Validation and psychometric properties of the Persian version of the Physician Self-Efficacy to Manage Emotional Challenges (P-PSMEC) scale among medical students: a methodological cross-sectional study

Abstract

Abstract Objectives Translate and culturally adapt the Physician Self-Efficacy to Manage Emotional Challenges (PSMEC) scale into Persian, then assess the validity and reliability of the Persian version of the PSMEC (P-PSMEC) among medical students. Design Methodological cross-sectional study. Setting Ardabil University of Medical Sciences, Ardabil, Iran. Participants A convenience sample of 237 medical students participated in the study between July and December 2024. Primary and secondary outcome measures The main focus was on evaluating the psychometric performance of the 17-item P-PSMEC scale, particularly its intended five-factor structure, examined through confirmatory factor analysis (CFA). Secondary outcomes encompassed face validity, content validity, internal convergent validity, discriminant validity, internal consistency and test-retest reliability. Additionally, an ordinal CFA sensitivity analysis was performed using the weighted least squares mean-adjusted and variance-adjusted (WLSMV) estimator. Results The P-PSMEC showed acceptable face and content validity with a Scale Content Validity Index/AVE of 0.871. The main maximum likelihood-based CFA indicated good model fit: χ²/df=1.415, root mean square error of approximation (RMSEA)=0.041, Comparative Fit Index (CFI)=0.984 and standardised root mean square residual (SRMR)=0.021. An ordinal CFA with WLSMV produced similar results: χ²=168.234, df=109, RMSEA=0.048, CFI=0.981, Tucker-Lewis Index=0.976, SRMR=0.049, with standardised loadings between 0.52 and 0.89. Evidence for internal convergent validity was supported by average variance extracted (AVE) values above 0.50 and composite reliability values above 0.70. Heterotrait-Monotrait ratio values were below 0.85, and maximum shared variance was lower than AVE, indicating good discriminant validity. Internal consistency was high (Cronbach’s α=0.902), and test-retest reliability was also strong (intraclass correlation coefficient=0.901). Conclusions The P-PSMEC shows good validity and reliability for measuring self-efficacy in managing emotional challenges among Persian-speaking medical students. The results support the proposed five-factor structure, although additional multisite, longitudinal, external validation and measurement-invariance studies are necessary.