Students' Perceptions on the Interprofessional Education: The
Differences among Medical, Nursing, and Pharmacy's Student
Edi Purwanto*, Anggraini Dwi Kurnia, Indah Dwi Pratiwi, and Nila Choirun Naili
Department of Nursing, Faculty of Health Science, University of Muhammadiyah Malang
Jalan Bendungan Sutami 188A Malang 65145 East Java Indonesia
Keywords: Interprofessional education, perception, collaboration, nursing’s student.
Abstract: Collaboration influences the quality of healthcare; therefore, collaboration skills must be owned by every
member of the healthcare team. The knowledge about competencies and the role of each profession must be
understood, so can avoid overlap of competencies, role, and responsibilities between professions. One of the
learning methods can improve collaboration skill is Interprofessional Education (IPE), so that every member
of healthcare can learn and discuss the case based on the competencies of each profession. This study is
aimed to know the perception of Interprofessional Education (IPE) students of medical, pharmacy, and
nursing science. This study used a pre-experimental design Factorial Design. This research was followed by
medical, pharmacy and nursing students of the University of Muhammadiyah Malang, Indonesia. This study
showed that perception of IPE before and after IPE was good for pre-test perception (85,95%) and post-test
(94,60). Results from the Wilcoxon Test (p <0.05) showed no significant changes in perception on IPE
(0.068> 0.05). However, the results of the analysis of each domain in IEPS for measure perception found a
significant change in the competence and autonomous domain (0.000). In conclusion, this study shows that
IPE can improve perceptions of competence, autonomy, and cooperation of IPE.
1 INTRODUCTION
Providing interdisciplinary care services that are able
to work together between medical teams, such as
doctors, nurses, pharmacy, and other medical
personnel, must always be maintained to provide
optimal and maximum health services. Collaboration
between teams originating from multidisciplinary
sciences must continue to be developed and improved
by conducting good collaboration or what is
commonly called Interprofessional Collaboration
(IPC) (Plake, Schafermeyer and McCarthy, 2012;
Donald A. Barr, 2016).
Lack of collaboration between medical teams will
have a negative impact, especially on patients such as
the case of Medication Error (ME), where ME is a
condition or event caused by improper treatment by
the medical team that endangers the patient (Zamjahn
et al., 2018). So far the case of Medication Error in
Indonesia has not been recorded clearly, but
according to a study conducted by Ernawati, Lee, and
Hughes (2015), a study conducted in Bali in 2014
reported that out of 7,662 doses of the drug given
were detected as ME with 1,563 (20, 4%). While the
most common causes of ME are Administration
Errors (59%), Transcription Errors (15%),
Dispensing Errors (14%), and Prescribing Errors
(7%).
One form of efforts to create a good and optimal
collaboration system is through integrated learning
called Interprofessional Education (IPE). Where IPE
is a method that must be followed by two or more
professions, the team conducts learning or discussion
to create effective collaboration in order to improve
health service outcomes. IPE not only discusses the
knowledge of each profession but also discusses the
skills needed to contribute to the welfare of patients
in terms of physical, mental, and social life so that
patients or clients are able to improve a better quality
of life holistically (World Health Organization,
2010).
The use of appropriate IPE methods must be
applied to provide good results so that in IPE there are
four essential components, namely knowledge, skills,
attitudes, and abilities of the team, where the four
components must be prioritized in learning IPE. So,
the right IPE method will produce perceptions and
readiness of students on a good IPE (Page et al., 2009;
252
Purwanto, E., Dwi Kurnia, A., Dwi Pratiwi, I. and Choirun Naili, N.
Students’ Perceptions on the Interprofessional Education: The Differences among Medical, Nursing, and Pharmacy’s Student.
DOI: 10.5220/0009143602520257
In Proceedings of the 2nd Health Science International Conference (HSIC 2019), pages 252-257
ISBN: 978-989-758-462-6
Copyright
c
 2020 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved

Stehlik, Frotjold and Schneider, 2018; Zamjahn et al.,
2018).
