Reliability and Performance of SEVQUAL Survey in Evaluating Quality of Medical Education Services

Document Type : Research Paper


1 Health Management Research Center, Baqiytallah University of Medical Sciences, Tehran, Iran

2 Health Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran

3 Research Center for Modeling in Health, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

4 Research Center for Health Services Management, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran


Background and Objectives: Considering the importance of medical education quality in achieving a healthy community, there is a need for the development of valid and reliable tools for efficient measurement of quality of medical education services. SEVQUAL is a popular services quality measuring framework used in assessment of quality in various service sectors. The purpose of this study was to examine the reliability and performance of this measurement model in the context of medical education.
Methods: This study is a cross-sectional study conducted in 2012 in Kermanshah University of Medical Sciences, situated in western Iran. A sample of 383 students of medical sciences participated in this survey. SEVQUAL services quality framework was used as the measurement tool, which assesses quality of services in five relevant dimensions, including Tangibles, Assurance, Responsiveness, Reliability, and Empathy. The survey was adjusted to the medical education environment, before being administered. Validity of the construct was confirmed by a panel of independent experts. The internal consistency reliability of the survey was measured using Cronbach’s alpha. Data were summarized using descriptive statistical methods. T-test and ANOVA were used to compare the mean values. P < 0.05 was considered to represent statistical significance.
Findings: While a reliability of 0.88 was obtained for the overall construct, the reliability of all individual dimensions was marginally (less that 0.1) below the threshold of 0.7. All items and dimensions showed a negative gap. A total gap of -1.58 was identified for the entire construct. The largest gap in medical education dimensions was identified for Responsiveness (-1.76), whereas the smallest gap was related to Reliability (-1.33). No significant difference in the total gap was identified between different demographic groups. Tangibles dimension showed a significantly wider gap as perceived by female students compared to their male counterparts (P = 0.034). In addition, the Tangibles gap dimension was significantly different among students in different disciplines (P = 0.004).
Conclusions: Cronbach’s alpha coefficients indicated an adequate reliability for the entire construct and a marginally inadequate reliability for the individual dimensions. This observation calls for further large-scale studies to achieve certain conclusion about the reliability of SERVQUAL use in the context of medical education services. Observation of an absolute negative gap in all items and dimenions, highlights the need for immediate investigation of causative factors, followed by devising and implementing improvement strategies.