Medical and Pharmacy Students’ Attitudes Towards Physician- Pharmacist Collaboration in Indonesia: A Case Study Approach

Learning process evaluation of Interprofessional Education (IPE) was crucial to determine the implementation process’s success. The evaluation can be done by researching student attitudes in IPE activities. Research on students' attitudes in medical education and pharmacy study programs is expected to be a guideline for the IPE curriculum drafting team at the Faculty of Medicine, Universitas Islam Sultan Agung, Semarang, to develop future IPE learning activities. The study design was observational analytic with a cross-sectional method involving all medical and pharmacy students of the Faculty of Medicine, Universitas Islam Sultan Agung who had participated in a Small Group Discussion with TB management and met the inclusion criteria. Data collection was carried out in August 2020 using an online google form questionnaire. Data obtained through the Scale of Attitudes Toward Psychic-Pharmacist Collaboration questionnaire contains 16 questions tested for validity and reliability. Questions were answered using a 4-point Likert Scale. The statistical test analysis results on the total score of the collaboration attitude scale using the Mann Whitney Test was a p-value of 0.000. The median total score of medical and pharmacy students was 47.00 and 56.00, respectively. The p-value indicates a significant difference between the total scores of medical and pharmacy students. Based on the analysis results, the study shows significant differences in collaboration attitudes. Medical education students fall into the "moderate" category and pharmacy students in the "high" category. The pharmacy students have a more positive collaboration attitude than medical education students toward future collaborative relationships.


INTRODUCTION
The framework for action on interprofessional education and collaborative practice states that the interprofessional team can provide a more comprehensive approach to managing and preventing disease. Therefore, collaborative processes and practices between physicians and pharmacists are essential to improve patient outcomes 1,2 . However, collaborative practice has not been fully implemented 3, 4 .
The lack of collaboration between health workers teams is also based on the Interprofessional Education process, which has not been widely implemented in the university learning curriculum 5 . The curriculum preparation process must be reviewed and evaluated to determine whether the learning goals to be achieved are appropriate or otherwise 6 . One way to evaluate interprofessional education learning is to conduct research related to student's collaboration attitudes 7 .
The interprofessional education process should have been widely implemented in various universities around

Medical and Pharmacy Students' Attitudes Towards Physician-Pharmacist Collaboration in Indonesia: A Case Study Approach
Learning process evaluation of Interprofessional Education (IPE) was crucial to determine the implementation process's success. The evaluation can be done by researching student attitudes in IPE activities. Research on students' attitudes in medical education and pharmacy study programs is expected to be a guideline for the IPE curriculum drafting team at the Faculty of Medicine, Universitas Islam Sultan Agung, Semarang, to develop future IPE learning activities. The study design was observational analytic with a cross-sectional method involving all medical and pharmacy students of the Faculty of Medicine, Universitas Islam Sultan Agung who had participated in a Small Group Discussion with TB management and met the inclusion criteria. Data collection was carried out in August 2020 using an online google form questionnaire. Data obtained through the Scale of Attitudes Toward Psychic-Pharmacist Collaboration questionnaire contains 16 questions tested for validity and reliability. Questions were answered using a 4-point Likert Scale. The statistical test analysis results on the total score of the collaboration attitude scale using the Mann Whitney Test was a p-value of 0.000. The median total score of medical and pharmacy students was 47.00 and 56.00, respectively. The p-value indicates a significant difference between the total scores of medical and pharmacy students. Based on the analysis results, the study shows significant differences in collaboration attitudes. Medical education students fall into the "moderate" category and pharmacy students in the "high" category. The pharmacy students have a more positive collaboration attitude than medical education students toward future collaborative relationships. Therefore, study about views from both perspectives (pharmacy and medical students) urgently needs to be done. Research on students' attitudes in medical education and pharmacy study programs is also expected to be a guideline for the interprofessional education curriculum drafting team at the Faculty of Medicine, Universitas Islam Sultan Agung, Semarang, to develop interprofessional education learning activities in the future. Hence, the purpose of this study was to measure attitude differences of undergraduate pharmacy and medical students toward physicianpharmacist collaboration after interprofessional education activities.

Materials
Data collection in this study was carried out by using a google form online questionnaire and could be accessed in https://bit.ly/SkripsiFutikha2020.

Methods
This research was an observational analytic study with cross-sectional methods because the independent and dependent variables were obtained simultaneously. The All items were directly scored except for the 9 th , a reversescored item (1: strongly agree; 2: agree; 3: disagree 4: strongly disagree). The respondent could score between 16 and 64. A high score means a more positive attitude about the relationship between physicians and pharmacists. Data analysis was performed using the Mann-Whitney test's discriminability test because the data were not normally distributed.

RESULTS AND DISCUSSION
The study was conducted to determine differences in collaboration attitudes between medical and pharmacy students on interprofessional education activities.
Respondents in the study were medical students' class of 2018 who entered their 4 th semester and pharmacy students' class of 2016 who entered their 8 th semester.
Pharmacy students of 2018 did not have a subject of pharmacotherapy yet, so the upperclassmen were chosen because they could collaborate with medical students and were eligible for this research. Both groups participated in the SGD on August 25 th , 2020 (SGD 1) and August 29 th , 2020 (SGD 2).
The data collected during August 2020 was 205 respondents, consisting of 153 medical students' class 2018 and 52 pharmacy students' class 2016. The results obtained were data tabulation, coding, and data entry, followed by normality and homogeneity tests as shown in Table I. The normality test results in the total score of medical and pharmacy students' using Kolmogorov-Smirnov conclude that the data were not distributed normally. The homogeneity test result using the Levene test is a sig value of 0.261, which was more than 0.05.
Hence the data was homogeneous. The results did not meet the parametric test requirements, which must be normally distributed and homogeneous. Therefore, a non-parametric test was carried out.

CONCLUSION
There is a significant difference in the total collaboration attitudes between medical and pharmacy students (p 0.000). Medical students are in the "moderate" category and pharmacy students in the "high" category. The pharmacy students have a more positive collaboration attitude than medical education students toward future collaborative relationships. It is recommended to conduct research related to physician-pharmacist collaboration obstacles to evaluate the implementation process of interprofessional education.

ACKNOWLEDGMENT
This research project was supported by a grant from the LPPM Universitas Islam Sultan Agung. Investigator, writing-review and editing.

DATA AVAILABILITY
None.