Abstract
This study aims to explore the construct validity, dimensionality, and internal consistency of a new attitude scale for measuring cardiology trainees' attitudes towards clinical supervision. A multi-centred, cross-sectional study involving 388 Indonesian cardiology trainees from eight universities was conducted using convenience sampling. Twenty-nine items have been generated based on an extensive literature review and conceptual framework of effective clinical supervision. Ten clinical experts reviewed the items to ensure the Cardiology Clinical Supervision Scale (CCSS) adequately represents the construct under study. An exploratory factor analysis using principal axis factoring (PAF) with oblique rotation was run to identify the internal structure of the scale. Items with factor loading <0.50 were deleted. In addition, inter-item correlations and items' communalities were analysed. Each subscale's internal consistency was assessed using Cronbach's alpha score. The content validity index provided evidence for CCSS' validity (G-coefficient=0.71). Scrutinising the experts' comments, we finalised the scale to include 27 items. Further, four items were deleted due to low inter-item correlation and communality. PAF analysis resulted in a two-factor model comprising the "Supervisory Interaction and Facilitation" factor (n=10 items) and the "Role Modelling" factor (n=9 items); four items were deleted due to low factor loading. The Cronbach's alpha score for SIF and RM factors were 0.93 and 0.89, respectively. The study's results support the validity, internal structure, and internal consistency of the new clinical supervision scale for cardiology training. Further studies are required to investigate other validity and reliability evidence for CCSS, including its cross-cultural validity.
Highlights
Clinical supervision is an integral part of medical training which can improve patients' safety and enhance the educational outcome of the trainees.[1]
principal axis factoring (PAF) analysis resulted in a two-factor model comprising the "Supervisory Interaction and Facilitation" factor (n=10 items) and the "Role Modelling" factor (n=9 items); four items were deleted due to low factor loading
The principles of effective clinical supervision may be similar across specialities,[2] it is a question of validity whether the scales developed for other fields can measure what is intended to be measured for cardiology trainees
Summary
Clinical supervision is an integral part of medical training which can improve patients' safety and enhance the educational outcome of the trainees.[1]. Studies have provided validity and reliability evidence for these scales using different psychometric approaches, most of them are lacking in one or more indicators (i.e., items), which are necessary for effective clinical supervision. The principles of effective clinical supervision may be similar across specialities,[2] it is a question of validity whether the scales developed for other fields can measure what is intended to be measured for cardiology trainees. Differences in the educational environment, the nature of the specialities, and the types of patients encountered daily by cardiologists (and their trainees) and internal medicine specialists may be the reason for the invalidity of this scale when used by cardiology trainees.[21] This indicates that cardiologists and medical educators need to develop items to reflect cardiology training more accurately
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