The purpose of this study was to develop and evaluate an interprofessional identity measurement instrument based on Extended Professional Identity Theory (EPIT). The latter states that interprofessional identity is a social identity superordinate to a professional identity consisting of three interrelated interprofessional identity characteristics: belonging, commitment and beliefs. Scale development was based on five stages: 1) construct clarification, 2) item pool generation, 3) review of initial item pool, 4) shortening scale length (EFA to determine top four highest factor loadings per subscale; 97 dental and dental hygiene students), and 5) cross-validation and construct validity confirmation (CFA; 152 students and 48 teachers from six curricula). Explained variance of the EPIS was 65%. Internal consistency of the subscales was 0.79, 0.81 and 0.80 respectively and 0.89 of the overall scale. CFA confirmed three-dimensionality as theorized by EPIT. Several goodness-of-fit indexes showed positive results: CFI = 0.968 > 0.90, RMSEA = 0.039 < 0.05, and SRMR = 0.056 ≤ 0.08. The factor loadings of the CFA ranged from 0.58 to 0.80 and factors were interrelated. The Extended Professional Identity Scale (EPIS) is a 12-item measurement instrument with high explained variance, high internal consistency and high construct validity with strong evidence for three-dimensionality.
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Interprofessional Education (IPE) as a preparatory stage for Interprofessional collaboration (IPC) is overlooked in some low-and middle-income countries, including Indonesia. One of the driving forces behind IPC is the development of Interprofessional Identity (IPI), which has yet to be assessed in the Indonesian context. Our study aims were translating and culturally adapting the Extended Professional Identity Scale (EPIS) and confirming its construct validity. We invited third-year students from three programs (medicine, nursing, and dietetics) without previous IPE experience to participate in the study. Using Confirmatory Factor Analysis (CFA), we examined the construct validity, analyzed internal consistency, and conducted a Kruskal–Wallis test to identify variations across professions. Of 513 students approached, 335 participated (response rate 65.3%). The CFA showed factor loadings ranging between.59 and.86, while correlations among subscales varied from.55 to.86. All five goodness-of-fit indices were sufficient. The internal consistency of subscales interprofessional belonging, commitment, and beliefs was.82,.84 and.87, respectively, and.90 for the overall scale. Interprofessional belonging and commitment were different among various students (p-value =.009 and.004) and the dietetics students had lower scores than other students. The Indonesian EPIS (EPIS-RI) demonstrated reliability and construct validity.
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Research on interprofessional identity using the Extended Professional Identity Theory (EPIT) has shown promising results in measuring this identity, predicting interprofessional collaboration, and improving team outcomes. However, EPIT-based interprofessional identity has not been studied in Türkiye due to the absence of a Turkish version of the Extended Professional Identity Scale (EPIS). We aimed to develop and validate a Turkish EPIS, the EPIS-TR, and explore interprofessional identities across eight different professions. A cross-cultural adaptation of EPIS was made by linguistic validation, followed by analysis of psychometric properties using a sample of students from four Turkish universities and eight professions/programs (n = 405). Confirmatory factor analysis and reliability analyses were performed. Differences between professions were explored with ANOVA and a post hoc test. Three out of seven goodness-of-fit indices showed acceptable fit (x2/df =.004; RMSEA =.07; GFI =.94), and others showed excellent fit (SRMR =.04; AGFI =.91; CFI =.97; NNFI =.96). The internal consistency of the EPIS-TR is.93. The EPIS-TR scale has strong psychometric properties. The construct validity of the EPIS-TR was similar to that of the original version. The interprofessional identity scores of the different professions were mostly similar. Based on these findings, the EPIS-TR is well suited for measuring interprofessional identity.
