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PubMed1994

Measuring quality of life in hospice patients using a newly developed Hospice Quality of Life Index.

The purpose of this study was to evaluate the validity and reliability of the newly developed Hospice Quality of Life Index (HQLI). Sixty-eight patient/caregiver dyads from one hospice were asked to fill out the HQLI on admission and after 3 weeks of hospice care. Hospice experts evaluated the items on the tool to assess content validity. The content validity index (0.83) and the alpha coefficients (r = 0.87 and 0.83) supported the validity and reliability of the HQLI. Item analysis revealed items with which patients were most satisfied and aspects of quality of life that were considered to be most important.

Adult↗

PubMed2000

Development of an audit instrument for nursing care plans in the patient record.

OBJECTIVES: To develop, validate, and test the reliability of an audit instrument that measures the extent to which patient records describe important aspects of nursing care. MATERIAL: Twenty records from each of three hospital wards were collected and audited. The auditors were registered nurses with a knowledge of nursing documentation in accordance with the VIPS model--a model designed to structure nursing documentation. (VIPS is an acronym formed from the Swedish words for wellbeing, integrity, prevention, and security.) METHODS: An audit instrument was developed by determining specific criteria to be met. The audit questions were aimed at revealing the content of the patient for nursing assessment, nursing diagnosis, planned interventions, and outcome. Each of the 60 records was reviewed by the three auditors independently and the reliability of the instrument was tested by calculating the inter-rater reliability coefficient. Content validity was tested by using an expert panel and calculating the content validity ratio. The criterion related validity was estimated by the correlation between the score of the Cat-ch-Ing instrument and the score of an earlier developed and used audit instrument. The results were then tested by using Pearson's correlation coefficient. RESULTS: The new audit instrument, named Cat-ch-Ing, consists of 17 questions designed to judge the nursing documentation. Both quantity and quality variables are judged on a rating scale from zero to three, with a maximum score of 80. The inter-rater reliability coefficients were 0.98, 0.98, and 0.92, respectively for each group of 20 records, the content validity ratio ranged between 0.20 and 1.0 and the criterion related validity showed a significant correlation of r = 0.68 (p < 0.0001, 95% CI 0.57 to 0.76) between the two audit instruments. CONCLUSION: The Cat-ch-Ing instrument has proved to be a valid and reliable audit instrument for nursing records when the VIPS model is used as the basis of the documentation.

Documentation↗

PubMed2003

Quality of psychiatric care: validation of an instrument for measuring inpatient opinion.

OBJECTIVES: To validate a brief self-completed questionnaire for routinely assessing patients' opinions on the quality of care in inpatient psychiatric wards (Rome Opinion Questionnaire for Psychiatric Wards). DESIGN: A preliminary version was assessed for face and content validity by eight psychiatrists and two patient focus groups. The final version was evaluated for acceptability, factor structure, internal consistency, and test-retest reliability. SETTING: An inpatient psychiatric ward in a general hospital in Rome. STUDY PARTICIPANTS: The questionnaire was administered to all consecutive inpatients admitted over a 6-month period (n = 169). Test-retest reliability was evaluated by administering the questionnaire for a second time to 27 inpatients. MAIN OUTCOME MEASURES: Face and content validity: psychiatrists and focus groups' opinions on relevance, importance, and clarity, acceptability: inpatients' opinions on user-friendliness; factor analysis: principal component analysis; internal consistency: Cronbach's alpha; test-retest reliability: Cohen's weighted kappa coefficient, intraclass correlation coefficient RESULTS: After evaluating face and content validity, the questionnaire was reduced to 10 items. Inpatients found the questionnaire to be acceptable. Factor analysis revealed that three factors-professional qualities of staff, information received, and physical environment-explained 67.2% of total variance. Cronbach's alpha was 0.82 for the questionnaire and 0.61, 0.71, and 0.35 for the three factors, respectively. Test-retest reliability was good; weighted kappa higher than 0.9 for three items and 0.6-0.9 for seven items. The intraclass correlation coefficient was 0.80. CONCLUSIONS: The questionnaire seems to be adequate for evaluating patients' opinions on care in inpatient psychiatric wards. Because of its user-friendliness, it may be particularly suitable for routine use.

Adult↗

PubMed2006

Evaluation of clinical research knowledge and interest among pharmacy residents: survey design and validation.

