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Development and Psychometric Validation of the Minho Suture Assessment Scale (Minho-SAS) for Medical Students
Nuno Silva Gonçalves1, Rita Matos Sousa1, Carlos Collares2
1School of Medicine. Universidade do Minho. & Life and Health Sciences Research Institute (ICVS). School of Medicine. Universidade do Minho. & Clinical Academic Center (2CA). Braga. Portugal.
Introduction:
Even though mastery of suturing is a core technical skill in surgical education, existing tools for its assessment often lack psychometric validation or are not specifically designed for undergraduate training. The aim of this study was to develop and validate the Minho Suture Assessment Scale (Minho-SAS), a structured instrument to evaluate fundamental suturing competencies in medical students. The research question was whether the Minho-SAS demonstrates validity and reliability as a psychometric tool.
Methods:
The development process involved collaboration with multidisciplinary surgical teams and experienced practitioners to ensure content validity. Data from a cohort of medical students were utilized for psychometric evaluation. Dimensionality was assessed using parallel analysis, Bayesian information criterion, unidimensional congruence, item unidimensional congruence, explained common variance, item explained common variance and mean of item residual absolute loadings. Validity based on internal structure was assessed with Rasch model analysis and factor analysis from the tetrachoric correlation matrix. Reliability was assessed using Rasch model standard errors of measurement to obtain a conditional reliability curve and Cronbach's alpha and McDonald's omega internal consistency coefficients.
Results:
Analyses supported a unidimensional structure for the Minho-SAS. The single-factor solution explained 39.96% of variance, and Rasch measures accounted for 29.15% (16.43% by persons, 12.72% by items). Residual correlations, factor loadings, and item fit statistics were within acceptable ranges. Reliability indices were satisfactory: Rasch reliability = 0.706; McDonald's omega = 0.889; Cronbach's alpha = 0.883.
Conclusion:
The Minho-SAS is a robust instrument specifically tailored for assessing fundamental suturing skills among medical students. Rasch model analysis yielded less favorable results than factor analysis, yet still acceptable. While demonstrating considerable potential, further exploration of Minho-SAS across diverse populations and educational settings is crucial to affirm its broader applicability and impact in medical education and clinical practice.
