Initial Psychometric Testing Research Articles

Development and Validation of the Family Quality of Life in Dementia Scale.

People with Alzheimer's disease and related dementias (ADRD) exhibit losses in daily function, as well as behavioral and psychological symptoms, that place a great deal of burden on family caregivers and exert a major influence on the quality of life of these individuals and their families. Despite years of intervention research in the field, there are few studies related to the impact of providing care for a person with ADRD on the family as the unit of analysis. While numerous findings have reported the effects of the chronic stress of caregiving for an individual, analysis of family quality of life is a concept that has been generally overlooked in the ADRD field. The purpose of the present study was to develop and test the Family Quality of Life in Dementia (FQOL-D) scale. Face validity was obtained via a Delphi survey of a multidisciplinary team of dementia providers and researchers; initial psychometric evaluation of the instrument was obtained via family respondents (N = 244). Internal consistency and reliability were established for the instrument. The FQOL-D scale exhibited excellent factorability and concurrent validity with existing scales assessing family psychosocial measures. The initial psychometric testing of the FQOL-D instrument is favorable. Additional use of the FQOL-D instrument in health care settings is warranted to evaluate further the clinical utility of the instrument.

Development and initial psychometric testing of a body-image domain within an electronic pelvic floor questionnaire (ePAQ-pelvic floor).

Urogynaecological conditions have been shown to negatively impact on body image in a number of previous studies. ePAQ-Pelvic Floor (ePAQ-PF) is a patient-reported outcome measure used in clinical practice to assess urogynaecological conditions and their impact on quality of life. This study aimed to develop and undertake initial psychometric testing of a new domain to assess urogynaecological body image within ePAQ-PF. A patient involvement group, analysis of free-text data from ePAQ-PF and a systematic review of existing PROMs assessing urogynaecological body image informed the content of a new body-image domain within ePAQ-PF. This was administered to 208 patients who consented to the use of their anonymised ePAQ-PF responses for research purposes. These data underwent factor analysis, internal consistency reliability and item-total correlation testing. Evidence-based hypotheses were formulated to test construct validity. Criterion validity was assessed against the Body-image Scale (BIS). Patients completed a separate questionnaire (QQ-11) to measure the face validity of ePAQ-PF. Factor analysis revealed a four-item body-image domain with good internal consistency reliability (Cronbach's α= 0.899) and item-total correlation (Spearman's rank r> 0.40). ePAQ-PF body-image domain scores correlated significantly with the BIS scores (r= 0.501). Age, prolapse, sexual dysfunction, pelvic pain and urinary incontinence scores correlated significantly with body-image domain score. QQ-11 value scores demonstrated good acceptability. Body-image assessment should form part of routine care in urogynaecology. Preliminary results support the validity, reliability and functionality of the body-image domain in ePAQ-PF. Further psychometric testing of this is required, including tests of responsiveness and stability.

Initial psychometric testing of the coach-adapted version of the empowering and disempowering motivational climate questionnaire: A Bayesian approach

ABSTRACT The present study examined the psychometric properties of the coach-adapted version of the Empowering and Disempowering Motivational Climate Questionnaire (EDMCQ) using Bayesian structural equation modelling (BSEM). The sample included 780 (M age = 36.4; SD = 10.8; males n = 698; females n = 54; 28 participants did not report sex) youth sport coaches representing five European countries (i.e., England, France, Greece, Norway, and Spain). The results did not support a 34-item five-factor, hierarchical, a two-factor BSEM, or a bifactor BSEM model across the participating countries. However, the results supported a reduced 19-item first-order, two-factor BSEM model that largely showed approximate metric invariance, but not approximate scalar invariance across the five countries. The pool of items constituting empowering and disempowering motivational climates should be refined to further enhance the empirical operationalisation of the coach-adapted version of the EDMCQ. Advancing the quality of translation-back-translation procedures across cultures and conducting multi-national pilot testing seems warranted as well. These recommendations may help to identify the distinctive aspects of each underlying sub-dimension of the EDMCQ, where coaches are the respondents, and pave the way for further examination of the proposed hierarchical multidimensional factor structure and the cross-cultural equivalence of the EDMCQ for this population.

