Face Validity Of Questionnaire Research Articles

Development and validation of a realistic type III esophageal atresia simulator for the training of pediatric surgeons

BackgroundThe technical complexity and limited casuistry of neonatal surgical pathology limit the possibilities of developing the necessary technical competencies by specialists in training. Esophageal atresia constitutes the paradigm of this problem. The use of synthetic 3D models for training is a promising line of research, although the literature is limited.MethodsWe conceptualized, designed, and produced an anatomically realistic model for the open correction of type III oesophageal atresia. We validated it with two groups of participants (experts and non-experts) through face, construct, and content-validity questionnaires.ResultsThe model was validated by nine experts and nine non-experts. The mean procedure time for the experts and non-experts groups was 34.0 and 38.4 min, respectively. Two non-experts did not complete the procedure at the designed time (45 min). Regarding the face validity questionnaire, the mean rating of the model was 3.2 out of 4. Regarding the construct validity, we found statistically significant differences between groups for the equidistance between sutures, 100% correct in the expert group vs. 42.9% correct in the non-expert group (p = 0.02), and for the item “Confirms that tracheoesophageal fistula closure is watertight before continuing the procedure”, correctly assessed by 66.7% of the experts vs. by 11.1% of non-experts (p = 0.05). Concerning content validity, the mean score was 3.3 out of 4 for the experts and 3.4 out of 4 for the non-experts.ConclusionsThe present model is a cost-effective, simple-to-produce, and validated option for training open correction of type III esophageal atresia. However, future studies with larger sample sizes and blinded validators are needed before drawing definitive conclusions.

Cleft lip and palate surgery simulator: Open source simulation model

ObjectiveCleft lip and palate is the most common craniofacial birth anomaly and requires surgery in the first year of life. However, craniofacial surgery training opportunities are limited. The aim of this study was to present and evaluate an open-source cleft lip and palate hybrid (casting and three-dimensional (3D) printing) simulation model which can be replicated at low cost to facilitate the teaching and training of cleft surgery anatomy and techniques. DesignThe soft tissue component of the cleft surgery training model was casted using a 3D printed 5-component mold and silicone. The bony structure was designed to simulate the facial anatomy and to hold the silicone soft tissue. SettingTwo groups, one group of trainees and one group of expert surgeons, at University Hospital Basel in Switzerland and Pontifical Catholic University of Chile in Santiago, Chile, tested the cleft lip and palate simulation model. Participants completed a Likert-based face and content validity questionnaire to assess the realism of the model and its usefulness in surgical training. ResultsMore than 70 % of the participants agreed that the model accurately simulated human tissues found in patients with unilateral cleft lip and palate. Over 60 % of the participants also agreed that the model realistically replicated surgical procedures. In addition, 80–90 % of the participants found the model to be a useful and appropriate tool for teaching the anatomy and surgical techniques involved in performing unilateral cleft lip and palate repair. ConclusionThis open-source protocol provides a cost-effective solution for surgeons to introduce the cleft morphology and surgical techniques to trainees on a regular basis. It addresses the current financial barrier that limits access to commercially available models during the early stages of surgeon training prior to specialization in the field.

Development and validation of a tool to assess researchers’ knowledge of human subjects’ rights and their attitudes toward research ethics education in Saudi Arabia

BackgroundResearchers must adhere to ethical and scientific standards in their research involving human subjects; therefore, their knowledge of human subjects’ rights is essential. A tool to measure the extent of this knowledge is necessary to ensure that studies with participants are conducted ethically and to enhance research integrity. Currently, no validated instrument is available for such an assessment. Therefore, the primary purpose of this study is to develop a reliable and valid instrument to assess researchers’ knowledge of human subjects’ rights in clinical settings, as well as a reliable and valid measure of their attitudes toward clinical research ethics education in Saudi Arabia.MethodsThe current study involves the development of a questionnaire about the rights of human subjects in research and the researchers’ attitudes toward research ethics education. The content was developed based on an extensive review of research ethics guidelines. A panel of experts tested the questionnaire for face validity (n = 5) and content validity (n = 8). The reliability of the questionnaire was established by a split-half reliability coefficient and item analysis among a sample (n = 301) of clinical researchers.ResultsFace validity demonstrated that the questionnaire was quick to complete and easy to answer. The global content validity indices (S-CVIs) were greater than 0.78 for all questionnaire sections; the split-half reliability coefficient was 0.755 for knowledge items; Cronbach’s alpha was 0.77 for researchers’ attitudes, showing good internal consistency. The difficulty index ranged from 12.0% to 98.7% for all knowledge items. Most questions were at an acceptable level of reliability and discrimination criteria. The final version of the questionnaire contained 89 items, distributed as 15 questions on demographic and professional characteristics, 64 questions items on knowledge, and 10 items on attitudes.ConclusionsThe questionnaire is a valid and reliable tool to assess biomedical researchers’ knowledge of human subjects’ rights and their attitudes toward research ethics education. This instrument could help address the gap in researchers’ knowledge of the rights and facilitate the development of educational intervention programs to set appropriate learning objectives.

