Development of the Australian Ageing Semantic Differential AASD), a novel instrument for measurement of medical student attitudes towards older people

Abstract

Attitudes of Australian medical students towards older people are important, as they can influence clinical practice. Initially I aimed to measure student attitude change after curriculum innovation. Literature review of Australian medical student attitudes revealed a gap for a valid, contemporary measure, inspiring the AASD. Review of international measures of student attitude identified semantic differential as the preferred instrument-type. A qualitative study of 151 medical students at the Universities of Wollongong (UOW) and Sydney (USYD) produced opposite word pairs for the AASD. The AASD was piloted at the University of New South Wales (UNSW), (n=140, response rate 77%). Removal of a redundant item pair resulted in a 19-item instrument (Cronbach’s α = 0.84). An AASD survey of New South Wales (NSW) medical students (n=321, response rate 72.6%) at UNSW, USYD, and UOW revealed: 1) A four-factor solution on exploratory factor analysis (Instrumentality (I), Personal Appeal (PA), Experience (E) and Sociability (S)), 2) No sequencing bias, 3) Cronbach’s α = 0.86, and 4) A positive mean AASD score (73.2/114), positive mean scores for three factors (PA, E and S) and negative mean I score. Female students had a significantly higher mean E score. Confirmatory factor analysis (CFA) demonstrated adequacy of fit for AASD survey data from outside NSW to our four-factor model. Melbourne University, University of Western Australia and University of Adelaide students (n=188, response rate 79%) had a mean AASD score (72.8/114) comparable to NSW data. The AASD is a reliable and generalisable instrument for measurement of Australian medical student attitudes towards older people, with face and structural validity. Deeper knowledge, within four factors of attitude, may be obtained from future medical education research employing the AASD.