Developing conceptually sound items for a clinical courage questionnaire

Introduction: Clinical courage can be described as a rural doctor’s adaptability and willingness to undertake clinical work at the limits of their training and experience to meet the needs of their patients. This article describes the in-house development of survey items to include in a quantitative measure of clinical courage. Methods: The questionnaire development involved two key concepts: a second-order latent factor model structure and a nominal group technique, used to develop consensus among the research team members. Results: The steps taken to develop a sound clinical courage questionnaire are described in detail. The resulting initial questionnaire is presented, ready for testing with rural clinicians and refinement. Conclusion: This article outlines the psychometric process of questionnaire design and presents the resultant clinical courage questionnaire.