The substance abuse attitude survey: an instrument for measuring attitudes.

Although attitudinal objectives in medical education about alcohol and drug misuse are important, adequate instruments for measuring the achievement of such objectives have been lacking. The development of a standardized Substance Abuse Attitude Survey (SAAS) is described. Multiple administrations and factor analyses selected and refined the item pool of the final scale. Five factors were derived from tests completed by 324 noncriterion clinicians: Permissiveness, Treatment Intervention, Nonstereotypes, Treatment Optimism and Nonmoralism. The factor structure was found to be internally consistent over repeated administrations. Validation was obtained by scoring surveys completed by 116 criterion clinicians experienced in treating patients who misuse alcohol and other drugs. The criterion clinicians scored significantly higher than the noncriterion clinicians on the Treatment Intervention and Treatment Optimism factors. The SAAS has been well accepted by medical students and practicing physicians. It has proven useful in developing attitudinal objectives, measuring achievement of these objectives and modifying teaching approaches in both undergraduate and continuing medical education.