Measuring women's experiences of maternity care: A systematic review of self-report survey instruments.

BACKGROUND: Recognition of the measurement of women's experiences of their maternity care as a critical component of care quality evaluation has led to a proliferation of instruments to measure this concept. However, the suboptimal methodological and psychometric quality of these instruments, or the lack of reporting of same, hinders the credibility and efficient use of the arising results, which often serve as an indicator for the direction of limited resources within maternity services. AIM: To review systematically and critically appraise self-report survey instruments measuring women's experiences of their maternity care. METHODS: A systematic review was conducted using comprehensive searches of the CINAHL, OVID MEDLINE and EMBASE citation databases. Inclusion and exclusion criteria were applied, and a stepped approach employed to facilitate evaluation of the methodological and psychometric quality of included instruments. FINDINGS: 4905 records were obtained from database searches. Additional records were obtained via reference checking and by expert suggestion. Following stepped screening, 40 papers related to 20 instruments are included in this review. Findings indicate that evidence of the methodological and psychometric quality have not been reported for many included instruments. CONCLUSIONS: Published evidence of the methodological and psychometric quality of self-report survey instruments to evaluate women's experiences of their maternity care is lacking. The conduct and reporting of future development processes of such instruments can be improved. Systematic review PROSPERO registration: CRD42018105325.

Development of a survey instrument to evaluate women's experiences of their maternity care.

BACKGROUND: The process of developing a survey instrument to evaluate women's experiences of their maternity care is complex given that maternity care encapsulates various contexts, services, professions and professionals across the antenatal, intranatal and postnatal periods. AIM: To identify and prioritise items for inclusion in the National Maternity Experience Survey, a survey instrument to evaluate women's experiences of their maternity care in the Republic of Ireland. METHODS: This study used an adapted two-phase exploratory sequential mixed methods design. Phase one identified items for possible inclusion and developed an exhaustive item pool through a systematic review, focus groups and one to one interviews, and a gap analysis. Phase two prioritised the items for inclusion in the final item bank through a Delphi study and consensus review. FINDINGS: Following iterative consultation with key stakeholder groups, a bank of 95 items have been prioritised and grouped within eight distinct care sections; care during your pregnancy, care during your labour and birth, care in hospital after the birth of your baby, specialised care for your baby, feeding your baby, care at home after the birth of your baby, overall care and you and your household. CONCLUSION: Robust and rigorous methods have been used to develop a bank of 95 suitable items for inclusion in the National Maternity Experience Survey.

Measuring women's experiences of maternity care: protocol for a systematic review of self-report survey instruments.

BACKGROUND: The use of survey instruments to measure women's experiences of their maternity care is regarded internationally as an indicator of the quality of care received. To ensure the credibility of the data arising from these instruments, the methodological quality of development must be high. This paper reports the protocol for a systematic review of self-report instruments used to measure women's experiences of their maternity care. METHODS: Citation databases CINAHL, Ovid MEDLINE and EMBASE will be searched from 2002 to 2018 using keywords including women, experience, maternity care, questionnaires, surveys, and self-report. Citations will be screened by two reviewers, in two rounds, for inclusion as per predetermined inclusion and exclusion criteria. Data extraction forms will be populated with data, extracted from each study, to evaluate the methodological quality of each survey instrument and the criteria for good measurement properties using quality criteria. Data will also be extracted to categorise the items included in each survey instrument. A combination of a structured narrative synthesis and quantitate summaries in tabular format will allow for recommendations to be made on the use, adaptation and development of future survey instruments. DISCUSSION: The value of survey instruments that evaluate women's experiences of their maternity care, as a marker of quality care, has been recognised internationally with many countries employing the use of such instruments to inform policy and practice. The development of these instruments must be methodologically sound and the instrument itself fit for the purpose and context in which it is used. This protocol describes the methods that will be used to complete a systematic review that will serve as a guide for choosing the most appropriate existing instruments to use or adapt so that they are fit for purpose, in addition to informing the development of new instruments. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018105325.

The effectiveness of concept mapping and retrieval practice as learning strategies in an undergraduate physiology course.

