Reliability and Validity of the Clinical Competency Scale for Nursing Students

Bo Young Kim; Myeong Jeong Chae; Yun Ok Choi

doi:10.12799/jkachn.2018.29.2.220

Journal List > J Korean Acad Community Health Nurs > v.29(2) > 1100764

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kim, Chae, and Choi: Reliability and Validity of the Clinical Competency Scale for Nursing Students

Original Article

J Korean Acad Community Health Nurs 2018;29(2):220-230.

Published online: 12 June 2018

DOI: https://doi.org/10.12799/jkachn.2018.29.2.220

Reliability and Validity of the Clinical Competency Scale for Nursing Students

Bo Young Kim¹, Myeong Jeong Chae², Yun Ok Choi³

¹College of Nursing · Institute of Health Sciences, Gyeongsang National University, Jinju, Korea

²Department of Nursing, Kwangju Women’s University, Gwangju, Korea

³Department of Nursing, Graduate School, Yonsei University, Seoul, Korea

Corresponding author: Choi, Yun Ok College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Tel: +82-2-2228-3279, Fax: +82-2-393-2808, E-mail: miffyliker@naver.com

Received 30 January 2018 Revised 10 May 2018 Accepted 11 May 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was conducted to evaluate clinical competency of nursing students and to examine the validity and reliability of the scale.

Methods

The Clinical Competency Scale was formed through modification of Lee's Clinical Competency Scale that was originally developed in 1990. The Clinical Competency Scale was applied to 203 nursing students. Construct validity, item convergent and discriminant validity, concurrent validity, and internal consistency reliability of the scale were evaluated.

Results

Exploratory factor analysis supported the construct validity with a five factor solution; that explained 63.6% of the total variance. Concurrent validity was demonstrated with the Nursing Competence Scale (r=.78, p<.001). Cronbach’s ⍺ coefficient for the scale was .96.

Conclusion

The results of this study suggest that the Clinical Competency Scale has relatively acceptable reliability and validity and can be used in clinical research to assess clinical competency for nursing students.

Keywords: Students, Nursing, Clinical competency, Psychometrics

References

1. Lee CH, Sung YH, Jung YY, Kim JS. Analysis of nursing care activities of nursing students in clinical experience. The Journal of Korean Academic Society of Nursing Education. 1998; 4(2):249–263.

2. Korean Accreditation Board of Nursing Education. Accreditation manual of nursing education [Internet]. Seoul: Korean Accreditation Board of Nursing Education;2017. [cited 2018 June 1] Available from:. http://www.kabone.or.kr/HyAdmin/upload/filelinkFile/%A1%DA%B0%A3%C8%A3%B1%B3%C0%B0%C0%CE%C1%F5%C6%F2%B0%A1%20%B1%E2%C1%D8%C1%FD_%C8%A8%C6%E4%C0%CC%C1%F6%20%B0%D4%BD%C3(2017.3).pdf.

3. Song KA, Park HJ, Yeom HA, Lee JE, Joo GE, Kim HJ. The development and evaluation of a new educational program, introduction to clinical nursing, for third year nursing students. Journal of Korean Academy of Fundamentals of Nursing. 2012; 19(3):322–333. https://doi.org/10.7739/jkafn.2012.19.3.322.

4. Lee OS, Gu MO. The relationship between emotional intelligence and communication skill, clinical competence & clinical practice stress in nursing students. Journal of the Korea Academia-Industrial cooperation Society. 2013; 14(6):2749–2759. https://doi.org/10.5762/KAIS.2013.14.6.2749.

5. Campbell B, Mackay G. Continuing competence: an Ontario nursing regulatory program that supports nurses and employers. Nursing Administration Quarterly. 2001; 25(2):22–30.

6. Byeon YS, Lim NY, Kang KS, Sung MS, Won JS, Ko IS, et al. Clinical nursing competency for new graduate nurses: A grounded theory approach. Journal of Korean Academy of Fundamentals of Nursing. 2003; 10(1):47–56.

7. Lee WH, Kim CJ, Yoo JS, Hur HK, Kim KS, Lim SM. Development of a clinical competency measurement tool for student. Yonsei Nursing. 1990; 13:17–29.

8. Kim JY, Kim MK, Cho JY. The mediating effect of the resilience on the relationship between stress in clinical practice and clinical competence in nursing students. Journal of the Korea Academia-Industrial cooperation Society. 2017; 18(1):669–678. https://doi.org/10.5762/KAIS.2017.18.1.669.

9. Choi MS. A study on the relationship between teaching effectiveness of clinical nursing education and clinical competency in nursing students [master's thesis]. [Seoul]: Ewha Womans University;2005. p. 79.