Initial Psychometric Testing of the Knowledge About Atrial Fibrillation and Self-Management Survey.

Guidelines endorse educating patients to self-manage atrial fibrillation (AF) to mitigate AF-related adverse events contributing to personal and societal burden. Published interventions to improve patients' knowledge about AF and self-management are emerging, but evaluations of interventions are limited by lack of a psychometrically sound instrument to measure learning outcomes. We report results of initial psychometric testing of the Knowledge about Atrial Fibrillation and Self-Management (KAFSM) survey. Participants (N = 383), from midwest and southeast medical centers, completed the KAFSM survey. Content validity was evaluated by expert review. Construct validity was evaluated using the Pearson correlation procedure for convergent validity with the Knowledge about Atrial Fibrillation test and independent t test for known groups. Factor analysis using principal axis factoring was performed with a tetrachoric matrix. The Kuder-Richardson procedure was used to determine internal consistency reliability. A content validity index of 0.86 resulted from expert review. A positive (r = 0.60) correlation between the KAFSM survey and Knowledge about Atrial Fibrillation test demonstrated convergent validity. Higher KAFSM scores (difference, 3.28; t = 6.44, P < .001) observed in participants who underwent AF ablation compared with those with an AF diagnosis of less than or equal to 6 months supported known groups validity. Factor analysis revealed a single-factor structure explaining 35% of the variance. The Kuder-Richardson coefficient was 0.86. The KAFSM survey demonstrates content and construct validity and internal consistency reliability. Implementation of the KAFSM in the clinical setting will permit evaluation of the feasibility of its use and value to assess learning outcomes of AF education.

Development and psychometric evaluation of the Beliefs about Home Hemodialysis Scale for patients on in-center hemodialysis&lt;span style="font-size: 12px"&gt;Running title: Health beliefs and home hemodialysis&lt;/span&gt;

Objective There is no valid and reliable instrument that evaluates health beliefs related to home hemodialysis of patients. This study aimed to develop the Beliefs about Home Hemodialysis Scale (BHHS) and evaluate its psychometric properties in a sample of patients on in-center hemodialysis. Methods This methodological study was carried out with 102 patients on in-center hemodialysis. Data were collected by a questionnaire, the Perceived Social Support from Family Scale, and the BHHS. The analysis of data was carried out using descriptive statistics, Mann-Whitney U test, Pearson's correlation coefficients, and psychometric tests. Results The overall content validity index of the scale was satisfactory with 1.00 for relevance and 0.97 for clarity. The exploratory factor analysis yielded a four-factor structure (perceived benefits, perceived barriers toward the environment, perceived barriers toward the procedure, and perceived barriers toward socioeconomic support) accounting for 64.5% of the total variance. The BHHS had acceptable internal consistency (Cronbach's alpha coefficient = 0.69–0.91), test-retest reliability (intraclass correlation coefficient = 0.88–0.95), concurrent validity with the Perceived Social Support from Family Scale scores and known group validity with wanting to start home hemodialysis. Conclusions The initial psychometric testing of the BHHS is favorable. The BHHS is a valid and reliable instrument for assessing the perceived benefits and barriers to home hemodialysis in patients on in-center hemodialysis. The results of this study will gain a better understanding of the beliefs about home hemodialysis of patients and will lead to more effective intervention strategies.

