Development and validation of an instrument to assess the self- confidence of students enrolled in the advanced pharmacy practice experience

American Journal of Pharmaceutical Education, Spring 2002 by Wongwiwatthananukit, Supakit, Newton, Gail D, Popovich, Nicholas G

Step 1: Instrument Development

Purpose. To define self-confidence, to identify instrument subscales, to generate items for the instrument, and to design the instrument format.

Definition of Self-Confidence. The content domain of interest in this study was a student's self-confidence in general competencies when performing tasks during the APPE. A student's self-confidence was defined/explained by the self-efficacy theory(7). It was defined as the pharmacy student's belief in his capability to perform general tasks within the clerkship experience. Informal interviews with clerkship preceptors/faculty members were also conducted to identify needed general competencies when performing tasks during clerkships.

Identification of Subscales and Generation of Items. Tentative subscales and an item pool for each subscale of the content domain were based extensively on the pharmaceutical literature related to the concept of pharmaceutical care and professional competencies, nineteen pharmacy schools' developed evaluation forms to assess students' professional competencies during the clerkship experience, and informal interviews with preceptors/faculty members. The information was analyzed and instrument items that assessed the aspect/domain of tasks/activities were extracted, pooled, and generated. Items measuring similar activities/tasks were categorized together. Based on the literature review, the initial 57-item instrument was created and intended to represent four subscales believed to represent the domain of self-confidence needed when performing tasks in clerkships: (i) pharmaceutical care; (ii) communication skills; (iii) knowledge base; and (iv) professionalism.

Instrument Format and Design. The instrument was designed for use by students as a self-assessment tool. The format and design of the scale, including selection of response choices, were based on the standard methodology for measuring self-efficacy beliefs from the self-efficacy theory(7). For this study, a single-judgment format using a single unit interval range from 0 to 10 was employed for every instrument item. The instrument was administered to pharmacy students who would be requested to judge confidence in their ability at the present time to complete tasks on a rating scale (i.e., a 10-point scale, 0 = not at all confident, 5 = moderately confident, to 10 = completely confident). A student's demographic form was also created during this step and reviewed by selected Purdue School of Pharmacy and Pharmacal Sciences APPE program faculty.

Step 2: Expert Review of the Instrument

Purpose. To obtain content validity of the instrument items that was relevant and representative of each subscale's domain by an internal and a national expert panel.

Internal Expert Panel. Sixteen Pharmacy Practice Department clinical faculty and affiliated Purdue University clerkship preceptors were asked to constitute an internal expert content panel to review the initial version of the instrument. The initial 57 items were prepared and formatted to facilitate review of the items. Ten of 16 clinical faculty and preceptors agreed to review the initial 57 pool items. Each item was reviewed for content, grammatical correctness, organization, readability, and clarity. The internal expert panel members were also asked to share/suggest any additional items/tasks that were related to the subscales and/or germane to the general competencies expected during the APPE that should be considered for inclusion in the instrument. This process increased the original 57-item instrument to 73 items. The 73 items were then prepared and formatted to facilitate review by a national expert panel.