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Diagnosing a learning practice: the validity and reliability of a learning practice inventory
  1. D R Kelly1,
  2. J Crossley2,
  3. M Lough1,
  4. R Rushmer3,
  5. G J Greig3,
  6. H T O Davies3
  1. 1NHS Education for Scotland, Glasgow, Scotland, UK
  2. 2Academic Unit of Medical Education, University of Sheffield, Sheffield, UK
  3. 3Social Dimensions of Health Institute, Universities of St Andrews and Dundee, Scotland, UK
  1. Correspondence to Diane R Kelly, NHS Education for Scotland, 3rd Floor, 2 Central Quay, 89 Hydepark Street, Glasgow G3 8BW, UK; diane.kelly{at}


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.

Method 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.

Conclusion 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.

  • Generalisability
  • reliability
  • validity
  • quality improvement
  • learning organisation
  • health care quality imrovement
  • general practice
  • culture
  • teams

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  • Funding NHS Education for Scotland.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.