Des chercheurs discutaient récemment de l’importance de rester à jour au sujet des plus récentes avancées en méthodes quantitatives. À ce titre, de nombreux auteurs ont exposé leur souhait de voir les chercheurs abandonner le populaire coefficient alpha de Cronbach. C’est dans une optique de diffusion et de vulgarisation que ce court article a comme objectif de présenter l’alternative qui semble la plus prometteuse pour mesurer la fidélité d’un test, le coefficient omega de McDonald, qui est basée sur l’analyse factorielle à un facteur commun.

BackgroundHelping trainees develop appropriate clinical reasoning abilities is a challenging goal in an environment where clinical situations are marked by high levels of complexity and unpredictability. The benefit of simulation-based education to assess clinical reasoning skills has rarely been reported. More specifically, it is unclear if clinical reasoning is better acquired if the instructor's input occurs entirely after or is integrated during the scenario. Based on educational principles of the dual-process theory of clinical reasoning, a new simulation approach called simulation with iterative discussions (SID) is introduced. The instructor interrupts the flow of the scenario at three key moments of the reasoning process (data gathering, integration, and confirmation). After each stop, the scenario is continued where it was interrupted. Finally, a brief general debriefing ends the session. System-1 process of clinical reasoning is assessed by verbalization during management of the case, and System-2 during the iterative discussions without providing feedback.ObjectiveThe aim of this study is to evaluate the effectiveness of Simulation with Iterative Discussions versus the classical approach of simulation in developing reasoning skills of General Pediatrics and Neonatal-Perinatal Medicine residents.MethodsThis will be a prospective exploratory, randomized study conducted at Sainte-Justine hospital in Montreal, Qc, between January and March 2016. All post-graduate year (PGY) 1 to 6 residents will be invited to complete one SID or classical simulation 30 minutes audio video-recorded complex high-fidelity simulations covering a similar neonatology topic. Pre- and post-simulation questionnaires will be completed and a semistructured interview will be conducted after each simulation. Data analyses will use SPSS and NVivo softwares.ResultsThis study is in its preliminary stages and the results are expected to be made available by April, 2016.ConclusionsThis will be the first study to explore a new simulation approach designed to enhance clinical reasoning. By assessing more closely reasoning processes throughout a simulation session, we believe that Simulation with Iterative Discussions will be an interesting and more effective approach for students. The findings of the study will benefit medical educators, education programs, and medical students.

En éducation, de nombreuses études portent sur la validation d’instruments de mesure, tels que des questionnaires ou des instruments d’évaluation. La revue Mesure et évaluation en éducation en publie d’ailleurs chaque année. Ces études peuvent être globalement classées en deux catégories : d’une part, celles dans lesquelles les procédures psychométriques, comme une analyse factorielle ou l’application d’un modèle de la théorie de réponses aux items (p. ex., le modèle de Rasch), constituent en elles-mêmes la démarche de validation ; d’autre part, celles dans lesquelles le recours à un panel d’experts pour concevoir l’instrument semble suffire à garantir sa validité. Cet article tente de montrer qu’il est nécessaire de faire reposer une démarche de validation sur un argumentaire basé sur des preuves de natures quantitative et qualitative, en proposant deux modèles qui, combinés, sont propres à guider la formulation des arguments pour soutenir la validation d’un instrument d’évaluation. L’idée est de contrer le fait que si l’on ne comprend pas ce qu’on essaie de montrer, le risque d’avoir des arguments peu utiles est grand.

Manuscrit reçu le 20 septembre 2014 ; commentaires éditoriaux formulés aux auteurs le 23 mai et le 6 juin 2015 ; accepté pour publication le 8 juin 2015Résumé -Contexte : Pour guider les programmes de formation, il est nécessaire de pouvoir poser une évaluation diagnostique du raisonnement clinique des infirmières. Or, les outils disponibles à cet effet présentent des problèmes majeurs. Abstract -Background:The development of training programs requires an evaluation of nurses' clinical reasoning. However, there are issues with the evaluation, which uses existing tools. The script concordance test is a promising and innovative evaluation alternative. Purpose: To explore the possibility of using questions from a script concordance test as an evaluation tool in assessing nursing students' clinical reasoning abilities. Data: Transcripts of interviews with nurses and nursing students (n = 55) from a previous study [1] were used. During the interviews, participants were asked to share their thoughts aloud while taking a script concordance test. Analysis: Transcripts were coded to identify thinking categories and strategies used by participants to answer questions from the script concordance test. Q-matrices were then developed to formalize relationships between thinking categories/strategies and the test questions in each group of participants. Results: Each group used different thinking categories/strategies to answer questions in the script concordance test. These questions could help assess nursing students' strengths and weaknesses as they relate to their development level. The reasoning of nursing experts was so unlike that of students that they could not be used as a benchmark for diagnostic evaluation. Conclusion: Depending on groups student nurses use different thinking categories and strategies, and some SCT questions show a diagnostic potential in evaluating nurses' clinical reasoning per level (1st, 2nd and 3rd year).

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