School of Medicine, Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil.
School of Psychology, Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil.
BMC Med Educ. 2019 May 16;19(1):151. doi: 10.1186/s12909-019-1587-x.
Training in the use of cost-conscious strategies for medical students may prepare new physicians to deliver health care in a more sustainable way. Recently, a role-modeling cost-conscious behaviors scale (RMCCBS) was developed for assessing students' perceptions of their teachers' attitudes to cost consciousness. We aimed to translate the RMCCBS into Brazilian Portuguese, adapt the scale, transculturally, and validate it.
We adopted rigorous methodological approaches for translating, transculturally adapting and validating the original scale English version into Brazilian Portuguese. We invited all 400 undergraduate medical students enrolled in the 5th and 6th years of a medical course in Northeast Brazil between January and March 2017 to participate. Of the 400 students, 281 accepted to take part in the study. We analyzed the collected data using the SPSS software version 21 and structural equation modeling (SEM) was performed using AMOS SPSS version 18. We conducted exploratory factor analysis (EFA), varimax rotation, with Kaiser Normalization and Principal Axis Factoring extraction method. We conducted confirmatory factor analysis (CFA), using the SEM. We used the following indexes of adherence of the model: Comparative fit index (CFI), Goodness-of-fit index (GFI) and Tucker-Lewis Index (TLI). We considered the Bayesian Information Criterion (BIC) for Sample-size adjusted. The root mean square error of approximation was calculated. Values below 0.08 were considered acceptable. Composite reliability analyzes were performed to evaluate the accuracy of the instrument. Values above 0.70 were considered satisfactory.
Of the 281 undergraduate medical students, 195 (69.3%) were female. Mean age of participants was 25.0 ± 2.6 years. In the EFA, the KMO was 0.720 and the Bartlett sphericity test was significant (p < 0.001). We conducted the EFA into two factors: role-modeling cost-conscious behaviors in health (seven items) and health waste behaviors (six items). The 13 item-scale was submitted to composite reliability analyzes, obtaining values of 0.813 and 0.761 for the role-modeling cost-conscious behaviors and the health waste behaviors factors, respectively.
We concluded that the cost-conscious behaviors scale has good psychometric properties and is a valid and reliable instrument for evaluating medical students' perception of their teachers' cost-conscious behaviors.
对医学生进行成本意识策略的培训，可以使新医生以更可持续的方式提供医疗服务。最近，开发了一种榜样成本意识行为量表（RMCCBS），用于评估学生对教师成本意识态度的看法。我们的目的是将 RMCCBS 翻译成巴西葡萄牙语，对其进行跨文化适应性调整，并对其进行验证。
我们采用了严格的方法来将原始量表的英文版本翻译成巴西葡萄牙文，并进行跨文化适应性调整和验证。我们邀请了 2017 年 1 月至 3 月期间在巴西北部的 5 年制和 6 年制医学课程中注册的 400 名本科生参加研究。在 400 名学生中，有 281 名接受了参加研究。我们使用 SPSS 软件版本 21 分析收集的数据，并使用 AMOS SPSS 版本 18 进行结构方程建模（SEM）。我们进行了探索性因素分析（EFA），采用方差极大旋转、凯泽归一化和主轴因子提取方法。我们进行了验证性因素分析（CFA），采用 SEM。我们使用模型的以下依从性指标：比较拟合指数（CFI）、拟合良好指数（GFI）和塔克-刘易斯指数（TLI）。我们考虑了样本量调整的贝叶斯信息准则（BIC）。计算了近似均方根误差。低于 0.08 的值被认为是可以接受的。进行了综合可靠性分析，以评估仪器的准确性。超过 0.70 的值被认为是令人满意的。
在 281 名本科生中，195 名（69.3%）为女性。参与者的平均年龄为 25.0±2.6 岁。在 EFA 中，KMO 为 0.720，巴特利特球形检验具有统计学意义（p<0.001）。我们进行了 EFA 成两个因素：卫生方面的榜样成本意识行为（七项）和卫生浪费行为（六项）。13 项量表进行了综合可靠性分析，榜样成本意识行为和卫生浪费行为因素的综合可靠性分析分别获得了 0.813 和 0.761 的值。
我们得出结论，成本意识行为量表具有良好的心理测量学特性，是评估医学生对教师成本意识行为看法的有效和可靠工具。
