Journal List > J Korean Acad Nurs > v.48(4) > 1108854

J Korean Acad Nurs. 2018 Aug;48(4):419-431. Korean.
Published online Aug 31, 2018.
© 2018 Korean Society of Nursing Science
Development and Psychometric Testing of the Clinical Nursing Competency Scale for Clinical Preceptor Use (CNCS-CP)
Eunmi Kwak,1 and Heeyoung Oh2
1Department of Nursing, Gyeongbuk College of Health, Gimcheon, Korea.
2College of Nursing, Eulji University, Daejeon, Korea.

Address reprint requests to : Oh, Heeyoung. College of Nursing, Eulji University, 77 Gyeryong-ro, 771beon-gil, Jung-gu, Daejeon 34824, Korea. Tel: +82-42-259-1713, Fax: +82-42-259-1709, Email:
Received Mar 12, 2018; Revised Jun 29, 2018; Accepted Jun 29, 2018.

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. ( If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.



The purpose of this study was to develop and establish the psychometric properties of a clinical nursing competency evaluation tool to be utilized by clinical preceptors.


The initial items were identified through in-depth literature review and field interviews based on a hybrid model. Content validation of the items was evaluated through three rounds of content validity testing. Participants were 34 clinical preceptors and 443 nursing students participating in clinical practice. Data were analyzed using exploratory and confirmatory factor analysis, convergence and discriminant validity, internal consistency and inter-rater reliability.


The final scale consisted of 23 items and four factors, fundamental nursing skills performance, critical thinking skills based on the nursing process, basic nursing knowledge, and professional attitude; these factor explained 69.7% of the total variance. The analysis with multi-trait/multi-item matrix correlation coefficients yielded 100.0% and 95.7 % convergence and discriminant validity, respectively. Cronbach's alpha for the total items was .95. The four subscale model tested by confirmatory factor analysis was satisfactory. Inter-rater reliability ranged from .912 to .967.


This scale was found to be a reliable and valid instrument that clinical preceptors can apply for evaluating the clinical nursing competency of nursing students in clinical settings.

Keywords: Clinical competence; Students; Nursing; Reproducibility of results



Table 1
Exploratory Factor Analysis and Reliability (N=205)
Click for larger imageClick for full table

Table 2
Multi-Trait/Multi-Item Matrix Analysis (N=205)
Click for larger imageClick for full tableDownload as Excel file

Table 4
Summary of Fit Indices from Confirmatory Factor Analysis (N=238)
Click for larger imageClick for full tableDownload as Excel file


This manuscript is a condensed form of the first author's doctoral dissertation from Eulji University. Year of approval 2017.

CONFLICTS OF INTEREST:The authors declared no conflict of interest.


다음은 임상간호역량 평가항목입니다. 실습중인 간호대학생을 대상으로 다음 항목을 읽고 해당되는 내용에 “V”표를 해주십시오.

