Development and validation of an instrument to measure physician awareness of bioethics and medical law in Oman

Background: A different ethos with respect to perception of medical ethics prevails in societies in transition such as those in the Arabian Peninsula, which make it difficult to apply international principles of bioethics in medical practice. This study aimed to develop and psychometrically test an instrument that measures physicians’ awareness of bioethics and medical law and their attitudes towards the practice of medical ethics. Additionally, it examined physician correlates influencing awareness of bioethics.Methods Following a rigorous review of relevant literature by a panel of experts, a 13-items instrument, the Omani physicians’ bioethics and medical law awareness (OBMLA) questionnaire, was developed with the aim of assessing physicians’ awareness of bioethics and medical law. The study tool’s construct validity and internal consistency reliability were examined by exploratory factor analysis (EFA) and Cronbach's alpha. In a cross-sectional study, the questionnaire was distributed among a random sample of 200 physicians at a tertiary hospital in Muscat, Oman. Participant characteristics that may influence awareness of bioethics and medical law were explored.Results EFA of the OBMLA questionnaire resulted in three well-loading factors: (i) Physicians’ bioethics practice subscale (ii) incentive related bioethics subscale and (iii) medical law awareness subscale. Internal consistency reliability ranged between Cronbach’s α: 0.73-0.8. Of total 200 participants, 52% reported that teaching medical ethics during medical school was inadequate. The overall mean (standard deviation, SD) of bioethics awareness score and Omani medical law awareness were 27.6 (3.5) and 10.1 (2.1) respectively. Majority of physicians (73%) reported that they frequently encountered ethical dilemmas in their practice and 24.5% endorsed the view that unethical decisions tended to occur in their practice.Conclusion The study provides insight into practice of bioethics, and awareness of bioethics and medical law among physicians in a teaching hospital in Oman. The OBMLA questionnaire appears to be a valid and reliable tool to assess physician awareness of bioethics and medical law. In this preliminary study, it appears that participants have suboptimal scores of indices measuring practice and awareness of bioethics and medical law.