Cross-cultural adaptation and validation of the Persian ADEA professionalism tool for dental students

Background Professional commitment means meeting patients’ legitimate expectations by acquiring the necessary skills while remaining attentive to others’ best interests. This study aimed to psychometrically evaluate the Persian version of the American Dental Education Association (ADEA) Tool for Action on Professionalism in Dental Education, producing the Persian, dental-student adaptation used in this study (hereafter, ADEA-P-DS), to develop an appropriate tool for assessing the characteristics of professionalism in Iranian dental students. Methods This cross-sectional study was conducted with 459 dental students in their second to sixth years at the Shiraz School of Dentistry during the 2024–2025 academic year. The original 81-item ADEA Statement was translated into Persian and culturally adapted for the Iranian dental education context through forward-backward translation, expert-panel review of face and content validity, and pilot testing, yielding the 31-item ADEA-P-DS categorized into six factors: competence, fairness, honesty, responsibility, respect, and willingness to serve. Statistical analyses were performed on participants’ item-level responses to the 31 questionnaire items, on the six corresponding factor (subscale) scores and the total score, and on demographic variables (age, gender, and academic year), which were used to assess reliability, sampling adequacy, and construct validity as described below. Reliability was evaluated separately for internal consistency (Cronbach’s alpha) and test-retest stability (intraclass correlation coefficient) over a two-week interval. The study also evaluated sample adequacy using the Kaiser-Meyer-Olkin (KMO) index and Bartlett’s test of sphericity, while construct validity was assessed through various fit indices, including CMIN/DF, RMSEA, CFI, TLI, IFI, and NFI. Data were analyzed using SPSS version 24 and Lisrel version 8.5. Results The content validity ratio (CVR) for the ADEA-P-DS was calculated to be 0.89, while the content validity index (CVI) exceeded 0.90 for individual questions and reached 0.98 for the entire ADEA-P-DS. Reliability was confirmed through a test-retest correlation study, yielding a high correlation coefficient ( r = 0.927) across all questions and subdomain scores. Internal consistency was also strong, with Cronbach’s alpha values surpassing 0.70, culminating in a value of 0.932 for the overall ADEA-P-DS. Factor analysis identified six components with eigenvalues greater than 1, explaining 65.385% of the total variance. Additionally, various fit indices indicated appropriate construct validity, including a CMIN/DF of 1.42, an RMSEA of 0.03, and a CFI value of 0.95, all within the excellent range. The IFI is likewise 0.95, with the TLI at 0.94 and the NFI at 0.93, all falling within the acceptable range. Overall, the analysis indicates that the ADEA-P-DS demonstrates reliability and validity as a measurement instrument. Conclusions Considering that the validity and reliability indices of the ADEA-P-DS have all been reported as satisfactory, this version appears to be a promising and psychometrically sound instrument for assessing professionalism-related competencies among dental students. However, because data were collected exclusively from a single dental school, further multi-center studies involving students from other Iranian dental schools are warranted before this tool can be recommended for nationwide behavioral research or policy-making purposes.