10. Schwirian PM. Evaluating the performance of nurses: a multidimensional approach. Nursing Research. 1978; 27(6):347–351.

11. DeBack V, Mentkowski M. Does the baccalaureate make a difference?: differentiating nurse performance by education and experience. Journal of Nursing Education. 1986; 25(7):275–285. https://doi.org/10.3928/0148-4834-19860901-05.

12. Rosenberg M. Self esteem scale. Ward MJ, Fettler ME, editors. Instruments for use in nursing education research. Boulder, Colorado: Western interstate commission for higher education;1979. p. 169–170.

13. Park JW, Kim CJ, Kim YS, Yoo MS, Yoo H, Chae S, et al. Impact of critical thinking disposition, general self-efficacy, and leadership on clinical competence in nursing students. Korean Journal of Medicine Education. 2012; 24(3):223–231. https://doi.org/10.3946/kjme.2012.24.3.223.

14. Shin KA, Cho BH. Professional self-concept, critical thinking disposition and clinical competence in nursing students. Journal of Korean Academy of Fundamentals of Nursing. 2012; 19(1):46–56. https://doi.org/10.7739/jkafn.2012.19.1.046.

15. Coates C. The evolution of measuring caring: moving toward construct validity. Watson J., editorAssessing and measur- ing caring in nursing and health science. 2nd ed. New York, NY: Springer Publishing;2009. p. 163–170.

16. Joo GE, Sohng KY. Development of nursing competence scale for graduating nursing students. Journal of Korean Public Health Nursing. 2014; 28(3):590–604. https://doi.org/10.5932/JKPHN.2014.28.3.590.

17. Martin JH, Kinnick VL, Hummel F, Clukey L, Baird SC. Developing outcome assessment methods. Nurse Educator. 1997; 22(6):35–40.

18. Webber PB. A curriculum framework for nursing. Journal of Nursing Education. 2002; 41(1):15–24. https://doi.org/10.3928/0148-4834-20020101-05.

19. Lenburg CB. The framework, concepts and methods of the competency outcomes and performance assessment (COPA) model. The Online Journal of Issues in Nursing. 1999; 4(2):1–12.

20. Polit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? appraisal and recommendations. Research in Nursing and Health. 2007; 30(4):459–467. https://doi.org/10.1002/nur.20199.

21. Field AP. Discovering statistics using IBM SPSS statistics. 4th ed. London, UK: Sage;2013. p. 952.

22. Fayers PM, Machin D. Quality of life: The assessment, analysis and reporting of patient-reported outcomes. 3rd ed. Chichester, UK: John Wiley & Sons;2015. p. 648.

23. Kim JS, Kim YM, Jang KS, Kim BN, Jeong SH. Concept analysis of nursing leadership. Journal of Korean Academy of Nursing Administration. 2015; 21(5):575–586. https://doi.org/10.11111/jkana.2015.21.5.575.

24. Choi AS, Oh PJ. A study on self-leadership, fall attitude, and nurses' behavior to prevent patient falls. Journal of Korean Academy of Nursing Administration. 2013; 19(3):394–403. https://doi.org/10.11111/jkana.2013.19.3.394.

25. Sung MH. Factors influencing the professional self-concept among nursing students. Journal of East-West Nursing Research. 2012; 18(1):18–24.

26. Lee I, Park CS. Factors influencing confidence in performance competence of core basic nursing skills by nursing students. Journal of Korean Academy of Fundamentals of Nursing. 2015; 22(3):297–307. https://doi.org/10.7739/jkafn.2015.22.3.297.

27. Kim KY, Lee E. The relationship among critical thinking disposition, nursing process competency and evidence-based practice competency in nurses working in hospitals. Journal of the Korean Data and Information Science Society. 2016; 27(2):451–461. https://doi.org/10.7465/jkdi.2016.27.2.451.

28. Song HS, Moon MY. Effects of critical thinking promoting nursing process education on critical thinking disposition and problem solving ability of nursing students. The Journal of Learner-Centered Curriculum and Instruction. 2017; 17:445–462. https://doi.org/10.22251/jlcci.2017.17.5.445.

29. Shin SH, Park H. Development and validation of the empowerment scale for woman with breast cancer. Journal of Korean Academy of Nursing. 2015; 45(4):613–624. https://doi.org/10.4040/jkan.2015.45.4.613.

30. Jang KS, Kim BN, Jeong SH, Kim YM, Kim JS. A study on evaluation system for nursing bachelor degree program outcomes: focus on improvement in nursing leadership ability. Journal of Korean Academy of Nursing Administration. 2016; 22(5):540–552. https://doi.org/10.11111/jkana.2016.22.5.540.

Table 1.

