The Japanese version of the European Moral Case Deliberation Outcomes Instrument (Euro-MCD 2.0): Validation and score distribution among nurses, doctors, and other healthcare providers—A cross-sectional study

Abstract

The European Moral Case Deliberation Outcomes Instrument (Euro-MCD 2.0) is a widely used instrument for evaluating moral case deliberation (MCD); however, its psychometric properties have not been fully validated in Japan. Our goal is to assess the validity, reliability, and score patterns of the Japanese version of the Euro-MCD 2.0 among healthcare providers in six national hospitals. A cross-sectional web-based survey was conducted at six national centers for advanced and specialized medicine in Japan. Construct validity was assessed through exploratory and confirmatory factor analysis. Convergent and discriminant validity were examined using composite reliability and average variance extracted. Internal consistency was evaluated with Cronbach's alpha and McDonald's omega. The sample included 359 doctors, nurses, pharmacists, and other healthcare providers involved in clinical practice. Participants who were not in an employment relationship (e.g., trainees) or directly involved with patients and their families in clinical practice were excluded. Items in the moral action domain had elevated 'I don't know' response rates, whereas Moral Competence items showed higher agreement. The three-factor model demonstrated acceptable fit, although discriminant validity between moral teamwork and moral action was limited. Healthcare providers with more years of experience scored higher across all subscales. The Japanese Euro-MCD 2.0 demonstrated acceptable validity and reliability, supporting its use in future evaluations in Japan.