Antibiotic knowledge assessment questionnaire in undergraduate pharmacy students: A Rasch analysis of validity evidence

Background: Antibiotic knowledge is crucial for undergraduate pharmacy students who are future healthcare professionals. However, a valid and reliable instrument to assess their knowledge is scarce. This study aimed to develop and validate an Antibiotic Knowledge Assessment Questionnaire (AKAQ). Methods: The AKAQ had three domains and 29 items, encompassing general antibiotic knowledge, antibiotic resistance, and antibiotic stewardship. Rasch analysis was used to assess psychometric properties, including validity parameters (item and person fit and structural validity), reliability (person and item reliability, Cronbach's Alpha value), item-person interaction, and item bias, using differential item functioning (DIF) based on tems. Results: This study included 500 undergraduate pharmacy students from 90 Indonesian universities. The validity of the questionnaire was demonstrated, except for one item. Person means infit and outfit for MNSQ were 1.02 and 0.95, whereas ZSTD were 0.11 and 0.08, respectively. Items means infit and outfit for MNSQ were 1.01 and 0.96, while ZSTD were 0.11 and-0.23. Item and person reliabilities were acceptable at 0.99 and 0.68. Cronbach's alpha reliability was acceptable at 0.71. Two items were biased by term. Conclusion: The AKAQ is a valid, reliable, and standard instrument for assessing the antibiotic knowledge levels of undergraduate pharmacy students.