Comparison of Subcategories for Clinical Competency

Subcategories	Korean accreditation board manual of nursing education [2]	Six-dimension scale of nursing performance (Six-D Scale) [10]	Nursing competence [16]	Outcome assessment [17]	Framework for nursing [18]	Competency outcomes and performance assesment (COPA) model [19]
Nursing process	O	O		O	O	O
Nursing skills	O		O	O	O
Communication	O	O	O	O	O	O
Management			O			O
Leadership	O	O	O		O	O
Coordinating	O				O
Teaching		O			O	O
Professional development	O	O	O		O
Interpersonal relationships	O	O	O		O	O
Critical thinking	O		O	O	O	O

Table 2.

Demographic Characteristics of Participants(N=203)

Characteristics	Categories	n (%) or M±SD
Age (year)		23.57±4.11
Gender	Female	192 (94.6)
	Male	11 (5.4)
Academic	High grades	14 (6.9)
achievement	Upper middle grades	46 (22.7)
	Middle grades	109 (53.7)
	Low grades	34 (16.8)
Satisfaction on	Dissatisfied	24 (11.8)
college life	Moderate	120 (59.1)
	Satisfied	49 (24.1)
	Very satisfied	10 (4.9)
Stress on	Not at all	5 (2.5)
college life	Moderate	67 (33.0)
	Somewhat	85 (41.9)
	A lot	46 (22.7)

Table 3.

Factor Analysis of Clinical Competency Scale (N=203)

Factors		Items	M±SD	Factor loading
Factors		Items	M±SD	F1	F2	F3	F4	F5
Nursing leadership	Item 22	I inform the patient's family of the patient's needs and encourage the family to take therapeutic care for the patient's care.	3.58±0.67	.70	.27	.22	.15	.23
	Item 27	I help patients identify and improve your poor health habits.	3.64±0.63	.67	.04	.12	.33	.16
	Item 26	I recognize the importance and necessity of regular health screenings.	3.73±0.65	.66	.09	-.03	.38	.09
	Item 25	I educate patients and families on disease prevention.	3.71±0.65	.64	.17	.06	.28	.29
	Item 16	I make a safe therapeutic environment	3.68±0.63	.63	.33	.29	.17	.21
	Item 23	I educate patients to identify patients' self-care skills and use them in the treatment process.	3.42±0.76	.61	.32	.31	.13	.30
	Item 28	I provide the necessary information for self-care after discharge.	3.67±0.67	.61	.16	.13	.38	.21
	Item 19	I acknowledge the nursing performed by the nurses and increase the morale.	3.32±0.75	.60	.33	.46	.11	.12
	Item 21	I assess the nursing activities performed for the patient.	3.38±0.80	.59	.33	.36	.13	.19
	Item 20	I observe that the patient's treatment plan is well implemented.	3.25±0.88	.59	.43	.38	.04	.14
	Item 24	I explain to the family about the patient's treatment process and participate the family in patient care.	3.74±0.71	.58	.24	.10	.26	.24
	Item 17	I consult with other health care providers when planning nursing care.	3.67±0.73	.51	.34	.28	.10	.21
Professional development	Item 41	I am responsible for my actions.	3.68±0.72	.32	.75	.01	.20	.18
	Item 40	I am committed to patient care with confidence and a positive attitude.	3.77±0.70	.32	.69	.23	.09	.12
	Item 44	I solve problems that can not be solved by myself with the advice of a clinical supervisor and a professional nurse.	3.62±0.67	.21	.67	.06	.36	.17
	Item 42	I have legal and ethical knowledge of nursing.	3.76±0.69	.19	.63	.10	.31	.22
	Item 45	I accept and promote new ideas in nursing practice.	3.68±0.66	.12	.58	.19	.38	.28
Nursing skills	Item 15	I know and use the principles and the use of machines and devices used in the treatment of patients.	3.73±0.67	.19	-.02	.77	.20	.16
	Item 14	I know the priority of treatment in emergency situations in clinical practice and perform it proficiently.	3.74±0.66	.13	.17	.75	.12	.20
	Item 13	I record the record of nursing activity performed by the patient in a scientific vocabulary.	3.83±0.66	.09	.14	.74	.06	.25
	Item 9	I understand the basic principles of doctor's prescription and implement it promptly and accurately.	3.70±0.67	.24	.11	.64	.14	.27
	Item 11	I perform patient preparation and nursing before and after the examination or treatment.	3.81±0.66	.36	.20	.46	.24	.31
Communication	Item 32	I try to understand, understand, and give the necessary help to the individual aspects of the patient (ex. religion, habits, tastes).	3.67±0.76	.30	.21	.15	.74	.01
	Item 31	I communicate with the patient and create an atmosphere that expresses fear and anxiety.	3.67±0.80	.18	.15	.11	.72	.18
	Item 33	I take every nursing procedure as an opportunity to interact with the patient.	3.68±0.70	.33	.32	.15	.58	.15
	Item 34	I try to meet the emotional needs of the patient.	3.76±0.68	.30	.49	.09	.53	.15
	Item 30	I fully explain purpose, sequence and method before examination, treatment, and nursing treatment.	3.84±0.66	.38	.29	.23	.52	.15
	Item 35	I acquire the desirable human relationship with the medical person and enhance the ability as mediator and leader.	3.63±0.72	.25	.46	.29	.51	.12
	Item 43	I accept and improve constructive criticism.	3.84±0.71	.17	.46	.14	.50	.20
Nursing process	Item 4 Item 5	I plan nursing care according to nursing diagnosis. I make problem identification and nursing diagnosis.	3.88±0.68 3.78±0.74	.28 .15	.20 .23	.18 .31	.16 .16	.75 .72
	Item 3	I analyze meaningful data.	3.70±0.71	.23	.13	.27	.09	.70
	Item 6	I plan nursing care according to the patient's condition.	3.82±0.68	.27	.20	.34	.10	.67
	Item 7	I plan nursing care to meet family needs and patient needs.	3.70±0.72	.41	.22	.23	.25	.58
Eigen value				15.51	2.35	1.47	1.19	1.10
Explained variance (%)				45.6	6.9	4.3	3.5	3.3
Accumulative variance (%)				45.6	52.6	56.9	60.4	63.6
Kaiser-Meyer-OIkin (KMO)=.94; Bartlett's test of sphericity x²=6,638.14 (p＜.001)
Cronbach's ⍺				.93	.86	.84	.89	.88
Total Cronbach's ⍺=.96

