title: When Educational Material Is Delivered: A Mixed Methods Content Validation Study of the Information Assessment Method.
abstract: BACKGROUND
  The Information Assessment Method (IAM) allows clinicians to report the cognitive impact, clinical relevance, intention to use, and expected patient health benefits associated with clinical information received by email. More than 15,000 Canadian physicians and pharmacists use the IAM in continuing education programs. In addition, information providers can use IAM ratings and feedback comments from clinicians to improve their products.
  
  
  OBJECTIVE
  Our general objective was to validate the IAM questionnaire for the delivery of educational material (ecological and logical content validity). Our specific objectives were to measure the relevance and evaluate the representativeness of IAM items for assessing information received by email.
  
  
  METHODS
  A 3-part mixed methods study was conducted (convergent design). In part 1 (quantitative longitudinal study), the relevance of IAM items was measured. Participants were 5596 physician members of the Canadian Medical Association who used the IAM. A total of 234,196 ratings were collected in 2012. The relevance of IAM items with respect to their main construct was calculated using descriptive statistics (relevance ratio R). In part 2 (qualitative descriptive study), the representativeness of IAM items was evaluated. A total of 15 family physicians completed semistructured face-to-face interviews. For each construct, we evaluated the representativeness of IAM items using a deductive-inductive thematic qualitative data analysis. In part 3 (mixing quantitative and qualitative parts), results from quantitative and qualitative analyses were reviewed, juxtaposed in a table, discussed with experts, and integrated. Thus, our final results are derived from the views of users (ecological content validation) and experts (logical content validation).
  
  
  RESULTS
  Of the 23 IAM items, 21 were validated for content, while 2 were removed. In part 1 (quantitative results), 21 items were deemed relevant, while 2 items were deemed not relevant (R=4.86% [N=234,196] and R=3.04% [n=45,394], respectively). In part 2 (qualitative results), 22 items were deemed representative, while 1 item was not representative. In part 3 (mixing quantitative and qualitative results), the content validity of 21 items was confirmed, and the 2 nonrelevant items were excluded. A fully validated version was generated (IAM-v2014).
  
  
  CONCLUSIONS
  This study produced a content validated IAM questionnaire that is used by clinicians and information providers to assess the clinical information delivered in continuing education programs.
authors.affiliation: Information Technology Primary Care Research Group, Department of Family Medicine, McGill University, Montreal, QC, Canada.
authors.forename: Hani
authors.identifier: http://orcid.org/0000-0002-4545-735X
authors.initials: H
authors.lastname: Badran
authors.affiliation: Information Technology Primary Care Research Group, Department of Family Medicine, McGill University, Montreal, QC, Canada.
authors.forename: Pierre
authors.identifier: http://orcid.org/0000-0002-9274-7720
authors.initials: P
authors.lastname: Pluye
authors.affiliation: Information Technology Primary Care Research Group, Department of Family Medicine, McGill University, Montreal, QC, Canada.|Herzl Family Practice Centre, Department of Family Medicine, McGill University, Montreal, QC, Canada.
authors.forename: Roland
authors.identifier: http://orcid.org/0000-0002-1591-613X
authors.initials: R
authors.lastname: Grad
keywords: Internet; continuing education; electronic mail; knowledge translation; physicians, family; primary health care; validity and reliability