Adaptation of the Knowledge Validation Inventory to Measure Training Needs of Vocational Rehabilitation Service Providers in Kuwait Schools

Abstract

Research on vocational rehabilitation in Kuwait is limited, in part, due to the availability of instruments validated for use in Arab countries. The purpose of this study was to adapt the Knowledge Validation Inventory (KVI) for use in Arabic populations and to determine the psychometric characteristics of the adapted inventory for assessing the training needs of vocational rehabilitation service providers in Kuwait. The Knowledge Validation Inventory–Arabic Version (KVI-A) was administered to a convenient sample of 764 service providers from Kuwait special schools. Internal consistency for the three scales of the KVI-A ranged from .94 to .97. Exploratory factor analysis identified six distinct factors: (a) assessment and career counseling; (b) resources and services of rehabilitation; (c) counseling theories, techniques, and applications; (d) medical, environmental, and functional implications of disability; (e) case management; and (f) techniques and strategies of disability prevention and working effectively. Years of experience, job title, and service provider qualifications predicted training needs scores. Significant differences in knowledge domains and training needs were obtained across the identified predictor variables. Evidence suggests that the KVI-A is applicable for use in primarily Arab countries. The knowledge domains identified can be used to develop a training curriculum and certification credentials for Kuwait.

Keywords

training needs vocational rehabilitation in Kuwait Kuwaiti service providers vocational rehabilitation counseling knowledge domains

Introduction

Rehabilitation counseling is a dynamic profession in which the scope of practice continues to evolve due to internal developments and external forces. As a result, practice within this profession and the knowledge required to meet the needs of individuals with disabilities have also changed over time. To identify the major knowledge domains in the practice of vocational rehabilitation counseling, several research studies have supported the development of the Knowledge Validation Inventory (KVI; Leahy, Chan, & Saunders, 2003; Leahy, Chan, Sung, & Kim, 2013; Leahy, Muenzen, Saunders, & Strauser, 2009; Leahy, Szymanski, & Linkowski, 1993). The KVI has been used as a basis to identify training needs and minimum competency standards of vocational rehabilitation counselors in the United States (e.g., Chan et al., 2003; Leahy et al., 2013) and in other countries (e.g., Millet & Vaittinen, 2011). However, exploration of the knowledge domains required for rehabilitation counseling practice and the utility of the KVI in Kuwait or other Arab countries is unknown.

The Vocational Rehabilitation Programs in Kuwait

In 2011, the Public Authority for Special Needs in Kuwait indicated that approximately 33,000 persons with disabilities were served in Kuwait and a large proportion, about 60%, are persons with physical, intellectual, or multiple disabilities. Vocational rehabilitation programs for persons with physical, intellectual, or multiple disabilities are offered in two specialized centers, fifteen private special schools, and five public special schools. The specialized centers provide for persons aged 18 years and above, whereas the schools serve students aged between 13 and 25 years old.

The traditional model of vocational rehabilitation services involves many human services specialists and a rehabilitation service coordinator called a rehabilitation counselor (Saravanabhavan, 1991). The position of the rehabilitation counselor is multifaceted, and different competencies are required of them to address the various tasks in their work. However, in rehabilitation counseling serviced in Kuwait, there are no rehabilitation counselors per se. Instead, the multiple tasks of the rehabilitation counselor are assumed by a multidisciplinary team (e.g., a case manager, a supervisor, a rehabilitation trainer, an assistant rehabilitation trainer, a psychologist, a social worker, an occupational therapist, a physical therapist, a speech and language specialist, and a nurse). This service delivery model is somewhat similar to that implemented in Sweden (Millet & Vaittinen, 2009). Although some of the service providers in the multidisciplinary team have received training in allied health, many of the other service providers are trained through in-service ad hoc programs specific to each agency. Furthermore, a certification in vocational rehabilitation does not exist in Kuwait resulting in variability in standards regarding knowledge and training.

A review of previous literature in Kuwait on vocational rehabilitation for students with physical, intellectual, or multiple disabilities revealed three studies that were conducted by Aldei (2008), Kamal (1993), and Meshal (2005). These studies were small-scaled and sampled only the two vocational rehabilitation centers in Kuwait. Vocational rehabilitation in Kuwait is limited by the paucity of research in this country on knowledge domains of persons engaged in rehabilitation counseling practice. The Knowledge Validation Inventory–Revised (KVI-R) has been used in the United States and other countries to identify knowledge domains that are considered important by vocational rehabilitation counselors. It has also been used to identify practitioner preparedness and training needs.