Concept mapping and retrieval practice are both educational methods that have separately been reported to provide significant benefits for learning in diverse settings. Concept mapping involves diagramming a hierarchical representation of relationships between distinct pieces of information, whereas retrieval practice involves retrieving information that was previously coded into memory. The relative benefits of these two methods have never been tested against each other in a classroom setting. Our study was designed to investigate whether or not concept mapping or retrieval practice produced a significant learning benefit in an undergraduate physiology course as measured by exam performance and, if so, was the benefit of one method significantly greater than the other. We found that there was a trend toward increased exam scores for the retrieval practice group compared with both the control group and concept mapping group, and that trend achieved statistical significance for one of the four module exams in the course. We also found that women performed statistically better than men on the module exam that contained a substantial amount of material relating to female reproductive physiology.

The Nature of Science Instrument-Elementary (NOSI-E): the end of the road?

This research continues prior work published in this journal (Peoples, O'Dwyer, Shields and Wang, 2013). The first paper described the scale development, psychometric analyses and part-validation of a theoretically-grounded Rasch-based instrument, the Nature of Science Instrument-Elementary (NOSI-E). The NOSI-E was designed to measure elementary students' understanding of the Nature of Science (NOS). In the first paper, evidence was provided for three of the six validity aspects (content, substantive and generalizability) needed to support the construct validity of the NOSI-E. The research described in this paper examines two additional validity aspects (structural and external). The purpose of this study was to determine which of three competing internal models provides reliable, interpretable, and responsive measures of students' understanding of NOS. One postulate is that the NOS construct is unidimensional;. alternatively, the NOS construct is composed of five independent unidimensional constructs (the consecutive approach). Lastly, the NOS construct is multidimensional and composed of five inter-related but separate dimensions. The vast body of evidence supported the claim that the NOS construct is multidimensional. Measures from the multidimensional model were positively related to student science achievement and students' perceptions of their classroom environment; this provided supporting evidence for the external validity aspect of the NOS construct. As US science education moves toward students learning science through engaging in authentic scientific practices and building learning progressions (NRC, 2012), it will be important to assess whether this new approach to teaching science is effective, and the NOSI-E may be used as a measure of the impact of this reform.

With hiccups and bumps: the development of a Rasch-based instrument to measure elementary students' understanding of the nature of science.

This research describes the development process, psychometric analyses and part validation study of a theoretically-grounded Rasch-based instrument, the Nature of Science Instrument-Elementary (NOSI-E). The NOSI-E was designed to measure elementary students' understanding of the Nature of Science (NOS). Evidence is provided for three of the six validity aspects (content, substantive and generalizability) needed to support the construct validity of the NOSI-E. A future article will examine the structural and external validity aspects. Rasch modeling proved especially productive in scale improvement efforts. The instrument, designed for large-scale assessment use, is conceptualized using five construct domains. Data from 741 elementary students were used to pilot the Rasch scale, with continuous improvements made over three successive administrations. The psychometric properties of the NOSI-E instrument are consistent with the basic assumptions of Rasch measurement, namely that the items are well-fitting and invariant. Items from each of the five domains (Empirical, Theory-Laden, Certainty, Inventive, and Socially and Culturally Embedded) are spread along the scale's continuum and appear to overlap well. Most importantly, the scale seems appropriately calibrated and responsive for elementary school-aged children, the target age group. As a result, the NOSI-E should prove beneficial for science education research. As the United States' science education reform efforts move toward students' learning science through engaging in authentic scientific practices (NRC, 2011), it will be important to assess whether this new approach to teaching science is effective. The NOSI-E can be used as one measure of whether this reform effort has an impact.

Diagnosing students' misconceptions in algebra: results from an experimental pilot study.

Computer-based diagnostic assessment systems hold potential to help teachers identify sources of poor performance and to connect teachers and students to learning activities designed to help advance students' conceptual understandings. The present article presents findings from a study that examined how students' performance in algebra and their overcoming of common algebraic misconceptions were affected by the use of a diagnostic assessment system that focused on important algebra concepts. This study used a four-group randomized cluster trial design in which teachers were assigned randomly to one of four groups: a "business as usual" control group, a partial intervention group that was provided with access to diagnostic tests results, a partial intervention group that was provided with access to the learning activities, and a full intervention group that was given access to the test results and learning activities. Data were collected from 905 students (6th-12th grade) nested within 44 teachers. We used hierarchical linear modeling techniques to compare the effects of full, partial, and no (control) intervention on students' algebraic ability and misconceptions. The analyses indicate that full intervention had a net positive effect on ability and misconception measures.