Examining Change in Confidence: A Unique Approach to Interprofessional Education Evaluation

Measuring student confidence is integral to evaluating student perceived ability regarding interprofessional collaborative practice. The purpose of this study was to examine change in confidence after an introductory interprofessional education assignment using Bandura’s self-efficacy framework. METHODS A retrospective pre-post design assessed change in student confidence, targeting the strength dimension of self-efficacy beliefs. Students enrolled in health discipline-specific courses in two sequential years participated in an introductory embedded case-based IPE assignment. Sixteen statements were developed to assess students’ confidence for specific Interprofessional Education Collaborative (IPEC) sub-competencies consistent with student learning outcomes. Descriptive statistics, paired sample t-tests (comparing pre-post), analysis of variance and independent samples t-tests (comparing across disciplines and the two years) were used in the analysis. RESULTS Data from 203 participants provided a useable response rate of 80.6%. The percent of students indicating an increase in their confidence for the different IPEC sub-competencies ranged from 38.9% for “Encourage ideas and opinions of other team members” to 82.3% for “Explain the roles and responsibilities of other professionals.” Differences in mean change in confidence was found among nine sub-competencies when comparing across the disciplines. In addition, students in Year 1 reported larger increases in confidence for nine sub-competencies compared to Year 2 students. DISCUSSION Results give insight to student perceptions for strategic formative assessment and IPE assignment design. A retrospective pre-post design provided a novel means of examining change in confidence that avoids response-shift bias, while providing students the opportunity to explicitly self-report change or lack of change in confidence. Smaller increases in confidence in Year 2 compared to Year 1 were unexpected and may be due to the Year 2 requirement that teams discuss and agree upon team rules. Although counter-intuitive, the potential for reducing the amount of conflict may have contributed to less of an increase in confidence, as confidence can be gained from not only being well prepared, but also overcoming adversity (mastery experience). Each Year 2 student also was required to write a reflection regarding team ground rules and their implementation. This may have helped students realize greater complexities of successful interprofessional collaboration and their own limitations to achieve it. Received: 07/18/2016 Accepted: 04/06/2018 © 2018 Hermansen-Kobulnicky, et al. This open access article is distributed under a Creative Commons Attribution License, which allows unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. H IP & Examining Change in Confidence ORIGINAL RESEARCH 3(3):eP1115 | 2 Confidence in one’s ability to engage in interprofessional interactions is recognized as a personal factor necessary for interprofessional collaboration (Henneman, Lee, & Cohen, 1995). With high levels of confidence, including confidence in social interactions, being prevalent among many of today’s young adults (Twenge, 2006), helping students to acknowledge where they perceive either an increase or decrease in confidence could prove useful when helping students to address their professional growth and goals. Providing students the opportunity to reflect on and self-assess skills and behaviors important to interprofessional practice (IPP) offers a means of comparison that helps to determine their self-efficacy (Resnick, 2013). We examined students’ perceived change in confidence regarding specified Interprofessional Education Collaborative (IPEC) sub-competencies (Interprofessional Education Collaborative, 2016) using Bandura’s (1977) self-efficacy framework. Self-efficacy appraisal has been shown to contribute to and predict achievement (Cervone, 2000). Self-efficacy is the perception of one’s ability to perform an action and is informed by self-reflection of accomplishments, vicarious learning, verbal persuasion, and physiological feedback (Bandura, 1986). Self-efficacy beliefs are measured according to the three dimensions of generality, magnitude, and strength (Bandura, 1977), with two of these, magnitude and strength, potentially being highly correlated (Cecil & Pinkerton, 2000; Lee & Bobko, 1994). Generality refers to the generalizability of behavioral expectations across contexts (Bandura, 1977). Magnitude measures one’s expectations in terms of ability to perform a behavior at a specific level of difficulty. This has been operationalized by asking if respondents can perform a particular activity (Lee & Bobko, 1994) and by rank ordering activities based on difficulty level (Cecil & Pinkerton, 2000). Strength, a key dimension of self-efficacy, measures one’s confidence or belief that a behavior can be performed successfully (Bandura, 1977). We propose that measuring student confidence can serve as an important means to evaluate changes in student perceptions of ability in regards to specified IPEC subcompetencies.