Development of the Australian Ageing Semantic Differential, a new instrument for measuring Australian medical student attitudes towards older people

Abstract

Objective This study outlines development of an instrument for measuring attitudes of medical students towards older people, the Australian Ageing Semantic Differential (AASD). Methods Words for AASD scales were derived from the reflections of 151 third year medical students attending two Australian medical schools. A pilot study of the AASD was then undertaken with third year students at another medical school to confirm usability and reliability of the instrument. After slight modification, a larger study using the AASD was then undertaken of medical students attending the three institutions, in order to obtain sufficient data for exploratory factor analysis. Results n = 321 (response rate 73%). Mean AASD score 73.2/114. Cronbach's α = 0.86. There was no evidence of sequence bias. Exploratory factor analysis (EFA) demonstrated four factors: Instrumentality; Personal Appeal; Experience; and Sociability. A lower mean instrumentality subscore for all students and a higher mean experience subscore for female students were noted. Conclusions The AASD instrument proved internally reliable, and its use was generalisable to different groups of medical students. Its design ensured construct and face validity, and responses were not affected by sequencing bias. This study has revealed positive student attitudes towards older people. Variation in attitudes requires further investigation.

Cross-sectional study of Australian medical student attitudes towards older people confirms a four-factor structure and psychometric properties of the Australian Ageing Semantic Differential

“…This study has provided robust evidence that the AASD as a measure of medical student attitudes towards older people is generalisable across both undergraduate and graduate medical programmes in Australia, and has performed with very good internal consistency in studies to date. As was demonstrated previously by the AASD developmental study findings from student surveys across three NSW medical schools (mean AASD score 73.2/114 and Cronbach's alpha=0.86), 28 this study of medical students outside NSW has again demonstrated positive Australian medical student attitudes towards older people (mean AASD score 72.8/114 and Cronbach's alpha=0.84). Independent t-testing confirms no significant difference in mean AASD scores of students surveyed outside NSW when compared with their NSW counterparts.…”

“…Pilot study of the prototype survey instrument was performed with third-year medical students attending the University of New South Wales medical school in late 2016, demonstrating internal reliability and usability for this instrument. 27 A recently published paper describes further development of the AASD from data obtained from surveying students in three NSW medical schools. 28 The AASD consists of 19 pairs of opposite adjectives, and can be viewed in figure 1.…”

“…27 A recently published paper describes further development of the AASD from data obtained from surveying students in three NSW medical schools. 28 The AASD consists of 19 pairs of opposite adjectives, and can be viewed in figure 1.…”

“…Exploratory factor analysis (EFA) of NSW student survey data indicated a four-factor solution as preferred for the AASD. 28 The four factors, in descending order of contribution to variance, are I, PA, E and S. We chose to retain two of the named factors from the original ASD: (1) I, with only 2 of the original 9 words kept ('strong' and 'healthy'), relating to the respondent's judgement of the perceived effectiveness or competency of an older person, and (2) PA, with 2 of the 14 original words retained ('pleasant' and 'friendly'). Thus, only 6 of 32 word pairs of the ASD are found within the AASD, with the new instrument using 13 new bipolar item pairs and introducing two new domains of attitude, E and S. Scores for each of the four factors are not intended to be weighted.…”

“…33 For this reason, we proposed to test the factor structure based on a minimum of four items per factor and made one change to the previous factor structure by including the item 'interesting' within the E factor instead of the PA factor, a decision influenced by high cross-loading noted for this item to both factors in the previously reported NSW study. 28 Four congeneric CFAs were then conducted for each factor, and model fit was assessed. The I factor consisted of the items energetic, fast, healthy, independent, orientated and strong.…”