Construction and validation of an instrument of clinical aptitude in breastfeeding in medical students

Abstract

Introduction: Clinical aptitude in breastfeeding has not been studied in medical students. Currently, no instrument assesses clinical aptitude for breastfeeding.

Objective: To construct and validate a questionnaire that measures clinical aptitude about breastfeeding in medical students.

Method: An instrument was constructed and validated with five clinical cases (CC): mastitis (MAST), cracked nipples (GR), hospital practice (PH), breast refusal (RS), poor milk production (POB), and five indicators: risk factors (FR), clinical diagnosis (DC), treatment (TR), breastfeeding contraindications (CL) and prognosis (PR). Delphi methodology was used for its validation with a panel of five experts and two rounds of review. The number of items per clinical case and indicator was balanced, resulting in 17 items per CC and 85 in total. Consistency of the instrument was determined (Kuder-Richardson) by administering the instrument to 30 eighth-semester medical students (EM) and 30 last-year students (MIP). To compare both groups U Mann-Whitney test was used. Answers due to random were calculated.

Results: A global consistency of 0.9 was calculated. Consistencies per indicator were as follows: 0.74 (FR), 0.58 (DC), 0.62 (TR), 0.72 (CL), 0.77 (PR). From the MIP group, 43% got in the low range, whereas 57% of the EM group answered due to random. The global median was higher in the MIP group (35 vs. 15, p < 0.01). Medians in the MIP group were higher for the indicators FR (p = 0.02), TR (p < 0.01), CL (p = 0.03), and PR (p < 0.01), and for four CC: MAST (p < 0.01), PH (p < 0.01), RS (p = 0.03), and POB (p = 0.02).

Conclusions: The administration of a valid and consistent instrument showed a very poor clinical aptitude in EM, which seems to be higher in MIP. Further measurements and interventions are needed to assess external validity.