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

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Kwak and Oh: Development and Psychometric Testing of the Clinical Nursing Competency Scale for Clinical Preceptor Use (CNCS-CP)
Original Article

J Korean Acad Nurs 2018;48(4):419-431.

Published online: 15 January 2018

DOI: https://doi.org/10.4040/jkan.2018.48.4.419

Development and Psychometric Testing of the Clinical Nursing Competency Scale for Clinical Preceptor Use (CNCS-CP)

Eunmi Kwak1, Heeyoung Oh2,

1Department of Nursing, Gyeongbuk College of Health, Gimcheon

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 E-mail: hoh123@eulji.ac.kr

Received 12 March 2018       Revised 29 June 2018       Accepted 29 June 2018

Copyright © 2018 Korean Society of Nursing Science

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) 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.

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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

References

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Figure 1.
Steps of instrument development.
jkan-48-419f1.tif
Table 1.
Exploratory Factor Analysis and Reliability (N=205)
Item Factor loading
1 2 3 4
25) Respect the privacy of the subject. .93 .10 .13 .05
26) Adhere to nursing-related rules, ethical principles and laws regarding the subject. .90 .17 .14 .11
27) Follow practice hours and hospital policy accurately. .89 .19 .07 .03
28) Fulfill one's own duties with responsibility .84 .18 .11 .19
30) Show an attitude of understanding and respecting the various circumstances related to the .82 .15 .26 .23
subject.
18) Communicate with the subject in a clear and open manner and listen carefully. .71 .30 .26 -.10
29) Demonstrate an active attitude of observing and learning from the preceptor. .59 .39 .17 .38
15) Evaluate the results of the nursing practice, replan and implement actions as needed. .09 .77 .28 .24
14) Present the logical and theoretical basis of one’s own nursing plan. .21 .70 .27 .18
11) Obtain the necessary information and resources and utilize them accordingly. .37 .68 .25 .10
16) Establish a proper discharge plan for the subject. .24 .65 .26 .30
13) Plan appropriate and safe nursing interventions according to the priority of the problem. .24 .65 .33 .14
12) Identify the nursing problem and make an adequate nursing diagnosis. .23 .56 .38 .16
5) Evaluate the results of education. .14 .32 .71 .15
6) Perform core nursing skills accurately according to the situation. .32 .19 .71 .21
3) Explain clearly the subject’s educational demands and needs .13 .37 .68 .04
4) Educate the subject with adequate knowledge and skills concerning health management. -.02 .44 .68 .15
8) Handle the situation rapidly and accurately. .22 .22 .62 .33
7) Prepare materials correctly to provide nursing care according to the situation. .45 .16 .58 .33
23) For major disease, explain diagnostic tests, medication, and special treatments accurately. -.05 .17 .18 .85
24) Explain the usage and principles of equipments or appliances used. .17 .15 .37 .73
21) Explain the subject‘s disease and treatment. .15 .47 .05 .61
22) Explain the nursing tasks of the assigned nursing unit. .42 .31 .24 .58
Eigen value 5.67 3.98 3.62 2.78
Explained variance (%) 24.6 17.3 15.7 12.1
Cumulative variance (%) 24.6 41.9 57.7 69.7
KMO (Kaiser-Meyer-Olkin)=.91, p<.001
Cronbach’s alpha (Total Cronbach’s a=.95) .87 .89 .83 .94
Table 2.
Multi-Trait/Multi-Item Matrix Analysis (N=205)
Item Factor r-2SE
1 2 3 4 r-2SE
Professional attitude Item 25 0.916 0.408 0.318 0.309 0.868
Item 26 0.903 0.478 0.335 0.390 0.857
Item 27 0.869 0.444 0.264 0.313 0.799
Item 28 0.901 0.464 0.326 0.408 0.859
Item 30 0.890 0.502 0.462 0.468 0.846
Item 18 0.710 0.518 0.317 0.259 0.578
Item 29 0.755 0.622 0.475 0.563 0.671
Critical thinking skills based on the nursing process Item 15 0.612 0.742 0.519 0.360 0.672
Item 14 0.576 0.704 0.492 0.438 0.634
Item 11 0.584 0.708 0.473 0.554 0.644
Item 16 0.596 0.690 0.551 0.483 0.620
Item 13 0.598 0.708 0.476 0.448 0.630
Item 12 0.602 0.690 0.493 0.436 0.606
Fundamental nursing skills performance Item 5 0.382 0.567 0.675 0.486 0.591
Item 6 0.472 0.589 0.725 0.492 0.661
Item 3 0.372 0.562 0.720 0.409 0.618
Item 4 0.273 0.602 0.758 0.457 0.672
Item 8 0.411 0.574 0.670 0.500 0.578
Item 7 0.586 0.592 0.674 0.550 0.596
Basic nursing knowledge Item 23 0.166 0.408 0.434 0.666 0.590
Item 24 0.376 0.496 0.366 0.690 0.612
Item 21 0.340 0.551 0.394 0.611 0.511
Item 22 0.565 0.592 0.428 0.699 0.607

SE=Standard error.

Table 3.
Inter-Rater Reliability (N=76)
Factor ICC 95% CI
Skill Fundamental nursing skills performance .915 .88~.94
Critical thinking skills based on the nursing process .912 .88~.94
Knowledge Basic nursing knowledge .951 .93~.97
Attitude Professional attitude .967 .95~.97

ICC=Interclass correlation coefficient.

Table 4.
Summary of Fit Indices from Confirmatory Factor Analysis (N=238)
CMIN(χ2) CMIN/DF RMR RMSEA CFI TLI IFI
χ2 Df p
Evaluation criteria a >.05 ≤3 ≤.05~.08 ≤.05~.08 ≥.90 ≥.90 ≥.90
CNCS-CP 538.114 206 <.01 2.766 .045 .086 .924 .904 .924

CMIN=χ index; TLI=Turker-lewis index; IFI=Incremental fit index.

2 test; Df=Degree of freedom; RMR=Root mean-square residual; RMSEA=Root mean square error of approximation; CFI=Comparative fit

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