Students' intentions to work with underserved populations and in interprofessional teams: Knowledge, attitudes, self-efficacy, and empathy

Background: Studies have found that interprofessional collaborative teams may improve student learning of material and patient outcomes and satisfaction with care (Carpenter et al., 2006), and health care professionals' attitudes toward other health care professions (Carpenter, 1995; Goelen et al., 2006). During training, one way to establish interprofessional team skills is through structured service learning placements with underserved populations (health clinics at migrant farms, soup kitchens and homeless shelters). Our study examines student attitudes and perceptions of interprofessional education through service learning, and student empathy and intentions to work with underserved populations. Methods: 499 students in medicine, dental medicine, pharmacy, nursing, and physician assistant programs from 2 large Northeastern universities completed self-report surveys across three waves beginning Fall 2006. We report baseline data here, collected prior to students' engagement in interprofessional service learning experiences. Measures include knowledge, attitudes, self-efficacy, empathy, and intentions related to interprofessional training and working with underserved populations. Results: 87% of students stated that their most desired positions upon graduation would involve working with members of other professions. 79% of students indicated interest in future training through interprofessional teamwork, while 51.1% of students indicated that gaining experience in interprofessional teamwork was among their top 3 reasons to volunteer for service learning experiences. Multiple regressions found that students' knowledge, attitudes and self-efficacy toward interprofessional work and their levels of empathy toward patients predicted intentions to work in an interprofessional team (F(4,492) = 40.69, p<.001), their intentions to work with underserved populations (F(4,492) = 43.997, p<.001) and their intentions to provide services to patients who cannot pay for them (F(4,492) = 59.46, p<.001). Compared to medical students, pharmacy and physician assistant students had lower intentions toward working with the underserved (p<.001 and p=.019, respectively), and pharmacy students had lower intentions toward providing services for patients who cannot pay for them, (p<.001). Discussion & Conclusions: Given that students' knowledge, attitudes, self-efficacy, and empathy were significant predictors of intentions for interprofessional teamwork, providing students with early educational experiences designed to optimize the opportunity for collaborative exchange among health-care disciplines may foster positive attitudes and empathy, while improving self-efficacy for working in interprofessional teams and with the underserved. These experiences may prove to be efficacious in leading to increases in the number of health care professionals coming into practice who are both experienced in and willing to work with underserved populations in interprofessional teams, which will fill growing needs in health care.