Open Access Research article

Measuring changes in perception using the Student Perceptions of Physician-Pharmacist Interprofessional Clinical Education (SPICE) instrument

Joseph A Zorek1*, Eric J MacLaughlin234, David S Fike5, Anitra A MacLaughlin26, Mohammed Samiuddin23 and Rodney B Young23

Author Affiliations

1 Pharmacy Practice Division, University of Wisconsin-Madison School of Pharmacy, 1016 Rennebohm Hall, 777 Highland Avenue, Madison, WI 53705-2222, USA

2 Department of Pharmacy Practice, Texas Tech University Health Sciences Center (TTUHSC) School of Pharmacy, Amarillo, TX, USA

3 Department of Family Medicine, TTUHSC School of Medicine, Amarillo, TX, USA

4 Department of Internal Medicine, TTUHSC School of Medicine, Amarillo, TX, USA

5 School of Graduate Studies and Research, University of the Incarnate Word, San Antonio, TX, USA

6 Hereford Pharmacy LLC, Hereford, TX, USA

For all author emails, please log on.

BMC Medical Education 2014, 14:101  doi:10.1186/1472-6920-14-101

Published: 20 May 2014



The Student Perceptions of Physician-Pharmacist Interprofessional Clinical Education (SPICE) instrument contains 10 items, 3 factors (interprofessional teamwork and team-based practice, roles/responsibilities for collaborative practice, and patient outcomes from collaborative practice), and utilizes a five-point response scale (1 = strongly disagree, 5 = strongly agree). Given the SPICE instrument’s demonstrated validity and reliability, the objective of this study was to evaluate whether it was capable of measuring changes in medical (MS) and pharmacy students’ (PS) perceptions following an interprofessional education (IPE) experience.


In this prospective cohort study, MS and PS completed the SPICE instrument before and after participation in a predefined IPE experience. Descriptive statistics were used to characterize students and pre-post responses. Independent samples t tests and Fisher’s Exact tests were used to assess group difference in demographic variables. Mann Whitney U tests were used to assess between-group differences in item scores. Wilcoxon Signed-Rank tests were used to evaluate post-participation changes in item scores. Spearman correlations were calculated to assess associations between ordinal demographic variables and item scores, and whether the number of clinic visits completed was associated with post-test responses. Paired samples t tests were used to calculate mean score changes for each of the factors.


Thirty-four MS and 15 PS were enroled. Baseline differences included age (25.3. ± 1.3 MS vs. 28.7 ± 4.4 PS; p = 0.013), years full-time employment (0.71 ± 0.97 MS vs. 4.60 ± 4.55 PS; p < 0.001), and number of prior IPE rotations (1.41 ± 1.74 MS vs. 3.13 ± 2.1 PS; p < 0.001). Two items generated baseline differences; 1 persisted post-participation: whether MS/PS should be involved in teamwork (3.91 MS vs. 4.60 PS; p < 0.001). For all students, significant mean score increases were observed for role clarity (“my role” [3.72 vs. 4.11; p = 0.001] and “others’ roles” [3.87 vs. 4.17; p = 0.001]), impact of teamwork on patient satisfaction (3.72 vs. 4.34; p < 0.001), and ideal curricular location for IPE (4.06 vs. 4.34; p = 0.002). Significant increases were observed for all three factors (teamwork, p = 0.003; roles/responsibilities and patient outcomes, p < 0.001).


This study demonstrated the SPICE instrument’s ability to measure changes in perception for medical and pharmacy students exposed to an IPE experience, both at the individual item level and at the factor level.

Interprofessional education; Interprofessional collaborative practice; Interprofessional teamwork; Interprofessional relations; Professional roles; Pretest-posttest