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However, AMR attitudes and perceptions have not been assessed in Indonesia. This study aimed to develop and validate a questionnaire to evaluate pharmacy students\u2019 Perceptions and Attitudes toward Antibiotic Resistance and Antimicrobial <jats:bold>S<\/jats:bold>tewardship (PATARAS) and investigate the relationship between students\u2019 perceptions and attitudes toward antibiotic resistance and stewardship. Using purposive sampling, 500 undergraduate pharmacy students were included in the study. The 20-item PATARAS questionnaire with 5-point Likert scales was developed. The PATARAS includes perception (rational drug use (RDU)\u00a0and antimicrobial stewardship (AMS)) and attitude (professional role (PRO) and inappropriate practice (IPP)) domains. The validity (convergent and discriminant) of the PATARAS was investigated using confirmatory factor analysis (CFA). The CFA model fit was assessed using various goodness-of-fit indices. Reliability was assessed using Cronbach\u2019s alpha (\u03b1) and McDonald\u2019s Omega (\u03c9) values. The relationship between subdomains was evaluated using structural equation modeling (SEM). The PATARAS questionnaire achieved acceptable convergent and discriminant validity. The CFA model achieved a good fit. The reliability was good with \u03b1 and \u03c9 values of 0.817 and 0.845, respectively. The SEM showed that RDU and AMS were positively correlated with PRO (\u03b2\u2009=\u20090.121 and 0.539, respectively, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05); RDU and IPP were also positively correlated (\u03b2\u2009=\u20090.313, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), while AMS and IPP were negatively correlated (\u03b2\u2009= \u2212\u20090.275, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). The PATARAS is a valid and reliable instrument for assessing undergraduate pharmacy students\u2019 perceptions and attitudes toward AMR and AMS.<\/jats:p>","DOI":"10.1186\/s12909-025-07375-5","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T17:17:26Z","timestamp":1748625446000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Development and validation of a psychometric scale for assessing pharmacy students\u2019 perceptions and attitudes toward antimicrobial resistance and antimicrobial stewardship in Indonesia: the PATARAS study"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1248-042X","authenticated-orcid":false,"given":"Ikhwan Yuda","family":"Kusuma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8009-8962","authenticated-orcid":false,"given":"Ria","family":"Benko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6582-5615","authenticated-orcid":false,"given":"Muh. 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Perspect Clin Res. 2017;8(3):107\u201312. https:\/\/doi.org\/10.4103\/picr.PICR_147_16.","journal-title":"Perspect Clin Res"}],"container-title":["BMC Medical Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-025-07375-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12909-025-07375-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-025-07375-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T17:17:30Z","timestamp":1748625450000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmededuc.biomedcentral.com\/articles\/10.1186\/s12909-025-07375-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,30]]},"references-count":56,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["7375"],"URL":"https:\/\/doi.org\/10.1186\/s12909-025-07375-5","relation":{},"ISSN":["1472-6920"],"issn-type":[{"value":"1472-6920","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,30]]},"assertion":[{"value":"28 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted in accordance with the ethical principles of the Declaration of Helsinki, a globally recognized standard for research involving human participants, established by the World Medical Association. This standard outlines guidelines for conducting ethical research, emphasizing respect for individuals, beneficence, and justice. Ethical approval for this study was granted by the Health Research Ethics Committee of Universitas Harapan Bangsa (approval number: B.LPPM-UHB\/726\/02\/2022). This approval ensured that the study design, recruitment, and data handling procedures adhered to established ethical standards for research involving human participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Informed consent was obtained from all pharmacy institutions and participants included in this study. An online consent form explained the study's purpose, the voluntary nature of participation, participant anonymity, confidentiality, and data handling procedures, ensuring that all participants were informed about the study\u2019s objectives and implications [].","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for participants"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"805"}}