Adaptation and psychometric evaluation of the Perceptions of Structural Equity (POSE) tool for PharmD students

The purpose of this study was to examine the psychometric properties of a modified measurement tool, termed the Perception of Structural Equity (POSE) tool by the current authors, for assessing student perceptions of social determinants of health (SDOH) and health equity, with a focus on structures (eg, policies, economic system) that interact with SDOH. The revised POSE tool included subscales measuring comprehension, readiness, awareness, and perceptions.

An existing measurement tool was adapted to include 19 items using a 5-point Likert agreement scale. The POSE tool was administered to first-year PharmD students from four schools. Internal structure validity evidence for the POSE tool was examined using item descriptives, Cronbach's alpha, and confirmatory factor analysis (CFA).

There were 237 valid responses. Most items correlated with the measures, however, two did not and were removed, resulting in a final 17-item POSE tool. Cronbach's alpha values for each subscale and the overall POSE tool were generally above 0.70, suggesting acceptable reliability. CFA results for the 17-item model suggested good model fit.

Overall, the revised POSE tool demonstrated strong psychometric properties, acceptable reliability, and detected change in perceptions over time. The final 17-item tool demonstrated good internal structure validity evidence, suggesting that the POSE tool may be useful as part of a comprehensive assessment plan. The tool can be used in its entirety or through use of one or more subscales. Future studies should examine the POSE tool in additional samples and continue evaluating its ability to assess change over time.