Assessing professional ethics in midwifery educators: development and validation of a specialized instrument

Assessing the professional ethics of midwifery educators is crucial for ensuring high-quality education and patient care. However, a comprehensive and validated instrument specific to this context is lacking, despite the unique ethical demands of their dual role in academia and clinical practice.

To develop and psychometrically validate a comprehensive, context-specific instrument to assess professional ethics among midwifery educators.

A sequential mixed-methods design.

A sequential mixed-methods study was conducted across midwifery education settings in three phases. Item generation involved a literature synthesis and consultations with five midwifery faculty members, yielding an initial pool of 67 items. Content validity was assessed by panels of midwifery experts and students (n = 20) using the Content Validity Ratio (CVR), with a critical value of ≥ 0.62 for item retention; this process resulted in the removal of 10 items, leaving 57 items for psychometric testing. Exploratory factor analysis (EFA) was performed with 200 students, leading to the removal of 2 items and the identification of a six-domain structure. Following reliability analysis, an additional 3 items were omitted. The final 52-item instrument demonstrates strong internal consistency (Cronbach's α = 0.94) and excellent test-retest reliability (ICC = 0.97), and requires 10-15 min to complete.

A total of 225 participants were included across the phases (response rate: 100%). The qualitative phase identified four core categories and twelve sub-categories. Following content validation, exploratory factor analysis (EFA) of the 57-item version led to the removal of 2 items and supported a robust six-factor structure. The final instrument comprises 52 items. The scale demonstrated excellent sampling adequacy (KMO = 0.978), strong internal consistency (α = 0.94), and high test-retest reliability (ICC = 0.97).

This study provides a preliminary 52-item instrument with strong initial psychometric properties for assessing professional ethics in midwifery educators. It serves as a sound tool for evaluation and faculty development, aiming to enhance ethical competencies. Further studies are needed to establish other psychometric properties, such as discriminant and cross-cultural validity.