Cross-cultural adaptation of the milestones project in otolaryngology for the brazilian reality

ABSTRACT Introduction: competency-based medical education is well established, but there is a worldwide shortage of instruments capable of assessing these doctors in training. Objective: to validate the instrument The Otolaryngology - Head and Neck Surgery Milestone Project for use in Residency Programs in Otorhinolaryngology in Brazil. Method: The study had 5 stages. In stage I, two independent translations of the Milestones Project in otorhinolaryngology were carried out. In step II, a synthesis of the translations was performed. Subsequently, the competencies required by the Brazilian Association of Otorhinolaryngology for training otorhinolaryngologists in Brazil were added. In step III, a back-translation of the instrument was carried out and sent to the original authors. Then, the instrument was sent to be evaluated by a committee of 8 experts. In stage IV, each expert made comments about each of the items, and after analyzing the suggestions, a new instrument was created. In stage V, this instrument was sent for evaluation by otorhinolaryngologists across the country. Results: after translations and expert evaluation, an instrument with 19 items was created. The instrument was submitted to analysis by Otorhinolaryngologists from all over Brazil. Acceptance percentages were: applicability (99.25%), reliability (99.5%), reproducibility (98.6%), reliability (93.84%), relevance (93.15%). Conclusion: the created instrument was considered applicable, reproducible, relevant, reliable and trustworthy, presenting content validity.

摘要

引言：基于胜任力的医学教育（Competency-Based Medical Education）已得到广泛认可，但全球范围内仍缺乏可用于评估在职培训医师的专用评估工具。

研究目的：对《耳鼻咽喉-头颈外科里程碑项目（Otolaryngology - Head and Neck Surgery Milestone Project）》评估工具进行效度验证，使其适用于巴西耳鼻咽喉科住院医师培训项目。

方法：本研究共分为5个阶段。第一阶段：对耳鼻咽喉科里程碑项目开展2次独立翻译。第二阶段：整合两次翻译结果，并补充巴西耳鼻咽喉科学会（Brazilian Association of Otorhinolaryngology）针对本国耳鼻咽喉科住院医师培训制定的胜任力要求条目。第三阶段：对该工具进行回译，并将回译版本提交给原作者。第四阶段：将工具交由由8名专家组成的委员会进行评估，每位专家针对各条目提出修改意见，经整合分析所有建议后，生成修订版评估工具。第五阶段：将该修订版工具发送至全国范围内的耳鼻咽喉科医师开展评估。

结果：经多轮翻译与专家评审后，最终生成包含19个条目的评估工具。该工具已提交巴西全国耳鼻咽喉科医师进行数据分析，其各项指标接受度分别为：适用性99.25%、信度99.5%、复现性98.6%、信度93.84%、相关性93.15%。

结论：本研究生成的评估工具被认定具备适用性、复现性、相关性、信度与可靠性，且具有良好的内容效度（Content Validity）。