Internal consistency reliability.

ObjectivesThis study aimed to validate the Collaborative Practice Assessment Tool (CPAT) in the Australian setting and provide a quality instrument in terms of psychometric properties that can be used to measure interprofessional outcomes for both healthcare practitioners and students. The outcomes evaluated include the capacity to work in an interprofessional team, good interprofessional communication skills, leadership skills, ensuring clear division of tasks and roles in a team, effective conflict management, and being actively involved with patients and their families/communities in care.MethodsThe COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) taxonomy and standards were used as guides for evaluating the psychometric properties of the Australian CPAT, which include evaluations regarding instrument development requirements of sample target and size, content validity, internal structure (structural validity, internal consistency reliability and measurement invariance), and hypotheses testing. CPAT Australia was developed through two stages involving pilot studies and a validation study, both of which included healthcare practitioners and students as participants. A pilot study examined content validity regarding item relevance, item comprehensibility, and instrument comprehensiveness. The validation study was carried out to assess the internal structure of CPAT Australia for aspects of structural validity, internal consistency reliabilities, and configural, metric and scalar measurement invariance. The structural validity was explored using the following three steps: exploratory, confirmatory, and multi-group factor analysis. Construct validity was evaluated to confirm direct and indirect paths of assumptions based on a previously validated model. Data collected between August 2021 and May 2022.ResultsThe content validity evaluation confirmed that all items were relevant, understandable and comprehensive for measuring interprofessional collaborative care in Australia. Three hundred ninety-nine participants contributed to the validation study (n=152 practitioners; n=247 students). The original instrument model of 8-Factor 56-Item was improved in the Australian CPAT. Two items, Item 27 (Physicians assume the ultimate responsibility) and Item 49 (Final decision rest with the physician), were consistently rejected and therefore discarded. The internal structure of the 7-Factor 54-Item solution was confirmed as a suitable model with fit indices meeting COSMIN standards for a good model in practitioner and student cohorts. Configural, metric and scalar invariances were confirmed, indicating the invariance of the instruments when used for the practitioner and student cohorts. The construct validity evaluation indicated that 81.3% of direct and indirect assumptions were accepted, fulfilling the COSMIN requirement of >75% of proposed assumptions being accepted.ConclusionThe Australian CPAT with a 7-factor 54-item solution was confirmed as a quality measure for assessing interprofessional education and collaborative practice for both healthcare practitioners and students in Australia with robust psychometric properties.### 研究目标 本研究旨在于澳大利亚语境下验证协作实践评估工具（Collaborative Practice Assessment Tool, CPAT），并开发一款具备良好心理测量学特性的高质量工具，用于测量医疗从业者与医护学生的跨专业实践成果。本次评估的实践成果包括：跨专业团队协作能力、良好的跨专业沟通技巧、领导能力、明确团队任务与角色分工、高效的冲突管理能力，以及积极参与患者及其家属/社区的照护工作。 ### 研究方法 本研究以COSMIN（基于共识的健康测量工具遴选标准，COnsensus-based Standards for the selection of health Measurement INstruments）分类体系与标准为指导，对澳大利亚版CPAT的心理测量学特性进行评估，评估内容涵盖工具开发环节中关于样本选取目标与样本量的要求、内容效度、内部结构（结构效度、内部一致性信度与测量不变性）以及假设检验。澳大利亚版CPAT的开发分为两个阶段：预试验与验证性研究，两个阶段均以医疗从业者与医护学生作为研究参与者。预试验针对条目相关性、条目易懂性与工具全面性开展内容效度评估。验证性研究用于评估澳大利亚版CPAT的内部结构，涉及结构效度、内部一致性信度，以及构型、度量与标量测量不变性。结构效度的探究采用以下三个步骤：探索性因子分析、验证性因子分析与多组因子分析。建构效度的评估基于此前已验证的模型，对假设的直接与间接路径进行验证。本研究的数据收集工作于2021年8月至2022年5月期间开展。 ### 研究结果 内容效度评估结果显示，所有条目均适用于澳大利亚境内跨专业协作照护的测量，且具备良好的易懂性与全面性。本次验证性研究共纳入399名参与者，其中152名为医疗从业者，247名为医护学生。澳大利亚版CPAT对原版8维度56条目工具模型进行了优化：第27条目（医师承担最终责任）与第49条目（最终决策由医师作出）因一致性未通过评估而被剔除。最终确立的7维度54条目模型内部结构符合研究要求，其拟合指数达到COSMIN标准中优质模型的阈值，适用于医疗从业者与医护学生两个群体。构型、度量与标量测量不变性均得到验证，表明该工具在用于医疗从业者与医护学生群体时具备良好的测量不变性。建构效度评估结果显示，81.3%的直接与间接假设得到验证，满足COSMIN提出的「超过75%的预设假设被接受」的要求。 ### 研究结论 本研究证实，具备7维度54条目结构的澳大利亚版CPAT具备良好且稳健的心理测量学特性，可作为一款高质量工具，用于评估澳大利亚境内医疗从业者与医护学生的跨专业教育与协作实践水平。