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Collaboration among various professions often faces barriers owing to divergent perspectives, priorities, and expertise shaped by distinct socialization processes. These differences can hinder effectiveness, efficiency, and workforce well-being. The Extended Professional Identity Theory (EPIT) addresses this issue by fostering an interprofessional identity without weakening professional identities. Drawing from psychological theories, EPIT explains the coexistence of interprofessional and professional identities, and predicts associated behaviors. It also emphasizes the importance of combining interprofessional identity formation with developing interprofessional competencies and adapting to environmental factors to achieve synergy in (temporary or permanent) mixed profession groups. Introduced in 2018, EPIT research initially relied on the measurement of congruent interprofessional behaviors as indirect indicators of interprofessional identity that could not yet be measured. An experiment demonstrated that enhancing social identification in mixed profession groups with interprofessional assignments reduced the social hierarchy within 6 h across three meetings. The 2020 development of the Extended Professional Identity Scale (EPIS) confirmed interprofessional identity as a three-dimensional social construct. So far, several scientific studies have supported many propositions of EPIT. These propositions are related to dimensionality and various psychometric properties, cross-cultural similarities, evidence and clues for interprofessional identity formation, and its predictive validity in interprofessional education and collaborative practice. Türkiye is among several countries (e.g., the Netherlands, Belgium, Germany, Lithuania, Finland, and Indonesia) where EPIT-based interprofessional identity is being investigated. To illustrate contextual differences and their potential cross-cultural implications, it is valuable to explore how interprofessional identity adds value in the Turkish context. This approach facilitates understanding the regional implications of interprofessional identity, including interprofessional education initiatives, increased university engagement, the development of measurement instruments, challenges and future directions, and national and international collaborations. This paper aims to explain and clarify EPIT propositions compared to other theories, describe current evidence, and outline future research directions, with a focus on developments within the Turkish context as a showcase.
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Introduction: It is unknown whether interprofessional identity is able to explain interprofessional behaviours. Extended professional identity theory provides clues by combining two psychological identity approaches. The aim of this study is to investigate whether interprofessional identity is a source for intrinsic motivation towards interprofessional collaboration related to wider group membership. Methods: Participants of this double-blinded study were 47 dentistry and 41 dental hygiene students (86.3% response) without interprofessional education (IPE) experience. Group productivity was used as indicator of group effort and equal communication as indication for interprofessional direction. The extended professional identity scale (EPIS) was used to measure interprofessional identity eight weeks prior to a mandatory IPE course. Based on EPIS levels, students were assigned to a low or high interprofessional identity group condition. Subsequently, 12 interprofessional teams (four to five members) were randomly composed per condition. Each group received eight problems (regarding roles, responsibilities and collaborative practice) for which they were expected to provide up to 10 solutions. Six trained psychologists rated the validity of solutions after which the percentage of solutions per group was calculated. Additionally, the psychologists rated interprofessional direction by observing team communication (asking questions, topic control, prosocial formulations, and speech frequency) during the second group meeting. Results: No interprofessional identity differences were found with regard to gender and profession. The mean difference between groups with low versus high interprofessional identity was 0.5 (M = 3.4; SD = 0.5 and M = 3.9, SD = 0.4, respectively), t = −5.880, p < 0.001. Groups with high identity generated more solutions compared to low identity groups (91.5% vs. 86.4%), t = −2938, p = 0.004. The correlation between individual interprofessional identity and group effort was significant, r = 0.22, p = 0.036. Groups with high identity showed more interprofessional direction, t = −2.160, p = 0.034. Discussion: Interprofessional identity has a positive effect on congruent interprofessional behaviours after 10 weeks. More research is required to understand interprofessional identity in relation to performance in education and work.
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Onderzoeksvraag/Doelstelling: Samenwerking in de gezondheidszorg wordt versterkt door de ontwikkeling van een gezamenlijke interprofessionele identiteit, wat leidt tot effectieve teamwork. De effectiviteit van interprofessionele samenwerking hangt in grote mate af van de mate waarin professionals erin slagen een interprofessionele identiteit te ontwikkelen. Om deze identiteitsontwikkeling te meten, die de drie kernaspecten van identiteit (interprofessionele verbondenheid, interprofessionele commitment en interprofessionele overtuigingen) omvat, werd de Extended Professional Identity Scale (EPIS) in Nederland ontwikkeld en gevalideerd. Het lijkt een robuust instrument te zijn voor het meten van interprofessionele identiteit.Het doel van deze studie is om een cross-culturele adaptatie van de EPIS-G (Duitstalige versie) uit te voeren en de constructvaliditeit ervan te bevestigen.Methoden: De vertaling werd uitgevoerd volgens de richtlijnen voor de "Guidelines for translation and intercultural adaptation for self-reported measures". De gezicht- en constructvaliditeit werden bevestigd tijdens het vertaalproces. Een confirmatorische factoranalyse (CFA) werd uitgevoerd met 199 antwoorden van studenten geneeskunde, fysiotherapie, verpleegkunde, ergotherapie en logopedie.Resultaten: Tijdens het vertalen werden de woorden en formuleringen van de originele EPIS zoveel mogelijk behouden. Aanpassingen werden alleen gemaakt wanneer de verantwoordelijke vertaler dit noodzakelijk achtte. Alle afwijkingen werden binnen het team besproken, met aandacht voor omgangstaal en de specifieke taal van de gezondheidszorgberoepen, totdat consensus werd bereikt. De voorlopige resultaten wijzen erop dat de gezicht- en inhoudsvaliditeit door het vertaalproces zijn bevestigd. Cronbach's alpha voor de interne consistentie van de volledige 12-item schaal van de EPIS bedroeg 0,89.Discussie: EPIS-G lijkt geschikt te zijn om de meting van interprofessionele identiteit bij een Duitstalige populatie in de gezondheidszorg te meten. Interprofessionele identiteit kan variëren tussen verschillende beroepsgroepen.Belangrijkste boodschap: In het onderwijs kan de EPIS-G worden ingezet om een interprofessionele identiteit te bevorderen. In een klinische context kan het gebruik van de EPIS-G potentiële ondersteuningsbehoeften signaleren bij het ontwikkelen van een interprofessionele identiteit, wat een cruciale factor is voor succesvolle interprofessionele gezondheidszorg.