The KVI-R

The KVI-R was originally developed by Leahy et al. (1993) and was subsequently revised (Leahy et al., 2003; Leahy et al., 2013; Leahy et al., 2009) to obtain the KVI-R. The KVI-R was chosen to be adapted for this research because (a) it has been used previously to identify knowledge domains and training needs in the vocational rehabilitation field, (b) the process of creation and development of the inventory had gone through multiple scientific development stages, (c) the inventory has been previously validated, and (d) the inventory is used by the Commission on Rehabilitation Counselor Certification (CRCC). The KVI-R was also used as a reference for studies in other countries (e.g., Matthews, Buys, Randall, Biggs, & Hazelwood, 2010; Millet & Vaittinen, 2011). Approval was obtained from the first author and the CRCC to adapt and translate this inventory into Arabic language for use in the current study. The KVI-R (Leahy et al., 2003) revealed six knowledge domains important to rehabilitative counseling practice: (a) career counseling, assessment, and consultation services; (b) counseling theories, techniques, and applications; (c) rehabilitation services and resources; (d) case and caseload management; (e) health care and disability systems; and (f) medical, functional, and environmental implications of disability.

The purpose of this research was to adapt and validate the KVI-R as a measure of the knowledge and training needs of vocational rehabilitation service providers in Kuwait. Rehabilitation counselor demographic variables such as gender, age, ethnicity, years of experience, qualification, disability status, work locations, and settings have been explored to identify significant predictors of training needs in this field (e.g., Froehlich & Linkowski, 2002). Of these, only academic qualification was found to be a predictor of need for training in 4 out of 10 knowledge domains (Froehlich & Linkowski, 2002). In this research, the relevant demographic variables to be explored in the Kuwait context include gender, age, years of experience, job category, type of school, and qualification.

Method

The International Test Commission (2010) guidelines for adapting and translating tests which have been previously field-tested were reviewed for the creation of the Arabic version of the KVI-R (Hambleton, 2001). In accordance with these guidelines, psychometric evidence of reliability, content validity, construct validity, and predictive validity was obtained and analyzed.

Adaptation of Instrument

The version of the KVI-R used in this research consisted of 92 items. To address the language, cultural context, and research objectives of the current study, certain items were deleted, resulting in the final adapted inventory consisting of 73 items. Items that were not relevant to the current context included those on “substance abuse and treatment” as schools in Kuwait do not deal with cases of addiction or drug abuse. Likewise, the item on “techniques for working with individuals with limited English proficiency” was also deleted due to lack of appropriateness for use in a Kuwaiti sample. Other items deemed not relevant were those items related to psychometric concepts and research, forensic and psychiatric rehabilitation and programs and services specific to the United States such as Medicare and Client Assistance Programs. The term Counselor was changed to Provider to refer to all persons who provide vocational rehabilitation services in the schools because in Arab countries the term counselor refers to a psychologist. These adaptations adhered to the guidelines by the International Test Commission (2010) on the need to take into account the linguistic and cultural differences among the populations for whom the instrument is intended.

To determine providers’ training needs, two 5-point Likert-type scales were used to assess importance and preparedness for each knowledge item. Respondents were asked to rate the importance of each knowledge item using a 5-point Likert-type scale (not important = 0, somewhat important = 1, important = 2, very important = 3, and extremely important = 4). Levels of perceived preparedness were also assessed by asking respondents to rate the degree of preparation they had received through education and training for each knowledge item, using a 5-point Likert-type scale (no preparation = 0, little preparation = 1, moderate preparation = 2, high degree of preparation = 3, very high degree of preparation = 4). This Likert-type scale, used in the KVI-R, was retained in the adaptation process because this scale is already familiar to the intended population (International Test Commission, 2010).

To calculate the training needs scores of the service providers, the discrepancy model used by Szymanski, Linkowski, Leahy, Diamond, and Thoreson (1993) and Froehlich and Linkowski (2002) was used. For each item in the adapted inventory, the Preparedness rating was subtracted from the Importance rating. The difference between the Importance and Preparedness ratings on the 73 knowledge items of the adapted inventory represents the training needs score (discrepancy score). As the maximum rating for Preparedness and Importance was 4, the possible training needs score (discrepancy score) for each item ranged from −4 to +4. A negative value meant that no training was required for knowledge of that item. A positive value indicated that training was required. The higher the positive value, the higher the perceived training need. There are limitations in using the basic discrepancy score to determine training needs. Some of these limitations were addressed in the more recent method used by Chan et al. (2003), which compared items ranked above the median in both the high importance item hierarchy and the limited preparedness item hierarchy. However, in this research, the method by Szymanski et al. (1993) was adopted because the scores were better suited for a principal component analysis (PCA) and multiple regression analysis.

The adapted inventory was translated following a standard forward–backward translation procedure. This procedure is widely used in cross-cultural psychology (Acquadro, Jambon, Ellis, & Marquis, 1996; Bullinger, Alonso, & Apolone, 1998). In the first phase, a certified translation officer and a researcher separately translated the original inventory into the Arabic language. The researcher was previously a vocational rehabilitation service provider in Kuwait schools and was familiar with the subject matter and culture. This was in accordance with the selection criteria suggested by the International Test Commission (2010) guidelines. The two Arabic versions were then compared to create a synthesized Arabic version.

In Phase 2, another certified translation officer and another bilingual translator were asked to back-translate the synthesized Arabic version produced in the first phase without being provided the English version of the inventory. These two translators were asked to then synthesize their translations into a single English version. In Phase 3, two fluent English language speakers compared the original inventory and the newly synthesized English version from the backward-translation process in Phase 2 for semantic discrepancies and conceptual equivalence. The final Arabic version of the adapted inventory was named as the Knowledge Validation Inventory–Arabic Version (KVI-A).

