Development and validation of self-assessment instrument to measure the digital professionalism of healthcare professionals using social media.

BACKGROUND: The use of social media across the globe has risen incrementally. During the COVID-19 pandemic, these sites undeniably provided new avenues for professional networking but also led to a surge in cases of online misconduct. Professionalism instruments and scales do not assess the digital attitude and behaviour of healthcare professionals (HCPs). The purpose of this study was to identify the domains and items of digital professionalism related to social media use and to validate a self-assessment instrument to assess the digital professionalism of HCPs using social media. METHODS: An instrument development multiphase mixed method study (exploratory sequential) was conducted in two phases: item development and qualitative content validation followed by validation of the instrument. Feedback was taken from 15 experts for qualitative content validation in phase 1. In phase 2, content validity was established through three rounds of modified Delphi. Validity evidence was collected for the content (content validity index), response process (cognitive interviews), internal structure (confirmatory factor analysis), and internal consistency (Cronbach's alpha). RESULTS: The 48-item preliminary instrument was reduced to a 28-item instrument with eight domains: self-anonymity, privacy settings, maintenance of boundaries and confidentiality, conflict of interest, accountability, respect for colleagues, and ethics. The content validity index of the scale was 0.91. The reliability and construct validity of the instrument was established by responses from 500 healthcare professionals from multiple hospitals. Confirmatory factor analysis showed a model with a goodness-of-fit index of 0.86, root mean square error of approximation of 0.06, and observed normed χ2 of 2.7. The internal consistency through Cronbach's alpha α was 0.96. CONCLUSION: The digital professionalism self-assessment instrument (DP-SAI) has an appropriate level of content and measures the construct reliably. It can be used by medical doctors, dental clinicians, nurses, physiotherapists, and clinical pharmacists to self-assess and reflect on their social media practices. This will help to address these issues to enhance the quality of online communication through various social media platforms.

Barriers and Facilitators for Female Healthcare Professionals to Be Leaders in Pakistan: A Qualitative Exploratory Study.

Purpose: Despite being in high numbers in medical colleges, only a small proportion of women join the workforce and even fewer reach leadership positions in Pakistan. Organizations like United Nations and Women Global Health are working towards closing the gender gap. The study aims to explore the enablers and barriers for women in healthcare leadership and to explore the strategies to promote women in leadership positions in Pakistan's specific societal culture. Methods: In this qualitative exploratory study, semi-structured interviews of 16 women holding leadership positions in the health-care profession, ie, medical and dental (basic or clinical sciences) were included. The data were collected until saturation was achieved. The data were analyzed in MS Excel. Deductive and Inductive thematic analysis was done. Results: Thirty-eight codes were generated that were combined in the form of categories. The major themes that emerged from the data were: elevating factors, the shackles holding them back, let us bring them up and implicit bias. Elevating factors were intrinsic motivation and exceptional qualifications, while the shackles were related to gender bias, male insecurities, and lack of political background. It was noteworthy that differences in gender roles were highly defined by culture and religion. Conclusion: There is a need to change the perception of South Asian society and redefine gender roles through media and individual attempts. Women must take charge of their choices and believe in themselves. The institutional policies to help promote gender equality would be mentorship programs for new faculty, gender-responsive training for everyone, equal opportunities for all, and maintaining gender diversity on all committees.

Establishing construct validity of AMEET (assessment of medical educational environment by the teachers) inventory.

OBJECTIVE: To establish the construct validity of Assessment of Medical Educational Environment by the Teachers inventory. METHODS: The cross-sectional analytical study was conducted from January to May 2017 and comprised doctors working as faculty in Rawalpindi Medical College, Rawalpindi, Pakistan, and its 3 teaching hospitals. Non-probability (purposive) sampling was used to meet the criteria of 5 participants per item of the Assessment of Medical Educational Environment by the Teachers inventory. Exploratory factor analysis was done using SPSS 20 and confirmatory factor analysis was done with version 16 of the Analysis of Moment Structures software. RESULTS: Of the 250 subjects, 126(50.4%) were males and 124(49.6%) were females. Exploratory factor analysis ended with extraction of 11 components. It showed sufficiency of sample size and no multi-collinearity. Three (50%) of the six domains were finalised on the whole and 10(20%) of the 50 items were debarred from the inventory. All three domains had high reliability. Root mean square residual and chi square / degree of freedom were within acceptable limit. However, comparative fit index, goodness of fit index, normed fit index and root mean square error of approximation portrayed not only poor model fit after re-running confirmatory factor analysis, but also led to omission of further 16(32%) items with poor loadings from the inventory. Thus, there was exclusion of total 26(52%) items from the tool and the finalised Assessment of Medical Educational Environment by the Teachers inventory comprised 24(48%) items. CONCLUSIONS: Construct validity of Assessment of Medical Educational Environment by the Teachers inventory could not be established, but the tool was found to be reliable.

Measuring assessment standards in undergraduate medical programs: Development and validation of AIM tool.

OBJECTIVE: To develop a tool to evaluate faculty perceptions of assessment quality in an undergraduate medical program. METHODS: The Assessment Implementation Measure (AIM) tool was developed by a mixed method approach. A preliminary questionnaire developed through literature review was submitted to a panel of 10 medical education experts for a three-round 'Modified Delphi technique'. Panel agreement of > 75% was considered the criterion for inclusion of items in the questionnaire. Cognitive pre-testing of five faculty members was conducted. Pilot study was done with 30 randomly selected faculty members. Content validity index (CVI) was calculated for individual items (I-CVI) and composite scale (S-CVI). Cronbach's alpha was calculated to determine the internal consistency reliability of the tool. RESULTS: The final AIM tool had 30 items after the Delphi process. S-CVI was 0.98 with the S-CVI/Avg method and 0.86 by S-CVI/UA method, suggesting good content validity. Cut-off value of < 0.9 I-CVI was taken as criterion for item deletion. Cognitive pre-testing revealed good item interpretation. Cronbach's alpha calculated for the AIM was 0.9, whereas Cronbach's alpha for the four domains ranged from 0.67 to 0.80. CONCLUSIONS: 'AIM' is a relevant and useful instrument with good content validity and reliability of results, and may be used to evaluate the teachers´ perceptions about assessment quality.