PURPOSE: The development and validation of a survey to describe the research knowledge, attitudes, and skills of pharmacy practice residents are described. SUMMARY: A survey was drafted to determine if pharmacy practice residency experience and the American Society of Health-System Pharmacists (ASHP)-required project improve the residents' objectively and subjectively assessed research knowledge, to determine if the residency experience and the ASHP-required project affect the residents' attitudes regarding research as a component of their future professional practice, and to subjectively assess the effect of the residency experience and the ASHP-required project on other essential skills, such as problem solving, critical thinking, and time management. An initial questionnaire was developed and underwent content validation testing by clinical pharmacists and faculty, residents, and research fellows. Following content validation, the questionnaire underwent construct validity testing (for discriminative validity and responsiveness) in students, residents, and clinical pharmacists and faculty. Reliability was tested in a subgroup of subjects who completed the questionnaire twice within two to four weeks. From the content validation phase, average scores for individual questions ranged from 1.00 to 2.00. Discriminative validity testing of the revised questionnaire demonstrated the instrument's ability to discriminate between groups expected to differ. Effect-size and mean-knowledge score differences indicated high levels of responsiveness, signifying the instrument's ability to detect change over time or after an intervention. CONCLUSION: A survey questionnaire developed to measure research knowledge and interest among pharmacy practice residents demonstrated its validity and reliability with significant sensitivity and responsiveness.

Data Collection↗

PubMedDate not supplied

Measurement of safe sex behavior in adolescents and young adults.

The aim of this project was to develop an instrument to measure use of safe sex practices among adolescents and to conduct initial evaluation of the psychometric properties of the instrument. The Safe Sex Behavior Questionnaire (SSBQ) was designed to measure the frequency of use of safe sex practices and was assessed for content validity, reliability, and construct validity through a series of tests. The content validity index computed for the SSBQ was 98%. Initial reliability computed for sums of items of the total scale was .82 among 89 college freshmen. Using a second sample of 531 subjects, the SSBQ was factor-analyzed separately for males and females and five similar factors emerged for each gender. Reliability coefficients for sums of salient items for each factor ranged from .52 to .85. Using a third sample of 174 subjects, construct validity was assessed by correlating the SSBQ with measures of general assertiveness and general risk-taking. The resulting correlations were appreciable and in the predicted directions, thus providing support for the construct validity of the instrument.

Acquired Immunodeficiency Syndrome↗

PubMed2005

Chinese version of the parent-proxy health-related quality of life measure for children with epilepsy: translation, cross-cultural adaptation, and reliability studies.

PURPOSE: The goal of this article is to report on the translation and reliability studies of the Parent-Proxy Response Scale of Quality of Life Measure for Children with Epilepsy for Hong Kong Chinese children. METHODS: In phase 1, forward and backward translations, expert panel review, and a series of pilot testing, cognitive interviewing, and pretesting with parents produced a Chinese translation. Content validity of the translated instrument was assessed. In phase 2, internal consistency was evaluated in 40 parents of children with epilepsy aged 8 to 18. Test-retest reliability was studied in 33 parents. RESULTS: The translation was judged to have good content validity by experts and was acceptable to parents. Internal consistency was good (Cronbach alpha=0.71-0.92). Test-retest reliability, determined with the intraclass correlation coefficient, ranged between 0.51 and 0.84. CONCLUSIONS: Our data suggest acceptable content validity, internal consistency, and reliability of the Chinese version of the Parent-Proxy Response Scale of the Quality of Life Measure for Children with Epilepsy. Studies with larger samples should be performed to further confirm other psychometric properties of the translated instrument.

Child↗

PubMed2004

Therapy outcome measures for allied health practitioners in Australia: the AusTOMs.

OBJECTIVE: The aim of this study was to develop a valid and reliable measure of therapy outcome for three allied health professions in Australia: speech pathology, occupational therapy, and physiotherapy. The Australian Therapy Outcome Measures (AusTOMs) enable measurement of the differences in client profiles and patterns of services provision across health care settings. In this paper we describe phase 1 of the study: the development and preliminary validation of the AusTOMs. METHOD: The UK TOMs, developed by Enderby, were scrutinized by the research team. A pilot core scale was developed, based on the structure of the TOM. Focus groups of expert clinicians for each profession, across the state of Victoria in Australia, analysed and refined the scales further. A mail-out survey was then sent to therapists across Australia to assess both face and content validity of the AusTOMs. MAIN RESULTS: A new tool, the AusTOM, was developed and tailored to the needs of each profession, with input from specialist clinicians and allied health researchers. The face and content validity of the new scales were assessed, and good consensus was obtained for the wording and content validity of the scales. The discriminative validity, concurrent validity, and reliability of the tool are now being evaluated. CONCLUSION: We have produced an outcome measure in the Australian context for speech pathology, physiotherapy, and occupational therapy. There are six speech pathology scales, nine physiotherapy scales, and 11 occupational therapy scales in the AusTOMs. A clinician chooses the relevant scale(s) for the client (based on the goals of therapy) and makes a rating across all domains for each scale. Further papers will report on the reliability, validity, and clinical usefulness of the AusTOMs.