Content Validity of Instrument

Content validation was conducted by an expert committee comprised of five faculty members who specialized in special education or vocational training at the University of Jordan, University of Kuwait, and several other Arab universities, and five service providers with different job titles to judge the appropriateness, applicability, and comprehensiveness of the instrument content. In addition to content, the clarity and language of the items of the instrument were also judged. A Content Validation Form was used to verify these aspects (content and format) on an item-by-item analysis, and also on the instrument as a whole. There was a consensus among the expert panel and service providers that all items of the KVI-A were appropriate, applicable, clear, and suitable for this study.

Pilot Study

A representative sample of 84 service providers from both private and public schools was chosen for the pilot study. The KVI-A was administered and the internal consistency of the instrument was calculated using Cronbach’s alpha coefficient. The alpha coefficient for the Importance scale was .81, and for the Preparedness scale it was .89.

Participants

The entire population of all services providers in Kuwait is 1,117 (private school n = 833 and public schools n = 284). Based on the Cochran formula (1977) as described in Bartlett, Kotrlik, and Higgins (2001), for an alpha level of .05, and 3% margin of error, a sample of 107 is adequate for this population. However, to conduct a factor analysis of the KVI-A, a sample size of 730 participants was required to achieve the optimal ratio of 10 observations to each item in the inventory (73 items).

Random cluster sampling identified 14 schools (11 private and 3 public schools) with 776 service providers. A total of 776 questionnaires were distributed and 764 (98.4% response rate) questionnaires were returned, excluding four, which was incomplete. The response rate was very high compared with previous research in this field. The first author was able to obtain a very good response from the participants most likely because he was a former service provider in one of the schools. The first author visited the schools and recruited the help of the social workers in the schools to distribute and collect the questionnaires. In addition, the first author followed-up with electronic reminders and school visits. The questionnaire was in pencil-and-paper format. The demographic variables of the respondents are summarized in Tables 1 and 2 below.

Table 1.

Demographic Variables of Service Providers (Categorical Data).

Variable	Categories	Frequency	%
Gender	Male	436	57.1
	Female	328	42.9
Qualification	BA	292	38.2
	BA and diploma	335	43.8
	MA or PhD	89	11.6
	Other	48	6.3
School type	Private	550	72.0
	Public	214	28.0
Job title	Trainer/manager
	Manager	24	3.1
	Supervisor	32	4.2
	Trainer	268	35.1
	Assistant trainer	256	33.5
	Related services
	Psychologist	34	4.5
	Social worker	31	4.1
	Physical therapist	35	4.6
	Occupational therapist	27	3.5
	Speech specialist	35	4.6
	Nurse	22	2.9

Table 2.

Demographic Variables of Service Providers (Continuous Data).

Variable	M	SD	Categories	Frequency	%
Age	36 years	6.5	22–32	247	32.3
			33–38	254	33.2
			39–54	263	34.4
Years of experience	5.5 years	2.5	4 or less	299	39.1
			5–6	237	31.0
			7 or above	228	29.8

Results

Descriptive Statistics

The descriptive statistics for each item in the KVI-A are displayed in Appendix A. A summary of the overall descriptive for the Importance, Preparedness, and Training Needs scales is presented in Table 3.

Table 3.

Descriptive Statistics for the Importance, Preparedness, and Training Needs Scale of KVI-A.

Scale	n items	Range	Minimum	Maximum	Overall M	Overall SD
Importance	73	0.80	2.74	3.54	3.20	0.20
Preparedness	73	1.68	0.85	2.53	1.53	0.35
Training Needs	73	1.76	0.76	2.52	1.67	0.37

Note. KVI-A = Knowledge Validation Inventory–Arabic Version.

Table 4 summarizes the frequency of the discrepancy training needs score for each item in the KVI-A (refer to Appendix A). Based on this table, the service providers perceived that they required training in all the knowledge areas listed in KVI-A, as all the discrepancy scores are positive values.

Table 4.

Frequency of Item Mean Discrepancy Score in the Training Needs Scale.

Range of item means	Frequency	%
0–0.99	3	4.1
1–1.99	58	79.5
2–2.99	12	16.4
Total	73	100

Psychometric Characteristics

Internal consistency reliability

Referring to Table 5 below, the alpha value was .94 for Importance scale, .97 for Preparation scale, and .96 for the Training Needs scale. An alpha value above .7 indicates that the scale has acceptable internal consistency reliability (DeVellis, 2011). Most items were found to correlate well with the corrected total. All items in the inventory contributed to the overall reliability of the inventory, and therefore all items were retained.

Table 5.

Internal Consistency Reliability for the KVI-A.

	n of items	n of respondents	Cronbach’s α
Importance scale	73	764	.94
Preparation scale	73	764	.97
Training Needs scale	73	764	.96

Note. KVI-A = Knowledge Validation Inventory–Arabic Version.

