The Dartmouth sleep knowledge and attitude survey: development and validation

To construct and validate an instrument for the purpose of assessing effectiveness of curriculum development and educational interventions in sleep medicine.

Medical school and graduate medical curricula have historically contained quite limited instruction in sleep physiology and sleep medicine. Recent initiatives, particularly the Sleep Academic Award program, have attempted to address this issue through support of programs designed to develop educational resources and implement curriculum change. Effective measures for assessment of educational outcome are an essential component of these interventions.

A panel of sleep experts, other medical professionals, and education consultants developed a knowledge and attitude survey, designed to address a broad range of topics in sleep physiology and medicine. The instrument was modified in response to pilot testing, and a final 24-item survey has been administered to two cohorts of college undergraduates before and immediately following a ten-week course of instruction and to a single cohort of first-year medical students. A group of sleep medicine experts served as the comparison population. Results were analyzed for item difficulty, item discrimination, and instructional sensitivity.

Analyses of item difficulty, item discrimination, and instructional sensitivity were in line with acceptable norms for criterion-referenced tests. There was evidence of discriminative validity, as shown by scores on the measure and acknowledged expertise.

This instrument demonstrates both logical and empirical evidence of validity and may serve as a useful tool in assessing outcome of educational interventions in sleep medicine.