TY - JOUR
T1 - Applying modern measurement approaches to constructs relevant to evidence-based practice among Canadian physical and occupational therapists
AU - Al Zoubi, Fadi
AU - Mayo, Nancy
AU - Rochette, Annie
AU - Thomas, Aliki
N1 - Funding Information:
The authors would like to thank Carly Goodman, MSc, for helping with sending invitations, developing the e-survey, data collection, data processing, and taking field notes. We wish to thank all physiotherapists and occupational therapists who took part in our study for their time. FAZ acknowledges the generous support of the postdoctoral bursary from the Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR).
Funding Information:
This study was funded by the Canadian Institutes of Health Research (CIHR). The funding body did not influence the study results and was not involved in the study in any way.
Publisher Copyright:
© 2018 The Author(s).
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2018/12/18
Y1 - 2018/12/18
N2 - Background: Evidence-based practice (EBP) is a complex process. To quantify it, one has to also consider individual and contextual factors using multiple measures. Modern measurement approaches are available to optimize the measurement of complex constructs. This study aimed to develop a robust measurement approach for constructs around EBP including practice, individual (e.g. knowledge, attitudes, confidence, behaviours), and contextual factors (e.g. resources). Methods: One hundred eighty-one items arising from 5 validated EBP measures were subjected to an item analysis. Nominal group technique was used to arrive at a consensus about the content relevance of each item. Baseline questionnaire responses from a longitudinal study of the evolution of EBP in 128 new graduates of Canadian physical and occupational therapy programmes were analysed. Principles of Rasch Measurement Theory were applied to identify challenges with threshold ordering, item and person fit to the Rasch model, unidimensionality, local independence, and differential item functioning (DIF). Results: The nominal group technique identified 70/181 items, and modified Delphi approach identified 68 items that fit a formative model (2 related EBP domains: self-use of EBP (9 items) and EBP activities (7 items)) or a reflective model (4 related EBP domains: attitudes towards EBP (17 items), self-efficacy (9 items), knowledge (11 items) and resources (15 items)). Rasch analysis provided a single score for reflective construct. Among attitudes items, 65% (11/17) fit the Rasch model, item difficulties ranged from -7.51 to logits (least difficult) to +5.04 logits (most difficult), and person separation index (PSI)= 0.63. Among self-efficacy items, 89% (8/9) fit the Rasch model, item difficulties ranged from -3.70 to + 4.91, and PSI = 0.80. Among knowledge items, 82% (9/11) fit the Rasch model, item difficulties ranged from -7.85 to 4.50, and PSI = 0.81. Among resources items, 87% (13/15) fit the Rasch model, item difficulties ranged from -3.38 to 2.86, and PSI = 0.86. DIF occurred in 2 constructs: attitudes (1 by profession and 2 by language) and knowledge (1 by language and 2 by profession) arising from poor wording in the original version leading to poor translation. Conclusions: Rasch Measurement Theory was applied to develop a valid and reliable measure of EBP. Further modifications to the items can be done for subsequent waves of the survey.
AB - Background: Evidence-based practice (EBP) is a complex process. To quantify it, one has to also consider individual and contextual factors using multiple measures. Modern measurement approaches are available to optimize the measurement of complex constructs. This study aimed to develop a robust measurement approach for constructs around EBP including practice, individual (e.g. knowledge, attitudes, confidence, behaviours), and contextual factors (e.g. resources). Methods: One hundred eighty-one items arising from 5 validated EBP measures were subjected to an item analysis. Nominal group technique was used to arrive at a consensus about the content relevance of each item. Baseline questionnaire responses from a longitudinal study of the evolution of EBP in 128 new graduates of Canadian physical and occupational therapy programmes were analysed. Principles of Rasch Measurement Theory were applied to identify challenges with threshold ordering, item and person fit to the Rasch model, unidimensionality, local independence, and differential item functioning (DIF). Results: The nominal group technique identified 70/181 items, and modified Delphi approach identified 68 items that fit a formative model (2 related EBP domains: self-use of EBP (9 items) and EBP activities (7 items)) or a reflective model (4 related EBP domains: attitudes towards EBP (17 items), self-efficacy (9 items), knowledge (11 items) and resources (15 items)). Rasch analysis provided a single score for reflective construct. Among attitudes items, 65% (11/17) fit the Rasch model, item difficulties ranged from -7.51 to logits (least difficult) to +5.04 logits (most difficult), and person separation index (PSI)= 0.63. Among self-efficacy items, 89% (8/9) fit the Rasch model, item difficulties ranged from -3.70 to + 4.91, and PSI = 0.80. Among knowledge items, 82% (9/11) fit the Rasch model, item difficulties ranged from -7.85 to 4.50, and PSI = 0.81. Among resources items, 87% (13/15) fit the Rasch model, item difficulties ranged from -3.38 to 2.86, and PSI = 0.86. DIF occurred in 2 constructs: attitudes (1 by profession and 2 by language) and knowledge (1 by language and 2 by profession) arising from poor wording in the original version leading to poor translation. Conclusions: Rasch Measurement Theory was applied to develop a valid and reliable measure of EBP. Further modifications to the items can be done for subsequent waves of the survey.
KW - Attitudes
KW - Evidence-based practice
KW - Knowledge
KW - Measure
KW - Measurement
KW - Occupational therapy
KW - Physical therapy
KW - Rasch Measurement Theory
KW - Rehabilitation
KW - Resources
KW - Self-efficacy
UR - http://www.scopus.com/inward/record.url?scp=85058790613&partnerID=8YFLogxK
U2 - 10.1186/s13012-018-0844-4
DO - 10.1186/s13012-018-0844-4
M3 - Journal article
C2 - 30563550
AN - SCOPUS:85058790613
SN - 1748-5908
VL - 13
JO - Implementation Science
JF - Implementation Science
IS - 1
M1 - 152
ER -