Factor structure of Training Needs scale (construct validity)

PCA was used to explore the number of factors that can be used to represent the interrelations among the set of items in the KVI-A. Kaiser–Meyer–Olkin (KMO) measure of sample size adequacy was .91, above the recommended value of .6, and Bartlett’s test of sphericity was significant (p < .05, .000). Intercorrelations matrix among some items revealed the presence of many with coefficients above .3, and the communalities were all above .5. Based on the results, factor analysis was conducted with all 73 items.

PCA showed the presence of 15 components with eigenvalues exceeding 1. The eigenvalues (Kaiser’s criterion) show that seven factors had eigenvalues greater than 2. The 8th to 15th factor had eigenvalues of just greater than 1. When the Kaiser criterion is used, many components are often extracted, so the scree plot was preferred. An inspection of the scree plot revealed that the first clear break was at the 6th component. The Factors 1 through 6 contributed 54% of cumulative variance, while Factors 7 to 15 contributed just 17%. From this plot, it was decided to retain 6 components for further investigation.

To aid in the interpretation of these six components, a PCA of the 73 items, using varimax and oblimin rotation, was performed, with the six factors that explain 54% of the variance. Varimax rotation provided the best defined factor structure. Sixty-four items had primary loadings greater than .5 and only 3 items had primary loading above .4. The factor loading matrix for this final solution is presented in Appendix B.

Factors extracted from this study were largely consistent with Leahy et al. (2003) in terms of number of factors and their labels. The first factor was labeled assessment and career counseling; second factor, resources and services of rehabilitation; third factor, counseling theories, techniques, and applications; fourth factor, medical, environmental, and functional implications of disability; fifth factor, case management and the last factor is labeled techniques and strategies of disability prevention and working effectively. Internal consistency for each factor and its descriptive are presented in Table 6.

Table 6.

Descriptive and Internal Consistency of the Six-Factor Knowledge Domains Solution.

Factor label	No. of items	α	M	SD
1. Assessment and career counseling	20	.95	37.97	18.10
2. Resources and services of rehabilitation	15	.94	24.20	15.04
3. Counseling theories, techniques, and applications	13	.91	22.51	12.41
4. Medical, environmental, and functional implications of disability	9	.90	11.93	8.99
5. Case management	7	.90	11.54	7.14
6. Techniques and strategies of disability prevention and working effectively	3	.67	3.12	2.98

Overall, the analysis indicated that six distinct factors were underlying service providers’ responses to the KVI-A items on the Training Needs scale, and that these factors were highly internally consistent. Six of the 73 items were eliminated during analysis. An approximately normal distribution was evident for the composite score data in the current study, thus the data were suited for parametric statistical analyses.

Factor structure from the Importance scale (construct validity)

A second PCA analysis was conducted to extract factors from the Importance scale as the original KVI-R (Leahy et al., 2003; Leahy et al., 2009) knowledge domains were extracted using the Importance scale. This analysis showed the presence of nine components with eigenvalues exceeding 1. The eigenvalues (Kaiser’s criterion) showed that seven factors had eigenvalues greater than 2. The eighth and ninth factors had eigenvalues just greater than 1. There was difficulty in interpreting the nine factors, so five-, six-, seven-, and eight-factor solutions were examined by using varimax rotations of the factor loading matrix. The interpretation was more clearly defined with the five-factor solution. A comparison was made between the factors extracted from the Training Needs scale and the Importance scale (refer to Table 7). The comparison showed similar results for both scales used, but with a difference in Factor 6 of the Training Needs scale. The three items in Factor 6 now loaded under Factors 3 and 5 in the Importance scale.

Table 7.

Comparison Between the Factors of the Importance Scale and the Training Needs Scale.

Factor	Factor label	Training Needs scale	Importance scale	Similarities	Differences
1	Assessment and career counseling.	20 items	19 items	19 items	Item 41 was eliminated in Importance scale
2	Resources and services of rehabilitation.	15 items	15 items	All 15 items	—
3	Counseling theories, techniques, and applications.	13 items	16 items	13 items	Items 1, 49, 50 came under Factor 3 in Importance scale
4	Medical, environmental, and functional implications of disability.	9 items	9 items	All 9 items	—
5	Case management.	7 items	9 items	7 items	Items 15, 42 came under Factor 5 in Importance scale
6	Techniques and strategies of disability prevention and working effectively	3 items	—	—	Item 42 came under Factor 5, and Items 49, 50 came under Factor 3 in Importance scale
Total		Six factors (67 items)	Five factors (68 items)
Eliminated items		6 items (1, 15, 30, 39, 40, 55)	5 items (30, 39, 40, 41, 55)	4 items (30, 39, 40, 55)	Item 41 came under Factor 1 in Training scale.Item 1 came under Factor 3 in Importance scale.Item 15 came under Factor 5 in Importance scale.