The Pediatric American Pain Society Patient Outcomes Questionnaire (Pediatric APS-POQ): Development and Initial Psychometric Evaluation of a Brief and Comprehensive Measure of Pain and Pain Outcomes in Hospitalized Youth

Pediatric pain assessment in the hospital traditionally involves the patient's self-report of pain intensity using a numeric rating scale, which does not capture the complexity of the pain experience. No valid, comprehensive measure of pain in hospitalized youth exists. This study was designed to develop and conduct initial psychometric testing of the Pediatric American Pain Society Patient Outcomes Questionnaire (Pediatric APS-POQ), a comprehensive patient-reported measure of pain and pain outcomes in hospitalized youth. A multidisciplinary group of pediatric pain researchers and clinicians collaborated to adapt the adult APS-POQ Revised to pediatrics, including a patient-report and parent proxy version. The adapted measures were administered to 218 pediatric inpatients (age M = 13.4 years, 56% female) and 214 of their parents (80% mothers) at 4 US children's hospitals. The measure was feasible to administer within the inpatient setting and was acceptable and understandable to pediatric patients and their parents. Internal consistency was adequate for both patient-report and parent proxy (α = 0.77). Confirmatory factor analysis supported the following 6 domains, consistent with the adult measure: pain intensity, functional interference, emotional response, side effects, perceptions of care, and usual pain. Additional research is needed to further support the reliability and validity of this measure in diverse clinical populations. PerspectiveTo reduce the impact of pain on hospitalized youth, pediatric pain assessment must move beyond ratings of pain intensity. The Pediatric APS-POQ provides a brief but comprehensive assessment of pain and pain outcomes in hospitalized children and adolescents, which will allow for greater individualization in hospital-based pain management and quality improvement purposes.

Pharmacist-initiated adherence promotion activities for persons living with HIV in ambulatory care settings: Instrument development and initial psychometric testing.

Consistent adherence to antiretroviral therapy (ART) remains a challenge for half the people living with HIV (PLWH) in the U.S. Pharmacists have the expertise in pharmacology and pharmacotherapeutics to manage ART and optimize PLWH outcomes. We developed and validated the psychometric properties of a scale to measure the breadth and depth of adherence promotion activities provided by pharmacists to PLWH in ambulatory care settings. An initial 37-item instrument was developed from 31 pharmacists' interviews and a comprehensive literature review. Psychometric properties were assessed from responses to questionnaires of 10 content experts and 184 ambulatory pharmacists in 37 States. Psychometric tests included: content validity index (CVI); Exploratory Factor Analysis (EFA); and internal reliability using Cronbach's alpha (α). 26 items were eliminated in the item reduction stage. The final 11-item adherence promotion activities scale (APAS) was a single factor with high loadings (0.51-0.85), good internal consistency (α ≤ 0.93) and an explained variance of 60%. For known-groups validity, HIV-certified pharmacists had comparatively higher and statistically significant APAS score compared to non-certified pharmacists (4.00, p < .001). Preliminary psychometric testing-factor analysis, and high internal consistency-depict that APAS can be useful in scientific research and pharmacy practice to assess the nature and range of pharmacists' above-and-beyond prescription services in real-world ambulatory settings. Further validation work is needed to establish conclusive reliability and validity of the newly developed scale.

Development and initial validation of an electronic personal assessment questionnaire for menstrual, pelvic pain and gynaecological hormonal disorders (ePAQ-MPH)