The effect of educational intervention based on the Progressively Lowered Stress Threshold extended model on the process of caregiving for people with dementia.

This study examined the impacts of an educational intervention based on the Progressively Lowered Stress Threshold (PLST) extended model on caregiving for people with dementia (PWD). This study was conducted in Isfahan, Iran, from May 2016 to June 2018, with 38 caregivers of PWD as participants assigned to an intervention group. Data were collected using a multi-sectional, researcher-developed questionnaire that recorded the demographic characteristics, and measured the dementia-related knowledge and caregiving practices of the participants. The questionnaire and an educational program were designed in three parts according to the educational needs of caregivers to enhance their practice, skills, and ability to handle challenging behaviours in PWD. The questionnaire's face validity was confirmed by expert review, and its reliability was assessed with Cronbach's alpha coefficient (knowledge section, 0.838; practice section, 0.802). The sampling method used was convenience sampling, and none of the caregivers refused to receive the educational content. Therefore, the evaluation of the program lacks a randomized controlled group. To tailor the intervention program to the participants' needs, the educational content was based on the PLST extended model. The mean scores for knowledge and practice increased following the intervention (P < 0.05). An educational intervention, using the PLST extended care model, thus produced positive impacts in improving the knowledge and practice of caregivers of PWD. Educating caregivers with the PLST extended model, with a specific focus on the cultural and religious backgrounds of societies, is recommended.

A low-cost prosthetic orbital simulation model for endoscopic anterior ethmoid artery ligation.

This study aimed to develop and evaluate a low-cost orbital prosthesis for simulation of endoscopically assisted intra-orbital anterior ethmoidal artery ligation. A low-cost orbital prosthesis was built and evaluated by ENT surgical trainees. Feedback was given following the assessment in the form of a face validity questionnaire. Results were scored on a Likert scale of 1-7 (low to high). Trainees had limited exposure to the procedure (40 per cent) and predominantly low levels of confidence (mean, 3.67) that correlated with a lack of first-hand experience. The anatomy and likeness to human tissue of the prosthesis were both ranked highly, with mean scores of 5.0 and 4.93, respectively. The results of this study support the idea that a simple anatomical prosthesis for the simulation of endoscopic anterior ethmoidal artery ligation can be created with potential value to otolaryngology surgical training. To the authors' knowledge, this is the first documentation of simulated surgical epistaxis management using an artificial anatomical model.

A CROSS-SECTIONAL STUDY ON THE ASSESSMENT OF KNOWLEDGE AND METHODS PRACTICED IN DISINFECTING AND DISPOSAL OF FACEMASKS AMONG THE GENERAL PUBLIC

Objectives: The vast amount of facemasks generated as waste should be disposed of appropriately and responsibly to prevent adverse effects on health and the environment. This study aims to assess the knowledge and methods commonly practiced by the public to disinfect and dispose of used facemasks. Methods: A cross-sectional study was conducted from June 2021 to December 2021 in the South Part of Karnataka using a face-validated questionnaire. The questionnaire included subject demographic details and methods to disinfect and dispose of masks. The data were recorded and analyzed using Microsoft Excel. Results: A total of (n=501) participants took part in the study. This study observed that the most commonly practiced method was to wash the masks with specific cleaners (n=259, 53%). We also assessed knowledge regarding the methods of disposal of a mask. The majority of the participants in our study are aware of the correct method for disposal of used masks(n=342, 68.26%), while (n=159, 31.73%) of subjects are not aware of the right facemask disposal method. Subjects who are educated (p=0.008) and regular mask users (p=0.011) are aware of the right method for mask disposal. Conclusion: Many people are unaware of the correct disposal methods. Hence, Manufacturers and Scientists should identify an effective way to disinfect and dispose of used masks and educate the public to practice the proper method of facemask disposal.

