A Mokken scale analysis of the peer physical examination questionnaire

Brett Vaughan,Sandra Grace

doi:10.1186/s12998-018-0176-0

Abstract

BackgroundPeer physical examination (PPE) is a teaching and learning strategy utilised in most health profession education programs. Perceptions of participating in PPE have been described in the literature, focusing on areas of the body students are willing, or unwilling, to examine. A small number of questionnaires exist to evaluate these perceptions, however none have described the measurement properties that may allow them to be used longitudinally. The present study undertook a Mokken scale analysis of the Peer Physical Examination Questionnaire (PPEQ) to evaluate its dimensionality and structure when used with Australian osteopathy students.MethodsStudents enrolled in Year 1 of the osteopathy programs at Victoria University (Melbourne, Australia) and Southern Cross University (Lismore, Australia) were invited to complete the PPEQ prior to their first practical skills examination class. R, an open-source statistics program, was used to generate the descriptive statistics and perform a Mokken scale analysis. Mokken scale analysis is a non-parametric item response theory approach that is used to cluster items measuring a latent construct.ResultsInitial analysis suggested the PPEQ did not form a single scale. Further analysis identified three subscales: ‘comfort’, ‘concern’, and ‘professionalism and education’. The properties of each subscale suggested they were unidimensional with variable internal structures. The ‘comfort’ subscale was the strongest of the three identified. All subscales demonstrated acceptable reliability estimation statistics (McDonald’s omega > 0.75) supporting the calculation of a sum score for each subscale.ConclusionThe subscales identified are consistent with the literature. The ‘comfort’ subscale may be useful to longitudinally evaluate student perceptions of PPE. Further research is required to evaluate changes with PPE and the utility of the questionnaire with other health profession education programs.

Highlights

Peer physical examination (PPE) is a teaching and learning strategy utilised in most health profession education programs
Two hundred and thirty responses were from Victoria University (VU) (n = 230, 73.2%)
All values for both ωt and ωh where above an acceptable level. ωh values obtained in the present study provide support for the calculation of a total score for each subscale [36] given that over three-quarters of the variance in the summed score for each subscale is attributable to the latent constructs of ‘comfort’, ‘concern’, and ‘professionalism and education’ respectively

Summary

Introduction

Peer physical examination (PPE) is a teaching and learning strategy utilised in most health profession education programs. The questionnaire was first developed in 1998 by O’Neill et al [11] and further developed to a whole of body approach by Chang and Power [12] who evaluated its face validity and pilot tested it with a convenience sample. Using this whole of body approach both sensitive regions (e.g. groin, rectal and external genitals) and non-sensitive regions (e.g. hands, feet, head) could be included. The survey was adapted by Rees et al [13] and used to ask medical students to indicate which of eleven body parts

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Discussion

Conclusion