ObjectiveMenstrual disorders, pelvic-pain and gynaecological hormonal conditions in women can have a significant impact on quality-of-life. Reliable assessment and monitoring of these intimate conditions is challenging. Patient reported outcome measures (PROMs) can be invaluable in providing objective assessment, but no comprehensive PROM assessing all of these conditions and their impact on quality of life is currently available. The purpose of this study was to develop and undertake initial psychometric testing of a comprehensive interactive electronic patient reported outcome measure for these conditions. Study designA prototype electronic PROM (ePAQ-MPH) was developed following systematic literature review, semi structured interviews with 25 patients and expert panel review. Exploratory factor analysis was undertaken in 291 women attending a menstrual-disorders clinic; establishing a domain structure and enabling item reduction. Two validated PROMS (Women’s Health Questionnaire and Menstrual Distress Questionnaire) were completed to assess criterion validity in 213 patients. Test-retest reliability was carried out in 30 women completing ePAQ-MPH at least one week apart. Patients' views on ‘Value’ and ‘Burden’ were assessed in 278 women using a validated 10-item survey measuring questionnaire utility (QQ-10). Confirmatory factor analysis (CFA) of the revised version of ePAQ-MPH following item reduction was undertaken in a different sample of 254 women. ResultsExploratory factor analysis identified 18 domains (Cronbach’s α > 0.7) and 30 redundant items. Test-retest analysis found acceptable intra-class correlations of 0.6–0.9 (p < 0.05). Eight domains were compared with Menstrual Distress Questionnaire showing moderate or strong correlation in seven domains. Ten domains were compared with Women’s Health Questionnaire, six of which showed moderate correlation. Mean QQ-10 Value and Burden scores were 76 and 25, respectively (SD=15.8 and 15.5). The mean completion time for ePAQ-MPH was 31 min. CFA of the revised version 2 instrument with 15 domains showed good model fit. ConclusionsWhilst wider psychometric testing of the revised version of ePAQ-MPH is required, including in different settings and in assessments of data quality and responsiveness, initial analysis provides some evidence for reliability, validity and acceptability of this multi-dimensional electronic PROM. ePAQ-MPH shows potential for both patient assessment and roles in service evaluation and research.

Initial psychometric testing and validation of the French version of the Canine Brief Pain Inventory

ObjectiveThe Canine Brief Pain Inventory (CBPI) is an owner-completed questionnaire quantifying the severity and impact of chronic pain in dogs. The English version of the CBPI was adapted into French and the objective of this study was to validate this French version of the CBPI. Study designProspective clinical study. AnimalsA group of 32 dogs with a medical history, clinical signs and radiographic evidence consistent with osteoarthritis. MethodsOwners of dogs with osteoarthritis who were native French speakers completed a single administration of the translated questionnaire. The psychometric properties were evaluated including construct validity (by factor analysis), reliability (internal consistency) and convergent validity. ResultsFactor analysis on the responses from this cohort confirmed a two-factor questionnaire: the Pain Severity (PS) factor and the Pain Interference (PI) factor. The mean inter-item correlation for PS and PI questions was 0.74 and 0.53, respectively. These findings reveal strong internal consistency, suggesting that the questions contained within each factor measure the same concept and can be pooled to generate the PS score (PSS) and PI score (PIS). Cronbach’s α was 0.91 and 0.87 for PSS and PIS, respectively. There was strong negative correlation between PSS and PIS with the overall quality of life score (r = –0.62 and r = –0.79, respectively, with p < 0.001 for both), consistent with the hypothesis that increases in PS and PS with function are highly correlated with a corresponding decrease in overall quality of life. Conclusions and clinical relevanceInitial validation of this French version of the CBPI represents an important step in the expanded use of validated owner-completed outcome assessment instruments for use by researchers and clinicians who seek reliable methods to quantify the severity and impact of chronic pain in dogs with osteoarthritis.

Development of the Self-Efficacy for Sleep Hygiene Inventory.

Few studies have examined how self-efficacy is related to sleep behaviors in young adults. The purpose of this study was to develop and test an instrument specifically designed to measure self-efficacy for sleep hygiene in young adults. The Self-Efficacy for Sleep Hygiene Inventory (SESHI) was developed in three phases using principal components analysis. The 30-item scale was pilot tested with a sample of 305 young adults. A second study with a sample of 96 young adults confirmed reliability. A 24-item three-factor solution: time management, disruptive influences, and sleep influences. Cronbach's alphas were 0.83 (total SESHI), 0.87 (time management), 0.69 (disruptive influences), and 0.73 (sleep influences). Initial psychometric testing indicated the SESHI may be a reliable measure of self-efficacy for sleep hygiene in this population.