Predictive validity

A standard multiple regression analysis was used to identify which set of six independent variables (see Tables 1 and 2) best predict the service providers’ training needs. Assumptions of multiple regression were checked. Tests for multicollinearity indicated that no multicollinearity was present (variance inflation factor [VIF] = 1.01 for gender, 1.24 for age, 1.27 for years of experience, 1.01 for job category, 1.05 for type of school, and 1.05 for qualification category). Assumptions of normality, linearity, and homoscedasticity were checked by inspecting the Normal Probability Plot and the Residual Plot. There is a slight curvature in the diagonal line of the Normal Probability Plot, and some deviations from a centralized rectangular distribution in Residual Scatter plot, suggesting that there was some violation of assumptions although not major. However, in this study, the number of cases (sample size) was quite large, and regression analysis has been shown to be quite robust even when normality assumptions were violated (Hair, Anderson, Tatham, & Black, 1998).

The results of the standard multiple regression analysis indicated that the combination of predictors in the model significantly explained 9.1% of the variance in training needs scores, R² = .091, F(6, 757) = 12.69, p < .000. Three of the predictor variables made statistically significant unique contributions to the prediction of the training needs scores. These predictor variables were years of experience, β = −.20, t(757) = −5.04, p < .001; job title category, β = −.15, t(757) = −4.41, p < .001; and qualification category, β = −.13, t(757) = −.3.62, p < .001.

Vocational Rehabilitation Counseling Knowledge Domains With High Training Needs

Training needs by knowledge domain was assessed using the discrepancy formula used by Szymanski et al. (1993). The mean discrepancy score for each knowledge domain was computed by summing the discrepancy score of the items in each factor and dividing by the number of items in that factor. Based on relative comparisons in previous research, low discrepancy ratings ranged from .0 to .39, moderate from .4 to .69, and high discrepancy ratings from .7 and above (Froehlich & Linkowski, 2002; Szymanski et al., 1993). Significant high training needs was indicated by high discrepancy ratings along with evidence of perceived importance of the knowledge items. The mean discrepancy scores for the knowledge domains and evidence of importance rating are shown in Table 8 in descending order. Based on the results in Table 8, it can be concluded that the service providers believed that they require significant high training needs in all the knowledge domains.

Table 8.

Mean Discrepancy Score and Standard Deviation by Knowledge Domains.

Knowledge domain	No. of items	Items rated important to very important	Items rated very important to extremely important	M discrepancy score	SD
Assessment and career counseling	20	—	20	1.90	0.90
Counseling theories, techniques, and applications	13	—	13	1.73	0.95
Case management	7	—	7	1.65	1.02
Resources and services of rehabilitation	15	2	13	1.61	1.00
Medical, environmental, and functional implications of disability	9	9	—	1.33	1.00
Techniques and strategies of disability prevention and working effectively	3	—	3	1.04	0.99

Knowledge Domains With Significant Training Needs Across Predictor Variables

A one-way, between-groups MANOVA was conducted to explore the knowledge domains reported to have significant training needs according to the three significant predictor variables, which were years of experience, job title, and qualification. Six dependent variables were used: Knowledge Domain 1 assessment and career counseling; Knowledge Domain 2 resources and services of rehabilitation; Knowledge Domain 3 counseling theories, techniques, and applications; Knowledge Domain 4 medical, environmental, and functional implications of disability; Knowledge Domain 5 case management; and Knowledge Domain 6 techniques and strategies of disability prevention and working effectively. Preliminary assumption testing was conducted to check for normality, linearity, homogeneity of variance–covariance matrices, and multicollinearity. No serious violations were noted. As the sample used was quite large, any minor violations can be tolerated.

Years of experience

The MANOVA analysis indicated that there was a significant difference between the years of experience categories on the six combined dependent variables: F(12, 1512) = 4.27, p = .000; Wilks’s Lambda = .94; $η_{p}^{2}$ = .03. When the results for the six dependent variables were considered separately with Bonferroni adjusted alpha level of .0083 (.05 divided by 6), significant differences were observed on five of the six knowledge domains. Significant differences were found for Knowledge Domain 2 (resources and services of rehabilitation): F(2, 761) = 7.53, p = .002, $η_{p}^{2}$ = .02; Knowledge Domain 3 (counseling theories, techniques, and applications): F(2, 761) = 6.17, p = .002, $η_{p}^{2}$ = .02; Knowledge Domain 4 (medical, environmental, and functional implications of disability): F(2, 761) = 16.87, p = .000, $η_{p}^{2}$ = .04; Knowledge Domain 5 (case management): F(2, 761) = 9.46, p = .000, $η_{p}^{2}$ = .02.; and Knowledge Domain 6 (techniques and strategies of disability prevention and working effectively): F(2, 761) = 6.03, p = .003, $η_{p}^{2}$ = .02.

Tukey’s post hoc comparison revealed that there was a significant difference in the resources and services of rehabilitation training needs knowledge domain between years of experience category 4 years or less, and 7 years and above. An inspection of the mean scores indicated that providers who had 4 years of experience or less reported slightly higher training needs in resources and services of rehabilitation knowledge domain (M = 26.06) compared with the other two experience categories: 5 to 6 (M = 24.85), 7 or above (M = 21.08).