The development and validation of a new simulator for endourology

IntroductionSimulation in medicine has developed a lot in the last few decades. There is a broad range of simulators available, above all for training in surgical procedures. Endourology can benefit much from simulation because the minimally-invasive procedures of endourology frequently have long learning curves, which can be reduced by training with simulators. Materials and methodsA low-fidelity simulator was designed for practicing endourology techniques that use cystoscopy. The process of validation involved 5 experts and 19 non-experts. Experts comprised medical professionals working in a department of urology who had performed at least 100 flexible cystoscopy procedures. Non-experts were residents in internal medicine without experience in any type of endoscopy. Information about face and content validity was collected by means of Likert scales from 1 to 5. To evaluate construct validity, we measured the time to complete two tasks, for which the procedure was evaluated by means of the OSATS global evaluation scale. ResultsNew simulator was successfully built according to its design. For all evaluated aspects of construct validity, there was a significant difference (p<0.05) between the group of experts and the group of non-experts. Content validity was scored 4.66 (standard deviation ±0.56) by the experts and 4.41 (±0.71) by the non-experts. In the face validity questionnaire, the average score was 4.14 (±0.94), the question receiving the highest score: 4.6 (±0.84) concerned immersion in the procedure. ConclusionThe simulator presented is valid both for training up new urologists in endourology technique and for experts seeking to perfect their skills.

Desarrollo y validación de un nuevo simulador para endourología

IntroductionSimulation in medicine has developed a lot in the last few decades. There is a broad range of simulators available, above all for training in surgical procedures. Endourology can benefit much from simulation because the minimally-invasive procedures of endourology frequently have long learning curves, which can be reduced by training with simulators. Material and methodsA low-fidelity simulator was designed for practicing endourology techniques that use cystoscopy. The process of validation involved 5 experts and 19 non-experts. Experts comprised medical professionals working in a department of urology who had performed at least 100 flexible cystoscopy procedures. Non-experts were residents in internal medicine without experience in any type of endoscopy. Information about face and content validity was collected by means of Likert scales from 1 to 5. To evaluate construct validity, we measured the time to complete two tasks, for which the procedure was evaluated by means of the OSATS global evaluation scale. ResultsNew simulator was successfully built according to its design. For all evaluated aspects of construct validity, there was a significant difference (P<.05) between the group of experts and the group of non-experts. Content validity was scored 4.66 (standard deviation±0.56) by the experts and 4.41 (±0.71) by the non-experts. In the face validity questionnaire, the average score was 4.14 (±0.94), the question receiving the highest score: 4.6 (±0.84) concerned immersion in the procedure. ConclusionThe simulator presented is valid both for training up new urologists in endourology technique and for experts seeking to perfect their skills.

Assessing Validity and Reliability of the Persian Version of Coronavirus Anxiety Scale Among Healthcare Workers

Background: There is a limited number of psychometric tools for measuring the psychological impacts of COVID-19 on healthcare workers (HCWs). The Coronavirus Anxiety Scale (CAS) is a brief questionnaire that identifies dysfunctional anxiety induced by the COVID-19 pandemic. Method: The authors translated the CAS into Persian and assessed its validity and reliability among Iranian HCWs. First, they calculated the content validity index (CVI) and the content validity ratio (CVR) based on six psychiatrists’ assessments. Then, 10 medical interns modified the questionnaire for face validity. In addition, 30 psychiatric residents contributed to the test-retest method to evaluate the intergroup correlation coefficient (ICC). Finally, they examined confirmatory factor analysis (CFA) for construct validity, based on the responses of participants to the scale, and they used Cronbach's alpha coefficient to assess the internal consistency. Results: 185 healthcare workers filled out the Persian version of the CAS. In the assessment of the content validity, all five questions of the CAS had CVI &gt; 0.79 and CVR &gt; 0.99, and all were statistically approved. The construct validity showed that the scale is one-dimensional. The internal consistency (Cronbach’s α= 0.878) and test-retest stability (ICC= 0.931) were accepted. Conclusions: After the localization of the questionnaire, no items were added or subtracted. The CAS presented adequate reliability and validity among Iranian HCWs. Therefore, future epidemiologic studies can consider it a valid scale for HCWs.

Development and validation of the clinical information literacy questionnaire.

