Evidence of validity and factorial invariance of the cultural competence measurement scale (EMCC-14) among students of healthcare sciences in Panama

巴拿马医疗保健科学专业学生文化能力测量量表(EMCC-14)的效度和因子不变性证据

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Abstract

INTRODUCTION: The assessment of cultural competence is crucial for preparing health science students in Latin America to provide equitable and culturally responsive care. The Cultural Competence Measurement Scale (EMCC-14), originally developed in Spanish within the region, has shown strong psychometric properties among healthcare professionals; however, its validity has not yet been examined in student populations. OBJECTIVE: To analyze the validity, reliability and factorial invariance of the EMCC-14 cultural competence scale in health science students in Panama. MATERIALS AND METHODS: A convenience sample of 565 students from nursing, medicine, pharmacy, psychology, and dentistry programs completed the EMCC-14 scale and a sociodemographic questionnaire. The validation process was conducted in two phases: (a) evaluation of the linguistic and cultural adequacy of the scale and (b) analysis of the internal structure through confirmatory factor analysis (CFA), estimation of reliability for the total scale and its dimensions, and assessment of factorial invariance across academic subgroups. RESULTS: No linguistic adjustments were needed. The CFA confirmed the original three-factor structure (χ²/df = 3.24, CFI = 0.943, TLI = 0.930, RMSEA = 0.063, 90% CI [0.054-0.072], SRMR = 0.046). The reliability indices were satisfactory for the overall scale (α = 0.867, ω = 0.866) as well as for the knowledge (α = 0.835, ω = 0.836) and skills (α = 0.837, ω = 0.837) dimensions. However, the sensitivity dimension showed lower reliability (α = 0.653, ω = 0.653). Measurement invariance was supported between medical and nursing students. CONCLUSIONS: The EMCC-14-PAN version for health science students showed adequate evidence of validity and reliability, similar to the original scale designed for health professionals. This version is a useful instrument for studying the cultural competence of students in health sciences.

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