Validation of Patient Perception Instruments for Junior Doctor Performance: a Factor Analysis

Mia Kusmiati, Rafidah Bahari, Noor Aini Abdul Hamid, Suhaila Sanip, Ova Emilia

Abstract


The patient is an essential stakeholder within the medical healthcare system and an important stakeholder of the medical education program. The patients should be able to assess the performance of junior doctors in general practitioner residency to ensure their competency. Some instruments of patient assessment are available, but they do not adapt to local needs and context. This study aims to validate newly developed evaluation instruments from the patient’s perspective against the performance of a junior doctor in a teaching hospital. Fifty patients from outpatient clinics of internal medicine of two teaching hospital Faculty of Medicine Universitas Islam Bandung were selected to fill out the questionnaire in September–October 2018. The tool consists of 20 items and used a 4-point Likert scale of strongly disagree, disagree, agree, and strongly agree. The SPSS version 21 have used to extract the data as the principal axis factoring of analysis. Oblimin rotation method was applied with Kaiser normalization to simplify and describe the data structure. The detailed analysis identified five factors based on the initial eigenvalue >1. Patient perception instruments of junior doctor performance (PIJDP) showed that five constructs extracted explained 81.27% of the variance of them. Constructs were namely: humanism, responsibility-accountability, communication-empathy, altruism, and pleasant manner. Construct validity achieved after the PIJDP run fifteen times, and consistency internal with Cronbach’s alpha was 0.95. In conclusions, the PIJDP could be used to assess the performance of junior doctors and could make a novel contribution to the development of medical education.

 

VALIDASI INSTRUMEN PERSEPSI PASIEN TERHADAP KINERJA DOKTER MUDA: SEBUAH ANALISIS FAKTOR

Pasien merupakan stakeholder kunci dalam sistem pelayanan kesehatan dan stakeholder penting dalam program pendidikan kedokteran. Pasien dapat menilai kinerja dokter muda dalam pemagangan umum untuk memastikan kompetensi mereka. Beberapa instrumen penilaian pasien sudah dibuat, namun mereka tidak diadaptasi terhadap kebutuhan dan konteks lokal. Penelitian ini bertujuan memvalidasi instrumen evaluasi yang baru dikembangkan menurut perspektif pasien terhadap kinerja dokter muda di rumah sakit pendidikan. Lima puluh pasien dari klinik rawat jalan penyakit dalam dua rumah sakit pendidikan Fakultas Kedokteran Universitas Islam Bandung dipilih untuk mengisi kuesioner pada September–Oktober 2018. Kuesioner berisi 20 item yang menggunakan Skala Likert empat poin dari sangat tidak setuju, tidak setuju, setuju, dan sangat setuju. SPSS versi 21 digunakan untuk menganalisis data melalui principal axis factoring. Metode rotasi oblimin dengan normalisasi Kaiser diaplikasikan untuk menyederhanakan dan menjelaskan struktur data. Hasil analisis mengidentifikasi lima faktor berdasar atas eigenvalue awal >1. Instrument persepsi pasien terhadap kinerja dokter muda (PIJDP) menggambarkan 5 construct yang diekstraksi sebesar 81,27% dari varian indikator dapat dijelaskan oleh faktor yang terbentuk. Faktor tersebut adalah humanisme, tanggung jawab-akuntabilitas, komunikasi-empati, altruisme, dan sifat menyenangkan. Kesahihan construct dicapai setelah PIJDP diulang lima belas kali dan konsistensi internal dengan Cronbach’s alpha sebesar 0,95. Simpulan, PIJDP dapat digunakan untuk menilai kinerja dokter muda dan dapat memberi kontribusi baru dalam pengembangan pendidikan kedokteran.


Keywords


Construct; evaluasi; evaluation; kinerja; pasien; patient; performance; psikometrik; psychometric

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References


Prideaux D. Curriculum development in medical education: from acronyms to dynamism. Teach Teach Educ. 2007;23(3):294–302.

Sanchez-Reilly S, Ross JS. Hospice and palliative medicine: curriculum evaluation and learner assessment in medical education. J Palliat Med. 2012;15(1):116–22.

