Kumar Archana Prabu, Mani Prabu Kumar Chokkalingam, Atta Komal, Omprakash Abirami, Maheshkumar K, Atwa Hany, Maruthy K N, R Padmavathi
Medical Education Department, College of Medicine and Health Sciences (CMHS), Arabian Gulf University (AGU), Manama, Bahrain.
Department of Pathology, Government Hospitals, Salmaniya Medical Complex, Manama, Bahrain.
BMC Med Educ. 2025 Jul 7;25(1):1017. doi: 10.1186/s12909-025-07582-0.
BACKGROUND: E-learning has emerged as a transformative approach in medical and dental education in India, offering flexibility and accessibility to students. However, there is a lack of a standardized tool to assess the multiple dimensions influencing e-learning utilization among undergraduate health profession students. This study aims to develop and validate the Comprehensive Knowledge, Attitude, and Practice Questionnaire (CKAPQ) to examine various factors affecting e-learning utilization among undergraduate medical and dental students. METHODS: The study employed a cross-sectional validation design using Zhou's Mixed Methods Model to develop and validate the CKAPQ. The initial questionnaire contained 59 items across eight theoretical factors. Content validity was assessed using the Lawshe method, and the CKAPQ survey was conducted from 2014 to 2017 among medical and dental students at a South Indian tertiary care university. Data were analyzed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to validate the questionnaire structure and verify the theoretical framework. Model fit was assessed using indices such as Goodness-of-Fit Index (GFI), Adjusted Goodness-of-Fit Index (AGFI), Root Mean Square Error of Approximation (RMSEA), Normed Fit Index (NFI), Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Standardized Root Mean Square Residual (SRMR). Construct validity and structural equation modelling (SEM) were assessed. RESULTS: A total of 960 students (61.6% females, 38.4% males) participated in the study. Through EFA, eight items were removed based on skewness and kurtosis values, and 35 items were excluded due to factor loadings < 0.5. The Bartlett's Test of Sphericity was significant (p < 0.001), and the Kaiser-Meyer-Olkin measure (0.733) indicated sampling adequacy. The final model comprised 16 items representing five constructs with factor loadings ranging from 0.557 to 0.834. The model demonstrated good reliability (Cronbach's α ranging from 0.65 to 0.78) and strong absolute fit indices (GFI = 0.982, AGFI = 0.971, SRMR = 0.063). Construct validity was supported by Composite Reliability (0.729-0.848), Average Variance Extracted (0.516-0.669), and Maximum Shared Variance (0.143-0.304). The SEM model revealed significant correlations between constructs, with PLE and PEI showing strong positive correlation (r = 0.614), while negative correlations were observed between PLE, PEI and other factors. CONCLUSION: The proposed theoretical model had eight factors, while the psychometric properties of the CKAPQ and calculations of fit revealed a five-factor model. The developed CKAPQ provides a new, standardized method to evaluate knowledge, attitudes, and practices related to E-learning among medical and dental students.
背景:电子学习已成为印度医学和牙科教育中的一种变革性方法,为学生提供了灵活性和可及性。然而,缺乏一种标准化工具来评估影响本科卫生专业学生电子学习利用的多个维度。本研究旨在开发并验证综合知识、态度和实践问卷(CKAPQ),以检查影响本科医学和牙科学生电子学习利用的各种因素。 方法:本研究采用横断面验证设计,使用周的混合方法模型来开发和验证CKAPQ。初始问卷包含八个理论因素的59个项目。使用劳希方法评估内容效度,并于2014年至2017年在印度南部一所三级护理大学的医学和牙科学生中进行CKAPQ调查。使用探索性因素分析(EFA)和验证性因素分析(CFA)对数据进行分析,以验证问卷结构并验证理论框架。使用拟合优度指数(GFI)、调整后拟合优度指数(AGFI)、近似均方根误差(RMSEA)、规范拟合指数(NFI)、比较拟合指数(CFI)、塔克-刘易斯指数(TLI)和标准化均方根残差(SRMR)等指标评估模型拟合。评估结构效度和结构方程模型(SEM)。 结果:共有960名学生(61.6%为女性,38.4%为男性)参与了该研究。通过EFA,根据偏度和峰度值删除了8个项目,由于因子载荷<0.5又排除了35个项目。巴特利特球形检验显著(p<0.001),凯泽-迈耶-奥尔金度量值(0.733)表明抽样充足。最终模型包括16个项目,代表五个结构,因子载荷范围为0.557至0.834。该模型显示出良好的信度(克朗巴哈α系数范围为0.65至0.78)和较强的绝对拟合指数(GFI = 0.982,AGFI = 0.971,SRMR = 0.063)。综合信度(0.729 - 0.848)、平均提取方差(0.516 - 0.669)和最大共享方差(0.143 - 0.304)支持了结构效度。SEM模型显示各结构之间存在显著相关性,PLE和PEI显示出强正相关(r = 0.614),而PLE、PEI与其他因素之间存在负相关。 结论:提出的理论模型有八个因素,而CKAPQ的心理测量特性和拟合计算显示为一个五因素模型。开发的CKAPQ提供了一种新的标准化方法,用于评估医学和牙科学生与电子学习相关的知识、态度和实践。
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