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Volume 30 (1)

Volume 30, Issue 1, Winter 2010line
J Contin Educ Health Prof 2010; 30(1):19-25
ORIGINAL RESEARCH

A construct validity study of clinical competence: A multitrait multimethod matrix approach
Lubna Baig, Claudio Violato, Rodney Crutcher

A b s t r a c t

Introduction: The purpose of the study was to adduce evidence for estimating the construct validity of clinical competence measured through assessment instruments used for high-stakes examinations.
Methods: Thirty-nine international physicians (mean age = 41 + 6.5 y) participated in high-stakes examination and 3-month supervised clinical practice to determine the practice readiness of physicians. Three traits - doctor - patient relationship, clinical competence, and communication skills - were assessed with objective structured clinical examinations, in-training evaluation reports, and clinical assessments. These traits were intercorrelated in a multitrait multimethod matrix (MTMM).
Results: The reliability of assessments ranged from moderate to high (Cronbach’s α: 0.58-0.98; Ep2 = 0.79). There is evidence for both convergent and divergent validity for clinical competence, followed by doctor-patient relationships, and communications (validity coefficients = 0.12-0.85). The correlations between the same methods but different traits indicate that there is substantial method specificity in the assessment accounting for nearly one-quarter of the variance (23.7%).
Discussion: There is evidence for the construct validity of all 3 traits across 3 methods. The MTMM approach, currently underutilized, could be used to estimate the degree of evidence for validating complex constructs, such as clinical competence.

Appendix A
Appendix B
Appendix C

Lessons for Practice
  • The multitrait multimethod matrix (MTMM) approach is useful for assessing clinical skills.
  • Analysis of variance can help to identify method effects in an MTMM construct validity study.
  • The reliability and validity of Physician Achievement Review, mini-clinical evaluation exercises, and in-training evaluation reports support their use during physician training.

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