The dutch knowledge test for general practice: Issues of validity

Objectives: This article describes a study performed to validate a nation-wide knowledge test for general practice. This test is administered to all GP-trainees in The Netherlands at fixed intervals during the time of their training. The test is a paper-and-pencil test with a progress testing format. Content and construct validity of the test are examined. Methods: The content validity of the test is investigated by examining the procedure of test and item construction, and by defining a multidimensional blueprint. Construct validity is investigated by comparing mean scores of different groups: medical students, trainees at six different training levels and qualified general practitioners. Results: A test blueprint is constructed which covers the domain of general practice care. The main dimension of the blueprint covers complaints and diseases, whereas additional dimensions provide an adequate age distribution of patient cases in the test, coverage of different aspects of the consultation, and the provision of enough cases dealing with emergency and chronic problems. The mean group score increases with training level. The mean score of trainees at the end of training surpasses the mean score of qualified general practitioners. Conclusions: It is concluded that the test assesses knowledge that is closely related to the GP's daily work. The test enables the monitoring of growth in knowledge during postgraduate training. Content and construct validity of the test are satisfactory.