Clinical Information Literacy (CIL) seems to be a prerequisite for physicians to implement Evidence-Based Medicine (EBM) effectively. This study endeavors to develop and validate a CIL questionnaire for medical residents of Isfahan University of Medical Sciences. This study employs sequential-exploratory mixed methods in 2019. The participants were 200 medical residents in different specialties; they are selected through the convenience sampling method. In the first (qualitative) phase, an early CIL questionnaire was designed by reviewing literature and performing complementary interviews with health professionals. In the second (validation) phase, the questionnaire's face validity and content validity were confirmed. In the third (quantitative) phase, the construct validity was examined via Item-Response Theory (IRT) model, and the factor loading was computed. The gathered data were analyzed using descriptive statistics, t-test, two-way ANOVA, as well as two-parameter IRT model in R software. In the qualitative phase, the concept of CIL is initially described in seven main categories and 22 subcategories, and the items were formulated. An initial 125-item questionnaire was analyzed by the research team, leading to a 43-item. Through the content validity and face validity examination, we removed 11 and 4 items in the Content Validity Ratio (CVR) and Content Validity Index (CVI), respectively. Throughout the face validity analysis, none of the items were removed. According to the construct validity results, difficulty coefficient, discriminant coefficient, and factor loading were confirmed, most of the other questions achieved a proper factor loading value that is higher than 0.30, and a value of 0.66 was achieved for the reliability via the Kuder-Richardson method. Ultimately, the real-assessment 28-item CIL questionnaire was developed with four components. The CIL questionnaire could be employed to examine the actual CIL basic knowledge. Because of using the real-assessment approach rather than self-assessment in the design, it can be claimed that this instrument can provide a more accurate assessment of the information literacy status of medical residents. This valid questionnaire is used to measure and train the skills needed by healthcare professionals in the effective implementation of EBM.

Assessment of Knowledge Gap on Cigarettes and Other Tobacco Products Act (COTPA) among Tobacco Vendors in Puducherry: A Mixed-Method Study.

Tobacco usage has been identified as a leading preventable cause of mortality and is responsible for six million fatalities per year globally. India had enacted COTPA in 2003. Tobacco vendors are one of the key stakeholders for Cigarettes and Other Tobacco Products Act (COTPA) implementation. To assess the knowledge gap on COTPA and to explore the perceived factors influencing implementation of COTPA among tobacco vendors in Puducherry. A mixed-method study was conducted among tobacco vendors from Point of Sale (PoS) around 230 educational institutions (schools and degree colleges) in Puducherry for three months. Simple random sampling was applied to select educational institutions and the tobacco vendors from PoS located around these institutions were included. Data capture was done using a pretested, face-validated questionnaire incorporated in Epicollect software 5 and data analysis by SPSSv24. Purposive sampling was employed to conduct in-depth interviews among tobacco vendors till the point of saturation and manual content analysis performed. Written informed consents were sought. Institutional Ethical Committee approval was obtained. Majority (95.7%) reported that they were aware of tobacco control legislation, but only one person had heard of COTPA. Awareness about the display of signage boards at PoS was observed in 75.7% vendors. Around 41.7% reported that they should not advertise any kind of tobacco products. Three major themes were identified: facilitators, barriers, and suggested measures for COTPA implementation. Tobacco vendors in Puducherry were aware of tobacco control legislations but not familiar with the COTPA and its provisions. It is necessary to put forth efforts to educate these important stakeholders to be more cognizant of COTPA and to effectively include them in anti-tobacco programs.

Investigating the Effect of Advertising on Attracting Customers of Sports Clubs in Karaj City

The purpose of this research was to investigate the mediating role of charitable marketing in the effect of advertising on attracting customers of sports clubs in Karaj city. The research method was applied descriptive which was conducted by field method using questionnaire. The statistical population included the athletes of sports clubs in Karaj city. The sample size was determined as 332 people based on Morgan’s table. The measurement tools included advertisement questionnaire (Moghimi &amp; Ramezani, 2007) and customer attraction questionnaire (Ravanbakhsh, 2019). Content and face validity of questionnaires were confirmed by management professors and Cronbach’s alpha reliability was reported as 0.72 for advertisement questionnaire and Cronbach’s alpha reliability of customer attraction questionnaire was reported as 0.71. To analyze the research hypotheses, the structural equation model was used by spss19 and Amos23 software. The findings of the research showed that charitable marketing has a mediating role in the effect of advertising on the attraction of customers of sports clubs in Karaj city, and this type of mediating is a partial mediating type. Therefore, it can be concluded that by using charitable marketing, new customers can be attracted to sports clubs, and charitable marketing is also a kind of advertisement for the club.