Australia↗

PubMed2006

Successful use of a competency step exam in a perfusion education program.

The perfusion education program at The Ohio State University uses a step exam to rank students and identify incompetent students in regard to the program learning objectives. The step exam determines student progress from the didactic to the clinical phase. Each student must pass the competency step exam to gain entry to the clinical rotations. The development, use, and results of the step exam are reported. The design and knowledge matrix establish the content validity of the exam. Single test question discrimination and difficulty statistics identify valid exam items. Examples of the exam's predictive ability are presented. The step exam is a 200-question exam using multiple choice items. The exam is modeled after several health-related national certification exam processes. The exam has content validity based on the published, written objectives for the education program. Each item on the exam has a history of use and meets criteria for difficulty, discrimination, and distraction. The use of a high-stake competency exam in clinical science and medical education programs is controversial and technically challenging. A step exam to have high-stake consequences must be reliable, meet requirements for content validity, and hopefully exhibit predictive validity.

Allied Health Occupations↗

PubMed2005

Readability and content of elder abuse instruments.

Since elder abuse was first acknowledged as a health care and social problem, incidence and prevalence of mistreatment has been assessed sparingly in the United States and other countries around the world. Standardized instruments for determining the prevalence of elder abuse have not been developed and other instruments measuring a person's function and spousal violence have been adapted for the measurement of elder abuse prevalence. The purposes of this paper are to (1) ascertain the reading grade level of the most frequently used elder abuse prevalence instrument's text and (2) determine the content validity of the instruments with respect to the types of elder abuse included in them. A review of the instruments used to measure elder abuse prevalence was completed and a questionnaire was developed to measure the reading grade level and type of elder abuse content in four instruments. The Fry Readability, Flesch Reading Ease, and McLaughlin Grading formulas were used to determine reading grade level. A questionnaire regarding content validity was sent to 69 faculty and staff in one university department and a 59% return was achieved. The Conflict Tactics Scale and the Hwalek-Sengstock Elder Abuse-Screening Test had the lowest mean score at the 6th grade reading level. Results of content analysis for types of elder abuse demonstrated none of the instruments are comprehensive. Instruments to measure the prevalence are needed which balance readability and content validity.

Journal Article↗

PubMed2004

[The development of a client health status outcome evaluation instrument in home care].

PURPOSE: This study was to develop a client health status outcome evaluation instrument, and examine content validity, reliability, construct validity, and the acceptability of this instrument. METHOD: A preliminary list was made of such key information as standards, criteria, indicators and measures, by means of a broad review of literature within the field. After determining the preliminary instruments, the study sought to obtain examination, consensus, and modification of two groups of experts in the home-care field. Finally, the instrument examined content validity, reliability, construct validity, and the acceptability of this instrument. RESULT: The tool was considered of 13 criteria, 48 indicators, and 167 detail measures. The content validity index of the tool was above 0.8 according to the expert group. Regarding the reliability of the evaluators of standards 1 and 2, the degree of agreement between evaluators was high(96.4% through 98.2%). Construct validity in this study, the difference in the mean score between the baseline point and the follow up point of each of standards 1 and 2 was significant, and the mean score of the follow up point was more than that of the baseline point. After examining the acceptability of this instrument with practice managers and home care nurses in home care institutions, a positive opinion was given of this instrument, and it was indicated that to be useful and applicable in home care practice. CONCLUSION: The results of evaluating client outcome will contribute to overall outcome-based quality improvement and service marketing in home care by providing a constant gauge of home care effectiveness.

Aged↗

PubMedDate not supplied

Measuring community coalition effectiveness using the ICE instrument.

