Re-evaluation of the interprofessional collaboration scale validation between nurses towards other health care professionals occupied in Italian emergency medical services

Main Article Content

Marco Carradore
Massimo Guasconi
Gian Domenico Giusti
Giovanna Artioli
Leopoldo Sarli


Interprofessional collaboration, validation, emergency medical services, nurses, multiple-group measurement, survey


Background and aim: Interprofessional collaboration (IPC) between health professionals is fundamental for the provision of an efficient and effective medical care service. This is especially so in states of emergency, as highlighted by the ongoing coronavirus disease 2019 pandemic. This study aimed to obtain further evidence regarding the validity and reliability of the Italian language IPC scale –an instrument for measuring interprofessional collaboration– in a setting that has yet to be investigated at an in-depth level: the emergency departments in Italian hospitals.

Methods: The survey tool was a structured questionnaire in the Italian language. It comprised the validated Italian version of the IPC scale plus a question concerning the frequency of collaborations between the nurses interviewed and other health professionals. Confirmatory factor analysis was applied to rate the three factors (“communication”, “accommodation” and “isolation”) that compose the scale.

Results: Four hundred thirty-six nurses working in an emergency department for at least one year completed the questionnaire, which assessed collaboration with other health professionals working in the same department. The model fit statistics are satisfactory for all the nurse-target group combinations analysed. Regarding the Cronbach’s alpha statistic used to compute the reliability of the scale, acceptable values were obtained for all items, except for those related to the isolation factor for each case of interprofessional collaboration considered.

Conclusions: The results confirm the validity of the IPC scale as an instrument for the assessment of interprofessional collaboration involving nurses and other workers occupied in the provision of healthcare in Italian emergency departments.