Osteoarthritis management: Does the pharmacist play a role in bridging the gap between what patients actually know and what they ought to know? Insights from a national online survey.

BackgroundGuidelines encourage engagement in self‐care activities for osteoarthritis (OA), but there are gaps in consumers' knowledge about suitable choices for self‐care. Community pharmacists are in an ideal position to contribute to OA management through screening and supporting evidence‐based pain management choices. Prior research established an association between health literacy and advice‐seeking and appropriateness of analgesics choices (both lower in participants with limited health literacy) amongst people living with OA. This article explores the implications of these data for pharmacists in OA management.MethodsA national online survey was conducted amongst 628 adults aged 45–74 years, currently residing in Australia, with self‐reported symptoms of OA. All data were collected using a customized online questionnaire, which was completed only once. ‘Self‐reported symptoms of OA’ was based on six validated screening questions to identify people with OA without a formal clinical diagnosis.ResultsRespondents matched the typical profile of people diagnosed with OA; more than half were female (56%), knees (59%) and hips (31%) were the primary affected joints and 74% were either overweight or obese. Self‐identification of OA was limited (41%). Overall, 38% self‐managed their pain, and limited health literacy was associated with less advice‐seeking. Efficacy and ease of use were the main reasons cited for prompting use across all classes of nonprescription analgesic, with less than 20% reporting recommendation from a pharmacist. Participants were managing their pain with an average of 1.74 (95% confidence interval: 1.60–1.88) analgesics, but 73% reported inadequate pain relief and 54% had disrupted sleep.ConclusionOur findings highlight three key themes: lack of self‐identification of OA, suboptimal pain relief and limited use of the community pharmacist as a source of management advice. Equipping community pharmacists with tools to identify OA could bridge this gap. More research is needed to determine if it will improve consumers' ability to appropriately manage OA pain.Patient or Public ContributionConsumers living with OA contributed to the study outcomes, reviewed the survey questionnaire for face validity and advised on plain language terminology.

Active vs passive haptic feedback technology in virtual reality arthroscopy simulation: Which is most realistic?

BackgroundVirtual Reality (VR) simulators are playing an increasingly prominent role in orthopaedic training and education. Face-validity - the degree to which reality is accurately represented - underpins the value of a VR simulator as a learning tool for trainees. Despite the importance of tactile feedback in arthroscopy, there is a paucity for evidence regarding the role of haptics in VR arthroscopy simulator realism. PurposeTo assess the difference in face validity between two high fidelity VR simulators employing passive and active haptic feedback technology respectively. Method38 participants were recruited and divided into intermediate and expert groups based on orthopaedic training grade. Each participant completed a 12-point diagnostic knee arthroscopy VR module using the active haptic Simbionix ARTHRO Mentor and passive haptic VirtaMed ArthroS simulators. Subsequently, each participant completed a validated simulator face validity questionnaire. ResultsThe ARTHRO Mentor active haptic system failed to achieve face validity with mean scores for external appearance (6.61), intra-articular appearance (4.78) and instrumentation (4.36) falling below the acceptable threshold (≥7.0). The ArthroS passive haptic simulator demonstrated satisfactory scores in all domains: external appearance (8.42), intra-articular appearance (7.65), instrumentation (7.21) and was significantly (p < 0.001) more realistic than ARTHRO Mentor for all metrics. 61% of participants gave scores ≥7.0 for questions pertaining to haptic feedback realism from intra-articular structures such as menisci and ACL/PCL for the ArthroS vs. 12% for ARTHRO Mentor. There was no difference in face-validity perception between intermediate and expert groups for either simulator (p > 0.05). ConclusionCurrent active haptic technology which employs motors to simulate tactile feedback fails to demonstrate sufficient face-validity or match the sophistication of passive haptic systems in high fidelity arthroscopy simulators. Textured rubber phantoms that mirror the anatomy and haptic properties of the knee joint provide a significantly more realistic training experience for both intermediate and expert arthroscopists.

