Department of Medical Education, Cerrahpasa Medical School, University of Istanbul-Cerrahpasa, Istanbul, Turkey.
Department of Medical Education, School of Medicine, Ege University, Izmir, Turkey.
PLoS One. 2021 Jan 8;16(1):e0245195. doi: 10.1371/journal.pone.0245195. eCollection 2021.
National and international medical organizations and boards have recognized the importance of Evidence Based Medicine (EBM) and emphasized that EBM training should be included in medical education programs. Although some Turkish medical schools have developed and implemented EBM training programs, no validated Turkish language assessment tool has been available to compare the effectiveness of these training programs to national or international standards. The aim of this study is to cross-culturally adapt the Fresno Test, which is a validated English language tool utilized worldwide in the assessment of EBM training.
This study is a cross-sectional validation study, which was performed in two stages: Cross-cultural adaptation of the Fresno Test into Turkish; and evaluation of the psychometric properties, validity, reliability and responsiveness, of the Turkish version of the Fresno Test.
The content validity of the test was evaluated by experienced physicians in the field of Evidence-Based Medicine, and the content validity index was 1.00. The Cronbach α coefficient was 0.78 on the post-test results. The intraclass correlation (ICC) coefficient and the kappa analysis were calculated to evaluate inter-rater reliability. The ICC coefficients ranged from 0.66 to 0.97 for pre- and post-test results. The Kappa coefficients were 1.00 for all pre-test and post-test questions except one post-test question which was 0.89. The change score of the Fresno Test was used to evaluate responsiveness. The students' score of the Turkish Fresno Test was 49.9 ±18.2 pre-training and 118.9 ±26.3 post-training with a change of 69 points (95% CI, 63.9-74.2). The Cohen's effect size was 3.04 (95% CI, 2.6-3.5) indicating a very large change in scores.
The Turkish adapted Fresno Test used to evaluate students' success and program effectiveness is a valid and reliable measurement tool. It will be of great benefit for the comparison of the effectiveness of Turkish education programs nationally and cross-culturally.
国际和国家医学组织和委员会已经认识到循证医学（EBM）的重要性，并强调 EBM 培训应纳入医学教育计划。虽然一些土耳其医学院已经制定并实施了 EBM 培训计划，但尚无经过验证的土耳其语评估工具可用于将这些培训计划的效果与国家或国际标准进行比较。本研究的目的是跨文化适应 Fresno 测试，这是一种在全球范围内用于评估 EBM 培训的经过验证的英语语言工具。
本研究是一项横断面验证研究，分为两个阶段进行：Fresno 测试的跨文化适应为土耳其语；并评估土耳其语 Fresno 测试的心理测量特性、有效性、可靠性和反应性。
该测试的内容有效性由循证医学领域的经验丰富的医生进行评估，内容有效性指数为 1.00。后测结果的 Cronbach α 系数为 0.78。计算组内相关（ICC）系数和 Kappa 分析以评估评分者间信度。预测试和后测试结果的 ICC 系数范围为 0.66 至 0.97。除一个后测问题为 0.89 外，所有预测试和后测试问题的 Kappa 系数均为 1.00。Fresno 测试的变化分数用于评估反应性。土耳其 Fresno 测试的学生分数在培训前为 49.9±18.2，培训后为 118.9±26.3，变化 69 分（95%CI，63.9-74.2）。Cohen 效应大小为 3.04（95%CI，2.6-3.5），表明分数有很大变化。
用于评估学生成功和计划效果的土耳其语适应 Fresno 测试是一种有效且可靠的测量工具。它将极大地有利于在全国范围内和跨文化比较土耳其教育计划的效果。