Table 4.

Multi-trait/Multi-item Matrix Analysis (N=203)

Factors	Items	F1	F2	F3	F4	F5	2 Standard error
Factors	Items	r	r	r	r	r	2 Standard error
Nursing	22	.82	.55	.50	.57	.58	.17
leadership	27	.71	.46	.41	.52	.46	.27
	26	.68	.45	.30	.53	.37	.22
	25	.74	.53	.42	.55	.51	.17
	16	.82	.59	.53	.61	.58	.16
	23	.80	.59	.58	.60	.63	.22
	28	.75	.52	.42	.62	.52	.20
	19	.80	.56	.62	.57	.56	.16
	21	.79	.55	.54	.58	.58	.19
	20	.78	.58	.55	.58	.56	.23
	24	.72	.53	.41	.57	.49	.29
	17	.71	.53	.48	.54	.53	.28
Professional	41	.60	.84	.33	.62	.46	.23
development	40	.60	.80	.44	.58	.48	.18
	44	.57	.83	.36	.67	.44	.27
	42	.54	.78	.38	.60	.47	.24
	45	.55	.78	.43	.72	.52	.38
Nursing skills	15	.46	.31	.82	.39	.47	.28
	14	.48	.41	.82	.41	.51	.28
	13	.43	.35	.79	.34	.50	.27
	9	.52	.37	.78	.43	.56	.23
	11	.62	.48	.71	.53	.59	.23
Communication	32	.55	.53	.35	.79	.37	.36
	31	.48	.48	.33	.75	.41	.19
	33	.60	.58	.41	.79	.48	.17
	34	.61	.67	.38	.80	.48	.27
	30	.64	.58	.46	.77	.49	.15
	35	.62	.66	.49	.79	.49	.25
	43	.52	.63	.39	.64	.45	.25
Nursing process	4	.58	.50	.52	.49	.84	.16
	5	.53	.49	.56	.50	.84	.22
	3	.52	.41	.52	.42	.80	.15
	6	.58	.51	.59	.47	.84	.15
	7	.68	.55	.56	.59	.81	.17

Table 5.

Correlations between Clinical Competency Scale and Nursing Competence Scale (N=203)

Variables	Nursing competence scale
	Total	NP	INCT	CS	NL	RL	SM	NR	CNS
	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)
Clinical competency	.78	.60	.72	.68	.67	.53	.67	.57	.56
scale	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)
Nursing leadership	.72	.56	.67	.65	.60	.49	.66	.45	.52
	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)
Professional	.71	.61	.64	.64	.57	.53	.60	.49	.48
development	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)
Nursing skills	.51	.27	.50	.38	.45	.38	.42	.44	.42
	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)
Communication	.72	.55	.63	.62	.65	.46	.57	.57	.55
	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)
Nursing process	.64	.51	.63	.53	.55	.38	.51	.50	.40
	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)

NP=nursing professionalism; INCT=integrated nursing through critical thinking; CS=communication skills; NL=nursing leadership; RL=respect of life; SM=stress management; NR=nursing research; CNS=core nursing skills.

TOOLS

Similar articles