Download data is not yet available.
Abstract 72 | PDF Downloads 35


1. Jachetti A, Colombo G, Brignolo-Ottolini B, Franchi J, Solbiati M, Pecorino Meli M, Bosco P, Costantino G, Emergency department reorganisation to cope With COVID-19 outbreak in Milan university hospital: A Time-sensitive challenge. BMC Emerg Med. 2021;21(1):1-8.
2. De Filippis G, Cavazzana L, Gimigliano A, Piacenza M, Vimercati S, Covid-19 pandemic: A frontline hospital reorganization to cope with therapeutic and diagnostic emergency. Pharmacol Res. 2020;161:105160.
3. Meschi T, Rossi S, Volpi A, Ferrari C, Sverzellati N, Brianti E, Fabi M, Nouvenne A, Ticinesi A, Reorganization of a large academic hospital to Face COVID‐19 Outbreak: The model of Parma, Emilia‐Romagna REGION, ITALY. Eur J Clin Invest. 2020;50(6): e13250.
4. Natale JAE, Boehmer J, Blumberg DA, Dimitriades C, Hirose S, Kair LR, Kirk JD, Mateev SN, McKnight H, Plant J, Tzimenatos LS, Wiedeman JT, Witkowski J, Underwood MA, Lakshminrusimha S, Interprofessional/interdisciplinary teamwork during the early Covid-19 pandemic: Experience from a CHILDREN’S hospital within an academic health center. J Interprof Care. 2020;34(5):682-686.
5. Chang WY, Ma JC, Chiu HT, Lin KC, Lee PH, Job satisfaction and perceptions of quality of patient care, collaboration and teamwork in acute care hospitals. J Adv Nurs. 2009;65(9):1946-1955.
6. Rawlinson C, Carron T, Cohidon C, Arditi C, Hong QN, Pluye P, Peytremann-Bridevaux I, Gilles I, An Overview of Reviews on Interprofessional Collaboration in Primary Care: Barriers and Facilitators. Int J Integr Care. 2021;21(2):32.
7. Sollami A, Caricati L, Sarli L, Nurse–physician collaboration: a meta-analytical investigation of survey scores. J Interprof Care. 2015;29(3):223-229.
8. Carradore M, Michelini E, Caretta I, Carpi S, Corradini L, Ganapini S, Lumetta F, Paterlini G, Pedroni E, Russo A, Sarli L, Artioli G, Interprofessional collaboration between different health care professions in Emilia Romagna. Acta Biomed. 2021;92(S2):e2021033.
9. D’Amour D, Ferrada-Videla M, San Martin Rodriguez L, Beaulieu MD, The conceptual basis for interprofessional collaboration: Core concepts and theoretical frameworks. J Interprof Care. 2005;19(sup1):116-131.
10. World Health Organization. 2010. Framework for action on interprofessional education and collaborative practice. Geneva, Switzerland: WHO.
11. Nair DM, Fitzpatrick JJ, McNulty R, Click ER, Glembocki MM, Frequency of nurse-physician collaborative behaviors in an acute care hospital. J Interprof Care. 2012;26(2):115-120.
12. Reeves S, Lewin S, Espin S, Zwarenstein M. 2010. Interprofessional Teamwork for Health and Social Care. London: Blackwell-Wiley.
13. Perreault K, Careau E, Interprofessional collaboration: One or multiple realities? J Interprof Care. 2012;26(4):256-258.
14. Barr H, Koppel I, Reeves S, Hammick M, Freeth D. 2005. Effective interprofessional education: Argument, assumption and evidence. Oxford: Blackwell.
15. Baggs JG, Schmitt MH, Mushlin AI, Mitchell PH, Eldredge DH, Oakes D, Hutson AD, Association between nurse-physician collaboration and patient outcomes in three intensive care units. Crit Care Med. 1999;27(9):1991-1998.
16. Vegesna A, Coschignano C, Hegarty SE, Karagiannis T, Polenzani L, Messina E, Zoli R, Maio V, Attitudes towards physician–nurse collaboration in a primary care team-based setting: Survey-based research conducted in the chronic care units of the Tuscany region of Italy. J Interprof Care. 2016;30(1):65-70.
17. Schraeder C, Shelton P, Sager M, The Effects of a Collaborative Model of Primary Care on the Mortality and Hospital Use of Community-Dwelling Older Adults. J Gerontol A Biol Sci Med Sci. 2001;56(2),M106-M112.
18. Bujak JS, Bartholomew K, Transforming physician-nurse communication. Deteriorating relationships must be reversed for the benefit of patients, staff and the organization. Healthc Exec. 2011;26(4):56-59.
19. Weiss SJ, Davis HP, Validity and reliability of the Collaborative Practice Scales. Nurs res.1985;34(5):299-305.
20. Archibald D, Trumpower D, MacDonald CJ, Validation of the interprofessional collaborative competency attainment survey (ICCAS). J Interprof Care. 2014;28(6):553-558.
21. Way D, Jones L, Baskerville NB. (2001). Improving the effectiveness of primary health care through nurse practitioner / family physician structured collaborative practice (Appendix Z). Ottawa: University of Ottawa. Retrieved Feb. 2, 2007. from physician.aspx
22. Kenaszchuk C, Reeves S, Nicholas D, Zwarenstein M, Validity and reliability of a multiple-group measurement scale for interprofessional collaboration. BMC Health Serv Res. 2010;10(1):1-15.
