Christopher Wittich (Mayo Clinic College of Medicine); Jason Szostek (Mayo Clinic College of Medicine); Darcy Reed (Mayo Clinic College of Medicine); Paul Mueller (Mayo Clinic College of Medicine); Jayawant Mandrekar (Mayo Clinic College of Medicine); Thomas Beckman (Mayo Clinic College of Medicine)
Purpose
The ultimate goal of Continuing Medical Education (CME) should be to enhance the quality of patient care, yet CME has been shown to have only a modest effect on physician and patient improvement. Transformative learning theory provides a framework for how learners might reflect on an activating event such as CME in order to transform their behaviors. Therefore, we developed and validated a new instrument for measuring reflection among Medical Grand Rounds participants.
Methods
Content for an 8-item (5-point Likert scales) reflection on CME instrument was adapted from our previously validated scale. The instrument was distributed at 25 weekly Medical Grand Rounds lectures from January 2011 to July 2011. Item scores were presented as means and standard deviations (SD). The dimensionality of instrument scores was determined using factor analysis to account for clustered data. Internal consistency (Cronbach’s alpha) and interrater reliability (intraclass correlation coefficients) were calculated.
Results
A total of 1134 evaluations were completed. Item mean scores ranged from 2.97 (SD=1.17) to 4.01 (SD=0.83) on 5-point scales. Factor analysis revealed 2 levels of reflection: Minimal (2 items) and High (6 items). Overall internal consistency reliability (alpha=0.71) and interrater reliability (ICC range 0.58 to 0.88) were very good.
Conclusions
We describe a method for measuring levels of reflection on CME presentations among participants at Medical Grand Rounds. The instrument demonstrated strong content and internal structure validity evidence, and may help CME course directors better understand the types of Grand Rounds presentations that facilitate self-reflection among learners.
Declaration
No authors have a conflict of interest.
