Abstract
IntroductionThis paper reports on the development of a scale to measure intrapersonal factors (IPF) that may influence speaking up behaviour in the operating room.MethodsParticipants were postgraduate year 2, 3, and 4 anaesthesiology residents and practising faculty anaesthesiologists at a large quaternary care academic hospital. Based on a literature review, the authors constructed the initial scale. Exploratory factor analysis was conducted to identify the underlying factor structure for the scale. A set of one-way ANOVAs and multiple ordinal regressions were carried out to provide additional validity evidence for the new scale.ResultsExploratory factor analysis indicated a three-factor solution accounting for 73% of the variance. The self-efficacy subscale included four items (Cronbach’s α = 0.86), and the social outcome expectations (Cronbach’s α = 0.86) and assertive attitude (Cronbach’s α = 0.67) subscales contained three items each. The effect of training level was significantly associated with self-efficacy (p < 0.001) and assertive attitude subscale scores (p < 0.001). Multiple ordinal regressions indicated that IPF predicted participants’ likelihood of speaking up in various hypothetical scenarios.DiscussionOur analyses provided initial evidence for the validity and reliability of a 10-item IPF scale. This instrument needs to be validated in other cohorts.
Highlights
This paper reports on the development of a scale to measure intrapersonal factors (IPF) that may influence speaking up behaviour in the operating room
Using multiple ordinal regressions with a Logit link, we examined whether the response variable, which reflects the likelihood of speaking up in three different hypothetical conditions, is explained by demographic variables, or intrapersonal variables (IPFS factor scores, which were entered in the regression model as covariates)
Using exploratory factor analysis (EFA), we developed a 10-item questionnaire, entitled the Intrapersonal Factors Scale (IPFS) for speaking up in the operating room (OR)
Summary
This paper reports on the development of a scale to measure intrapersonal factors (IPF) that may influence speaking up behaviour in the operating room. It should be obvious that timely and well-coordinated, rapid team efforts are crucial for safe and effective patient care in the operating room (OR), especially when faced with unexpected events. High-acuity, time-critical ORs, staffed by professionals from diverse disciplines with differing training and experience, are especially vulnerable to such errors. We addressed the questions whether a psychometrically sound scale could be developed to measure intrapersonal factors that influence decisions to speak up about patient management concerns in the operating room. This study provides initial evidence for the validity and reliability of a 10-item scale, which attempts to measure three distinct aspects of the intrapersonal factors for speaking up in the OR
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