Development and Validation of the Medical Brain Drain Attitudes Scale (MBDAS) in Turkey

This study aimed to develop and psychometrically validate the Medical Brain Drain Attitudes Scale (MBDAS) to measure attitudes towards the conditions underlying medical brain drain. The final scale was also used to describe the attitudinal pattern observed in the study sample.

During the scale development process, we generated the item pool and examined face and content validity. We then conducted exploratory factor analysis using data from 246 clinical and intern medical students. Next, we performed confirmatory factor analysis and tested the convergent, discriminant, and criterion validity with a further sample of 560 participants. We assessed reliability using Cronbach's alpha, item analysis, upper-lower 27% group comparisons, and test-retest analysis with 87 participants. Once the final scale was established, we calculated mean values for its dimensions in the study sample.

The final scale comprised a total of 18 items within six dimensions: Earnings and Living Standards (ELS), Professional Safety and Fairness (PSF), Professional Prestige (PP), Workload and Duty (WD), Career and Development (CD), and SocioPolitical Climate (SPC). Factor analyses supported this structure and confirmatory analysis indicated acceptable model fit. Analyses of validity and reliability confirmed the psychometric adequacy of the MBDAS. In the study sample, mean values across the scale dimensions were high or very high.

The MBDAS enables attitudes towards emigration to be examined multidimensionally on the basis of the conditions associated with physician emigration. The scale serves as a quantitative assessment tool that extends beyond the commonly used binary push-pull framework. In this study's sample, the highest mean values were observed in relation to economic conditions, violence in healthcare settings, the functioning of the health system, and workload conditions.