The diagnosis of tuberculosis (TB) has evolved with the advent of new diagnostics. It is important for internal medicine (IM) and infectious disease (ID) trainees to effectively diagnose TB, as IM and ID providers are often first to suspect it. We developed and validated an instrument to assess trainees’ ability to obtain and interpret TB diagnostics.
We created an instrument with 10 multiple-choice items based on the US CDC's Core Curriculum on TB. Ten ID experts reviewed the items for content and accuracy. The instrument was emailed as an online survey using Qualtrics® software to 86 IM residents at Johns Hopkins (JH) Hospital and JH Bayview Medical Center, and 43 ID fellows at JH, Emory, and Vanderbilt. Resident responders were offered a $10 gift card. We used the American Association for Public Opinion Research's response rate 1 method and performed item analyses. Items were rewritten if they had correct response proportions of <0.20 or >0.95 or point-biserial correlations of <.20 (denoting low item and test performance correlation). The mean number of correct items between residents, fellows, and institutions were compared using student t-tests and one-way analysis of variance. We used the Kuder–Richardson Formula 20 (KR-20) to assess internal consistency.
The response rate was 57% (74/129), with 53% (46/86) of residents and 65% (28/43) of fellows responding; rates by institution and year of training were similar. The mean instrument completion time was 15 minutes (SD 2). One item with a point-biserial correlation of .01 and one with a correct response proportion of 14% were rewritten; the KR-20 coefficient showed satisfactory reliability at 0.72. There was a significant difference between the mean number of correct items between fellows and residents (7 [SD 1.8] versus 3.8 [SD 1.7], respectively; p<.001); there were no differences between fellows' or residents' scores by institution.
We developed and validated a 10-item instrument that can be readily used among IM and ID trainees to assess their ability to obtain and interpret TB diagnostics. Employing the instrument to identify trainees’ knowledge gaps will allow for the creation of focused educational interventions on TB diagnostics.
A. Gupta, None
M. T. Melia, None