Wu Xi Vivien, Enskär Karin, Pua Lay Hoon, Heng Doreen Gek Noi, Wang Wenru
Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11, 10 Medical Drive, Singapore, 117597, Singapore.
School of Health and Welfare, Jönköping University, Jönköping, Sweden.
BMC Med Educ. 2016 Sep 22;16(1):248. doi: 10.1186/s12909-016-0768-0.
A major focus in nursing education is on the judgement of clinical performance, and it is a complex process due to the diverse nature of nursing practice. A holistic approach in assessment of competency is advocated. Difficulties in the development of valid and reliable assessment measures in nursing competency have resulted in the development of assessment instruments with an increase in face and content validity, but few studies have tested these instruments psychometrically. It is essential to develop a holistic assessment tool to meet the needs of the clinical education. The study aims to develop a Holistic Clinical Assessment Tool (HCAT) and test its psychometric properties.
The HCAT was developed based on the systematic literature review and the findings of qualitative studies. An expert panel was invited to evaluate the content validity of the tool. A total of 130 final-year nursing undergraduate students were recruited to evaluate the psychometric properties (i.e. factor structure, internal consistency and test-retest reliability) of the tool.
The HCAT has good content validity with content validity index of .979. The exploratory factor analysis reveals a four-factor structure of the tool. The internal consistency and test-retest reliability of the HCAT are satisfactory with Cronbach alpha ranging from .789 to .965 and Intraclass Correlation Coefficient ranging from .881 to .979 for the four subscales and total scale.
HCAT has the potential to be used as a valid measure to evaluate clinical competence in nursing students, and provide specific and ongoing feedback to enhance the holistic clinical learning experience. In addition, HCAT functions as a tool for self-reflection, peer-assessment and guides preceptors in clinical teaching and assessment.
护理教育的一个主要重点是对临床实践表现的评判，由于护理实践的多样性，这是一个复杂的过程。提倡采用整体方法评估能力。护理能力有效且可靠的评估措施开发存在困难，这导致了评估工具的发展，其表面效度和内容效度有所提高，但很少有研究对这些工具进行心理测量学测试。开发一个整体评估工具以满足临床教育的需求至关重要。本研究旨在开发一种整体临床评估工具（HCAT）并测试其心理测量学特性。
HCAT是基于系统的文献综述和定性研究结果开发的。邀请了一个专家小组来评估该工具的内容效度。共招募了130名护理学本科最后一年的学生来评估该工具的心理测量学特性（即因子结构、内部一致性和重测信度）。
HCAT具有良好的内容效度，内容效度指数为0.979。探索性因子分析揭示了该工具的四因子结构。HCAT的内部一致性和重测信度令人满意，四个分量表和总量表的Cronbach's alpha系数在0.789至0.965之间，组内相关系数在0.881至0.979之间。
HCAT有潜力作为评估护生临床能力的有效工具，并提供具体和持续的反馈以增强整体临床学习体验。此外，HCAT可作为自我反思、同伴评估的工具，并指导临床教师进行临床教学和评估。
