Journal of Continuing Education in the Health Professions



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CURRENT ISSUE BACK ISSUES SUBSCRIBE ADVERTISE ABOUT JCEHP FOR AUTHORS JCEHP AWARD SEARCH (Members only) FULL-TEXT		Volume 30 (1) Volume 30, Issue 1, Winter 2010 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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