The development and psychometric evaluation of the Electronic Fetal Monitoring Knowledge Scale
Abstract Background. The aim of this study was to develop and assess the psychometric properties of the Electronic Fetal Monitoring Knowledge Scale (EFMKS), a self-report and short instrument measuring knowledge concerning Electronic Fetal Monitoring (EFM). Additionally, it was aimed to use the EFMKS for briefly assessing EFM knowledge in midwives and doctors working in labour ward. Methods. The EFMKS was developed in a three-phase process by using an integrated mixed-methods approach that included literature reviews, professional focus groups, expert consultations and a psychometric survey evaluation. The psychometric evaluation was conducted by recruiting a sample of 128 professionals (midwives and doctors). Data were collected between April and July of 2016 in two public hospitals of Athens, Greece. Content validity, exploratory factor analysis, discriminant and construct validity, test-retest reliability and internal consistency were explored. Results. The expert panel determined that the content validity was satisfactory. The final 10-item scale consisted of three factors explaining 73% of the total variance in the data. Discriminant validity was satisfactory. Internal consistency reliability (α = 0.89) and test-retest reliability (0.85) were satisfactory. The majority of the midwives and the obstetricians had a good level of knowledge while approximately one third of them had a low level of knowledge in EFM. Midwives and doctors having a lower level of knowledge related to EFM, were more frequently professionals with less than five years of clinical experience in the labor ward and reported low confidence for cardiotocography (CTG) interpretation and inadequate preparation for CTG usage.Conclusion. The EFMK demonstrated good content validity, an easily interpretable three-factor structure, high internal consistency, high test-retest reliability, and satisfactory discriminant and construct validity with sample characteristics. The EFMKS may be used for evaluating the EFM knowledge of health professionals and for identifying the areas of their knowledge gap. Based on study findings, an annual multi-professional CTG training is necessary for all intrapartum staff and in particular for the midwives and doctors with shorter clinical experience in the labor ward.