Increased collaboration and collaboration because
in IPE, students are required to have good knowledge
not only in terms of clinical knowledge and expertise,
but also in organizational or team management, good
attitude in collaborating in teams, and able to
contribute in teams so that they have good team skills
(Hall and Zierler, 2015; Lehrer et al., 2015). Such
competence will create good perceptions and
readiness in all team members, change in better
behavior, expertise, and knowledge and change in
good organizational practices (Huang, 2008). Team
members clearly know the rights and responsibilities
that they get and live them, so that with this awareness
of respect among interprofessional members (Ong et
al., 2017) while the readiness of team members is
closely related to improving the quality of health
services, because of members (Thannhauser, Russell-
Mayhew and Scott, 2010).
The purpose of this study was to determine
changes in perceptions of students of medical,
pharmacy, and nursing in interprofessional education
learning at the University of Muhammadiyah Malang,
Indonesia.
2 METHOD
The research design used in this study is factorial
design where researchers only use one group and do
not use a control group in this study (Denise, F. Polit,
and Cheryl, Tatano, 2013) and the selection of
samples is done randomly, in the method of data
collection using quantitative data which is done
twice, namely pre (before) and post (after) because
in measuring the level of perception carried out
before and after the implementation of
Interprofessional Education (IPE). The population in
this study was a medical, pharmacy, and nursing
students of the University of Muhammadiyah
Malang Indonesia, who participated in the
2017/2018 academic year IPE were 530 students
using a non-probability sampling method. The
number of samples used was 206 students consisting
of 62 medical students, 49 nursing students, and 95
pharmacy students. This study has already approved
by both Dean of Faculty of Medicine and Faculty of
Health Science, University of Muhammadiyah
Malang.
The research instrument used the IEPS
(Interdisciplinary Education Perception Scale and
Subscale) questionnaire to measure students'
perceptions of Interprofessional Education (IPE)
(Stull and Blue, 2016). The validity test uses the
Spearman Correlation and the correlation
probability value [sig. (2-tailed)] <0.05 (95% truth
level) then made a comparison of r arithmetic and r
tables and the reliability test using Cronbach alpha
with provisions> 0.6 using SPSS 23. The
Kolmogorov-Smirnov table shows that the
Perception of data distribution is not normal because
0,000 is less than 0.05 and seen from the histogram
that the medical, pharmaceutical and nursing study
programs show an abnormal distribution.
3 RESULTS AND DISCUSSION
Table 1 shows that the study was dominated by 166
women with a percentage of 80.6%, while men
amounted to 40 with a percentage of 19.6%.
Table 2 shows that perceptions before attending
IPE in the three majors of medicine, pharmacy, and
nursing have ethical perceptions where medicine is
90.3%, pharmacy 93.7%, and nursing science
93.9%.
Table 1: Respondent Charactersitic by gender
Characteristic
Frequencies
n
%
Medical
Students
Pharmacy
Students
Nursing
Students
Male
18
9
13
40
19,4
Female
44
86
36
166
80,6
Total Score
62
95
49
206
100%
Students’ Perceptions on the Interprofessional Education: The Differences among Medical, Nursing, and Pharmacy’s Student
253

Table 2: Perceptions before learning Interprofessional Education (IPE)
Study Program
Pre-Test
Perception
n
%
Medical
Good
56
90,3 %
Moderate
6
9,7 %
Poor
0
0%
Total Score
62
100 %
Pharmacy
Good
89
93.70 %
Moderate
6
6,3 %
Poor
0
0%
Total Score
95
100%
Nursing
Good
40
81,6%
Moderate
9
18,4%
Poor
0
0%
Total Score
49
100%
Table 3: Perceptions about collaboration in Interprofessional Education (IPE) of medical, pharmacy and nursing students
Perception
Pre-Test
Post-Test
Deviation
n
%
n
%
Good
185
89,80%
195
94,70%
4,9%
Moderate
21
10,20%
11
5,30%
Poor
0
0
0
0
Total Score
206
100%
206
100%
Table 4: Changes in perception about collaboration on IPE in medical, pharmacy and nursing science students
Medical
Pharmacy
Nursing
Average
Z Asymp. Sig. (2-
tailed)
-1,000
0,317
-0,333
0,739
-1,732
0,083
-1,826
0,068
Based on table 3, it can be seen that the majority of
respondents had good perceptions of IPE before, and
after attending Interprofessional Education (IPE),
there was an increase of 4,9 %.
Based on table 4, using the significance of p ≤
0.050 for medicine, pharmacy and nursing does not
show a significant value, the results of the
combination of the three also found no significant
value so that Ho is accepted which means there is no
change in perception about collaboration in
Interprofessional Education medical students,
pharmacy and nursing.
