Faculty of Psychology and Educational Sciences, Department of Work, Organisation and Society, Research Group Vocational and Personnel Psychology, Ghent University, H. Dunantlaan 2, Ghent, 9000, Belgium.
Faculty of Psychology and Educational Sciences, Department of Experimental Psychology, Ghent University, Henri Dunantlaan 2, Ghent, 9000, Belgium.
Int J Equity Health. 2024 Nov 5;23(1):226. doi: 10.1186/s12939-024-02309-x.
Measuring intercultural attitudes can aid in understanding and addressing persistent inequities in healthcare. Instead of creating new instruments, several sources call for a more rigorous revalidation of existing instruments towards a more broad population. As an example of such an existing instrument, the EMP-3 (Ethnic Minority Patients) focuses on the attitudes of physicians towards ethnic minority patients. Starting from a robust theoretical underpinning and a rigorous methodological setup, the present study revalidates the EMP-3 instrument for physicians towards the REMP-3 instrument for graduate healthcare practitioners.
We assessed the reliability and validity of the old EMP-3, which we then updated to a new REMP-3 instrument. We used structural equation modeling to model the framework of intercultural effectiveness on two waves of independent data, N = 368 and N = 390. Within this framework, we tested the new REMP-3 instrument as an operationalization of intercultural attitudes. We conducted a confirmatory factor analysis on the first wave, after which we made adaptations to the original EMP-3 instrument to obtain a new REMP-3 instrument. The new REMP-3 instrument was then cross-validated using the data of the second wave.
The new REMP-3 instrument is a psychometric upgrade compared to the EMP-3. The REMP-3 now has a cross-validated structure, with three subscale dimensions (i.e., task perception, background perception and the perceived need to communicate) and an overarching higher-order, full-scale dimension. Both the subscales as well as the full instrument show acceptable to good internal consistency reliability, with a reduced number of items from eighteen to ten. As theoretically predicted, the REMP-3 also functions as a measure of intercultural attitudes in an intercultural competence framework.
Ultimately, the REMP-3 instrument can contribute to more equity in healthcare by concisely and reliably assessing and monitoring attitudes in healthcare practitioners. This attitude assessment represents the potential of learning new skills and knowledge to address interactions with ethnic minority patients, which is especially useful during training situations like an internship.
衡量跨文化态度有助于理解和解决医疗保健中持续存在的不平等问题。一些来源呼吁，除了创建新的工具外，还需要对现有的工具进行更严格的重新验证，以涵盖更广泛的人群。作为现有工具的一个例子，EMP-3（少数民族患者）侧重于医生对少数民族患者的态度。本研究从坚实的理论基础和严格的方法设置出发，重新验证了 EMP-3 工具，将其应用于研究生医疗保健从业者的 REMP-3 工具。
我们评估了旧的 EMP-3 的可靠性和有效性，然后对其进行了更新，得到了新的 REMP-3 工具。我们使用结构方程模型在两个独立数据波中对跨文化有效性框架进行建模，N=368 和 N=390。在这个框架内，我们将新的 REMP-3 工具作为跨文化态度的操作化进行了测试。我们在第一个波次进行了验证性因素分析，之后对原始 EMP-3 工具进行了调整，得到了新的 REMP-3 工具。然后使用第二个波次的数据对新的 REMP-3 工具进行了交叉验证。
与 EMP-3 相比，新的 REMP-3 工具在心理测量学上有所提升。REMP-3 现在具有交叉验证的结构，有三个子量表维度（即任务感知、背景感知和感知沟通需求）和一个整体的高级、全量表维度。子量表和整个工具都具有可接受至良好的内部一致性信度，项目数从 18 项减少到 10 项。正如理论预测的那样，REMP-3 也可以作为跨文化能力框架中的跨文化态度的测量工具。
最终，REMP-3 工具通过简洁、可靠地评估和监测医疗保健从业者的态度，为医疗保健中的公平做出贡献。这种态度评估代表了学习新技能和知识以应对与少数民族患者互动的潜力，这在实习等培训情况下尤其有用。
