College of Nursing, Brigham Young University, Provo, Utah, USA.
Compassus, Monument, Colorado, USA.
J Adv Nurs. 2022 Nov;78(11):3662-3672. doi: 10.1111/jan.15262. Epub 2022 Apr 20.
To develop and test the Organizational Learning Instrument: Development Stages instrument, a measure of hospital units' readiness to engage in organizational learning.
Cognitive interviewing, expert review and a quantitative, cross-sectional survey.
Item development was informed by previous research on organizational learning. Content validity was assessed and strengthened using cycles of cognitive interviewing and expert review. The resulting instrument was distributed by email to all nurses providing direct patient care in inpatient units in 11 Magnet® hospitals. Data were collected in 2018. Intraclass correlations, using hospital unit as the grouping variable, indicated the need to use multilevel methods to analyse the survey data. Thus, coefficient omega and multilevel confirmatory factor analysis were used to estimate the instrument's reliability and construct validity, respectively.
The Organizational Learning Instrument: Development Stages is a 35-item survey comprised of four scales: Identity & Ownership, Team & Respect, Accountability & Support and Reliability & Sustainability. The expert review yielded scale-level content validity scores from 0.90 to 1.0 and item-level content validity scores from 0.86 to 1.0. Survey participants were 1212 nurses, working in 99 inpatient units, across 11 Magnet® hospitals. Intraclass correlations ranged from 0.113 to 0.158. Coefficient omega reliability for the four scales was 0.981-0.993. Standardized factor loadings for the 35 items were 0.699-0.961, with acceptable model fit statistics (comparative fit index = 0.980, Tucker-Lewis Fit Index = 0.979, and root mean squared error of approximation = 0.060).
These results indicate the instrument meets or exceeds generally accepted criteria for content validity, reliability and construct validity instrument, and is suitable for further use and testing.
Nurse administrators, managers and researchers now have a valid, reliable instrument to better foster and study organizational learning in hospital units. Advances in organizational learning are expected to improve a variety of patient, staff and organizational outcomes in hospital units.
开发和测试组织学习工具：发展阶段工具，这是衡量医院单位准备从事组织学习的一个指标。
认知访谈、专家审查和定量、横断面调查。
项目开发的依据是组织学习的先前研究。使用认知访谈和专家审查的循环来评估和加强内容的有效性。由此产生的工具通过电子邮件分发给 11 家磁铁®医院所有直接为住院病人提供护理的护士。数据于 2018 年收集。使用医院单位作为分组变量的组内相关系数表明，需要使用多层次方法来分析调查数据。因此，使用 omega 系数和多层次验证性因素分析分别估计工具的可靠性和结构有效性。
组织学习工具：发展阶段是一个由 35 个项目组成的调查，包括四个尺度：身份与所有权、团队与尊重、责任与支持以及可靠性与可持续性。专家审查得出的尺度水平内容有效性分数为 0.90 到 1.0，项目水平内容有效性分数为 0.86 到 1.0。调查参与者为 1212 名护士，分布在 11 家磁铁®医院的 99 个住院病房。组内相关系数范围为 0.113 到 0.158。四个尺度的 omega 可靠性为 0.981-0.993。35 个项目的标准化因子负荷为 0.699-0.961，具有可接受的模型拟合统计数据（比较拟合指数=0.980，塔克-刘易斯拟合指数=0.979，均方根误差逼近=0.060）。
这些结果表明，该工具符合或超过了内容有效性、可靠性和结构有效性工具的一般接受标准，适合进一步使用和测试。
护士管理人员、经理和研究人员现在有了一个有效的、可靠的工具，以更好地促进和研究医院单位的组织学习。预计组织学习的进步将改善医院单位的各种病人、员工和组织结果。
