Validating an instrument for clinical supervision using an expert panel

Use of research instruments standardised in English-speaking countries is commonplace in non-English speaking countries. This article describes technical, linguistic and conceptual issued raised in the translation and validation of an acceptable country-specific instrument. The Manchester Clinical Supervision Scale was validated for use in clinical supervision in Finland using quantitative and qualitative methods. The approach applied was triangulation. The focus of this paper, is to describe the item validation process of the scale using an expert panel (n=11) by means of the content validity index and panel interview. The process resulted in a country-specific 33-item instrument. The study indicated that content validity index and panel discussion are easy, but reliable ways of demonstrating the instrument's content validity.     

Development of a formative assessment tool for measurement of performance in multi-professional resuscitation teams

Background

Treating cardiac arrest is linked to the mutual performance of several health-care individuals’ task coordination. Non-technical skills, including communication, leadership and team interaction, could improve sequencing the tasks in the cardiac arrest algorithm. Non-technical skills have been a part of crew resource management training, created to improve safety in aviation. This study aimed, first, to establish crew resource management and non-technical skill-based learning objectives and behavioural markers for the performance of multi-professional resuscitation teams; second, to develop a checklist and to evaluate the validity and reliability of the checklist; and, finally, to develop a simulation-based course including the checklist on behavioural markers, as a tool for learning and assessment.

Method

A seven-step procedure was used. Findings from interviews with Advanced Life Support instructors and analysis of critical incidents were used to create learning objectives, assessment tools and course curriculum. Reliability and validity were tested by assessing digital versatile disc (DVD)-recorded simulated cardiac arrests.

Results

A checklist with 22 behavioural markers based on nine learning objectives was developed and embedded in an 8-h full-scale simulation course. Inter-rater reliability of the checklist (intra-class correlation) was 0.9. Concurrent validity (intra-class correlation) was 0.93. Rate of agreement (0.58-0.91) and kappa values (0.03-0.82) on single items varied.

Conclusion

A full-scale simulation course and a checklist with 22 behavioural markers were developed. Good inter-rater reliability and concurrent validity of the checklist were demonstrated. Single items on the checklist need refinement to improve accuracy.     

Changing conceptions of practical skill and skill acquisition in nursing education

Changing conceptions of practical skill and skill acquisition in nursing education
The learning of practical skill in nursing is not a priority of nursing education today. This is a result of a narrow and mechanistic concept of practical skill and its acquisition in nursing education. This paper reviews these conceptions as they have been developed in major textbooks for nurse teachers and in research articles on skill teaching, learning and evaluation over the past 50 years. Nursing research must move out of the laboratory and into the clinical setting in order to incorporate the typical aspects of practical skill learning in nursing. Future challenges in this kind of research are discussed.     

From simplicity to complexity: developing a model of practical skill performance in nursing

The purpose of this article is to present and discuss a new model of practical skill performance in nursing. The model is conceptualized as having five components: substance and sequence; accuracy; fluency; integration; and caring conduct. The model challenges the truism of 'simple' nursing procedures. It is argued that performance of practical skills in nursing is characterized by complexity on many levels. Complexity lies within and between the components of the performance model and in the interaction between the nurse and the clinical context where practical nursing actions are performed. These complexities are described. Examples that illustrate the complex and reciprocal nature of these components are drawn from an empirical study of graduate nurses' development of practical skill in surgical hospital units. Implications of the model for education, practice and research are discussed.     

Practice guidelines for inflammatory bowel disease: an instrument for assessment.

The development of practice guidelines is problematic because guidelines that are too broad have no value and guidelines that are highly specific cannot address the nuances of every patient's illness. In this article, we present the hypothesis that practice guidelines that provide specific objectives for assessment and intervention in inflammatory bowel disease can be used to measure practice variation. These guidelines are proposed as 15 specific objectives with options for intervention. These objectives could be used as an instrument to quantify variations in clinical practice and to assess the benefits of practice guidelines.     

The care dependency scale, an assessment instrument

The Care Dependency Scale, an instrument for the assessment of patients'care dependency, has been translated into German. The scale was tested on (inter-) rater reliability and criterion and construct validity in a hospital population on geriatric, surgical and paediatric wards. As the results of this study were very satisfying, positive recommendations regarding the suitability of the scale for use in the German nursing care situation could be made. However further psychometric testing of the scale is important, for instance in other populations. A final conclusion is that the scale may be used in care settings in German-speaking countries.     

Paradigms for assessment: women's knowledge and skill attainment

This article describes two models of assessment that nurses can use with women throughout their life span: (1) knowledge attainment (Belenky, Clinchy, Goldberger, & Tarule, 1986) and (2) skill attainment (Dreyfus & Dreyfus, 1996). These models consider each woman's unique reality, acknowledging that how she experiences pregnancy and postpartum is based on how she has lived her life. Her integration of experiences, coping strategies, and life events may be the foundation upon which she will incorporate the new experiences of pregnancy and motherhood. Using these models can help provide the maternal-child nurse with a blueprint for the development of appropriate care plans and teaching plans.     

