文化适应和验证 Lasater 临床判断量表在西班牙护理学生中的应用。
Cultural adaptation and validation of the Lasater Clinical Judgment Rubric in nursing students in Spain.
机构信息
Primary Health Care Centre Victoria, District of Primary Health Care of Málaga, Spain; Faculty of Health Sciences, Department of Nursing, University of Malaga, Spain.
Faculty of Health Sciences, Department of Nursing, University of Malaga, Spain.
出版信息
Nurse Educ Today. 2018 May;64:71-78. doi: 10.1016/j.nedt.2018.02.002. Epub 2018 Feb 9.
BACKGROUND
The clinical judgment and decision-making abilities of nurses can influence many health outcomes, hence the importance of addressing these qualities in university studies. In this respect, clinical simulation is a commonly employed teaching method. The evaluation of simulation activities requires standardised instruments, such as the Lasater Clinical Judgment Rubric, which is widely used for this purpose, although a culturally adapted and validated version in Spain is not available.
AIMS
To obtain a Spanish culturally adapted and validated version of the rubric for undergraduate students of nursing.
DESIGN, PARTICIPANTS AND SETTING: Cultural adaptation and psychometric validation study carried out with undergraduate nursing students in the simulation laboratories at the University of Málaga (Spain).
METHODS
A process of translation/back-translation and cultural adaptation was carried out in accordance with international standards. The rubric was empirically evaluated in standardised scenarios with high and medium-fidelity simulators. Each student took part in two different simulation sessions, led by two instructors. In each simulation, the data were collected by two independent observers.
RESULTS
152 observations were obtained from 76 students. The interobserver reliability was high, with an intraclass correlation coefficient of 0.93 (95% CI 0.92-0.95) (p = 0.0001) and Cronbach's alpha of 0.93. According to the confirmatory factor analysis, the fit of the model was satisfactory in all indices, with a χ/df value of 1.08, GFI 0.96, TLI 0.99, NFI 0.97 and RMSEA 0.24 (90% CI 0.000-0.066).
CONCLUSIONS
The rubric obtained is culturally adapted to the Spanish educational context, and is valid and reliable for nursing students. Further prospective studies should be undertaken to evaluate the responsiveness, potential for transfer to clinical practice and cost-benefit ratios of different simulation designs.
背景
护士的临床判断和决策能力会影响许多健康结果，因此在大学学习中重视这些素质非常重要。在这方面，临床模拟是一种常用的教学方法。模拟活动的评估需要使用标准化的工具，例如 Lasater 临床判断量表，该量表广泛用于此目的，尽管西班牙没有经过文化适应性和验证的版本。
目的
获得适用于护理专业本科生的 Lasater 临床判断量表的西班牙文化适应性和验证版本。
设计、参与者和设置：在马拉加大学（西班牙）的模拟实验室中，对护理专业本科生进行文化适应性和心理测量学验证研究。
方法
根据国际标准进行翻译/回译和文化适应性调整。该量表在具有高和中逼真度模拟器的标准化场景中进行了实证评估。每位学生参加了由两位讲师领导的两个不同的模拟课程。在每个模拟中，由两位独立观察员收集数据。
结果
从 76 名学生中获得了 152 次观察结果。观察者间的可靠性很高，组内相关系数为 0.93（95%CI 0.92-0.95）（p=0.0001），Cronbach's alpha 为 0.93。根据验证性因子分析，模型在所有指标中的拟合度均令人满意，χ/df 值为 1.08，GFI 为 0.96，TLI 为 0.99，NFI 为 0.97，RMSEA 为 0.24（90%CI 0.000-0.066）。
结论
获得的量表在西班牙教育背景下进行了文化适应性调整，对护理专业学生具有有效性和可靠性。应进一步进行前瞻性研究，以评估不同模拟设计的反应性、潜在的临床应用转移能力和成本效益比。
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