Interprofessional Education Perceptions: Reliability of Longitudinal Retrospective Pre-test Design Scores

A commonly used method to measure IPE learning outcomes is through the use of validated IPE perception or attitudinal questionnaires. Perception change can be measured using a retrospective pre-/post-test design (RPP). A RPP survey is administered at a single point after the intervention, and asks participants to reflect on a timepoint before the experience, thus keeping the frame of reference constant, eliminating response shift bias (Howard, 1980).
Faculty at a U.S. based academic health sciences center used the RPP design to measure student perceptions using the Student Perceptions of Interprofessional Clinical Education-Revised instrument, version 2 (SPICE-R2) (Zorek et al., 2017) over a two-year longitudinal curriculum. Students were first and second year students, enrolled in one of eighteen health professional programs. Students completed both Year 1 (2018-2019) and Year 2 (2019-2020) of the curriculum. After the final presentations for Year 1 and Year 2, students were given a week to complete the SPICE-R2. At both timepoints, students were asked to retrospectively reflect on their perceptions prior to beginning the two-year curriculum.
Five hundred and fifty-two students completed the SPICE-R2 at the end of Year 1 and Year 2. When students were asked to reflect upon their perception at the beginning of the experience, the results of this study indicated student retrospective pre-test responses after Year 2 were not similar to retrospective pre-test responses after Year 1. The lack of reliability in consistently reporting the same retrospective pre-test timepoint should be considered when reporting and interpreting longitudinal outcomes. In this case, the change in perception after year 1 is independent of the change in perception after year 2. The interpretation of results would differ if using a traditional pre/post-test design, because one could evaluate change in scores between any two timepoints.