Interprofessional education and its impact on learners' attitudes over time: a cross-lagged panel analysis

Interprofessional education (IPE) prepares healthcare professionals (HCP) for interprofessional collaborative practice (IPCP) by fostering knowledge, skills, values, and attitudes. Attitudes trigger approach or avoidance motivation, making engagement with IPCP more likely when HCPs hold positive attitudes. As research has struggled to consistently demonstrate a positive, long-term impact of IPE on healthcare students' attitudes, we investigated attitude development longitudinally in three undergraduate cohorts studying to become dieticians, midwives, nurses, or physiotherapists at a university of applied sciences in Switzerland. Specifically, we examined (1) whether related interprofessional attitude dimensions influenced each other over time, (2) how stable these dimensions were, (3) the impact of student characteristics, and (4) whether attitudes improved across time.

We conducted a longitudinal study using structural equation modeling (SEM) to estimate cross-lagged panel models (CLPM) based on two out of three dimensions of the German version of the Interprofessional Attitudes Scale (G-IPAS): Teamwork, Roles, Responsibilities (TRR) and Community-Centeredness (CC). Of 879 undergraduate students who began their studies between 2018 and 2021, 234 provided data at least twice and were included in the final analyses.

No cross-lagged effects were found between TRR and CC, however they showed moderate to moderate-to-strong stability across time. Student characteristics influenced attitudes: semester of study was positively associated with CC, male sex was negatively associated with CC, dietetics students reported more positive CC attitudes, and physiotherapy students reported more negative TRR attitudes. TRR attitude scores decreased significantly over time, while a change in CC could not be verified due to inadequate model fit.

IPE did not produce the expected positive effect on interprofessional attitude development during undergraduate healthcare studies, in contrast to much previous research. The absence of reciprocal effects between attitude dimensions across time may indicate that they are serving different underlying psychological functions, with TRR being more utilitarian and CC being more value-oriented. Tailoring IPE curricula to the underlying psychological functions that interprofessional attitudes serve in different learner groups may enhance their effectiveness, thereby fostering positive and durable attitudinal change.