Changes in perception about the collaboration of medical, pharmacy and nursing students in
each domain.
Table 5: Changes in perception about collaboration on IPE of medical, pharmacy and nursing students in each
domain
Component
No
Pre
Post
P-value
Information
Competence and autonomy
1
4,66
4,96
0,001
Significantly different
3
4,87
5,05
0,03
Significantly different
7
4,77
4,87
0,136
No significant difference
13
4,79
4,95
0,010
Significantly different
16
4,90
5,11
0,001
Significantly different
23,98
24,94
0,000
Significantly different
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Component
No
Pre
Post
P-value
Information
Perception of the need to work together
2
4,79
5,03
0,000
Significantly different
8
5,03
5,11
0,209
No significant difference
9
5,00
5,17
0,012
Significantly different
10
5,04
5,19
0,014
Significantly different
11
5,01
5,09
0,200
No significant difference
24,87
25,61
0,002
Significantly different
The need to collaborate
4
5,33
5,37
0,258
No significant difference
5
4,97
5,09
0,024
Significantly different
6
4,15
4,13
0,919
No significant difference
12
4,90
5,05
0,028
Significantly different
19,37
19,54
0,427
No significant difference
Understanding of other professions
15
4,51
4,58
0,562
No significant difference
14
4,98
5,11
0,023
Significantly different
9,50
9,70
0,184
No significant difference
Based on table 5, the average total pretest and
posttest scores of domains the need to collaborate and
understanding of other professions in the perception
variable obtained p-values higher than the real level
of 0.05, so that it was concluded that in the two
domains, there was no difference between before and
after giving treatment. While in domains 1 and 2, the
p-value is smaller than the 0.05 level, so it can be
concluded that in the two domains, there are
differences between before and after treatment.
This study shows that the perception of
collaboration before Interprofessional Education is
good. This can be due to knowledge about the
competencies, roles, and functions of each profession
previously obtained. Knowledge greatly influences
perception, considering that one aspect of knowledge
is the psychological aspect, which is an aspect of
human behavior after obtaining information (Judge et
al., 2015; Seaman et al., 2017).
This research is in line with research conducted by
Lairamore et al. (2013), in which this study was
attended by 594 nutrition students, nurses, therapists,
physical therapists, and speech linguists. This study
uses RIPLS to test readiness and IEPS to test
perceptions, proving that perceptions and readiness
about collaboration before joining IPE are good. In
addition, the study was conducted by Ernawati, Lee
& Hughes (2015), where the research was conducted
on 21 medicine, 16 nursing, and 22 pharmacies. The
research examines the readiness to collaborate, using
the RIPLS questionnaire, the research shows that
before joining IPE, students have good readiness.
Research conducted by Zanotti, Sartor, & Canova
(2015) was conducted on 421 students, while only
277 students followed this study until IPE was
completed. The research uses IEPS questionnaire to
see the perceptions and results of this study before
participating in the IPE.
So this research is in line with previous studies that
before participating in the IPE is good. Research
conducted at the University of Muhammadiyah
Malang, it can be because aspects of prior knowledge
can influence the results of this study, besides the
disproportionate number of samples can affect the
results of research because of one of the groups that
dominate in determining answers.
Perceptions about the Collaboration of Medical,
Pharmacy and Nursing Students after following
Interprofessional Education
The results of this study indicate that perceptions
about the collaboration of medical, pharmacy, and
nursing students after attending Interprofessional
Education are good, where the results of this study
show an improvement after attending IPE. The
existence of this good perception is because when
IPE, each student is able to master the competencies
in Interprofessional Education, namely knowledge,
skills, attitudes and team abilities (Purwanto and
Pratiwi, 2017). The discussion process that involves
each different profession will create more effective
collaboration.
Research on Interprofessional Education which
also measures perceptions about collaboration using
IEPS is research conducted by Lairamore et al. (2013)
which shows that after learning IPE perceptions that
students have are good, in addition there is an
increase between before and after participating in
IPE. Ernawati, Lee & Hughes (2015) also examined
with the same variables where this study also showed
that the readiness for collaboration after
Interprofessional Education was good and showed a
positive increase. Another study that measures
perception is the study of Zanotti, Sarto & Canova
(2015), using IEPS which proves that after IPE
Students’ Perceptions on the Interprofessional Education: The Differences among Medical, Nursing, and Pharmacy’s Student
255

students have a good perception, and there is an
increase in perception.
