Background/Purpose: In 2020, the American College of Rheumatology (ACR) published clinical practice guidelines addressing reproductive health for patients with rheumatic diseases. The guidelines are the culmination of a 5-year, multi-specialty, interprofessional effort, now known as the Reproductive Health Initiative (RHI). The 2-fold purpose of this study was to (Part I) design national surveys of rheumatology fellows and fellowship program directors (PDs) to inform development of curricula and programs relating to RHI guidelines, and to examine evidence of validity of these surveys using Messick’s framework prior to (Part II) future implementation of an ACR sponsored national survey project, coordinated through the Committee on Training and Workforce.

Methods:
Content
Constructs of interest were defined through literature review and refined by reflective critique from 8 RHI members, facilitated by a former PD working with a member of the ACR administrative staff. A panel of 9 outside expert reviewers (5 rheumatology fellows and 4 PDs) evaluated survey items for relevance to the constructs and clarity of communication. Descriptive statistical analyses of ratings were performed, and content validity index (CVI) for each item was calculated. Items with CVI < 0.7 were discarded.

Response Process
Cognitive interviewing, consisting of “think aloud interviewing” in which a participant was asked to verbalize their understanding of items through paraphrase, was used to clarify the mental model emerging through survey use.

Results: The construct of interest was defined as “interest in curriculum”, and was considered separately for fellows and PDs. Both fellow and PD constructs were conceptualized as 4 dimensions: 1) confidence in the current curriculum relating to RHI guidelines; 2) personal interest in the topic; 3) opinions of the importance of the topic; and 4) interest in a range of learning materials and educational experiences. Initial surveys consisted of 27 items for fellows and 28 items for PDs. Expert review ratings are shown in Table 1 (fellow survey) and Table 2 (PD survey), and led to discarding 9 items for fellows and 6 items for PDs; 5 of these were corresponding questions shared across the 2 surveys. Cognitive interviewing suggested that fellows considered questions relating to their level of interest in reproductive health as connecting to a sense of ownership or responsibility for addressing these issues. Final versions of the surveys consisted of 18 items for fellows and 22 items for PDs and are being sent to 753 fellows and 179 program directors representing adult and pediatric rheumatology fellowships.

Conclusion: Validity evidence from content and response process sources support national distribution of the surveys to rheumatology fellows and fellowship PDs. Data collected through (Part II) this ACR sponsored national survey will be of value to educational leaders in developing curricula and programs to improve reproductive health for patients with rheumatic disease.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/bringing-reproductive-health-guidelines-into-fellowship-training-a-national-survey-of-adult-and-pediatric-rheumatology-fellows-and-program-directors-to-assess-educational-need-and-inform-curriculum-d/