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

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), breast-feeding 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, re- sulting 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. Con-sistencies 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.