A Mokken scale analysis of the peer physical examination questionnaire

Document Type


Publication details

Vaughan, B & Grace, S 2018, 'A Mokken scale analysis of the peer physical examination questionnaire', Chiropractic & Manual Therapies, vol. 26, no. 6.

Article available on Open Access

Peer Reviewed



Background: Peer physical examination (PPE) is a teaching and learning strategy utilised in most health professioneducation programs. Perceptions of participating in PPE have been described in the literature, focusing on areas ofthe body students are willing, or unwilling, to examine. A small number of questionnaires exist to evaluate theseperceptions, however none have described the measurement properties that may allow them to be used longitudinally.The present study undertook a Mokken scale analysis of the Peer Physical Examination Questionnaire (PPEQ) to evaluateits dimensionality and structure when used with Australian osteopathy students.

Methods: Students enrolled in Year 1 of the osteopathy programs at Victoria University (Melbourne, Australia) andSouthern Cross University (Lismore, Australia) were invited to complete the PPEQ prior to their first practical skillsexamination class. R, an open-source statistics program, was used to generate the descriptive statistics and perform aMokken scale analysis. Mokken scale analysis is a non-parametric item response theory approach that is used to clusteritems measuring a latent construct.

Results: Initial analysis suggested the PPEQ did not form a single scale. Further analysis identified three subscales:‘comfort’, ‘concern’, and ‘professionalism and education’. The properties of each subscale suggested they were unidimensional with variable internal structures. The ‘comfort’ subscale was the strongest of the three identified.All subscales demonstrated acceptable reliability estimation statistics (McDonald’s omega > 0.75) supporting thecalculation of a sum score for each subscale.

Conclusion: The subscales identified are consistent with the literature. The ‘comfort’ subscale may be useful to longitudinally evaluate student perceptions of PPE. Further research is required to evaluate changes with PPE and the utility of the questionnaire with other health profession education programs.

Find in your library