Cognitive and Initial Psychometric Testing of the Errors of Care Omission Survey: A New Patient Safety Tool for Primary Care.

Most patient safety studies focus on errors of commission rather than on errors of omission. No tools measure errors of omission in primary care. We developed the Errors of Care Omission Survey (ECOS) and present its cognitive and psychometric testing. Twenty-six primary care providers (PCPs) participated in cognitive interviews, which were audiotaped, transcribed, and analyzed. ECOS was also pilot tested with 37 PCPs. Item analysis and reliability testing w conducted. Interviewees agreed that ECOS measures errors of omission and items were clear. The response categories were revised. All items were correlated and subscales had high internal consistency reliability. ECOS can measure errors of omission in primary care.

Development of the Self-Rated Abilities for Health Practices-Adolescent Version: A Self-Efficacy Measure.

An instrument to measure wellness behaviors in adolescent females did not appear in the literature. The purpose of this article is to describe the development and evaluation of the Self-Rated Abilities for Health and Practices Scale-Adolescent Version (SRAHP-A). Initial psychometric testing was conducted with a sample of 265 adolescents and young adults aged 13-24 years. Data collection occurred through paper and pencil surveys. Exploratory factor analysis using maximum likelihood factor extraction method and oblique ration was conducted. A four-factor structure consisting of Exercise, Nutrition, Health Practices, and Well-Being emerged. Initial psychometric testing suggested that it is a valid and reliable measure of wellness behaviors in adolescent females. Further testing is necessary; however, it appears this instrument has the potential to move wellness care for adolescents and young adults forward.

Development and psychometric testing of the Canine Owner-Reported Quality of Life questionnaire, an instrument designed to measure quality of life in dogs with cancer.

OBJECTIVE To describe development and initial psychometric testing of an owner-reported questionnaire designed to standardize measurement of general quality of life (QOL) in dogs with cancer. DESIGN Key-informant interviews, questionnaire development, and field trial. SAMPLE Owners of 25 dogs with cancer for item development and pretesting and owners of 90 dogs with cancer for reliability and validity testing. PROCEDURES Standard methods for development and testing of questionnaire instruments intended to measure subjective states were used. Items were generated, selected, scaled, and pretested for content, meaning, and readability. Response items were evaluated with exploratory factor analysis and by assessing internal consistency (Cronbach α) and convergence with global QOL as determined with a visual analog scale. Preliminary tests of stability and responsiveness were performed. RESULTS The final questionnaire-which was named the Canine Owner-Reported Quality of Life (CORQ) questionnaire-contained 17 items related to observable behaviors commonly used by owners to evaluate QOL in their dogs. Several items pertaining to physical symptoms performed poorly and were omitted. The 17 items were assigned to 4 factors-vitality, companionship, pain, and mobility-on the basis of the items they contained. The CORQ questionnaire and its factors had high internal consistency (Cronbach α = 0.68 to 0.90) and moderate to strong correlations (r = 0.49 to 0.71) with global QOL as measured on a visual analog scale. Preliminary testing indicated good test-retest reliability and responsiveness to improvements in overall QOL. CONCLUSIONS AND CLINICAL RELEVANCE The CORQ questionnaire was a valid, reliable owner-reported questionnaire that measured general QOL in dogs with cancer and showed promise as a clinical trial outcome measure for quantifying changes in individual dog QOL occurring in response to cancer treatment and progression.

Psychometric properties of the Canine Symptom Assessment Scale, a multidimensional owner-reported questionnaire instrument for assessment of physical symptoms in dogs with solid tumors.