So that research on perceptions about the
collaboration of medical, pharmacy, and nursing
students after Interprofessional Education at the
University of Muhammadiyah Malang shows that
perception are good, and the results of this study are
supported by previous research. This is because the
method in IPE allows interprofessional students to
discuss and cooperate in problem-solving, where each
profession performs their respective roles and
functions according to the ethical legality of the
practice.
Changes in Perception on the Collaboration of
Medical, Pharmacy and Nursing Students in
Interprofessional Education and each Domain
This research shows that there is no change in
perception about the significant collaboration after
conducting Interprofessional Education as a whole.
So that researchers look at each question domain, for
the IEPS questionnaire, there are four dominants,
namely competence and autonomy, perception of the
need to work together, they need to work together,
understanding in other professions (Stull and Blue,
2016).
The results of this study indicate that the overall
of the IEPS questionnaire does not show significant
changes, whereas seen from each domain, there are
significant changes, namely in the domains of
competence and autonomy, and the perception of the
need to cooperate there are significant differences.
Overall for IEPS there was no change before IPE
students already had a good perception, although
there was an increase, but the increase was not
significant. That is because before IPE students have
gotten about the material competencies, roles,
functions, and legality of professional practice. So
that knowledge about collaboration is good,
considering that knowledge has psychomotor aspects
that can affect students' perceptions, besides the
disproportionate number of samples, will have an
impact on the similarity of answers in dominating
groups.
However, seen from each domain of perception
for the domain of competence and autonomy and the
perception of the need for cooperation there is a
change in that because when IPE students can
effectively discuss directly with other professions so
that they are able to apply their knowledge according
to the competence and autonomy of each profession.
The results of this study are consistent with the
research that Judge et al. (2015), where the study
conducted a pre-posttest method to see the readiness
of 308 students from dentistry, nutrition, medicine,
pharmacy, and therapists. Using the IEPS
questionnaire generated that overall, there was no
significant change in perception. However, seen in
each domain, there are significant changes in
competence and autonomy.
Another study that is in line with the results of this
study is the research of Tsang et al. (2016), which was
published in the Journal of Interprofessional Care
participated by 21 University of British Columbia
students, resulting in no significant overall changes
but seen in each domain there were changes
significant in the domains of competence and
autonomy and cooperation. So, it was concluded that
for the overall perception, there was no change, but in
the domain of competence and autonomy and the
perception of the need for cooperation, there was a
significant increase.
The results of this study are not in accordance
with research conducted by Seaman et al. (2017),
where the study was attended by 51 students from
seven professions who participated in the IPE
program for 13 weeks, where this study uses pre-post
measurements that result in an increase in readiness
for IPE on a "teamwork & collaborating" scale with a
significance value of 0,000 and a scale of "positive
professional identity" with a significance value of
0.001. Research conducted by Gunaldo et al. (2015)
found that there was a change in readiness at the IPE
when viewed from per item and domain; namely,
question item 18 "I am not sure what my professional
role will be" and the domain of roles and
responsibilities. The journal revealed that the research
was only conducted with small respondents so that
overall IPE readiness was not significant, and only
one question and domain of significance was
significant. Besides the significant results in that
section, it was difficult to determine the factors
associated with these changes.
The difference in the results of this study is
because medical, pharmacy, and nursing students of
the University of Muhammadiyah Malang know how
to collaborate and collaborate, professional identity,
and professional roles and responsibilities because
before learning about professional identity, roles, and
responsibilities and cooperating on previous material.
The researcher realizes that this study still has
shortcomings and limitations in its implementation,
the following are the limitations of the study as seen
from the bias factors including the uneven proportion
of samples because the number of pharmacy students
who dominated in this study, influenced the results of
this study. It is hoped that further research will
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involve a larger population so that it can provide more
significant results.
4 CONCLUSIONS
The conclusion of this study is the perception of
medical, pharmacy, and nursing students
respectively, both before and after undergoing
interprofessional education. Despite an increase in
perception of IPE, the results are not significant.
However, in the domains of competence, autonomy,
and cooperation, there is a significant increase.
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