This article presents the development and psychometric testing of the Internal Coalition Effectiveness (ICE) instrument, which was based on the conceptual model Internal Coalition Outcome Hierarchy. Sixty-one items were derived from literature about successful coalitions, and the ICE instrument was tested for reliability and validity. A national panel of eight experts conducted content validity. Remaining tests involved a sample of 61 members and leaders of a large midwestern coalition (77% response rate, n=47). Content validity involved a two-stage process for rigorous item development and quantification (0.88, p<0.05). Internal consistency was based on bivariate Pearson's correlation of 0.30-0.70 for two-item scales and Cronbach's alpha(alpha=0.70). Construct validity was assessed by correlation analysis, independent Student's t tests, and informal coalition feedback. The final 30-item version of ICE is psychometrically sound. Findings were shared with the local coalition, and, in support of the instrument's validity, members and leaders found this information useful for promoting coalition sustainability by identifying internal strengths and areas for improvement. The ICE instrument adds to the body of literature by measuring critical constructs of coalition effectiveness and has significant application for public health nurses working as evaluators for coalitions engaged in community health programming.

Health Care Coalitions↗

PubMed1996

Development of a clinical tool and patient questionnaire for evaluation of patellofemoral pain syndrome patients.

OBJECTIVE: To develop an evaluation tool for patellofemoral pain syndrome (PFPS) patients. DESIGN: Exploratory, descriptive content validation study. PARTICIPANTS: Convenience sample, three groups of clinicians: 15 sports physical therapists, 9 sports medicine physicians, and 10 physical therapists and physicians with limited experience with PFPS. Selection based on specialization qualifications and experience with PFPS patients. DESCRIPTION OF TESTS: Content validation questionnaire to determine importance of clinical outcomes in determining change in PFPS patients. Using 10-cm visual analogue scales, reviewers rated the importance of five domains and rated the importance of twenty-one clinical tests; using a categorical scale, determined appropriateness and clarity of potential patient questionnaire items. MAIN RESULTS: Correlation values indicated significant correlation (p < 0.01) between pain and functional limitations (r = 0.068) and activity and functional limitations (r = 0.67), indicating that functional limitation may not be a unique component, but is integrated with pain and activity. A set of five pain questions, twelve function questions and six activity questions was developed. No statistical differences (p < 0.05) between the three groups of clinicians for the majority of clinical tests. Statistical differences (p < 0.05) between the three groups for rating of importance of flexibility of hip flexor and flexibility of gastrocnemius-soleus muscle groups, knee swelling, and radiographs. Good internal consistency among the 21 clinical tests (Cronbach's alpha = 0.84). The five top rated tests considering mean score values and standard deviations: lower extremity alignment, patellar orientation, patellar mobility, and flexibility of rectus femoris and tensor fasciae latae muscle groups. CONCLUSIONS: The results provide evidence of content validity for the components of PFPS evaluation investigated. The findings provide a basis of design of an evaluation tool for PFPS patients consisting of patient self-report questionnaire items and clinical tests.

Adult↗

PubMed2003

Measuring cultural awareness in nursing students.

Recognizing the need for a valid and reliable way to measure outcomes of a program to promote multicultural awareness among nursing faculty and students, the authors developed a cultural awareness scale. In the first phase of the study, a scale consisting of 37 items was generated from a literature review on cultural awareness, sensitivity, and competence in nursing. A Cronbach's alpha reliability coefficient of .91 was obtained from a sample of 72 student nurses. In the second phase, the items were presented to a panel of experts in nursing and culture to determine content validity. A content validity index of .88 was calculated, and the total number of items on the scale was reduced to 36. The scale then was administered to 118 nursing students. Data from the two samples then were combined, and factor analysis was conducted to support construct validity. Cronbach's alpha for the combined samples was .82.

Attitude of Health Personnel↗

PubMed2005

Validation of a short questionnaire in English and French for use in patients with persistent upper gastrointestinal symptoms despite proton pump inhibitor therapy: the PASS (Proton pump inhibitor Acid Suppression Symptom) test.