OBJECTIVE To describe development and initial psychometric testing of the Canine Symptom Assessment Scale (CSAS), a multidimensional owner-reported questionnaire instrument, in a population of dogs with solid tumors enrolled in clinical trials. DESIGN Questionnaire development and validation study. ANIMALS 238 client-owned dogs with solid tumors. PROCEDURES A 14-symptom questionnaire was developed. Symptoms were defined as subjective physical disturbances dogs experienced during the course of daily living as assessed through proxy reports of pet owners. For each symptom, owners reported frequency and severity of the symptom and extent of distress caused by the symptom for the dog and the owner. Questionnaire content, symptom prevalence and dimensionality, internal consistency, and factor structure were examined. Construct and criterion validity were examined via comparison with the Canine Brief Pain Inventory (CBPI). RESULTS Symptom prevalence was high, with pain and lack of energy reported in most dogs. Severity, versus frequency, was most highly correlated with both dog and owner distress. Two symptoms were removed from consideration because of poor performance. Analysis of the remaining 12 symptoms revealed that they could be grouped into 3 factors: malaise, anxiety, and digestive upset. The CSAS factor and total scores demonstrated predictable relationships with quality of life and pain scores as measured by the CBPI, including a significant association between increasing symptom burden and decreasing quality of life. The Cronbach α for the CSAS was 0.77. CONCLUSIONS AND CLINICAL RELEVANCE The 12-item CSAS was a psychometrically sound owner-reported instrument for assessment of symptom frequency and characteristics in client-owned dogs with solid tumors. Potential applications include clinical research and practice settings.

Initial psychometric testing of the sleep condition indicator in a Swedish context

Introduction: There are several rating scales for insomnia; however, diagnostic criteria have changed over time. This means that the usefulness and validity of earlier scales may be compromised. Th ...

Measuring the patient perspective on latissimus dorsi donor site outcomes following breast reconstruction

There is little evidence about the long-term donor site outcome of latissimus dorsi breast reconstruction and no patient-reported outcome measures designed specifically for the procedure. A prospective cohort of breast cancer patients having latissimus dorsi reconstruction after a mastectomy was recruited from 270 hospitals in the United Kingdom. An 18-month follow up questionnaire containing two novel scales was sent to consenting patients. The prevalence of aesthetic and functional morbidity at the donor site was described. The two new scales were refined using the Rasch measurement model and subsequently validated. 1,096 women completed the new scales. 78% of patients reported that no back appearance issues had bothered them "most of the time" or "all of the time" in the past two weeks. The equivalent figure for functional morbidity was 60%. Four items were eliminated following initial psychometric testing. This produced an 8-item Back Appearance scale and an 11-item Back and Shoulder Function scale. Both scales showed adequate fit to the Rasch measurement model. Higher levels of aesthetic and functional bother were observed for completely autologous procedures versus those where latissimus dorsi reconstruction was used to cover an implant (p <0.05). Higher levels of aesthetic bother were observed in women who had suffered a perioperative complication at the donor site (p = 0.003). These results can inform patients of the morbidity associated with latissimus dorsi reconstruction. The new scales can be used to compare groups undergoing different variations of the procedure and to monitor individual patients.

Initial psychometric testing and validation of the patient participation in pressure injury prevention scale.

The aim of this study was to develop the Patient Participation in Pressure injury Prevention (PPPIP) scale and undertake initial testing of some of its psychometric properties. Clinical practice guidelines recommend patient involvement in pressure injury prevention. There is some evidence that patients are willing to participate in this activity, but there are currently no instruments to measure this participation. This methodological study used data collected as part of a cluster randomized trial to develop and test the PPPIP scale. A sample of 688 of patients with complete PPPIP scale data was used. A stratified random subsample, (Subsample A) was created and the remainder became Subsample B. Item analysis, exploratory factor analysis and Cronbach's alpha reliability were undertaken in Subsample A. Confirmatory factor analysis and Cronbach's alpha reliability were undertaken in Subsample B. Data collection occurred between June 2014 - May 2015. In Subsample A (n=320), inter-item correlations, item total correlations met the acceptance criteria and an exploratory factor analysis identified a one factor solution. In Subsample B (n=368), the confirmatory factor analysis supported this one factor. In both subsamples, the Cronbach's alpha was 0·86. This study provides preliminary evidence of acceptable reliability and validity of the PPPIP scale in two subsamples of hospitalized patients who had limited mobility. It may be used in research and quality improvement activities. As a better conceptual understanding of patient participation emerges, the PPPIP scale may require refinement.

