Development of a scale to measure intrapersonal factors influencing speaking up in the operating room

Serkan Toy, Rodrigo J. Daly Guris, Shirley S. Duarte, Priyanka Dwivedi

Research output: Contribution to journalArticlepeer-review


Introduction: This paper reports on the development of a scale to measure intrapersonal factors (IPF) that may influence speaking up behaviour in the operating room. Methods: Participants were postgraduate year 2, 3, and 4 anaesthesiology residents and practising faculty anaesthesiologists at a large quaternary care academic hospital. Based on a literature review, the authors constructed the initial scale. Exploratory factor analysis was conducted to identify the underlying factor structure for the scale. A set of one-way ANOVAs and multiple ordinal regressions were carried out to provide additional validity evidence for the new scale. Results: Exploratory factor analysis indicated a three-factor solution accounting for 73% of the variance. The self-efficacy subscale included four items (Cronbach’s α = 0.86), and the social outcome expectations (Cronbach’s α = 0.86) and assertive attitude (Cronbach’s α = 0.67) subscales contained three items each. The effect of training level was significantly associated with self-efficacy (p < 0.001) and assertive attitude subscale scores (p < 0.001). Multiple ordinal regressions indicated that IPF predicted participants’ likelihood of speaking up in various hypothetical scenarios. Discussion: Our analyses provided initial evidence for the validity and reliability of a 10-item IPF scale. This instrument needs to be validated in other cohorts.

Original languageEnglish (US)
Pages (from-to)253-260
Number of pages8
JournalPerspectives on Medical Education
Issue number4
StatePublished - Aug 1 2019


  • Anaesthesiology residency education
  • Assertive attitude
  • Outcome expectations
  • Scale development
  • Self-efficacy
  • Speaking up in the operating room

ASJC Scopus subject areas

  • Education


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