Determining the Validity and Revision of the Neurological and Mental Illnesses Part of the Medical Exemption Regulation

 The high transparency and validity of the Medical Exemption Regulations can improve the unity of the procedure. The aim of this study was to determine the validity and revision of the neurological and mental illnesses part of the medical exemption regulation for 2021.

 A qualitative study with the classical Delphi technique approach was performed in three rounds. The first round consisted of interviews and focus group discussions to extract the flaws and ambiguities of the existing regulation. In the second round, the face and content validity of the amended regulations were assessed based on the opinions of experts, and in the third round, the opinions of experts were assessed to investigate the agreement on the final regulations. The study population consisted of psychiatrists, conscientious objectors, and medical doctors with experience in attending medical commissions.

 Thirty-two specialists participated in at least one round of the study. The mean age and experience of their presence in medical commissions were 47.9 ± 5.8 and 10.7 ± 5.5 years, respectively. In the first round, a total of 62 initial codes were extracted. The regulation document, including 15 clauses and 27 sub-categories, was provided to the participants to assess the content validity (second round) and the content validity index (CVI), and the content validity ratio (CVR) for the neurological and mental illnesses part of the medical exemption regulation were 84.87 and 61.1, respectively. The final version of regulations with 14 clauses and 25 sub-categories was provided to the experts to assess the agreement, and the mean agreement for the neurological and mental illnesses part of the medical exemption regulation was 84.8.

 The revised regulation can be used as an alternative to the existing regulation. Utilizing the opinions of a large number of experts during different rounds and using different approaches has increased the validity of the findings and provided reliable results.