Development and validation of the Comprehensive Preparedness for Service in Neglected Communities Questionnaire (C-PISCO)

Introduction: Every year about 5,000 general practitioners join the rural marginalized urban service, representing a transition to a practice and evidence of unrealized competencies. There is no instrument to assess the preparedness of doctors for this new challenge. Objective: To develop and validate the comprehensive preparation questionnaire for service in forgotten communities (C-PISCO) for the assessment of self-perceived competencies of general practitioners in Peru. Method: We designed a questionnaire based on the Peruvian ministry of health’s core competency profile for physicians. It was administered to 190 general practitioners who performed mandatory rural services between 2020 and 2023. We carried out the evaluation of structure and consistency with an exploratory graph analysis (EGA), exploratory factor analysis (EFA), and McDonald’s omega. Results: The C-PISCO was based on the Peruvian ministry of health’s profile of essential medical competencies, providing evidence of content validity. It was evaluated by recent graduates of the SERUMS for face validity. Finally, the EGA showed 3 domains: clinical physician, integrative physician, and health-promoting physician with 15 items in total, demonstrating construct validity. In addition, a reliability of 0.94 was found for the McDonald omega test. Conclusions: the C-PISCO presents evidence of validity for measuring self-perceived competencies in general practitioners. The exploratory graphical analysis showed three dimensions: clinician, health-promoting physician, and holistic physician. The C-PISCO could be used to assess the training needs of general practitioners, given that, in our context, it is the only instrument designed for this purpose.