Abstract
BackgroundMany health professions learners report feeling uncomfortable and underprepared for professional interactions with inner city populations. These learners may hold preconceptions which affect therapeutic relationships and provision of care. Few tools exist to measure learner attitudes towards these populations. This article describes the development and validity evidence behind a new tool measuring health professions learner attitudes toward inner city populations.MethodsTool development consisted of four phases: 1) Item identification and generation informed by a scoping review of the literature; 2) Item refinement involving a two stage modified Delphi process with a national multidisciplinary team (n = 8), followed by evaluation of readability and response process validity with a focus group of medical and nursing students (n = 13); 3) Pilot testing with a cohort of medical and nursing students; and 4) Analysis of psychometric properties through factor analysis and reliability.ResultsA 36-item online version of the Inner City Attitudinal Assessment Tool (ICAAT) was completed by 214 of 1452 undergraduate students (67.7% from medicine; 32.3% from nursing; response rate 15%). The resulting tool consists of 24 items within a three-factor model – affective, behavioural, and cognitive. Reliability (internal consistency) values using Cronbach alpha were 0.87, 0.82, and 0.82 respectively. The reliability of the whole 24-item ICAAT was 0.90.ConclusionsThe Inner City Attitudinal Assessment Tool (ICAAT) is a novel tool with evidence to support its use in assessing health care learners’ attitudes towards caring for inner city populations. This tool has potential to help guide curricula in inner city health.
Highlights
Many health professions learners report feeling uncomfortable and underprepared for professional interactions with inner city populations
Item identification and generation Identification of existing tools A librarian-facilitated search to identify existing tools, following methodology outlined by Arksey and O’Malley [29] and Levac [30] was performed to identify previously published tools for assessing health care learner attitudes toward inner city populations [27]
Preliminary item generation Through conceptual analysis, the research team assembled 54 relevant items into seven themes that reflected attitudes toward inner city populations
Summary
Many health professions learners report feeling uncomfortable and underprepared for professional interactions with inner city populations. These learners may hold preconceptions which affect therapeutic relationships and provision of care. This article describes the development and validity evidence behind a new tool measuring health professions learner attitudes toward inner city populations. Despite regular opportunity for interaction with this population, learners may feel uncomfortable or underprepared for professional interactions with individual patients and their unique context and health care needs [8]. Over the course of health professions training, some learners develop progressively more negative attitudes towards, and greater reluctance to work with, specific marginalized populations [1, 8]. Supported exposure to inner city patients and focused curricula can improve attitudes towards at-risk populations and increase the likelihood that learners will choose to work with these groups [11,12,13]
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