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Development and Testing of a Scale to Assess Physician Attitudes about Handheld Computers with Decision Support

^a University of Alabama at Birmingham, Birmingham, AL
^b Deep South Center for Effectiveness Research, Birmingham Veterans Affairs Medical Center, Birmingham, AL
^c Birmingham Veterans Affairs Medical Center, Birmingham, AL
^d The Florida State University, College of Medicine, Tallahassee, FL

^_* Correspondence and reprints to: Midge N. Ray, MSN, RN, Associate Professor, Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, 1675 University Boulevard, Room 654, Birmingham, AL 35294-3361. (Email: midgeray{at}uab.edu).

Received for publication: 03/07/06; accepted for publication: 06/05/06.

OBJECTIVE: The authors developed and evaluated a rating scale, the Attitudes toward Handheld Decision Support Software Scale (H-DSS), to assess physician attitudes about handheld decision support systems.

DESIGN: The authors conducted a prospective assessment of psychometric characteristics of the H-DSS including reliability, validity, and responsiveness. Participants were 82 Internal Medicine residents. A higher score on each of the 14 five-point Likert scale items reflected a more positive attitude about handheld DSS. The H-DSS score is the mean across the fourteen items. Attitudes toward the use of the handheld DSS were assessed prior to and six months after receiving the handheld device.

STATISTICS: Cronbach's Alpha was used to assess internal consistency reliability. Pearson correlations were used to estimate and detect significant associations between scale scores and other measures (validity). Paired sample t-tests were used to test for changes in the mean attitude scale score (responsiveness) and for differences between groups.

RESULTS: Internal consistency reliability for the scale was = 0.73. In testing validity, moderate correlations were noted between the attitude scale scores and self-reported Personal Digital Assistant (PDA) usage in the hospital (correlation coefficient = 0.55) and clinic (0.48), p < 0.05 for both. The scale was responsive, in that it detected the expected increase in scores between the two administrations (3.99 (s.d. = 0.35) vs. 4.08, (s.d. = 0.34), p < 0.005).

CONCLUSION: The authors' evaluation showed that the H-DSS scale was reliable, valid, and responsive. The scale can be used to guide future handheld DSS development and implementation.