Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.
Acad Med. 2010 Sep;85(9):1518-25. doi: 10.1097/ACM.0b013e3181eac3fb.
To determine the psychometric properties of a theoretically based continuing medical education (CME) evaluation instrument examining attitudinal determinants of physicians' changes in medical practices after a CME intervention. The instrument's scales represented constructs from the theory of planned behavior.
The authors based the template instrument on educational objectives of the CME intervention and adapted it to the clinical domain of preoperative breast cancer therapy. Development of the initial survey involved cognitive testing, pilot tests, and expert reviews. The authors asked 269 clinicians to complete the 35-item instrument before the CME intervention. Factor analysis and item analysis guided the development of the final six subscales: positive behavioral beliefs, negative behavioral beliefs, attitude toward the behavior, perceived behavior control (self-efficacy), subjective norms, and behavioral intention.
Cognitive testing and pilot tests ensured the accuracy and clarity of the language and a reasonable survey length. Of the 269 clinicians, 168 (134 physicians) responded. Scales clustered according to the theoretical constructs. Items not loading in any subscales were eliminated. The final 25 items loaded on six subscales with loadings >0.54. Reliability for the subscales ranged from 0.73 to 0.93 (good for the scale development stage). The authors revised the instrument template and protocol after this initial study to increase the possibility of use in future CME evaluations.
The levels of content and construct validity and reliability of the CME evaluation instrument are acceptable for evaluation of CME activities targeting physicians. Instruments adapted from this template could potentially evaluate future CME activities.
确定一个基于理论的继续医学教育（CME）评估工具的心理测量学特性，该工具考察了医生在 CME 干预后改变医疗实践的态度决定因素。该工具的量表代表了计划行为理论的结构。
作者基于 CME 干预的教育目标为模板工具，并将其改编为术前乳腺癌治疗的临床领域。初始调查的开发涉及认知测试、试点测试和专家审查。作者要求 269 名临床医生在 CME 干预前完成 35 项的工具。因素分析和项目分析指导了最终六个分量表的开发：积极行为信念、消极行为信念、对行为的态度、行为感知控制（自我效能）、主观规范和行为意图。
认知测试和试点测试确保了语言的准确性和清晰度以及合理的调查长度。在 269 名临床医生中，有 168 名（134 名医生）做出了回应。量表根据理论结构聚类。未加载到任何分量表中的项目被删除。最后 25 个项目加载到六个分量表上，加载值>0.54。分量表的可靠性范围为 0.73 至 0.93（对于量表开发阶段来说是良好的）。作者在这项初步研究后修改了仪器模板和方案，以增加在未来 CME 评估中的使用可能性。
CME 评估工具的内容、结构有效性和可靠性水平可用于评估针对医生的 CME 活动。从该模板改编的工具可能会评估未来的 CME 活动。
