Faculdade São Leopoldo Mandic, Campinas, Brazil.
Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Clin Teach. 2023 Dec;20(6):e13619. doi: 10.1111/tct.13619. Epub 2023 Aug 23.
Uncertainty tolerance (UT) is attracting increasing attention in medical education due to the numerous challenges associated with uncertainty in professional life. Inconsistencies in analysing the relationship between UT and moderators may arise from inadequate measurement methods. Most instruments were formulated before the most widely accepted framework was published. Our aim was to investigate the validity of an UT scale using an actual framework to corroborate with better and accurate instruments.
A total of 1052 students were invited. Various psychometric methods were used to explore validity of the TAMSAD scale in light of actual framework. Classic exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed. Secondly, content item classification was triangulated with exploratory graph analysis (EGA), and the new EFA, CFA, and cognitive diagnostic modelling (CDM) analysis were conducted. The reliability was calculated using Cronbach's alpha and McDonald's omega.
A total of 694 students (65.9%) responded to the questionnaire. The reliability of the TAMSAD scale was 0.782. The initial EFA revealed no clear interpretable dimensions. The TAMSAD scale items can be classified into sources of uncertainty. The EGA has three dimensions, and the new EFA led to a 17-item TAMSAD scale with the following three dimensions: ambiguity, complexity, and probability. These dimensions lead to better adjustment fit indices in the new CFA and CDM analyses.
We found evidence that the TAMSAD scale can be considered a multidimensional scale, organised in terms of sources of uncertainty.
由于不确定性在职业生涯中带来的诸多挑战，不确定性容忍度（UT）在医学教育中受到越来越多的关注。由于测量方法不完善，分析 UT 与调节变量之间关系的结果可能不一致。大多数工具都是在最广泛接受的框架公布之前制定的。我们的目的是使用实际框架来研究 UT 量表的有效性，以验证更好和更准确的工具。
共邀请了 1052 名学生。根据实际框架，采用多种心理测量方法来探讨 TAMSAD 量表的有效性。进行了经典探索性因子分析（EFA）和验证性因子分析（CFA）。其次，使用探索性图形分析（EGA）对内容项目分类进行三角剖分，并进行新的 EFA、CFA 和认知诊断建模（CDM）分析。使用 Cronbach 的 alpha 和 McDonald 的 omega 计算可靠性。
共有 694 名学生（65.9%）回答了问卷。TAMSAD 量表的可靠性为 0.782。初始 EFA 没有显示出明确的可解释维度。TAMSAD 量表项目可分为不确定性的来源。EGA 有三个维度，新的 EFA 导致了一个 17 项的 TAMSAD 量表，有以下三个维度：模糊性、复杂性和概率。这些维度在新的 CFA 和 CDM 分析中导致了更好的调整拟合指数。
我们有证据表明，TAMSAD 量表可以被认为是一个多维量表，根据不确定性的来源进行组织。