There was also a significant difference in the counseling theories, techniques, and applications training needs knowledge domain between years of experience category 4 or less and 7 or above. An inspection of the mean scores indicated that providers who had 4 years of experience or less reported slightly higher training needs in counseling theories, techniques, and applications knowledge domain (M = 23.87) compared with the other 2 years of experience categories: 5 to 6 (M = 23.02), 7 or above (M = 20.17).

Medical, environmental, and functional implications of disability training needs knowledge domain also differed based on experience. An inspection of the mean scores indicated that providers who had 4 years of experience or less (M = 13.62) and providers who had 5 to 6 years of experience (M = 12.44) reported higher training needs in medical, environmental, and functional implications of disability knowledge domain, compared with the providers who had 7 years of experience or above (M = 9.20).

In the case management training needs knowledge domain, there was a significant difference between years of experience category 4 or less and 7 or above. An inspection of the mean scores indicated that providers who had 4 years of experience or less reported slightly higher training needs in the case management knowledge domain (M = 12.63) compared with the other two experience categories: 5 to 6 (M = 11.70), 7 or above (M = 9.94).

In the techniques and strategies of disability prevention and working effectively training needs knowledge domain, significant differences were also observed based on the number of years of experience. An inspection of the mean scores indicated that providers who had 4 years of experience or less (M = 3.33) and providers who had 5 to 6 years of experience (M = 3.40) reported slightly higher training needs in techniques and strategies of disability prevention and working effectively knowledge domain, compared with the providers who had 7 years of experience or above (M = 2.55).

Therefore, in terms of years of experience, service providers who had 4 years of experience or less rated training needs in Knowledge Domain 2 (resources and services of rehabilitation), Knowledge Domain 3 (counseling theories, techniques, and applications), Knowledge Domain 4 (medical, environmental, and functional implications of disability), and Knowledge Domain 5 (case management) as significantly higher than the other two experience groups. However, service providers who had 5 to 6 years of experience rated training needs in Knowledge Domain 6 (techniques and strategies of disability prevention and working effectively) as significantly higher than the other two “less” experienced groups.

Qualification

The MANOVA analysis revealed that there was a significant difference between those with bachelor or less qualifications and those with higher than bachelor qualifications on the six combined dependent variables: F(6, 757) = 7.08, p = .000; Wilks’s Lambda = .95; $η_{p}^{2}$ = .05.

When the results for the six dependent variables were considered separately with Bonferroni adjusted alpha level of .008, there were significant differences in three of the six knowledge domains. Significant difference was obtained for Knowledge Domain 3 (counseling theories, techniques, and applications): F(1, 762) = 18.69, p = .000, $η_{p}^{2}$ = .02; Knowledge Domain 4 (medical, environmental, and functional implications of disability): F(1, 762) = 10.59, p = .001, $η_{p}^{2}$ = .01, and Knowledge Domain 6 (techniques and strategies of disability prevention and working effectively): F(1, 762) = 34.27, p = .000, $η_{p}^{2}$ = .04.

An inspection of the mean scores indicated that providers who held bachelor qualification or less reported slightly higher training needs in counseling theories, techniques, and applications knowledge domain (M = 24.65) than providers who held higher than bachelor qualification (M = 20.79). Likewise, the mean scores for providers who held bachelor qualification or less reported higher training needs in medical, environmental, and functional implications of disability knowledge domain (M = 13.11) than providers who held higher than bachelor qualification (M = 10.99). Finally, the mean scores also indicated that providers who held bachelor qualification or less reported slightly higher training needs in techniques and strategies of disability prevention and working effectively knowledge domain (M = 3.81) than providers who held higher than bachelor qualification (M = 2.56).

Therefore, in terms of qualification, service providers who held bachelor qualification or less rated training needs in Knowledge Domains 3 (counseling theories, techniques, and applications), 4 (medical, environmental, and functional implications of disability), and Knowledge Domain 6 (techniques and strategies of disability prevention and working effectively) as significantly higher than providers who held higher than bachelor qualification.

Job title

MANOVA analysis indicated that there was a significant difference between the two dichotomous job title categories (trainer/manager and related service providers) on the six combined dependent variables: F(6, 757) = 7.56, p = .000; Wilks’s Lambda = .94; $η_{p}^{2}$ = .06.

When the results for the six dependent variables were considered separately with the Bonferroni adjusted alpha level of .008, there were significant differences only in Knowledge Domain 3 (counseling theories, techniques, and applications): F(1, 762) = 38.22, p = .000, $η_{p}^{2}$ = .05. An inspection of the mean scores indicated that providers in the trainer/manager category reported higher training needs in counseling theories, techniques, and applications knowledge domain (M = 24.04) than providers in the related service providers category (M = 17.70). Therefore, in terms of job title, service providers in the trainer/manager category rated significant training needs in Knowledge Domain 3 (counseling theories, techniques, and applications).

Discussion

Psychometric Evidence

Based on the psychometric characteristics of the sample reviewed in the “Results” section, the KVI-A can be considered both reliable and valid for use in the Kuwait context. Content validity was obtained from an expert panel. The coefficient alpha for the Training Needs scale was .96, which indicated high internal consistency reliability of items in the scale. Subsequent analysis also revealed high internal consistency reliability of the six subscales (range = .67–.95).