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Although Item Response Theory (IRT) has been recommended for helping advance interprofessional education (IPE) research, its use remains limited. This may be partly explained by potential misconceptions regarding IRT`s “limitation” to cross-sectional data. The aim of this study is to demonstrate how Item Response Theory (IRT) can be applied effectively in before-and-after designs in IPE research. Specifically, a two-week before-after design with survey methodology using the Extended Professional Identity Scale (EPIS), an interprofessional identity measure, was conducted among n = 146 mixed health-science students. Results indicated that EPIS increased significantly before-after intervention by.74 standardised mean differences, t146 = 7.73, p
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Background: Frailty and multimorbidity are common among patients in geriatric rehabilitation care (GRC). Proper care of these patients involves multiple professionals which requires optimal interprofessional collaboration to provide the best possible support. Interprofessional collaboration (IPC) goes beyond multi-professional collaboration. It requires professionals to think beyond the expertise of their own discipline and work on joint outcomes in which the patient is actively involved. This study describes the development of the GRC teams of an elderly care organization towards the IPC. Methods: Mixed method pre-post study of 15 months. The interprofessional training program comprised team trainings, webinars, and online team sessions. Data was aggregated by administering the Extended Professional Identity Scale (EPIS) and QuickScan Interprofessional Collaboration (QS) measurements to GRC staff and by observations of the multi-professional team consultation (MPC) meetings of six GRC teams of an organization for elderly care in Drachten and Dokkum in the Netherlands. ADL independence (Barthel Index) and number of inpatient days were analyzed before and after the project. Results: Pretest healthcare professional response was 106, patients for analyses was 181; posttest response was 84, patients was 170. The EPIS shows improvement on “interprofessional belonging” (P =.001, 95%CI: 0.57–2.21), “interprofessional commitment” (P =.027, 95%CI: 0.12–1.90), and overall “interprofessional identity” (P =.013, 95%CI: 0.62 − 5.20). On the QS, all domains improved; “shared values” (P =.009, 95%CI: 0.07 − 0.47), “context” (P =.005, 95%CI: 0.08 − 0.44), “structure & organization” (P =.001, 95%CI: 0.14 − 0.56), “group dynamics & interaction” (P
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Background: Structured psychotherapy is recommended as the preferred treatment of personality disorders. A substantial group of patients, however, has no access to these therapies or does not benefit. For those patients who have no (longer) access to psychotherapy a Collaborative Care Program (CCP) is developed. Collaborative Care originated in somatic health care to increase shared decision making and to enhance self management skills of chronic patients. Nurses have a prominent position in CCP’s as they are responsible for optimal continuity and coordination of care. The aim of the CCP is to improve quality of life and self management skills, and reduce destructive behaviour and other manifestations of the personality disorder. Methods/design: Quantitative and qualitative data are combined in a comparative multiple case study. This makes it possible to test the feasibility of the CCP, and also provides insight into the preliminary outcomes of CCP. Two treatment conditions will be compared, one in which the CCP is provided, the other in which Care as Usual is offered. In both conditions 16 patients will be included. The perspectives of patients, their informal carers and nurses are integrated in this study. Data (questionnaires, documents, and interviews) will be collected among these three groups of participants. The process of treatment and care within both research conditions is described with qualitative research methods. Additional quantitative data provide insight in the preliminary results of the CCP compared to CAU. With a stepped analysis plan the ‘black box’ of the application of the program will be revealed in order to understand which characteristics and influencing factors are indicative for positive or negative outcomes. Discussion: The present study is, as to the best of our knowledge, the first to examine Collaborative Care for patients with severe personality disorders receiving outpatient mental health care. With the chosen design we want to examine how and which elements of the CC Program could contribute to a better quality of life for the patients.
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