Validity of the Diabetic Wound Assessment Learning Tool

The development of the Diabetic Wound Assessment Learning Tool (DiWALT) has previously been described. However, an examination of its application to a larger, more heterogeneous group of participants is lacking. In order to allow for a more robust assessment of the psychometric properties of the DiWALT, we applied it to a broader group of participants.

We built validity evidence for the tool by assessing 74 clinician participants' during two simulated wound care scenarios: Two assessors independently rated each participant using our tool, with a total of five raters providing scores. We evaluated validity evidence using generalizability theory analyses and by comparing performance scores across the three experience levels using ANOVA.

The tool differentiated between novices and the other two groups well (p < 0.01) but not between intermediates and experts (p = 0.34). Our generalizability coefficient was 0.87, and our phi coefficient was 0.87.

The accumulated validity evidence suggests our tool can be used to assess novice clinicians' competence in initial diabetic wound management during simulated cases. Further work is required to clarify the DiWALT's performance in a broader universe of generalisation and to examine evidence for its extrapolation and implications inferences.