title: Diagnosing a learning practice: the validity and reliability of a learning practice inventory.
abstract: BACKGROUND
  There is an increasing literature on learning organisations as a way of fostering communication, teamwork, collaboration and collective learning, thereby promoting quality improvement and enhancing patient safety. An increasing number of instruments are being developed in an attempt to measure learning organisation characteristics. However, the majority of these tools are created for a business setting, have not been scientifically tested and have not been applied in healthcare.
  
  
  OBJECTIVE
  To evaluate elements of the validity and reliability of an instrument (ie, learning practice inventory (LPI)) for diagnosing learning practice characteristics in primary healthcare.
  
  
  METHODS
  Content validity was evaluated using a modified nominal group technique and a content validity rating scale. Construct validity and reliability evaluation was undertaken with 10 staff members from 10 general practices in the west of Scotland. Staff completed the inventory twice, 4-6 weeks apart. Applying generalisability theory, a variance component analysis was performed.
  
  
  RESULTS
  The main findings present evidence that the inventory has acceptable reliability and content validity. The results also demonstrate that the inventory can reflect the consistent and uniquely different perspectives of particular designations of staff within a practice. It is possible to compare practices' overall learning environments and to identify specific areas of practice strength as well as areas for development.
  
  
  CONCLUSIONS
  This study demonstrates the psychometric properties of a learning practice diagnostic inventory. It highlights the consistently different perspectives that individual staff groups have on the function of their practice, suggesting that the success of quality improvement initiatives may be compromised without the involvement and true engagement of each staff group.
authors.affiliation: NHS Education for Scotland, 3rd Floor, 2 Central Quay, 89 Hydepark Street, Glasgow G3 8BW, UK. diane.kelly@nes.scot.nhs.uk
authors.forename: D R
authors.initials: DR
authors.lastname: Kelly
authors.forename: J
authors.initials: J
authors.lastname: Crossley
authors.forename: M
authors.initials: M
authors.lastname: Lough
authors.forename: R
authors.initials: R
authors.lastname: Rushmer
authors.forename: G J
authors.initials: GJ
authors.lastname: Greig
authors.forename: H T O
authors.initials: HT
authors.lastname: Davies
mesh_terms: D003142:Communication; D003299:Cooperative Behavior; D006801:Humans; D007858:Learning; D010348:Patient Care Team; D011320:Primary Health Care / Q000458:organization & administration*; D011594:Psychometrics; D011787:Quality of Health Care; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires