Clinical Information System Questionnaire
CISQ-36©
CISQ-36s' Roots: The CISQ-15©
Gugerty,
Wooldridge, and Brennan
developed the Clinical Information System Questionnaire (CISQ-15)
as part of a larger study that evaluated a Critical Care Clinical Information
System implementation. The CISQ-15
was designed to measure staff involvement in and attitudes towards CIS
implementation on a critical care unit and was developed by grounded theorizing.
Shortly after the successful administration of the CISQ-15,
an expert panel was asked to evaluate the items on the CISQ-15
and to suggest further items, based on their own experiences and observations,
that could usefully be added to the tool.
Development
of the CISQ-36
Brian
Gugerty convened an expert panel to review the instrument in order to
develop negatively phrased items (in order to counterbalance for acquiescence
response set bias) and to improve it's generalizabilty. Seven experienced CIS
nurse implementers, representing four different healthcare organizations in the
US and Canada, participated in two 2- hour teleconferences with intervening
e-mail exchanges.
The
five sub-dimensions of the CISQ-15 --1) training adequacy and effectiveness
[TRAINING]; 2) participation/ ownership [OWNERSHIP]; 3) impact on nursing
practice & patient outcomes [PRACTICE]; 4) feedback [SUGGESTIONS], and 5)
general satisfaction [SATISFACTION]-- were confirmed by the experts as applying
well to their organizations and experiences.
The panel suggested additional items that could be potentially classified
within the PRACTICE, TRAINING, OWNERSHIP, and SUGGESTION sub dimensions.
Furthermore, the panel identified issues that suggested new sub
dimensions which had not been covered by the CISQ-15.
These sub dimensions were tentatively labeled: TECHNICAL DIFFICULTIES,
TEAM, and WORKLOAD. The expert
panel added 21 items to the CISQ-15, resulting in the
CISQ-36. Ten of the new items
could logically be placed in the existing CISQ-15
sub-dimensions of PRACTICE, TRAINING, SUGGESTIONS, and OWNERSHIP.
The other eleven items were tentatively grouped under proposed
new sub-dimensions of the CISQ; these were TECHNICAL DIFFICULTIES, TEAM and,
WORKLOAD. These subdimensions
are intended only as an initial grouping for discussion purposes.
Definitive sub-dimension categorization will require analyses based on
sample sizes much larger than the two administrations (n=38 and n=19) of the
CISQ to date. The expert panel and
new item creation process resulted in a 36-item CISQ instrument, which was
piloted on the same units that had previously been studied, using the CISQ-15.
Results
of CISQ-36 Pilot
Nineteen
nurses completed the CISQ-36 questionnaire.
Fourteen of the respondents
had been practicing on the study units prior to the implementation of the CCCIS.
Of the remainder, all had been working with the CCCIS for at least 3
months prior to the administration of the CISQ-36. Item total correlations for
the CISQ-36 ranged from .176 to .858. [5] Three of the twenty-one new items were
dropped from the scaling because of low item correlation and ambiguity
concerning whether agreement shows a favorable or unfavorable attitude towards
the CCCIS implementation.
The
pilot study administration of the CISQ-36 had a high internal consistency
(alpha=.959), based on the 33 items that remained in the CISQ-36 after deleting
three items. This high alpha
reliability coefficient indicates that the high reliability of the CISQ-15
(as a measure of the extent to which a staff member had a generally positive
involvement in and attitude towards the implementation of the CCCIS) was
maintained by the CISQ-36. The CISQ-36 is better counterbalanced for error due
to acquiescence response set bias, since subjects who have a tendency to agree
with items will score high on the + items, but low on the - items. It also has
improved content validity, since it includes important issues which were not
adequately represented in the CISQ-15.
One
should keep in mind that the CISQ-36 has at this point only been pilot tested.
Further research will be needed to arrive at a final tool, and demonstrate its
reliability and validity. This does not mean, however, that these tools cannot be
very helpful to evaluators administrators even in their current forms and states
of development.
For more information on the CISQ-36, click here to download the abstract of the poster presentation,
The Expansion of a Tool to Measure Staff Involvement in and Attitudes Toward the Implementation of a Clinical Information System
Authored by:
Kim Utech, MS, RN
Published in the Proceedings of the American Medical Informatics Association Annual Symposium, 2001
Gugerty, B., Wooldridge, P., Utech, K. & Wenkosky, A. (2001, November). The expansion of a tool to measure staff involvement in and attitudes toward the implementation of a clinical information system. Poster session presented at the American Medical Informatics Annual Symposium, Washington, DC.
You will need Adobe® Acrobat® Reader® to view this abstract. Click below to download it now!
If you would like to use this or one of the other CISQ Measurement Instruments, please go to the CISQ Measurement Instrument Request Form page.
Last Updated: June 26, 2002