Ellett JD, Campbell JA, Gonsalves WC. Patient satisfaction in a student-run free medical clinic. Fam Med. 2010;42(1):16–8.

Ruhe V, Boudreau JD. The 2011 Program Evaluation Standards: a framework for quality in medical education programme evaluations. J Eval Clin Pract. 2013;19(5):925–32.

Spiel C, Schober B, Reimann R. Evaluation of curricula in higher education: challenges for evaluators. Eval Rev. 2006;30(4):430–50.

Dilmore TC, Rubio DM, Cohen E, Seltzer D, Switzer GE, Bryce C, et al. Communications psychometric properties of the mentor role instrument when used in an academic medicine setting. Clin Transl Sci. 2010;3(3):104–8.

Costello AB, Osborne JW. Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis. Pract Assess Res Eval. 2005;10(7).

van der Vleuten CPM, Schuwirth LWT. Assessing professional competence: from methods to programmes. Med Educ. 2005;39(3):309–17.

Francis MD, Warm E, Julian KA, Rosenblum M, Thomas K, Drake S, et al. Determinants of patient satisfaction in internal medicine resident continuity clinics: findings of the Educational Innovations Project Ambulatory Collaborative. J Grad Med Educ. 2014;6(3):470–7.

Worthington RL, Whittaker TA. Scale development research: a content analysis and recommendations for best practices. Couns Psychol. 2006;34(6):806–38.

DeVellis RF. Scale development: theory and applications. 4th Edition. Thousand Oaks, California: SAGE Publication; 2016.

Creswell JW, Guetterman TC. Educational research: planning, conducting, and evaluating quantitative and qualitative research. 6th Edition. Boston, Massachusetts: Pearson Publication; 2018.

Creswell JW. A concise introduction to mixed methods research. Thousand Oaks, California: SAGE Publication; 2015.

Shirali G, Shekari M, Angali KA. Assessing reliability and validity of an instrument for measuring resilience safety culture in sociotechnical systems. Saf Health Work. 2018;9(3):296–307.

Boerebach BCM, Lombarts KMJMH, Arah OA. Confirmatory factor analysis of the System for Evaluation of Teaching Qualities (SETQ) in graduate medical training. Eval Health Prof. 2016;39(2):21–32.

Anthoine E, Moret L, Regnault A, Sébille V, Hardouin JB. Sample size used to validate a scale: a review of publications on newly-developed patient reported outcomes measures. Health Qual Life Outcomes. 2014;12:176.

Velicer WF, Fava JL. Effects of variable and subject sampling on factor pattern recovery. Psychol Methods. 1998;3(2):231–51.

Cabrera-Nguyen P. Author guidelines for reporting scale development and validation results in the Journal of the Society for Social Work and Research. J Soc Social Work Res. 2010;1(2):99–103.

Arnold L. Assessing professional behaviour: yesterday, today, and tomorrow. Acad Med. 2002;77(6):502–15.

Klamen DL, Williams RG. The effect of medical education on students’ patient-satisfaction ratings. Acad Med. 1997;72(1):57–61.

Donini-Lenhoff FG, Hedrick HL. Increasing awareness and implementation of cultural competence principles in health professions education. J Allied Health. 2000;29(4):241–5.

Betancourt JR. Cross-cultural medical education: conceptual approaches and frameworks for evaluation. Acad Med. 2003;78(6):560–9.

Aragaw A, Yigzaw T, Tetemke D, G/Amlak W. Cultural competence among maternal healthcare providers in Bahir Dar City Administration, Northwest Ethiopia: cross sectional study. BMC Pregnancy Childbirth. 2015;15:227.

Lynch DC, Surdyk PM, Eiser AR. Assessing professionalism: a review of the literature. Med Teach. 2004;26(4):366–73.

Berendonk C, Stalmeijer RE, Schuwirth LW. Expertise in performance assessment: assessors’ perspectives. Adv Health Sci Educ. 2013;18(4):559–71.




DOI: https://doi.org/10.29313/gmhc.v7i1.4611


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