The development and psychometric testing of a theory-based instrument to evaluate nurses' perception of clinical reasoning competence

J Adv Nurs. 2016 Mar;72(3):707-17. doi: 10.1111/jan.12831. Epub 2015 Oct 12.

Abstract

Aim: The purpose of the study was to develop and psychometrically test the Nurses Clinical Reasoning Scale.

Background: Clinical reasoning is an essential skill for providing safe and quality patient care. Identifying pre-graduates' and nurses' needs and designing training courses to improve their clinical reasoning competence becomes a critical task. However, there is no instrument focusing on clinical reasoning in the nursing profession.

Design: Cross-sectional design was used. This study included the development of the scale, a pilot study that preliminary tested the readability and reliability of the developed scale and a main study that implemented and tested the psychometric properties of the developed scale.

Method: The Nurses Clinical Reasoning Scale was developed based on the Clinical Reasoning Model. The scale includes 15 items using a Likert five-point scale. Data were collected from 2013-2014. Two hundred and fifty-one participants comprising clinical nurses and nursing pre-graduates completed and returned the questionnaires in the main study. The instrument was tested for internal consistency and test-retest reliability. Its validity was tested with content, construct and known-groups validity.

Results: One factor emerged from the factor analysis. The known-groups validity was confirmed. The Cronbach's alpha for the entire instrument was 0·9.

Conclusion: The reliability and validity of the Nurses Clinical Reasoning Scale were supported. The scale is a useful tool and can be easily administered for the self-assessment of clinical reasoning competence of clinical nurses and future baccalaureate nursing graduates. Study limitations and further recommendations are discussed.

Keywords: clinical reasoning; instrument development; nurses; reliability; validity.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • China
  • Clinical Competence / standards*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nurses / psychology*
  • Pilot Projects
  • Psychometrics / instrumentation*
  • Reproducibility of Results
  • Thinking*