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Measuring Health Care Work-Related Contextual Factors: Development of the McGill Context Tool
Aliki Thomas1, Christina St-Onge, Jean-Sébastien Renaud
1Dr. Thomas , Associate Professor, School of Physical and Occupational Therapy, Research Scientist, Institute of Health Sciences Education, McGill University. Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada. Dr. St-Onge , Professor, Department of Medicine and Center for Health Sciences Education, Université de Sherbrooke. Paul Grand'Maison de la Société des Médecins de l'Université de Sherbrooke-Research Chair in Medical Education, Sherbrooke, Quebec, Canada. Dr. Renaud , Professor, Department of Family and Emergency Medicine, VITAM Research Center, Université Laval, Quebec, Quebec, Canada. Ms. George , School of Physical and Occupational Therapy, Research Scientist, McGill University, Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada. Dr. Iqbal , Post-Doctoral Fellow, School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Centre for Interdisciplinary Research in Rehabilitation Montreal, Quebec, Canada. Dr. Brousseau , Professor, Department of Occupational Therapy, Université du Québec à Trois Rivieres, Trois-Rivières, Quebec, Canada. Dr. Dyer , Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal. Groupe interdisciplinaire de recherche sur la cognition et le raisonnement professionnel, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada. Dr. Gallagher , Professor, Faculty of Medecine and Health Sciences. School of Nursing, Université de Sherbrooke, Research Group in Pursuit of Validity, Centre de Recherche Du CHUS, Sherbrooke, Quebec, Canada. Dr. Lacasse, Professor, Département de Médecine Familiale et de Médecine D'urgence, Faculté de Médecine, Université Laval, Quebec, Quebec, Canada. Dr. Ledoux , Associate Professor, Faculty of Medicine and Health Sciences, School of Nursing, Université de Sherbrooke, Sherbrooke, Quebec, Canada. Dr. Vachon, Associate Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal. Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada. Dr. Rochette , Professor, Occupational Therapy Program, School of Rehabilitation, Université de Montréal. Centre for Interdisciplinary Research in Rehabilitation, Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Montreal, Quebec, Canada.
Introduction:
Contextual factors can influence healthcare professionals' (HCPs) competencies, yet there is a scarcity of research on how to optimally measure these factors. The aim of this study was to develop and validate a comprehensive tool for HCPs to document the contextual factors likely to influence the maintenance, development, and deployment of professional competencies.
Methods:
We used DeVellis' 8-step process for scale development and Messick's unified theory of validity to inform the development and validation of the context tool. Building on results from a scoping review, we generated an item pool of contextual factors articulated around five themes: Leadership and Agency, Values, Policies, Supports, and Demands. A first version of the tool was pilot tested with 127 HCPs and analyzed using the classical test theory. A second version was tested on a larger sample (n = 581) and analyzed using the Rasch rating scale model.
Results:
First version of the tool: we piloted 117 items that were grouped as per the themes related to contextual factors and rated on a 5-point Likert scale. Cronbach alpha for the set of 12 retained items per scale ranged from 0.75 to 0.94. Second version of the tool included 60 items: Rasch analysis showed that four of the five scales (ie, Leadership and Agency, Values, Policies, Supports) can be used as unidimensional scales, whereas the fifth scale (Demands) had to be split into two unidimensional scales (Demands and Overdemands).
Discussion:
Validity evidence documented for content and internal structure is encouraging and supports the use of the McGill context tool. Future research will provide additional validity evidence and cross-cultural translation.
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