Measuring Moral Courage for Interns and Residents: Scale Development and Initial Psychometrics

Area of Science:

• Medical Education
• Professional Ethics
• Psychometrics

Background:

• Physician moral courage is crucial for patient care and safety.
• Existing measures for physician moral courage are limited.
• Assessing moral courage is essential for evaluating medical training.

Purpose of the Study:

• To develop and validate a practical survey instrument to measure moral courage in physicians.
• To establish the psychometric properties of the new measure.

Main Methods:

• A survey assessing moral courage, empathy, and speaking up was administered to 352 internal medicine and surgical residents.
• Principal components analysis was used to identify the underlying factor structure of the moral courage items.
• Reliability (Cronbach's alpha) and validity (convergent, discriminant, concurrent) were assessed.

Main Results:

• The Moral Courage Scale for Physicians (MCSP) emerged as a reliable (Cronbach's alpha = 0.90) nine-item measure.
• MCSP scores demonstrated discriminant, convergent, and concurrent validity.
• MCSP scores were associated with physician level (intern vs. resident) and empathy.

Conclusions:

• The MCSP provides a psychometrically sound tool for measuring physician moral courage.
• This scale can be used by researchers and educators to assess moral courage and evaluate interventions.
• The MCSP facilitates tangible measurement and tracking of desired physician behaviors.