Validation and application of a tool to assess self-confidence to do improvement.

Abstract

Introduction: Increasing improvement capability in the workforce is vital within healthcare. The type of quality improvement training to increase capability varies. One way to measure the impact of improvement training is self-confidence to do improvement.

Objectives: Our objectives were to validate a tool to assess self-confidence to do improvement and to observe the degree of change before and after improvement training. We aimed to assess the degree of impact on self-confidence associated with varying exposure to quality improvement training.

Methods: We used an online 10-item and 4-point scale to assess self-confidence before and after improvement training. Reliability analysis using Cronbach's alpha was performed. The nature of the underlying construct was investigated using exploratory factor analysis and a full set of pre and post measures were used, and to compare individual question changes, a series of paired Wilcoxon tests were performed with Bonferroni post hoc corrections for multiple comparisons. To assess the differing lengths of programmes, individual results from each programme were combined meta-analytically with course duration added as a moderator.

Results: 252 completed questionnaires were analysed at baseline and a full set of pre and post measures were available for 128 participants. Cronbach's alpha for the tool was satisfactory at 0.93 (0.92-0.94) and measured a single underlying construct with an eigenvalue of 6.17. A significant increase in confidence to improve from before to after intervention was found (t(127) = 14.36, p<0.001, d=1.27 (95% CI 1.03-1.50)). Post-testing differences were significant (F(6,125) = 2.89, p=0.02) with shorter courses having significantly smaller increases in confidence.

Conclusions: This manuscript provides a validated self-confidence tool to help assess improvement capability. Our tool offers a way to measure the impact of improvement capability on varying training durations and inform decisions about allocating staff time to this activity.