Development and Pilot Validation of a Kirkpatrick-Informed tool integrating patient safety culture for evaluating quality improvement training program

Abstract Background The Healthcare system is strengthened by Quality Improvement and Patient safety Training. Despite significant institutional investment, Training Impact evaluation remains largely confined to the participants satisfaction and knowledge gains, whereas behavioural change and organizational outcomes rarely assessed. Existing tools like Kirkpatrick’s model and patient safety culture framework, help to address this dimension of assessment. Objective To develop and pilot-validate a questionnaire for a comprehensive impact assessment of Quality Improvement and Patient Safety training Programs. Methods A cross-sectional pilot study was conducted among 40 healthcare professionals who attended blended QI and PS training programmes delivered by the Consortium of Accredited Healthcare Organisations (CAHO), India, between 2023 and 2025. Tool development followed a three-phase process: expert focus group discussions informed initial item generation; content validity was assessed using the Content Validity Ratio (CVR); and construct validity and reliability were examined through exploratory factor analysis (EFA) with oblimin rotation and Cronbach’s alpha, using JAMOVI software. Results An initial 27-item questionnaire was refined to 22 items following content validity assessment (mean scale-level CVR = 0.82). EFA yielded a five-factor structure accounting for 74.5% of total variance, comprising: Instructor Effectiveness, Post-Training Influence and Improvement Capacity, Safety Communication and Speaking Up, Resource Competition, and Supervisor/Leadership Support for Safety. The final tool demonstrated acceptable internal consistency (Cronbach’s α = 0.783, P < .05). Conceptual mapping confirmed alignment of each domain with corresponding Kirkpatrick levels and established patient safety culture constructs. Conclusion The developed tool offers a theoretically grounded and practically applicable framework for evaluating QI and PS training beyond traditional metrics. By integrating training evaluation with organisational and cultural dimensions, it functions both as an outcome measure and a diagnostic instrument for identifying barriers to translating learning into practice. Further validation across diverse healthcare settings and larger samples is recommended.