Avaliação de atitudes de estudantes de odontologia em relação às competências odontológicas: elaboração e validação de um instrumento

2017 
The purpose of this thesis was to elaborate and validate a scale to evaluate the attitudes of dental students in relation to dental competences during their training. The theoretical framework involved concepts of social psychology and education, among them the dental competencies described in the National Curricular Guidelines: Health Care, Communication, Lifelong Education, Decision Making, Leadership, and Management. It was a methodological development study that resulted in three articles, considering: 1) content validation; 2) evaluation of the psychometric properties of the scale; and 3) multidimensional analysis and a short version of the scale. For article 1, the nominal group technique was used with a group of experts to validate the theoretical model, resulting in the consensus of a matrix of indicators, which served as the basis for the elaboration of the items. Face validation of the preliminary version of the scale occured with the specialists and a pilot study with the target population. In article 2, the methodology involved the application of the final version of the scale and a research questionnaire containing sociodemographic and academic information to a sample of undergraduated students from two dental school in one capital of the Northeastern of Brazil. The test-retest occurred between 10 and 15 days of interval in order to test reproducibility of the scale. Data analysis involved the characterization of the sample, characterization of the items (mean, standard deviation, corrected item-total correlation), scale score (mean and standard deviation), test-retest (Spearman correlation coefficient), the internal consistency of the instrument (Cronbach's alpha). Article 3 corresponded to the presentation of the reduced version obtained after exploratory factorial analysis (Minimum Rank Factor Analysis, Promin Rotation). A local ethics committee approved the project. The product of the thesis was the scale of attitudes related to dental competences (DACS) composed of 53 items with five-point Likert, responses including five indicators. A total of 644 students were approached, of whom 575 completed the scale (response rate 89.3%). The comparison of the scores in the first and second moments of the retest sample (76 subjects) indicated a positive correlation (p <0.001). The internal consistency was good (α = 0.85) for the total scale. Most items had good corrected item-total correlation. The model obtained by the exploratory factorial analysis corresponded to the theoretically proposed five indicators of attitudes related to dental competences: Empathy in the Professional-Patient Relationship (10 items, α = 0.58), Lifelong Learning (11 items, α = 0 , 73), Readiness for Interprofessional Education (11 items, α = 0.70), Social Responsibility (11 items, α = 0.71) and Patient Rights Protection (10 items, α = 0.62). The short version with 27 items presented good internal consistency (α = 0.78). The scale of attitudes related to dental competences developed in this study showed good results in the validation process. The direction for future studies would be its longitudinal application and verify its use as formative assessment as well as an evaluation of the attitudes in curricular dynamics in Dentistry.
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