Sparkman Center for Global Health, The University of Alabama at Birmingham, Birmingham, Alabama, USA
International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
BMJ Open. 2024 Jul 16;14(7):e082250. doi: 10.1136/bmjopen-2023-082250.
INTRODUCTION: Methods and validated tools for evaluating the performance of competency-based implementation research (IR) training programmes in low-middle-income countries (LMICs) are lacking. In this study, we developed tools for assessing the performance of IR training programmes based on a framework of IR core competencies in LMICs. METHODS: We developed self-assessment and objective-assessment tools drawing on the IR competency framework. We used exploratory factor analyses and a one-parameter logistic model to establish construct validity and internal consistency of the tools drawing on a survey conducted in 2020 with 166 trainees before and after an index IR course across five universities and LMICs under the Special Program for Research and Training in Tropical Diseases postgraduate IR training scheme. We conducted key informant interviews (KII) with 20 trainees and five trainers to reflect on the usefulness of the tools and framework for guiding IR training in LMICs. RESULTS: Two 16-item tools for self-assessment of IR knowledge and self-efficacy and a 40-item objective assessment tool were developed. The factor loadings of items in the self-assessment tools were 0.65-0.87 with Cronbach's alpha (α) of 0.97, and 0.77-0.91 with α of 0.98 for the IR knowledge and self-efficacy tools, respectively. The distribution of item difficulty in the objective-assessment tool was consistent before and after the index IR course. Pearson correlation coefficient (r) between the self-assessed and objectively assessed IR knowledge before the index IR course was low, r=0.27 (p value: <0.01), with slight improvements after the index IR course, r=0.43 (p value: <0.01). All KII respondents reported the assessment tools and framework were valid for assessing IR competencies. CONCLUSION: The IR competency framework and tools developed for assessing IR competencies and performance of IR training programmes in LMICs are reliable and valid. Self-assessment methods alone may not suffice to yield a valid assessment of performance in these settings.
简介：在中低收入国家（LMICs），缺乏评估基于能力的实施研究（IR）培训计划绩效的方法和经过验证的工具。在这项研究中，我们根据 LMICs 中的 IR 核心能力框架，开发了评估 IR 培训计划绩效的工具。
方法：我们借鉴 IR 能力框架，开发了自我评估和客观评估工具。我们使用探索性因素分析和单参数逻辑模型，在 2020 年对五个大学和热带病研究和培训特别方案下的五个 LMIC 中的 166 名学员在参加一个指数 IR 课程前后进行了调查，以建立工具的结构有效性和内部一致性。我们对 20 名学员和 5 名培训师进行了关键知情人访谈（KII），以反映工具和框架在指导 LMIC 中的 IR 培训方面的有用性。
结果：开发了两个用于评估 IR 知识和自我效能的 16 项自我评估工具和一个 40 项客观评估工具。自我评估工具中项目的因子负荷为 0.65-0.87，Cronbach's alpha（α）为 0.97，IR 知识和自我效能工具的α分别为 0.77-0.91。在指数 IR 课程前后，客观评估工具中项目难度的分布一致。在指数 IR 课程之前，自我评估和客观评估的 IR 知识之间的 Pearson 相关系数（r）较低，r=0.27（p 值：<0.01），在指数 IR 课程之后略有提高，r=0.43（p 值：<0.01）。所有 KII 受访者都报告说，评估工具和框架可用于评估 LMICs 中的 IR 能力。
结论：为评估 LMICs 中的 IR 能力和 IR 培训计划的绩效而开发的 IR 能力框架和工具是可靠和有效的。在这些环境中，仅使用自我评估方法可能不足以进行有效的绩效评估。
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