s11606-013-2686-8

[71] Suter E, Deutschlander S, Mickelson G, et al. Can interprofessional collaboration provide health human resources solutions? A knowledge synthesis. J Interprof Care. 2012; 26(4): 261-8. PMid:22390728 https://doi.org/10.3109/13561820.2012.663014

[72] Zieli´nska-Tomczak Ł, Cerbin-Koczorowska M, Przymuszała P, Marciniak R. How to effectively promote interprofessional collaboration? - a qualitative study on physicians’ and pharmacists’ perspectives driven by the theory of planned behavior. BMC Health Serv Res. 2021; 21(1): 903. PMid:34474676 https://doi.org/10.1186/s12913-021-06903-5

[73] Wald HS. Professional identity (trans)formation in medical education: reflection, relationship, resilience. Acad Med. 2015; 90(6): 701-6. PMid:25881651 https://doi.org/10.1097/ACM.0000000000000731

[74] Keshmiri F, Hosseinpour A. Interprofessional professionalism as a motivating force in interprofessional collaboration. J Med Ethics Hist Med. 2022; 15: 8. PMid:37143523 https://doi.org/10.18502/jmehm.v15i8.11050

[75] Cruess RL, Cruess SR, Boudreau JD, et al. Reframing medical education to support professional identity formation. Acad Med. 2014; 89(11). PMid:25054423 https://doi.org/10.1097/ACM.0000000000000427

[76] Keeling AW, Hehman MC, Kirchgessner JC. History of professional nursing in the United States. 1 ed. New York: Springer Publishing Company; 2017.

[77] Keller T, Ridenour N. Ethics. In: Giddens JF, editor. Concepts for Nursing Practice. 3 ed: Elsevier Health Sciences; 2021.

[78] Committee on Measuring the Impact of Interprofessional Education on Collaborative Practice and Patient Outcomes, Board on Global Health, Institute of Medicine. Measuring the impact of interprofessional education on collaborative practice and patient outcomes. Washington, DC: National Academies Press (US); 2015.

[79] Global Forum on Innovation in Health Professional Education, Board on Global Health, Institute of Medicine. Assessing health professional education:workshop summary. Washington, DC: National Academies Press (US); 2014.

[80] Thistlethwaite J, Kumar K, Moran M, et al. An exploratory review of pre-qualification interprofessional education evaluations. J Interprof Care. 2015; 29(4): 292-7. PMid:25431833 https://doi.org/10.3109/13561820.2014.985292

[81] Institute of Medicine Committee on the Health Professions Education Summit. Health professions education:a bridge to quality. Greiner AC, Knebel E, editors. Washington (DC): National Academies Press (US); 2003.

[82] Team performance in health care: assessment and development. 1 ed. Heinemann GD, Zeiss AM, editors. New York, NY: Springer 2002.

[83] Heinemann GD, Schmitt MH, Farrell MP, et al. Development of an Attitudes toward Health Care Teams scale. Eval Health Prof. 1999; 22(1): 123-42. PMid:10350960 https://doi.org/10.1177/01632789922034202

[84] McFadyen AK, Maclaren WM, Webster VS. The Interdisciplinary Education Perception Scale (IEPS): An alternative remodelled sub-scale structure and its reliability. J Interprof Care. 2007; 21(4): 433-43. PMid:17654160 https://doi.org/10.1080/13561820701352531

[85] Parsell G, Bligh J. The development of a questionnaire to assess the readiness of health care students for interprofessional learning (RIPLS). Medical Education. 1999; 33(2): 95-100. PMid:10211258 https://doi.org/10.1046/j.1365-2923.1999.00298.x

[86] Pollard K, Miers ME, Gilchrist M. Second year scepticism: Prequalifying health and social care students’ midpoint self-assessment, attitudes and perceptions concerning interprofessional learning and working. J of Interprof Care. 2005; 19(3): 251-68. PMid:16029979 https://doi.org/10.1080/13561820400024225

[87] Pollard KC, Miers ME, Gilchrist M. Collaborative learning for collaborative working? Initial findings from a longitudinal study of health and social care students. Health Soc Care Community. 2004; 12(4): 346-58. PMid:15272890 https://doi.org/10.1111/j.1365-2524.2004.00504.x

[88] Hammer D, Anderson M, Brunson W, et al. Defining and measuring construct of interprofessional professionalism. J Allied Health 2012; 41(Summer): e49-53.

[89] Clark PG. What would a theory of interprofessional education look like? Some suggestions for developing a theoretical framework for teamwork training. J Interprof Care. 2006; 20(6): 577-89. PMid:17095437 https://doi.org/10.1080/13561820600916717

[90] Gittell JH, Weinberg DB, Bennett AL, et al. Is the doctor in? A relational approach to job design and the coordination of work. Hum Resour Manag. 2008; 47(4): 729-55. https://doi.org/10.1002/hrm.20242

[91] McNair RP. The case for educating health care students in professionalism as the core content of interprofessional education. Med Educ. 2005; 39(5): 456-64. PMid:15842679 https://doi.org/10.1111/j.1365-2929.2005.02116.x

[92] Swick HM. Toward a normative definition of medical professionalism. Acad Med. 2000; 75(6). PMid:10875505 https://doi.org/10.1097/00001888-200006000-00010

[93] Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed: Routledge; 1988.