Murdoch M M, Kressin N, Fortier L, Giuffre P A, Oswald L
Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center, MN 55417, USA.
Acad Med. 2001 Feb;76(2):157-65. doi: 10.1097/00001888-200102000-00015.
To develop and validate a survey instrument to measure medical students' career-related values.
A literature review yielded seven content domains that consistently correlated with medical students' career choices: biosocial orientation, bioscientific orientation, academic interest, prestige, income, desire to avoid role strain, and desire for role support. Item pools for the content domains were developed by examining previously published questionnaires and research and by interviewing health professionals, medical students, and premedical students. The instrument was tested in two phases. In phase 1, a 96-item questionnaire was mailed to all 847 students at the University of Minnesota School of Medicine. Results were submitted to item analysis and exploratory factor analysis. Construct validity of the questionnaire was assessed by (1) seeing if the seven scales correlated to one another in expected directions, (2) correlating students' survey responses with their self-reported interests in primary care, surgery, or radiology, and (3) seeing if anticipated sex differences were realized across the seven content domains. In phase 2, a random subgroup of 134 students was sent the final 46-item instrument twice to determine its short-term test-retest reliability.
In phase 1, 670 students (79.2%) returned usable questionnaires. Seven scales corresponding to the content domains emerged from factor analyses. Cumulatively, they accounted for 43.9% of the variance in students' responses, and their internal consistency coefficients ranged from.71 to.87. All scales correlated with one another in the directions expected and, with two exceptions, at highly significant levels. High scores on bioscientific orientation, prestige, and income scales correlated positively with students' interest in surgery or radiology careers, but correlated negatively with their interest in primary care. High scores on biosocial orientation and avoid role strain scales correlated positively with students' interest in primary care, but correlated negatively with students' interest in surgery or radiology. Women had higher scores than did men on biosocial orientation, avoid role strain, and role support scales and lower scores on bioscientific orientation, academic interest, prestige, and income. Of these, all but the difference in role support scores were highly significant. In phase 2, 89 students (66%) returned questionnaires. Test-retest reliability for the seven scales ranged from.83 to.92.
The seven scales pertaining to students' career-related values collectively demonstrated high internal consistency, short-term test-retest reliability, and evidence of construct validity. If predictive validity can be demonstrated in future research, the scales could have important applications for researchers, guidance counselors, and students, and they might also be useful to administrators who wish to identify students interested in primary care earlier in the students' training.
开发并验证一种用于测量医学生职业相关价值观的调查问卷工具。
通过文献综述得出与医学生职业选择始终相关的七个内容领域:生物社会取向、生物科学取向、学术兴趣、声望、收入、避免角色压力的愿望以及对角色支持的渴望。通过审查先前发表的问卷和研究以及访谈健康专业人员、医学生和医学预科学生,为这些内容领域开发了项目池。该工具分两个阶段进行测试。在第一阶段,向明尼苏达大学医学院的所有847名学生邮寄了一份96项的问卷。结果提交进行项目分析和探索性因素分析。通过以下方式评估问卷的结构效度:(1)查看七个量表是否按预期方向相互关联;(2)将学生的调查回答与其自我报告的对初级保健、外科或放射科的兴趣进行关联;(3)查看七个内容领域是否实现了预期的性别差异。在第二阶段,向134名学生的随机子样本发送了最终的46项工具两次,以确定其短期重测信度。
在第一阶段,670名学生(79.2%)返回了可用问卷。因素分析得出了与内容领域相对应的七个量表。它们累计解释了学生回答中43.9%的方差,其内部一致性系数范围为0.71至0.87。所有量表均按预期方向相互关联,除两个例外,均在高度显著水平上相关。生物科学取向、声望和收入量表的高分与学生对外科或放射科职业的兴趣呈正相关,但与他们对初级保健的兴趣呈负相关。生物社会取向和避免角色压力量表的高分与学生对初级保健的兴趣呈正相关,但与学生对外科或放射科的兴趣呈负相关。女性在生物社会取向、避免角色压力和角色支持量表上的得分高于男性,在生物科学取向、学术兴趣、声望和收入量表上的得分低于男性。其中,除角色支持得分差异外,其他差异均高度显著。在第二阶段,89名学生(66%)返回了问卷。七个量表的重测信度范围为0.83至0.92。
与学生职业相关价值观相关的七个量表总体上表现出高内部一致性、短期重测信度和结构效度证据。如果在未来研究中能够证明其预测效度,这些量表可能对研究人员、指导顾问和学生具有重要应用价值,对于那些希望在学生培训早期识别对初级保健感兴趣的学生的管理人员也可能有用。