Translating and Validating the Japanese Version of the Tolerance for Ambiguity Scale

Abstract

Background: Ambiguity is inherent in medicine, and tolerance for ambiguity (TFA) has recently been of substantial interest. Effective medical education for TFA requires a validated inventory; one validated measure in wide use is the seven-item TFA scale. In Japan, however, a tool for measuring TFA in undergraduate medical education has not been available. Here, we aimed to develop and validate the Japanese version of the TFA scale (J-TFA scale). Methods: We translated the original English scale into Japanese following an international guideline. We then conducted a validation survey by distributing an online anonymous self-administered questionnaire to medical students at three medical schools in Japan. We assessed the structural validity and internal reliability of consistency of the scale. Results: A total of 399 participants were included in our analysis. We used a split-half validation approach, with exploratory factor analysis (EFA) on the first half and confirmatory factor analysis (CFA) on the second. EFA indicated a two-factor structure. CFA showed that the two-factor structure suggested by EFA had acceptable model fitness indices. Cronbach’s alpha was 0.72, exceeding the satisfactory internal reliability consistency criteria. Conclusions: The J-TFA scale was developed and its psychometric properties were confirmed. This instrument may be useful for future educational interventions and research on TFA.