Stroke Awareness among Elderly Hypertensives in a Rural Area of Bangalore District, India

ObjectivesIndia faces a high and growing burden of hypertension, which is an important cerebrovascular risk factor, especially in elderly persons. Poor awareness contributes to delays in seeking health care, which is undesirable given the emergent nature of stroke. Literature regarding awareness in this subgroup of the population is scarce. Our objective was to assess awareness regarding cerebrovascular disease among elderly persons with hypertension residing in a rural area of Bangalore district, and estimate their individual risk of stroke. Material & MethodsWe randomly selected 144 elderly hypertensives residing in a rural area in Bangalore district from a list of known hypertensives maintained as part of a population-based senior citizen health service. We developed an open-ended, face-validated questionnaire, which was administered following informed consent, to assess stroke awareness. We defined good awareness as knowing at least one risk factor, one warning sign, and having the knowledge that stroke requires immediate treatment. Univariate and multivariate analyses were performed to assess factors associated with good or poor awareness. Results40% of the study population had not heard of the term ‘stroke’. Only 22% could identify the brain as the organ affected. 51% could name at least one symptom. 45% of males and 24% of females believed that their hypertension predisposed them to stroke. 56% could not name a single risk factor. Only 37% of the males and 18% of the females had good overall awareness. Female gender and low literacy were associated with poor overall awareness, while being gainfully employed, a history of alcohol use and doing higher levels of exercise were associated with greater awareness on univariate analysis. None of these factors were statistically significantly related to stroke awareness on multivariate analysis. ConclusionsAwareness of different aspects of stroke was very poor, highlighting the need for stroke education at all levels of care.

Assessment of Housing Conditions among the Residents of a Village in Rural Karnataka

Introduction: Poor housing conditions contribute to respiratory infections, skin diseases, injuries, mental illness.&#x0D; Objective: To assess the housing standards of the residents of Mugalur village, Sarjapur PHC, Bangalore.&#x0D; Methodology: A cross-sectional study was conducted among residents of 252 households in Mugalur village. A structured, face-validated questionnaire was developed to assess the housing conditions and scored on a scale of 0-20 with a higher score depicting better housing conditions.&#x0D; Results: The mean family size was 3.7 + 1.6, 222(88.1%) had Below Poverty Line card. The mean housing standard score was 12.0 + 2.5, 151(59.9%) houses were pucca. For drinking purposes, 138(54.5%) of the households bought water from Community Reverse Osmosis plant. Most of the households did not have exhaust vent 132(52.4%), adequate setback 133(52.8%) and waste segregation 169(67.1%). Toilet facility was present in 193(76.6%) of the households. The criterion for adequate sanitation was met by 35(13.8%) of the households, 252(100%) practiced inappropriate waste disposal. There was a significant association between the duration of stay and the mean housing standard score.&#x0D; Conclusion: The mean housing standard score was 12.0 + 2.5 out of a total score of 20. Areas for improvement were solid waste management and sullage disposal.

Assessment of a virtual reality temporal bone surgical simulator: a national face and content validity study

BackgroundTrainees in Otolaryngology–Head and Neck Surgery must gain proficiency in a variety of challenging temporal bone surgical techniques. Traditional teaching has relied on the use of cadavers; however, this method is resource-intensive and does not allow for repeated practice. Virtual reality surgical training is a growing field that is increasingly being adopted in Otolaryngology. CardinalSim is a virtual reality temporal bone surgical simulator that offers a high-quality, inexpensive adjunct to traditional teaching methods. The objective of this study was to establish the face and content validity of CardinalSim through a national study.MethodsOtolaryngologists and resident trainees from across Canada were recruited to evaluate CardinalSim. Ethics approval and informed consent was obtained. A face and content validity questionnaire with questions categorized into 13 domains was distributed to participants following simulator use. Descriptive statistics were used to describe questionnaire results, and either Chi-square or Fishers exact tests were used to compare responses between junior residents, senior residents, and practising surgeons.ResultsSixty-two participants from thirteen different Otolaryngology–Head and Neck Surgery programs were included in the study (32 practicing surgeons; 30 resident trainees). Face validity was achieved for 5 out of 7 domains, while content validity was achieved for 5 out of 6 domains. Significant differences between groups (p-value of < 0.05) were found for one face validity domain (realistic ergonomics, p = 0.002) and two content validity domains (teaching drilling technique, p = 0.011 and overall teaching utility, p = 0.006). The assessment scores, global rating scores, and overall attitudes towards CardinalSim, were universally positive. Open-ended questions identified limitations of the simulator.ConclusionCardinalSim met acceptable criteria for face and content validity. This temporal bone virtual reality surgical simulation platform may enhance surgical training and be suitable for patient-specific surgical rehearsal for practicing Otolaryngologists.