Construct validity evidence, obtained from the six-factor solution, accounted for 54% of the variance in the Training Needs scale. The six factors were assessment and career counseling; resources and services of rehabilitation; counseling theories, techniques, and applications; medical, environmental, and functional implications of disability; case management; and techniques and strategies of disability prevention and working effectively. The knowledge domains extracted from the Importance scale were very similar to that of the Training Needs scale indicating that the knowledge domains in KVI-A are both rated as highly important and having high training needs. A major discrepancy in knowledge domain importance and preparedness was not observed in Kuwait. The lack of discrepancy is likely related to the underdeveloped structured training approach. As a majority of the training in Kuwait is conducted on-site as an in-service training, awareness of the knowledge necessary for practice is likely well distributed. However, in the absence of a formal, nationalized program of study or curriculum, many providers may have indicated a need for training as a result of the limited training they were offered at their respective schools or agencies.

The knowledge domain constructs for KVI-A were also consistent with the results obtained by Leahy et al. (2003) for KVI-R. An extended research study by Leahy et al. (2009) obtained three-factor solutions in which 12 knowledge domains were subsumed. All 12 knowledge domains underlying vocational rehabilitation counseling that were obtained by Leahy et al. (2009) fall within the six-factor solution of the current study. In contrast, Millet and Vaittinen (2011) in Sweden found only the existence of three factors for knowledge domains, which was attributed to the limitation in scope and depth of the Swedish rehabilitation process. Millet and Vaittinen have suggested that the lack of independent, distinct factors in their study was due to the fact that compared with U.S., the Swedish system was based on a whole team, rather than on a specific professional profile with a “multifaceted role.” In this study, even though the Kuwait service delivery model appeared more similar to the Swedish model, the six-factor knowledge domains solution was more consistent with the knowledge domain structure identified by Leahy et al. (2003) regarding rehabilitation counseling practice in the United States.

The researchers also conducted an analysis with regard to demographic factors associated with the need for training. The results of the current study revealed that the combination of three predictors (years of experience, job title category, and qualification) was associated with the variance in training needs scores. This finding indicates that with preservice training, increased experience and subsequent promotion within an agency were linked to individuals endorsing less of a need for training than their novice peers with training in certain areas.

Knowledge Domains With High Training Needs

The results indicated a lack of preparation in all the knowledge domains in the KVI-A. The factors containing the greatest number of critical training needs for the entire sample were the assessment and career counseling factor with 20 knowledge items, and the counseling theories, technique, and applications factor with 13 knowledge items. Further analysis also revealed differences in knowledge domain training needs across specific demographic profiles, with those with less experience, less qualification, and holding trainer/manager job category requiring significantly higher training needs comparatively. According to Szymanski et al. (1993), differences in training needs across demographic characteristics would suggest that these variables be included in human resource development assessment and planning. However, it must be cautioned that in future research that focuses on identification of training needs, apart from evidence obtained through discrepancy scores, other contextual factors such as role and responsibilities, and work settings need to be considered to provide a more comprehensive picture of the need of training. Interpretation of training needs based solely on discrepancy between perceived importance and preparedness of the KVI-A would be limited.

Implication of the Study

The first implication of the study is that there is now a KVI-A and the KVI-A can be considered valid and reliable for use in the determination of knowledge domain importance, preparedness, and training needs of vocational rehabilitation service providers in Arab countries. The current validation focused on service providers in Kuwait. However, the similarity of language and culture across the Arab region lends credence to the generalizability of the KVI-A in this region. The KVI-A fills a void in the lack of rehabilitation measurement tools in the Middle East.

The knowledge domains identified in this research can be used as a blueprint to develop a vocational rehabilitation curriculum and certification credentials for Kuwait and other countries in the Arab region. Preservice and in-service curriculum training can be formalized using the knowledge domain areas obtained from this research to meet the needs of vocational rehabilitation service providers consistent with suggestions by Leahy et al. (2009) to utilize research on knowledge domains to evaluate, update, and revise vocational rehabilitation counseling training.

Another practical implication relates to future training of personnel by a school or an agency. As service providers develop trainings to address needs, particularly for new hires who hold degrees in areas unrelated to working with persons with disabilities, the training can be designed according to developmental demographic profiles. The ability to differentiate training specific to demographic profiles along a continuum will allow for increased efficiency in training and eventually practice. Therefore, the findings from this research lend credence to the need to view education and training in vocational rehabilitation from a developmental perspective as suggested by Chan et al. (2003). In addition to the developmental perspective, the specific profile-to-knowledge domain training needs also suggest that training can be differentiated into core courses to be taken by all service providers at an agency along with additional electives for continuing education and specialization based on individual needs.