Measuring Mental Health Provider-Based Stigma: Development and Initial Psychometric Testing of a Self-Assessment Instrument.

This article describes the development and initial psychometric testing of the Mental Health Provider Self-Assessment of Stigma Scale (MHPSASS), a 20-item instrument crafted in reflection of Charles' (Social Work in Mental Health 11:360-375, 2013) empirically derived, experience-based, five-themed model of provider stigmatization. Following model and item review by construct experts, 220 mental health service providers in Virginia's public mental health centers and in-patient facilities completed the survey package. Results indicate the refined MHPSASS is a reliable measure of provider-based stigma with promising face and content validity. However, rather than they hypothesized five-factors, analysis indicates a four-factor solution, a key finding signaling a discrepancy between what providers endorse and what clients' experience. Notably absent from the MHPSASS' were items related to blame and shame, in contrast to the experience of clients and families. Further refinement is indicated, particularly reconsideration of blame and shame items due to their practical and theoretical significance.

Development and testing of the Quint Leveled Clinical Competency Tool

BackgroundSimulation practice evaluation has evolved from self-reports of indirect measures such as learner satisfaction and confidence to more direct measures of learning and performance improvement. There is a need for psychometrically tested instruments to document direct learner outcomes. MethodsThis article describes the history, development, and initial psychometric testing of the Quint Leveled Clinical Competency Tool using both generalizability theory and traditional reliability testing. The instrument can be used in both simulation and clinical environments and is designed to rate observed learner performance for ten competencies derived from Tanner’s model. Results and ConclusionsThe QLCCT instrument has a high inter-rater reliability (0.87) and coefficient alpha (0.83), but generalizability theory analysis indicates that additional psychometric testing and factor analysis is necessary to complete full psychometric testing.

The MacTRAUMA TTL Assessment Tool: Developing a Novel Tool for Assessing Performance of Trauma Trainees: Initial Reliability Testing

To develop a novel assessment tool for trainees-led trauma resuscitation. Assess psychometric properties of the proposed tool. Evaluate feasibility and utility of the tool. Trauma resuscitation is a structured and complex process involving unique sets of skills. There is currently no published structured formative evaluation tool for trauma trainees. Therefore, many trauma trainees rely upon limited, unstructured feedback on their performance. We developed a tool to assess trainee performance while leading a trauma resuscitation and to assist faculty in providing trainee feedback after the encounter. This study was conducted in a level I trauma centre in Ontario, Canada. Principles of learning theories, literature review, and clinical expert opinions were used to design a tool to assess clinical competence required to lead the resuscitation. In total, 5 critical domains were identified. High-fidelity simulation-based environment was used to test interrater reliability using intraclass correlation coefficients. To gauge feasibility, practicality, and utility of the tool, an online survey was sent to raters and trainees at the end of the study. We found "excellent" agreement for "initial critical assessment" domain (0.80) and "moderate to good" agreement for the "communication and leadership" (0.67) and "clinical performance" domains (0.53). "Poor" agreement was identified for the "decision-making" domain (0.33). The coefficients for individual items reached "good" agreement for 5 items, and "moderate" agreement for 8 items. Intraclass correlation coefficients for the remaining 7 items were "fair" or "poor." Most raters agreed that items in the medical training domain were not applicable. Feedback from raters and trainees confirmed the feasibility and acceptability of the tool for formative feedback, in addition to some suggestions to enhance the tool. MacTrauma TTL assessment tool is a novel tool for formative feedback for trainees' performance during trauma resuscitation. Initial psychometric property testing is promising. Further reliability and validity testing of the modified tool is needed. The tool has been shown to be feasible and acceptable by both trainees and faculty as a formative assessment tool.