Validation and reliability of the self-efficacy scale to assess the professional competence of pediatricians participating in continuing medical training program according to the ECHO model
Authors: Nhung Le Hong , Hang Pham Thu , Thuy Nguyen Thu , Hoc Pham , Lan Nguyen Phuong , Han Pham Duc , Benitez Piter Martinez 
Published: August 2023

Abstract
Background
ECHO, (Extension for Community Healthcare Outcomes) model, is a platform for tele-education to expand healthcare workforces to meet the demand of community’s healthcare (1). This program used the connection model between the expert at hubs and the primary health workers (PHWs) in different regions at spokes through video teleconferencing sessions (2). The ECHO program is regarded as a continuous medical training activity to improve professional capacity and job satisfaction at spokes. Currently, there have been many studies on this model, proving that it is effective in improving knowledge and skills for PHWs (3, 4). One of the measures to evaluate the professional development of PHWs is the scale of self-efficacy or self-assessment of competency (5).We carried out a research topic: "Validation and reliability of the self-efficacy scale to assess the professional competence of pediatricians participating in continuing medical training according to the ECHO model" to help applying to research at ECHO-clinics
Methods
Applying cross-sectional study design, implementing mixed methods including quantitative and qualitative in order to adjust the scale of self-efficacy to assess the professional capacity improvement of the healthcare workers to ensure the validity and reliability of the scale. The study proceeds in the following steps: 1) Reviewing the sets of scales for self-assessment of competency (self-efficacy) according to the ECHO model in the world to identify issues of professional competence being assessed and developed the toolkit that suitable to the Vietnamese context; 2) Collecting the decissions from the panel of experts to determine the content of primary toolkit to improve professional capacity through continuous medical training (2); 3) Test the scale on a sample of learners participating in a continuing medical training program using the ECHO model. In this step 3, the research team evaluate the surface validity, the content of validity including the convergent value and discriminant value and the structural reliability with Crobach's Alpha internal consistency index.
Results
The study has reviewed literature about the referred scale of evaluation the professional capacity improvement of health workers following the ECHO model in the world. In order to implement the ECHO model effectively in Vietnam, the study has shown that the adaptation the referred scales need to be dealt in accordance with the socio-cultural-politic context in Vietnam. The adjusted scale of 22 sub-items was built based on the results of qualitative and quantitative research, is considered to be a reliable scale to be applied to the further studies on the ECHO model in Vietnam.
Conclusions
The scale to access the healthcare providers’s improvement of professional capacity has been adjusted accordingly to each ECHO program in the world since 2007. However, in this topic, we still conduct the assessment of the level of professional competence. The reliability and validity of the scale according to Delphi and Campell Fiske method to evaluate the face validity and content validity, combined with testing the toolkit in the field to calculate reliability with Crobach Alpha index. Therefore, this assessment tool is a valid and highly reliable.