Occupational stress and its associated factors among school teachers in Rural Karnataka: A cross sectional study

Teachers play a vital role in the society by helping students acquire knowledge and moral values. The objectives of our study were to measure the occupational stress and factors associated with them among school teachers. A cross sectional study was conducted among 102 teachers using eight item, pretested, semi-structured, face-validated questionnaire to assess the factors contributing to occupational stress and scored on a scale of 8-16 with a higher score depicting lower stress. In this study, 35(34.3%) teachers were in the age group of 22-31 years, 72(70.6%) were males, 73(59.8%) were working for more than 5 years, 68(66.7%) were permanent employees, little less than half 42(41.2%) had completed Post-Graduation. The mean occupational stress was 10.8 + 0.96. Factors like male gender, number of classes per day, work distribution, work pressure, strength of the class, duration of travel to work place and job satisfaction had significant impact on work related stress.

Nurses' perceptions of pain management adequacy in mechanically ventilated patients.

To examine how nurses' knowledge of behaviours indicating pain in mechanically ventilated patients and self-perceived collaboration between nurses and physicians affects the adequacy of departmental pain management. Pain management is a vital factor of medical treatment in a hospital setting. Inadequate pain management requires attention both from a patient-focused perspective and from a departmental one. It would be particularly troubling in the case of inadequate pain management of mechanically ventilated patients. The study utilised a cross-sectional design. The instruments developed were validated by a focus group of 25 pain management nurses, who reviewed the questionnaire for face validity, feasibility and comprehensibility, and who did not participate in the study. The questionnaire was revised, readjusted and formulated based on their responses and comments. A self-administered questionnaire administered in Israel with a convenience sample of 187 registered nurses (RN) from internal medicine and surgical departments and ICUs. Data were collected during February-May 2015. The "STROBE" EQUATOR checklist was used. Nurses working in the ICU scored significantly higher on knowledge of behaviours indicating pain in mechanically ventilated patients and on self-perceived collaboration between nurses and physicians. Self-perceived collaboration between physicians and nurses was positively correlated with perceived departmental pain treatment adequacy. Self-perceived collaboration between nurses and physicians, knowledge of behaviours indicating pain in mechanically ventilated patients and seniority (with a borderline significance) explained 27% of the variance of perceived departmental pain management. Nurses' knowledge of behaviours indicating pain in mechanically ventilated patients, as well as self-perceived collaboration between nurses and physicians, promotes reported adequate pain management. Pain management would benefit from being conducted as a well-performed interprofessional self-perceived collaborative practice. Knowledgeable nurses tend to critically assess the level of departmental pain management.

Translation and validation of the Clinical Trial Nursing Questionnaire in Swedish-A first step to clarify the clinical research nurse role in Sweden.

To translate the Clinical Trial Nursing Questionnaire (CTNQ) into Swedish and test it for face and content validity as well as internal consistency and reproducibility using test-retest procedures. In many countries, as in Sweden, a registered nurse can be involved in research by becoming a clinical research nurse. The clinical research nurse plays a pivotal role in clinical studies as a part of the research team. Scales have been developed and used with the objective to clarify the role of clinical research nurses: one of them is the CTNQ. A quantitative cross-sectional design with a test-retest procedure was applied to validate the translated questionnaire. By using a snowball sampling method, relevant participants were identified and 49 registered nurses working in the field of research as clinical research nurses answered the questionnaire on two occasions. An expert panel of three clinical research nurses evaluated the questionnaire for face and content validity. The STROBE checklist for observational research has been followed for presenting the research (see File S1). Face and content validity was agreed upon in the expert panel group. Tests for internal consistency of the CTNQ was calculated and showed a high Cronbach's alpha for both the frequency and importance subscales. The test-retest correlation analysis (reproducibility) also revealed a high correlation coefficient for both subscales. The CTNQ-SWE is a valid and robust instrument in a Swedish version. The instrument can be of importance in assessing the role of clinical research nurses in Sweden in future studies. Use of the CTNQ-SWE in future research can be of value for clarification and professional development of the clinical research nurse role in Sweden. The further use of the CTNQ in Sweden can be of value in understanding the process where licensed nurses make a transition into becoming a clinical research nurse, and to identify needs for customised education.