1. McKown T, McKeon L, Webb S. Using quality and safety education for nurses to guide clinical teaching on a new dedicated education unit. J Nurs Educ 2011;50(12):706–710. [doi: 10.3928/01484834-20111017-03]
2. Song JH, Kim MW. Study on clinical education for nursing in hospitals in Korea. J Korean Acad Soc Nurs Educ 2013;19(2):251–264. [doi: 10.5977/jkasne.2013.19.2.251]
3. Im EJ. Developing and testing an evaluation tool to measure clinical teaching. Korean J Med Educ 2011;23(1):49–59. [doi: 10.3946/kjme.2011.23.1.49]
4. Bourbonnais FF, Langford S, Giannantonio L. Development of a clinical evaluation tool for baccalaureate nursing students. Nurse Educ Pract 2008;8(1):62–71. [doi: 10.1016/j.nepr.2007.06.005]
5. Msiska G, Smith P, Fawcett T, Munkhondya TM. Where is the grade coming from? Problems and challenges in evaluating the clinical performance of nursing students. Open J Nurs 2015;5(5):470–481. [doi: 10.4236/ojn.2015.55050]
6. Bradshaw C, O'Connor M, Egan G, Tierney K, Butler MP, Fahy A, et al. Nursing students' views of clinical competence assessment. Br J Nurs 2012;21(15):923–927. [doi: 10.12968/bjon.2012.21.15.923]
7. Kown IS, Seo YM. Nursing students' needs for clinical nursing education. J Korean Acad Soc Nurs Educ 2012;18(1):25–33. [doi: 10.5977/jkasne.2012.18.1.025]
8. Korean Accreditation Board of Nursing Education. Nursing education accreditation standards: Evaluation criteria and indicators [Internet]. Seoul: Korean Accreditation Board of Nursing Education; c2014 [cited 2016 Mar 21].
9. Sung MS, Jeong GH, Jang HJ. Development of clinical evaluation tool for nursing students. J Korean Acad Soc Nurs Educ 1998;4(2):172–186.
10. Campbell B, Mackay G. Continuing competence: An Ontario nursing regulatory program that supports nurses and employers. Nurs Adm Q 2001;25(2):22–30. [doi: 10.1097/00006216-200101000-00006]
11. Nam HH. In: Development of a clinical evaluation tool for nursing students [master's thesis]. Seoul: University of Ewha; 1996. pp. 80-82.
12. Joo GE, Sohng KY. Development of nursing competence scale for graduating nursing students. J Korean Public Health Nurs 2014;28(3):590–604. [doi: 10.5932/JKPHN.2014.28.3.590]
13. Lin CC, Wu CJ, Hsiao YC, Han CY, Hung CC. An exploratory factor analysis for developing and validating a scale of nursing students competence Instrument. Nurse Educ Today 2017;50:87–91. [doi: 10.1016/j.nedt.2016.12.007]
14. Wangensteen S, Johansson IS, Nordström G. Nurse competence scale--psychometric testing in a Norwegian context. Nurse Educ Pract 2015;15(1):22–29. [doi: 10.1016/j.nepr.2014.11.007]
15. Lee KJ, Chang CJ, Hong SS. Development of clinical evaluation tool for nursing student. J Korean Acad Nurs Adm 2001;7(3):473–485.
16. DeVellis RF. In: Scale development: Theory and applications. 3rd ed. Los Angeles (CA): Sage Publications Inc.; 2012. pp. 42-60.pp. 80-110.
17. Schwartz-Barcott D, Kim HS. An expansion and elaboration of the hybrid model of concept development. In: Rodgers BL, Knafl KA, editors. Concept Development in Nursing: Foundations, Technqiues, and Applications. 2nd ed. Philadelphia (PA): W.B. Saunders; 2000. pp. 129-159.
18. Spencer LM, Spencer SM. In: Competence at work: Models for superior performance models for superior performance. New York: John Wiley & Sons; 1993. pp. 3-15.
19. Lynn MR. Determination and quantification of content validity. Nurs Res 1986;35(6):382–386. [doi: 10.1097/00006199-198611000-00017]
20. Polit DF, Beck CT. In: Nursing research: Generating and assessing evidence for nursing practice. 8th ed. Philadelphia (PA): Lippincott Williams & Wilkins, Wolter Klwer; 2008. pp. 458-486.
21. Hinkin TR. A brief tutorial on the development of measures for use in survey questionnaires. Organ Res Methods 1998;1(1):104–121. [doi: 10.1177/109442819800100106]
22. Anderson JC, Gerbing DW. Structural equation modeling in practice: A review and recommended two-step approach. Psychol Bull 1988;103(3):411–423. [doi: 10.1037/0033-2909.103.3.411]
23. Ware JE Jr, Gandek B. Methods for testing data quality, scaling assumptions, and reliability: The IQOLA Project approach. International Quality of Life Assessment. J Clin Epidemiol 1998;51(11):945–952. [doi: 10.1016/S0895-4356(98)00085-7]
24. Tabachnick BG, Fidell LS. In: Using multivariate statistics. Needham Heights (MA): Allyn & Bacon; 2006. pp. 607-675.
25. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;33(1):159–174. [doi: 10.2307/2529310]
26. Kang H. A guide on the use of factor analysis in the assessment of construct validity. J Korean Acad Nurs 2013;43(5):587–594. [doi: 10.4040/jkan.2013.43.5.587]
27. Hair JF, Black WC, Babin BJ, Anderson RE. In: Multivariate data analysis. 7th ed. Upper Saddle River (NJ): Prentice Hall; 2010. pp. 609-732.
28. Skúladóttir H, Svavarsdóttir MH. Development and validation of a clinical assessment tool for nursing education (CAT-NE). Nurse Educ Pract 2016;20:31–38. [doi: 10.1016/j.nepr.2016.06.008]
29. Worthington RL, Whittaker TA. Scale development research a content analysis and recommendations for best practices. Couns Psychol 2006;34(6):806–838. [doi: 10.1177/0011000006288127]