BACKGROUND: The management of persistent symptoms during acid suppression therapy in patients with gastroesophageal reflux disease or dyspepsia might be improved if patient-physician communication regarding the presence and character of these persistent symptoms were facilitated. AIM: To validate a short, simple questionnaire (the Proton pump inhibitor [PPI] Acid Suppression Symptom [PASS] test), in English and French, to identify patients with persistent acid-related symptoms during PPI therapy and document their response to a change in therapy. METHODS: Patients with persistent acid-related symptoms on PPI therapy were interviewed to produce a draft, five-item questionnaire; content validity was evaluated by focus groups comprising English- and French-speaking patients. Psychometric validity was subsequently evaluated in a multicentre, family practice-based study of English- and French-speaking patients with persistent acid-related upper gastrointestinal symptoms despite PPI therapy. The PASS test, Global Overall Symptom scale, Gastrointestinal Symptom Rating Scale (GSRS), Quality of Life in Reflux and Dyspepsia questionnaire and Reflux Disease Questionnaire were completed at baseline and repeated after one week while patients continued their original PPI therapy. All patients then received esomeprazole 40 mg once daily for four weeks, after which all questionnaires and an evaluation of overall treatment effect were completed. RESULTS: Content validity was established in 20 English- and 16 French-speaking patients. Psychometric validation in 158 English- and 113 French-speaking patients revealed good-to-excellent test-retest reliability coefficients: 0.76 for English; 0.68 for French. For construct validity, the PASS test showed moderate-to-high correlation with the GSRS scale (0.51 for English; 0.43 for French). After four weeks of therapy, the PASS test score fell to zero in 30% of English- and 33% of French-speaking patients, while the Global Overall Symptom score fell to one (no symptoms) in 32% of patients (English- and French-speaking); the PASS test demonstrated good responsiveness in comparison with the GSRS, Reflux Disease Questionnaire and Quality of Life in Reflux and Dyspepsia questionnaire. CONCLUSION: The five-item PASS test is a valid tool for the evaluation of persistent acid-related symptoms in patients receiving PPI therapy. It demonstrates good content validity, test-retest reliability, responsiveness and construct validity in both English and French forms. The PASS test is a simple, clinically applicable tool for the identification of patients with persistent acid-related symptoms during therapy and the assessment of their responses to a change in therapy.

Dyspepsia↗

PubMed2001

Genetic counseling outcomes validation by genetics nurses in the UK and US.

PURPOSE: To validate genetic counseling outcomes with a sample of genetics nurses from the United Kingdom (UK), and to compare elements of genetic counseling outcomes with those from a sample of genetics nurses from the United States (US). DESIGN: Descriptive-comparative survey. METHODS: Concept analysis and literature review were used to designate outcomes, and genetics nurses were surveyed to validate the outcomes. A revision of Fehring's 1987 methodology for assessing content validity was used to estimate content validity and sensitivity of the genetic counseling outcomes. Data are reported on a convenience sample of 50 UK nurse members of the Association of Genetic Nurses and Counsellors. Findings were correlated with prior data from a convenience sample of 92 U.S. nurse members of the International Society of Nurses in Genetics, Inc., and data were compared between groups. FINDINGS: A significant positive correlation was found between samples of U.K. and U.S. nurses regarding components of outcomes of the genetic counseling process and between groups regarding extent of contribution of nurses to the outcomes. Strength of nursing contributions to knowledge of disease and indicators of coping varied according to country. CONCLUSIONS: Genetics nurses in the UK and US had similar definitions of outcomes of genetic counseling, but priorities of indicators differed between countries. Terminology used in measures to identify outcomes of the process of genetic counseling must be consistent with cultural norms.

Genetic Counseling↗

PubMed2004

A strategy for the management of HIV/ AIDS in the health sector of the city of Johannesburg.

The HIV/AIDS pandemic is posing major challenges to all sectors in South Africa, including the health sector of the city of Johannesburg. The health sector of the city of Johannesburg, as a result of the pandemic, is faced with increasing demands on its scarce resources at a time of major reform at local government level including transformation of the health sector. The overall objective of the study is to explore and describe a strategy for the management of HIV/AIDS by the health sector of the city of Johannesburg. An exploratory, descriptive and quantitative research design was utilized and the UNAIDS "Guide to the strategic planning process for a national response to HIV/AIDS" (1998), was employed to formulate the strategy. The content validity of the strategy was determined according to the process originally described by Lynn (1986) and adopted by Muller (in Booyens, 1998:607-609). The research was conducted in two phases. The first phase, the developmental phase, involved the exploration and description of the theoretical framework and the response to the pandemic, and formulation of a draft strategy. The second phase, the quantification phase, involved the assertion of the content of the strategy by a group of experts and determination of the content validity index (CVI). The final strategy focused on the following: to lead and facilitate intersectoral collaboration; to strengthen primary health care services to provide comprehensive community-based care; prevention of new infections; community mobilization towards prevention, non discrimination and non stigmatization and empowerment of the health sector to deal with the AIDS.pandemic. The CVI results showed that the average content validity index determined during this study was adequate: full score (1.0) for acceptability and technical soundness, and 0.89 for feasibility and perceived affordability. The strategy formulated for the management of HIV/AIDS by the health sector of the city of Johannesburg is therefore acceptable, technically sound and feasible and perceived as affordable. It was finally recommended that the strategy be adopted for implementation within the health sector of the city of Johannesburg.

