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Development and testing of study tools and methods to examine ethnic bias and clinical decision-making among medical students in New Zealand: The Bias and Decision-Making in Medicine (BDMM) study.

Harris R, Cormack D, Curtis E, Jones R, Stanley J, Lacey C - BMC Med Educ (2016)

Bottom Line: This assisted in the prioritisation and selection of measures that worked best in the New Zealand context and aligned with constructs of interest.Piloting (18 participants) confirmed the overall functionality of the web-based questionnaire, with a few minor revisions made to the final study.This paper has utility for other researchers in this area by informing potential development approaches and identifying possible measurement tools.

View Article: PubMed Central - PubMed

Affiliation: Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand.

ABSTRACT

Background: Health provider racial/ethnic bias and its relationship to clinical decision-making is an emerging area of research focus in understanding and addressing ethnic health inequities. Examining potential racial/ethnic bias among medical students may provide important information to inform medical education and training. This paper describes the development, pretesting and piloting of study content, tools and processes for an online study of racial/ethnic bias (comparing Māori and New Zealand European) and clinical decision-making among final year medical students in New Zealand (NZ).

Methods: The study was developed, pretested and piloted using a staged process (eight stages within five phases). Phase 1 included three stages: 1) scoping and conceptual framework development; 2) literature review and identification of potential measures and items; and, 3) development and adaptation of study content. Three main components were identified to assess different aspects of racial/ethnic bias: (1) implicit racial/ethnic bias using NZ-specific Implicit Association Tests (IATs); (2) explicit racial/ethnic bias using direct questions; and, (3) clinical decision-making, using chronic disease vignettes. Phase 2 (stage 4) comprised expert review and refinement. Formal pretesting (Phase 3) included construct testing using sorting and rating tasks (stage 5) and cognitive interviewing (stage 6). Phase 4 (stage 7) involved content revision and building of the web-based study, followed by pilot testing in Phase 5 (stage 8).

Results: Materials identified for potential inclusion performed well in construct testing among six participants. This assisted in the prioritisation and selection of measures that worked best in the New Zealand context and aligned with constructs of interest. Findings from the cognitive interviewing (nine participants) on the clarity, meaning, and acceptability of measures led to changes in the final wording of items and ordering of questions. Piloting (18 participants) confirmed the overall functionality of the web-based questionnaire, with a few minor revisions made to the final study.

Conclusions: Robust processes are required in the development of study content to assess racial/ethnic bias in order to optimise the validity of specific measures, ensure acceptability and minimise potential problems. This paper has utility for other researchers in this area by informing potential development approaches and identifying possible measurement tools.

No MeSH data available.


Related in: MedlinePlus

Overview of phases of development, testing and finalisation of study content
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Related In: Results  -  Collection

License 1 - License 2
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Fig1: Overview of phases of development, testing and finalisation of study content

Mentions: Study content was developed and pretested over eight stages within five phases (Fig. 1), drawing on established techniques for developing reliable and valid measurement tools [23, 24]. Ethics approval for study development and pretesting (Reference 010898) and piloting (Reference 011693) was granted by the University of Auckland Human Participants Ethics Committee and ratified by the University of Otago Human Ethics Committee.Fig. 1


Development and testing of study tools and methods to examine ethnic bias and clinical decision-making among medical students in New Zealand: The Bias and Decision-Making in Medicine (BDMM) study.

Harris R, Cormack D, Curtis E, Jones R, Stanley J, Lacey C - BMC Med Educ (2016)

Overview of phases of development, testing and finalisation of study content
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4940847&req=5

Fig1: Overview of phases of development, testing and finalisation of study content
Mentions: Study content was developed and pretested over eight stages within five phases (Fig. 1), drawing on established techniques for developing reliable and valid measurement tools [23, 24]. Ethics approval for study development and pretesting (Reference 010898) and piloting (Reference 011693) was granted by the University of Auckland Human Participants Ethics Committee and ratified by the University of Otago Human Ethics Committee.Fig. 1

Bottom Line: This assisted in the prioritisation and selection of measures that worked best in the New Zealand context and aligned with constructs of interest.Piloting (18 participants) confirmed the overall functionality of the web-based questionnaire, with a few minor revisions made to the final study.This paper has utility for other researchers in this area by informing potential development approaches and identifying possible measurement tools.

View Article: PubMed Central - PubMed

Affiliation: Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand.

ABSTRACT

Background: Health provider racial/ethnic bias and its relationship to clinical decision-making is an emerging area of research focus in understanding and addressing ethnic health inequities. Examining potential racial/ethnic bias among medical students may provide important information to inform medical education and training. This paper describes the development, pretesting and piloting of study content, tools and processes for an online study of racial/ethnic bias (comparing Māori and New Zealand European) and clinical decision-making among final year medical students in New Zealand (NZ).

Methods: The study was developed, pretested and piloted using a staged process (eight stages within five phases). Phase 1 included three stages: 1) scoping and conceptual framework development; 2) literature review and identification of potential measures and items; and, 3) development and adaptation of study content. Three main components were identified to assess different aspects of racial/ethnic bias: (1) implicit racial/ethnic bias using NZ-specific Implicit Association Tests (IATs); (2) explicit racial/ethnic bias using direct questions; and, (3) clinical decision-making, using chronic disease vignettes. Phase 2 (stage 4) comprised expert review and refinement. Formal pretesting (Phase 3) included construct testing using sorting and rating tasks (stage 5) and cognitive interviewing (stage 6). Phase 4 (stage 7) involved content revision and building of the web-based study, followed by pilot testing in Phase 5 (stage 8).

Results: Materials identified for potential inclusion performed well in construct testing among six participants. This assisted in the prioritisation and selection of measures that worked best in the New Zealand context and aligned with constructs of interest. Findings from the cognitive interviewing (nine participants) on the clarity, meaning, and acceptability of measures led to changes in the final wording of items and ordering of questions. Piloting (18 participants) confirmed the overall functionality of the web-based questionnaire, with a few minor revisions made to the final study.

Conclusions: Robust processes are required in the development of study content to assess racial/ethnic bias in order to optimise the validity of specific measures, ensure acceptability and minimise potential problems. This paper has utility for other researchers in this area by informing potential development approaches and identifying possible measurement tools.

No MeSH data available.


Related in: MedlinePlus