Factors influencing theoretical knowledge and practical skill acquisition in student nurses: an empirical experiment

A previous qualitative study [Nurse Education Today 20 (2000) 499] investigated perceptions of nurse teachers, student nurses and preceptors of the theory-practice gap said to exist within nursing. One theme was views of how the theory-practice gap could be closed. A subsequent quantitative study is reported here, in which this theme was translated into three factors. A full factorial experimental design was used to study the effect of these factors on theoretical knowledge and practical skill acquisition in a sample of first year undergraduate student nurses from one institution of higher education (n=19). The effect of whether a nurse teacher or preceptor taught students theoretical elements relating to a clinical specialty, whether the nurse teacher and preceptor collaborated on the content of what was taught to students and whether students went straight to, or delayed the clinical specialty following theoretical input, was examined. The results demonstrated preceptors were more effective than nurse teachers in promoting theoretical knowledge relating to their clinical specialty. Collaboration between the preceptors and nurse teachers on teaching content was ineffective at increasing theoretical knowledge. Delay between theoretical input and clinical experience was not detrimental for medical placements and for rehabilitation placements, resulted in an improved theoretical knowledge.     

形成性评价与终结性评价在护理专业英语教学中的应用

[目的]探索护理专业英语教学评价考核新模式。[方法]在2009级护理本科班70名学生中进行形成性评价和终结性评价相结合的教学实践应用,采用自设问卷进行学习兴趣调查和标准专业英语能力测试。[结果]形成性评价应用于护理专业英语教学前后,学生学习兴趣和专业英语能力差异有统计学意义(P<0.05)。[结论]形成性评价和终结性评价有效结合激发了学生学习英语的兴趣,提高了专业英语教学效果和学生的专业英语能力。     

中职护理教育形成性评价体系构建及实践研究

以护士职业素养与能力作为护理教育的新评价标准,构建中职护理教育形成性评价体系。评价体系包括自主学习、综合能力、学习态度、课业、社会活动、学习发展轨迹6个一级指标,并在教学中进行实践,其中自主学习和综合能力采用自设的《自主学习能力评价表》和《综合能力核查表》进行评价。在中职护理教育中融入形成性评价,实现了学生知识学习、能力发展和素质提高的有机统一。     

Development of the MG-DIS: an ICF-based disability assessment instrument for myasthenia gravis

Abstract

Purpose: To develop a preliminary version of a disease-specific, patient-reported disability assessment instrument for myasthenia gravis (MG) based on the International Classification of Functioning, Disability and Health (ICF): the MG-DIS. Methods: Five consecutive steps were taken: literature review and selection of outcome measures; linking of measures’ concepts to ICF categories and selection of those reported by 30% of the instruments; comparison of linking results with a previous selection of MG-relevant ICF categories; patient interview; development of questions based on retained ICF categories. Results: Thirty-one papers containing 21 different outcome measures were found: 13 ICF categories were linked to them. Fifty-five items were retained after the comparison with the list of MG-specific categories, and were used for patient interview. Thirteen interviews were conducted before saturation of data was reached and the final list was composed of 42 categories: based upon them, 44 questions were developed. Conclusions: The preliminary version of the MG-DIS contains more information than each single MG-specific tool, in particular, for the component of environmental factors. Further research is needed to test its psychometric properties.

• Implications for Rehabilitation

• It is important that patient-reported outcome is incorporated in MG patient’s assessment.

• MG features can be evaluated with ICF-based methods.

• An MG-specific patient-reported disability assessment instrument can be used to monitor changes of functioning in patients on MG-specific treatments, and can be used in clinical trials as outcome measure.

     

Development of an instrument to measure mothers' performance of self-care activities for children

One who performs self-care activities for another is known as a dependent care agent, according to Orem. Attempts to study mothers' performance of self-care activities for children have been impeded by the lack of an instrument with which to measure dependent care agent performance. Findings based on a sample of 475 women indicate that the Dependent Care Agent (DCA) questionnaire developed in this study had a coefficient alpha of .91, with item-total correlations ranging from .27 to .63. Although Orem's expected dimensions of universal, developmental, and health deviation requisites were not represented in the factor analysis, individual requisites for self-care were clearly present.     

形成性评价在护士层级培训中的应用

目的:探讨形成性评价在护士层级培训中的应用及效果,使护士层级培训评价更加合理有效。方法:在2011～2012年我院护理部护士层级培训中以护士、科室、培训师资为评价主体,进行基础护理操作的形成性评价。结果:形成性评价的应用更好地激发了护士参与培训的积极性,促进了师资更新教学理念、改进教学方法。结论:形成性评价是一种客观、有效的教育评价,力求做到评价的客观、公正,对护士层级培训有很好的促进作用。