Acquired Immunodeficiency Syndrome↗

PubMed1996

A menopause-specific quality of life questionnaire: development and psychometric properties.

OBJECTIVE: To develop a condition-specific quality of life questionnaire for the menopause with documented psychometric properties, based on women's experience. METHODS SUBJECTS: Women 2-7 years post-menopause with a uterus and not currently on hormone replacement therapy. Questionnaire development: A list of 106 menopause symptoms was reduced using the importance score method. Replies to the item-reduction questionnaire from 88 women resulted in a 30-item questionnaire with four domains, vasomotor, physical, psychosocial and sexual, and a global quality of life question. Psychometric properties: A separate sample of 20 women was used to determine face validity, and a panel of experts was used to confirm content validity. Reliability, responsiveness and construct validity were determined within the context of a randomized controlled trial. Construct validation involved comparison with the Neugarten and Kraines'Somatic, Psychosomatic and Psychologic subscales, the reported intensity of hot flushes, the General Well-Being Schedule, Channon and Ballinger's Vaginal Symptoms Score and Libido Index, and the Life Satisfaction Index. RESULTS: The face validity score was 4.7 out of a possible 5. Content validity was confirmed. Test-retest reliability measures, using intraclass correlation coefficients were 0.81, 0.79, 0.70 and 0.55 for the physical, psychosocial, sexual domains and the quality of life question. The intraclass correlation coefficient for the vasomotor domain was 0.37 but there is evidence of systematic change. Discriminative construct validity showed correlation coefficients of 0.69 for the physical domain, 0.66 and 0.40 for the vasomotor domain, 0.65 and -0.71 for the psychosocial domain, 0.48 and 0.38 for the sexual domain, and 0.57 for the quality of life question. Evaluative construct validity showed correlation coefficients of 0.60 for the physical domain, 0.28 for the vasomotor domain, 0.55 and -0.54 for the psychosocial domain, 0.54 and 0.32 for the sexual domain, and 0.12 for the quality of life question. Responsiveness scores ranged from 0.78 to 1.34. CONCLUSIONS: The MENQOL (Menopause-Specific Quality of Life) questionnaire is a self-administered instrument which functions well in differentiating between women according to their quality of life and in measuring changes in their quality of life.

Attitude to Health↗

PubMed2006

Professionalism in general practice: development of an instrument to assess professional behaviour in general practitioner trainees.

INTRODUCTION: The aim of this study is to develop a new tool to assess professional behaviour in general practitioner (GP) trainees: the evaluation of professional behaviour in general practice (EPRO-GP) instrument. METHODS: Our study consisted of 4 phases: (1) development of a model of professionalism in general practice based on a literature review on professionalism, competency models of general practice and the overall educational objectives of postgraduate training for general practice; (2) development of the EPRO-GP instrument in collaboration with a sounding board; (3) establishing the content validity of the EPRO-GP instrument using a nominal group technique; and (4) establishing the feasibility of the EPRO-GP instrument in 12 general practice trainees and their general practice trainers. RESULTS: The model of professionalism in general practice encompassed 4 themes within professionalism: (a) professionalism towards the patient; (b) professionalism towards other professionals; (c) professionalism towards the public; and (d) professionalism towards oneself. These 4 themes covered 26 elements of professionalism. This model provided the framework of the EPRO-GP instrument, which we developed further by operationalising the 26 elements in 127 behavioural items. The expert ratings confirmed the content validity of the instrument with one exception: the element "altruism" was removed as a stand-alone category but it remained throughout the tool in items giving primacy to patient welfare. The results on the feasibility of the EPRO-GP instrument were very encouraging. All tutorials yielded professional behaviour learning points. DISCUSSION: Our results support the content validity of the EPRO-GP instrument as well as its feasibility as a tool to educate for professionalism in general practice.

Clinical Competence↗