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Study of Constructing Indicators and Developing Assessment Tool of Physician’s Professional Competence on Health Literacy
modified Delphi method
Background and objectives: This study was based on health literacy perspectives. The concept, content, and indicators of the physician’s professional competence in health literacy were constructed, and a professional competence assessment tool was developed. This study aimed to enhance healthcare providers’ attentiveness, understanding, and response toward patients’ health literacy. This would improve physician-patient communication and facilitate the effective use of medical resources by patients, thereby promoting medical care quality. Methods: A literature review was conducted to help formulate key points for the interviews. Subsequently, 3 focus group interviews involving 21 physicians, medical students, and patients were conducted. Using the modified Delphi method, 3 rounds of surveys were completed by 13 experts, and the indicators for the physician’s professional competence on health literacy were formulated. Next, a questionnaire based on the corresponding indicators was developed, and the experts analyzed the content validity. Following pretesting, a sample of medical students from 3 national medical schools in Taiwan was selected. Data were collected using an online questionnaire. Exploratory factor analysis (N=127) and confirmatory factor analysis (N=203) were performed to complete the development of the physician’s professional competence on health literacy assessment scale. Results: Following the focus group interviews and the modified Delphi rounds, the physician’s professional competence on health literacy were categorized into 4 aspects, 13 sub-aspects, and 44 indicators. Specifically, the 4 aspects were “concept and evaluation,” “acceptance and respect,” “communication and interaction,” and “medical information and decision-making.” A 47-item questionnaire was created based on the corresponding indicators. All questions were retained after the content validity was analyzed by experts. The questionnaire was tested in 2 stages—pretesting and formal testing. Item analysis and correlation analysis revealed good internal consistency of the questionnaire. About 15 questions were removed after exploratory factor analysis, and 5 questions were removed after confirmatory factor analysis. Finally, the “Physician’s Professional Competence on Health Literacy Scale” was established. Conclusions: The indicators and scale for evaluating the physician’s professional competence on health literacy established in this study can be used as a foundation for developing relevant pre-employment and on-the-job training programs for physicians and medical students. They may be used to assess and enhance healthcare providers’ knowledge, attitudes, and skills. This will be beneficial to physicians as they evaluate, accept, plan, and guide health literacy matters. Furthermore, the established indicators and scale may serve as a basis for the development of creative teaching modules for use in medical education to increase the physicians’ professional competence in health literacy.
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