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Peer-reviewedCC BY-NC 4.0BMJ Open

Cross-cultural adaptation and validation of an expanded Chinese version of the training needs analysis questionnaire: evidence from rural-oriented general practitioners in Chongqing, China

  • Xintao Huang1,2
  • Haochen Yu3
  • Mo Chen1,4
  • Xingxin Deng1
  • Min Tang5
  • Huisheng Deng1
  • Zhenrong Tang3
5 affiliations
  1. 1Department of General Practice, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
  2. 2Department of General Practice, Shangqingsi Community Health Service Center of Yuzhong District, Chongqing, China
  3. 3Department of Breast and Thyroid Surgery, Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
  4. 4Renhe Community Health Center of Liangjiang New Area, Chongqing, China
  5. 5Department of Academic Affairs, College of General Practice (Fifth Clinical College), Chongqing Medical University, Chongqing, China
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Abstract

Objectives: No validated instrument exists for assessing the training needs of rural-oriented general practitioners (GPs) in China. This study translated, cross-culturally adapted and expanded the Hennessy–Hicks Training Needs Analysis (HHTNA) questionnaire for this workforce and examined the psychometric properties of the resulting Chinese version (Ch-HHTNA).

Design: Two-phase instrument development and validation study: translation with a modified Delphi consensus exercise (September 2024 to January 2025), followed by a cross-sectional validation survey (February to April 2025).

Setting: Primary care in Chongqing, China, spanning three geographic regions: the central urban area, Three Gorges Reservoir area and Wuling Mountain area.

Participants: Rural-oriented GPs registered in general practice, employed in a primary care institution in Chongqing and graduates of the Rural-oriented Medical Students Training Project. Quota sampling yielded 420 distributed questionnaires, of which 401 (95.5%) were returned and 385 (96.0% of those returned) analysed (mean age 28.7 years, 57.4% female).

Outcome measures: Structural validity, internal consistency and criterion-related validity of the Ch-HHTNA and the item-level training-need difference (importance − proficiency).

Results: The Ch-HHTNA comprised 37 items. Principal axis factoring with promax rotation yielded five factors that accounted for 57.9% of the total items. Internal consistency was high (Cronbach’s α 0.979 for scale A; category range, 0.841–0.958; split-half reliability, 0.953). Discrimination and content validity were adequate (corrected item-total correlation ≥0.30; scale-level content validity index, 0.992 and 0.996). Training-need gaps were largest for research-related tasks (writing reports: mean A − B 1.92, 95% CI 1.74 to 2.10).

Conclusions: The Ch-HHTNA is a reliable and valid instrument for assessing the training needs of rural-oriented GPs in China and can inform the design of CME/CPD curricula. The adaptation procedure may serve as a methodological reference for comparable work elsewhere.

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Cite

BibTeXRIS
BibTeX
@article{huang2026crosscultural,
  title = {{Cross-cultural adaptation and validation of an expanded Chinese version of the training needs analysis questionnaire: evidence from rural-oriented general practitioners in Chongqing, China}},
  author = {Xintao Huang and Haochen Yu and Mo Chen and Xingxin Deng and Min Tang and Huisheng Deng and Zhenrong Tang},
  journal = {BMJ Open},
  year = {2026},
  month = oct,
  doi = {10.1136/bmjopen-2026-119190},
  url = {https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-119190},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Cross-cultural adaptation and validation of an expanded Chinese version of the training needs analysis questionnaire: evidence from rural-oriented general practitioners in Chongqing, China
AU  - Xintao Huang
AU  - Haochen Yu
AU  - Mo Chen
AU  - Xingxin Deng
AU  - Min Tang
AU  - Huisheng Deng
AU  - Zhenrong Tang
PY  - 2026
DA  - 2026/10/27
JO  - BMJ Open
DO  - 10.1136/bmjopen-2026-119190
UR  - https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2026-119190
AB  - Objectives: No validated instrument exists for assessing the training needs of rural-oriented general practitioners (GPs) in China. This study translated, cross-culturally adapted and expanded the Hennessy–Hicks Training Needs Analysis (HHTNA) questionnaire for this workforce and examined the psychometric properties of the resulting Chinese version (Ch-HHTNA).  Design: Two-phase instrument development and validation study: translation with a modified Delphi consensus exercise (September 2024 to January 2025), followed by a cross-sectional validation survey (February to April 2025).  Setting: Primary care in Chongqing, China, spanning three geographic regions: the central urban area, Three Gorges Reservoir area and Wuling Mountain area.  Participants: Rural-oriented GPs registered in general practice, employed in a primary care institution in Chongqing and graduates of the Rural-oriented Medical Students Training Project. Quota sampling yielded 420 distributed questionnaires, of which 401 (95.5%) were returned and 385 (96.0% of those returned) analysed (mean age 28.7 years, 57.4% female).  Outcome measures: Structural validity, internal consistency and criterion-related validity of the Ch-HHTNA and the item-level training-need difference (importance − proficiency).  Results: The Ch-HHTNA comprised 37 items. Principal axis factoring with promax rotation yielded five factors that accounted for 57.9% of the total items. Internal consistency was high (Cronbach’s α 0.979 for scale A; category range, 0.841–0.958; split-half reliability, 0.953). Discrimination and content validity were adequate (corrected item-total correlation ≥0.30; scale-level content validity index, 0.992 and 0.996). Training-need gaps were largest for research-related tasks (writing reports: mean A − B 1.92, 95% CI 1.74 to 2.10).  Conclusions: The Ch-HHTNA is a reliable and valid instrument for assessing the training needs of rural-oriented GPs in China and can inform the design of CME/CPD curricula. The adaptation procedure may serve as a methodological reference for comparable work elsewhere.
SN  - 2044-6055
SN  - 2044-6055
ER  -