Development and validation of a national questionnaire assessing knowledge, attitudes, and practices on neglected tropical diseases among italian medical trainees

Background Neglected Tropical Diseases (NTDs) affect nearly two billion people worldwide, yet preparedness to diagnose and manage them remains limited in high-income countries (HICs), where shifting epidemiology driven by climate changes, migration, mobility, international food and animal trade and global interconnectedness requires broader clinical competencies. Evidence on NTD-related knowledge among medical trainees in Europe is scarce. This study aimed to develop, validate, and field-test a comprehensive instrument assessing knowledge, attitudes, and practices (KAP) regarding NTDs among Italian medical students, recent graduates, and residents. Methods A structured questionnaire was developed using a multi-step approach informed by World Health Organization (WHO) Neglected Tropical Diseases priorities and a targeted literature review. Content validity was assessed through a two-round Delphi process with a multidisciplinary national expert panel (Round 1: n = 36; Round 2: n = 34), followed by external expert evaluation (n = 17). Quantitative content validation included Item- and Scale-Level Content Validity Indices (I-CVI, S-CVI/Ave) and interquartile ranges (IQR) to assess expert consensus. Reliability and psychometric properties were evaluated in a national sample of Italian medical trainees (n = 96), including internal consistency (Cronbach’s α; KR-20), test–retest reliability (ICC; Cohen’s κ), and item performance analyses. Results Across Delphi rounds, 91–98% of items reached consensus (IQR ≤ 1), and overall content validity was excellent (S-CVI/Ave 0.96–0.98). Reliability metrics confirmed strong internal consistency (α = 0.863; KR-20 = 0.82) and good temporal stability (ICC = 0.89; κ = 0.72–0.84). Known-groups validity was demonstrated by significantly higher knowledge scores among residents compared with medical students (p = 0.014). Conclusions This study provides the first Delphi-validated national instrument assessing NTD-related knowledge among Italian medical trainees. The tool can offer a foundation for evaluating curricula and informing educational reform, supporting the integration of NTD-related competencies in European medical education in response to evolving global health challenges.

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Journal
PLoS neglected tropical diseases
Published
2026-08-24
DOI
https://doi.org/10.1371/journal.pntd.0014644
Primary Topic
Global Health and Surgery
Type
article
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article

Development and validation of a national questionnaire assessing knowledge, attitudes, and practices on neglected tropical diseases among italian medical trainees

Marco Giuseppe Prato, Chiara Sepulcri, Marco Pombi, Alberto Matteelli et al.
PLoS neglected tropical diseases
Global Health and Surgery
article

Development and validation of a national questionnaire assessing knowledge, attitudes, and practices on neglected tropical diseases among italian medical trainees

Marco Giuseppe Prato, Chiara Sepulcri, Marco Pombi, Alberto Matteelli, Spinello Antinori, Angela Corpolongo, Caterina Monari, Roberta Papagni, Rosalia Marrone, Michele Spinicci, Trentina Di Muccio, Francesca Serapide, Marco Di Luca, Federica Perego, Natalia Tiberti, Flavia Riccardo, Nicoletta Basilico, F GOBBI, Gioia Bongiorno, Susanna Capone, F. Gennaro, Luisa Frallonardo, Mariantonietta Pisaturo, Emanuele Nicastri, Fabrizio Bruschi, Alessandra D’Abramo, Ilenia Annunziata Ritacco, Guido Favia, Antonio Cascio, Beatrice Formenti, Agnese Comelli, Anna Barbiero, Giacomo Guido, Lorenzo Zammarchi, Stefano D’Amelio, Sara Epis, Adriano Casulli, Sergio Lo Caputo, Salvatore Scarso, Serena Cavallero, Eleonora Perugini, Roberta Iatta, Francesca Mariotti, Alessandro Bartoloni, Benedetta Rossi, Giovanni Dolci, Giuseppina De Iaco, Claudia Mangiapelo, Annalisa Saracino, Simona Gabrielli, Valentina Mangano, Samuele Gaggioli, Laura Rinaldi, Marco Del Riccio, Emanuele Rollo, Carlo Torti
article en

Abstract

Background Neglected Tropical Diseases (NTDs) affect nearly two billion people worldwide, yet preparedness to diagnose and manage them remains limited in high-income countries (HICs), where shifting epidemiology driven by climate changes, migration, mobility, international food and animal trade and global interconnectedness requires broader clinical competencies. Evidence on NTD-related knowledge among medical trainees in Europe is scarce. This study aimed to develop, validate, and field-test a comprehensive instrument assessing knowledge, attitudes, and practices (KAP) regarding NTDs among Italian medical students, recent graduates, and residents. Methods A structured questionnaire was developed using a multi-step approach informed by World Health Organization (WHO) Neglected Tropical Diseases priorities and a targeted literature review. Content validity was assessed through a two-round Delphi process with a multidisciplinary national expert panel (Round 1: n = 36; Round 2: n = 34), followed by external expert evaluation (n = 17). Quantitative content validation included Item- and Scale-Level Content Validity Indices (I-CVI, S-CVI/Ave) and interquartile ranges (IQR) to assess expert consensus. Reliability and psychometric properties were evaluated in a national sample of Italian medical trainees (n = 96), including internal consistency (Cronbach’s α; KR-20), test–retest reliability (ICC; Cohen’s κ), and item performance analyses. Results Across Delphi rounds, 91–98% of items reached consensus (IQR ≤ 1), and overall content validity was excellent (S-CVI/Ave 0.96–0.98). Reliability metrics confirmed strong internal consistency (α = 0.863; KR-20 = 0.82) and good temporal stability (ICC = 0.89; κ = 0.72–0.84). Known-groups validity was demonstrated by significantly higher knowledge scores among residents compared with medical students (p = 0.014). Conclusions This study provides the first Delphi-validated national instrument assessing NTD-related knowledge among Italian medical trainees. The tool can offer a foundation for evaluating curricula and informing educational reform, supporting the integration of NTD-related competencies in European medical education in response to evolving global health challenges.

PLoS neglected tropical diseasesVol. 20(8)
Università Cattolica del Sacro Cuore (IT), University of Foggia (IT), University of Pisa (IT), Università di Camerino (IT), University of Milan (IT), University of Campania "Luigi Vanvitelli" (IT), University of Pavia (IT), Istituto Superiore di Sanità (IT), Agostino Gemelli University Polyclinic (IT), Brescia University (US), Magna Graecia University (IT), Azienda Sanitaria Unità Locale di Reggio Emilia (IT), Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani (IT), Ospedale Sacro Cuore Don Calabria (IT), Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT), Federico II University Hospital (IT), Ospedale Madonna Delle Grazie (IT), Istituti di Ricovero e Cura a Carattere Scientifico (IT), Azienda Usl Toscana Centro (IT), University of Florence (IT), University of Bari Aldo Moro (IT), University of Naples Federico II (IT), University of Brescia (IT), University of Genoa (IT), Sapienza University of Rome (IT)
Openalex Percentile: Top 7%
Global Health and Surgery
DOIOpen Access PDFOpenAlex
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