Finally, in terms of knowledge base on vocational rehabilitation, this research has contributed empirical evidence on the content and construct validity of knowledge domains required for the vocational rehabilitation profession. It would appear that the knowledge domain constructs from previous research in the United States can be generalized to different environments, regardless of differences in language, culture, and service delivery option. This implies that training curriculum and credentials derived from KVI-R (Leahy et al., 2009), such as the Certified Rehabilitation Counselor Examination by CRCC, may be adaptable for adoption by the vocational rehabilitation providers in the Arab region and other areas seeking to increase the professionalism and quality of services provided to persons with disabilities.

Footnotes

Appendix

Appendix B

Factor Loading Matrix for Six-Factor Solution Based on a Principal Component Analysis With Varimax Rotation for 73 Items From Knowledge Validation Inventory: Rotated Component Matrix

	Component
	1	2	3	4	5	6
Work conditioning or work hardening resources and strategies.	.830
The workplace culture, environment, and business terminology.	.717
Job analysis.	.709
Employer development for job placement.	.700
Interpretation of assessment results for vocational rehabilitation planning purposes.	.700
Program evaluation procedures for assessing the effectiveness of vocational rehabilitation services and outcomes.	.672
Ergonomics, job accommodations, and assistive technology.	.670
Marketing strategies and techniques for rehabilitation services.	.662
Consultation process with employers related to management of disability issues in the workplace.	.660
Job modification and restructuring techniques.	.658
Occupational and labor market information.	.657
Theories of career development and work adjustment.	.656
Computer-based and online assessment tools.	.653
Vocational implications of functional limitations associated with disabilities.	.639
Transferable skills analysis.	.635
The tests and evaluation techniques available for assessing clients’ needs.	.632
Internet-based rehabilitation counseling tools and resources.	.607
Job readiness including seeking and retention skills development.	.598
Job placement and job development strategies.	.586
Workers’ compensation laws and practices.	.416
Vocational rehabilitation research methods and statistics.
Human resource practices, diversity in the workplace, and workplace supports for people with disabilities.		.791
Advocacy processes needed to address institutional and social barriers that impede access, equity, and success for clients.		.785
Demand-side employment issues related to hiring, return to work, and retention.		.780
Programs and services for specialty populations (e.g., school-to-work transition, spinal cord injury, traumatic brain injury, intellectual disabilities, developmental disability).		.764
Credentialing issues related to the vocational rehabilitation counseling profession.		.756
Services available from one-stop career centers.		.752
Dual diagnosis and the workplace.		.745
Supported employment strategies and services.		.730
School to work transition for students with disabilities.		.701
Social Security programs, benefits, work incentives, and disincentives.		.667
Financial resources for vocational rehabilitation services.		.664
Independent living services.		.658
Community resources and services for vocational rehabilitation planning.		.657
Organizational structure of the public and private vocational rehabilitation service delivery systems.		.656
Establishing and maintaining effective working alliances with the clients we serve.		.638
Individual counseling theories.			.713
Behavior and personality theory.			.707
Treatment planning for clinical problems (e.g., depression and anxiety).			.685
Family counseling practices and interventions.			.674
Rehabilitation techniques for individuals with psychological disabilities.			.670
Individual counseling practices and interventions.			.669
Family counseling theories.			.668
Diversity and multicultural counseling issues.			.629
Health promotion and wellness concepts and strategies for people with chronic illness and disability.			.627
Human growth and development.			.543
Human sexuality and disability issues.			.534			.421
Evidence-based practice and research utilization.			.519
Societal issues, trends, and developments as they relate to vocational rehabilitation.			.444
Historical and philosophical foundations of rehabilitation.
The functional capacities of individuals with disabilities.				.778
Medical aspects and implications of various disabilities.				.756
Rehabilitation terminology and concepts.				.754
The psychosocial and cultural impact of disability on the individual and his family.				.752
Educating employers on disability-related issues (e.g., compliance/disability law).				.740
Implications of medications as they apply to individuals with disabilities.				.709
Environmental and attitudinal barriers for individuals with disabilities.				.692
Risk management and professional ethical standards for rehabilitation counselors.				.677
Laws and public policy affecting individuals with disabilities.				.592
Health care benefits and delivery systems.
Case management process and tools.					.676
Negotiation, mediation, and conflict resolution strategies.					.628
Clinical problem-solving and critical-thinking skills.					.621
The case management process, including case finding, planning, service coordination, referral to and utilization of other disciplines, and client advocacy.					.602
Case recording and documentation.					.567
Principles of caseload management.					.516
Professional roles, functions, and relationships with other human service providers.					.467
The services available for a variety of rehabilitation populations, including persons with multiple disabilities.
Appropriate medical intervention resources.
Techniques for working effectively in teams and across disciplines.						.697
Ethical decision-making models and processes.						.642
Disability prevention and management strategies.						.615
Vocational rehabilitation research literature related to evidence-based practice.

Note. Extraction method: principal component analysis. Rotation method: varimax with Kaiser normalization. Rotation converged in seven iterations.

Authors’ Note

This research project has been supported with permission from the Commission on Rehabilitation Counselor Certification (CRCC) to adapt the Knowledge Validation Inventory–Revised (KVI-R), subject to a caveat of explicit and detailed disclosure on potential external validity problems in interpreting the results due to differences in the original norming group and the current sample.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

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