Aizer Juliet, Abramson Erika L, Berman Jessica R, Paget Stephen A, Frey Marianna B, Cooley Victoria, Li Ying, Hoffman Katherine L, Schell Julie A, Tiongson Michael D, Lin Myriam A, Mandl Lisa A
Weill Cornell Medicine and Hospital for Special Surgery, New York, New York.
Weill Cornell Medicine, New York, New York.
ACR Open Rheumatol. 2023 Jan;5(1):4-9. doi: 10.1002/acr2.11505. Epub 2022 Nov 1.
Self-efficacy, the internal belief that one can perform a specific task successfully, influences behavior. To promote critical appraisal of medical literature, rheumatology training programs should foster both competence and self-efficacy for critical appraisal. This study aimed to investigate whether select items from the Clinical Research Appraisal Inventory (CRAI), an instrument measuring clinical research self-efficacy, could be used to measure critical appraisal self-efficacy (CASE).
One hundred twenty-five trainees from 33 rheumatology programs were sent a questionnaire that included two sections of the CRAI. Six CRAI items relevant to CASE were identified a priori; responses generated a CASE score (total score range 0-10; higher = greater confidence in one's ability to perform a specific task successfully). CASE scores' internal structure and relation to domain-concordant variables were analyzed.
Questionnaires were completed by 112 of 125 (89.6%) trainees. CASE scores ranged from 0.5 to 8.2. The six CRAI items contributing to the CASE score demonstrated high internal consistency (Cronbach's α = 0.95) and unidimensionality. Criterion validity was supported by the findings that participants with higher CASE scores rated their epidemiology and biostatistics understanding higher than that of peers (P < 0.0001) and were more likely to report referring to studies to answer clinical questions (odds ratio 2.47, 95% confidence interval 1.41-4.33; P = 0.002). The correlation of CASE scores with percentage of questions answered correctly was only moderate, supporting discriminant validity.
The six-item CASE instrument demonstrated content validity, internal consistency, discriminative capability, and criterion validity, including correlation with self-reported behavior, supporting its potential as a useful measure of critical appraisal self-efficacy.
自我效能感，即一个人认为自己能够成功完成特定任务的内在信念，会影响行为。为促进对医学文献的批判性评价，风湿病学培训项目应培养批判性评价的能力和自我效能感。本研究旨在调查临床研究评价量表（CRAI）（一种测量临床研究自我效能感的工具）中的特定条目是否可用于测量批判性评价自我效能感（CASE）。
向来自33个风湿病学项目的125名学员发送了一份问卷，其中包括CRAI的两个部分。事先确定了与CASE相关的6个CRAI条目；这些条目的回答生成了一个CASE分数（总分范围为0至10；分数越高 = 对自己成功执行特定任务能力的信心越强）。分析了CASE分数的内部结构及其与领域一致变量的关系。
125名学员中有112名（89.6%）完成了问卷。CASE分数范围为0.5至8.2。对CASE分数有贡献的6个CRAI条目显示出高度的内部一致性（Cronbach's α = 0.95）和单维度性。标准效度得到以下结果的支持：CASE分数较高的参与者对流行病学和生物统计学的理解评分高于同龄人（P < 0.0001），并且更有可能报告参考研究来回答临床问题（优势比2.47，95%置信区间1.41 - 4.33；P = 0.002）。CASE分数与正确回答问题的百分比之间的相关性仅为中等，支持了区分效度。
六项CASE工具显示出内容效度、内部一致性、区分能力和标准效度，包括与自我报告行为的相关性，支持其作为批判性评价自我效能感有用测量工具的潜力。
