用于评估护理临床推理的脚本一致性测试的开发：关于结构效度的经验教训。

Development of script concordance test for assessment of clinical reasoning in nursing: Lessons learned regarding construct validity.

作者信息

Habes E V, Kolk J E M, Van Brunschot M F M, Bouwes A

机构信息

Institute of Nursing Studies, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands.

Vakbekwaamheid in Zicht, Oisterwijk, the Netherlands.

出版信息

Heliyon. 2024 Jul 24;10(15):e35151. doi: 10.1016/j.heliyon.2024.e35151. eCollection 2024 Aug 15.

DOI:10.1016/j.heliyon.2024.e35151

PMID:39161805

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11332874/

Abstract

BACKGROUND

The script concordance test (SCT) has been shown to be an effective tool to assess the clinical reasoning skills of nursing students. Various nursing studies have demonstrated the construct validity of this test. However, studies on the barriers that may impede construct validity during the development process are limited.

OBJECTIVE

This evaluation describes the barriers to the development of SCT for Bachelor's nursing students and the lessons learned regarding construct validity.

METHODS

We conducted a descriptive evaluation of the SCT development and a validation process was performed. The evaluation was based on written comments during the assessment ( = 327), a Student's Perspective Questionnaire ( = 100), and student feedback during three live review sessions ( = 27).

RESULTS

Despite consideration of the guidelines during SCT development, we encountered three main barriers that may impede construct validity. We undertook the necessary efforts to recruit an appropriate expert panel. We overestimated the experts' and students' understanding of the SCT methodology. Additionally, four potential causes of invalid item construction were identified. These possible causes were 'questionable intervention, hypothesis, or investigation', 'blurred data in new information', 'regression to the middle', and 'misinterpretation of the midpoint'.

CONCLUSION

The three lessons learned are as follows: 1) The recruitment of an appropriate expert panel must not be underestimated. Besides clinical expertise, experts need training in SCT methodology, including awareness of possible pitfalls; 2) SCT training is a prerequisite for SCT as an assessment; and 3) student feedback may offer a deeper understanding of potential hidden script errors and causes for misinterpretation of SCT. Further studies are necessary to identify additional causes which may impede the construct validity of SCT in nursing education.

摘要

背景

脚本一致性测试（SCT）已被证明是评估护生临床推理能力的有效工具。多项护理研究已证实该测试的结构效度。然而，关于在开发过程中可能阻碍结构效度的障碍的研究有限。

目的

本评估描述了本科护生SCT开发过程中的障碍以及在结构效度方面吸取的经验教训。

方法

我们对SCT开发进行了描述性评估，并进行了验证过程。评估基于评估期间的书面评论（n = 327）、学生视角问卷（n = 100）以及三次现场评审会议期间的学生反馈（n = 27）。

结果

尽管在SCT开发过程中考虑了指导方针，但我们遇到了三个可能阻碍结构效度的主要障碍。我们努力招募了合适的专家小组。我们高估了专家和学生对SCT方法的理解。此外，还确定了无效项目构建的四个潜在原因。这些可能的原因是“可疑的干预、假设或调查”、“新信息中的数据模糊”、“向中间回归”以及“对中点的错误解释”。

结论

吸取的三个经验教训如下：1）绝不能低估招募合适专家小组的重要性。除了临床专业知识外，专家还需要接受SCT方法的培训，包括对可能陷阱的认识；2）SCT培训是将SCT用作评估的前提条件；3）学生反馈可能有助于更深入地理解潜在的隐藏脚本错误以及SCT误解的原因。有必要进行进一步研究，以确定可能阻碍护理教育中SCT结构效度的其他原因。