23. Prentice D, Jung B, Taplay K, Stobbe K, Hildebrand L, Staff perceptions of collaboration on a new interprofessional unit using the Assessment of Interprofessional Team Collaboration Scale (AITCS). J Interprof Care. 2016;30(6):823-825.
24. Rettke H, Lehmann AI, Brauchli R, Bauer GF, Petry H, Spirig R, Capturing interprofessional collaboration between physicians and nurses in an acute care setting. A validation study of the revised German version of the Collaborative Practice Scales. J Interprof Care. 2020;34(2):211-217.
25. Caricati L, Mancini T, Sollami A, Guidi C, Prandi C, Bianconcini M, Silvano R, Taffurelli C, Artioli G, Nurse-physician collaborative scale: A contribution to the Italian validation. TPM - Testing, Psychometrics, Methodology in Applied Psychology. 2013;20:263-276.
26. di Giulio P, Arnfield A, English M, Fitzgerald E, Kelly D, Jankovic M, Gibson F, Collaboration between doctors and nurses in children’s cancer care: Insights from a European project. Eur J Oncol Nurs. 2013;17(6):745-749.
27. Alcusky M, Ferrari L, Rossi G, Liu M, Hojat M, Maio V, Attitudes Toward Collaboration Among Practitioners in Newly Established Medical Homes. Am J Med Qual. 2016;31(6):526-535.
28. Tousijn W, Integrating health and social care: Interprofessional relations of multidisciplinary teams in Italy. Curr Sociol. 2012;60(4):522-537.
29. Tonarelli A, Takeshi Yamamoto T, Foà C, Miraglia Raineri A, Artioli G, Baccarini E, Giampellegrini P, Masciangelo I, Moggi E, Toni D, Valcavi L, Sarli L, Italian Validation of the Chiba Interprofessional Competency Scale (CICS29). Acta Biomed. 2020; 91(2-S):58-66.
30. Vittadello F, Mischo-Kelling M, Wieser H, Cavada L, Lochner L, Naletto C, Fink V, Reeves S, A multiple-group measurement scale for interprofessional collaboration: Adaptation and validation into Italian and German languages. J Interprof Care. 2018;32(3):266-273.
31. Wieser H, Mischo-Kelling M, Vittadello F, Cavada L, Lochner L, Fink V, Naletto C, Reeves S, Perceptions of collaborative relationships between seven different health care professions in Northern Italy. J Interprof Care. 2018;33(2):133-142.
32. Ragazzoni P, Baiardi P, Zotti AM, Anderson N, West M, Research note: Italian validation of the team climate inventory: A measure of team climate for innovation. J Manag Psychol. 2002;17(4): 325-336.
33. Caricati L, Guberti M, Borgognoni P, Prandi C, Spaggiari I, Vezzani E, Iemmi M, The role of professional and team commitment in nurse–physician collaboration: A dual identity model perspective. J Interprof Care. 2015;29(5):464-468.
34. Franc JM, Verde M, Gallardo AR, Carenzo L, Ingrassia PL, An Italian version of the Ottawa Crisis Resource Management Global Rating Scale: a reliable and valid tool for assessment of simulation performance. Intern Emerg Med. 2017;12(5):651-656.
35. Caruso R, Magon A, Dellafiore F, Griffini S, Milani L, Stievano A, Orchard CA, Italian version of the Assessment of Interprofessional Team Collaboration Scale II (I-AITCS II): a multiphase study of validity and reliability amongst healthcare providers. Med Lav. 2018;109(4):316-324.
36. Bentler PM, Comparative fit indexes in structural models. Psychol Bull. 1990;107(2):238-246.
37. Byrne BM, 2012. Structural equation modeling with Mplus: Basic concepts, applications, and programming. Routledge/Taylor & Francis Group.
38. Browne MW, Cudeck R, Alternative Ways of Assessing Model Fit. Sociol Methods Res. 1992;21(2):230-258.
39. Hu LT, Bentler PM, Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equ Model. 1999;6(1):1-55.
40. DiStefano C, McDaniel HL, Zhang L, Shi D, Jiang Z, Fitting Large Factor Analysis Models With Ordinal Data. Educ Psychol Meast. 2019;79(3):417-436.
41. Marsh HW, Hau KT, Wen Z, In Search of Golden Rules: Comment on Hypothesis-Testing Approaches to Setting Cutoff Values for Fit Indexes and Dangers in Overgeneralizing Hu and Bentler’s (1999) Findings. Struct Equ Model. 2004;11(3):320-341.
42. Brown TA, (2015). Confirmatory Factor Analysis for Applied Research, Second Edition (Methodology in the Social Sciences) (Second ed.). The Guilford Press.
43. Taber KS, The Use of Cronbach’s Alpha When Developing and Reporting Research Instruments in Science Education. Res Sci Educ. 2018;48:1273-1296.
44. Cazzola M, Hanania N, MacNee W, Rudell K, Hackford C, Tamimi N, A review of the most common patient-reported outcomes in COPD – revisiting current knowledge and estimating future challenges. Int J Chron Obstruct Pulmon Dis. 2015;10:725-38
45. Nunnally J, Bernstein I, 1994. Psychometric Theory. New York: McGraw-Hill.

Most read articles by the same author(s)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 > >>