Development and validation of a Clinical Assessment Tool for Nursing Education (CAT-NE)

The aim of this study was to develop a valid assessment tool to guide clinical education and evaluate students’ performance in clinical nursing education. The development of the Clinical Assessment Tool for Nursing Education (CAT-NE) was based on the theory of nursing as professional caring and the Bologna learning outcomes. Benson and Clark’s four steps of instrument development and validation guided the development and assessment of the tool. A mixed-methods approach with individual structured cognitive interviewing and quantitative assessments was used to validate the tool. Supervisory teachers, a pedagogical consultant, clinical expert teachers, clinical teachers, and nursing students at the University of Akureyri in Iceland participated in the process.This assessment tool is valid to assess the clinical performance of nursing students; it consists of rubrics that list the criteria for the students’ expected performance. According to the students and their clinical teachers, the assessment tool clarified learning objectives, enhanced the focus of the assessment process, and made evaluation more objective. Training clinical teachers on how to assess students’ performances in clinical studies and use the tool enhanced the quality of clinical assessment in nursing education.     

Development of a Chronic Pain Assessment Tool

Research demonstrates that many nurses lack knowledge about pain assessment, the differences between acute and chronic pain, and the use of pain rating scales. In this article, the authors describe an instrument for evaluating chronic pain, the purpose of which is to assess systematically the various dimensions of chronic pain and its impact on quality of life. This assessment can establish a baseline for developing clients' treatment plans and can be used to evaluate the effectiveness of treatment plans. Using this tool can provide an accurate multidimensional assessment of clients' chronic pain experiences. The article also discusses recommendations for other applications of the tool.     

Development and Validation of a Family Meeting Assessment Tool (FMAT)

Context

A cornerstone procedure in Palliative Medicine is to perform family meetings. Learning how to lead a family meeting is an important skill for physicians and others who care for patients with serious illnesses and their families. There is limited evidence on how to assess best practice behaviors during end-of-life family meetings.

Development of the Texas Textbook Evaluation Tool (T-TET).

Nurse educators face many challenges in evaluating textbooks to meet the needs of their students and preparing professional nurses who will practice in the next millennium. Using four phases of development, the Texas Textbook Evaluation Tool (T-TET) was created to develop a reliable and valid textbook evaluation instrument. The T-TET may be used to evaluate all levels of textbooks, including specialty textbooks in nursing.     

The Simulation Team Assessment Tool (STAT): development, reliability and validation

Introduction

Simulation sessions prepare medical professionals for pediatric emergencies. No validated tools exist to evaluate overall team performance. Our objective was to develop and evaluate the inter-rater reliability and validity of a team performance assessment tool during simulated pediatric resuscitations.

Methods

We developed the Simulation Team Assessment Tool (STAT) which evaluated 4 domains: basic assessment skills, airway/breathing, circulation, and human factors. Scoring of each element was behaviorally anchored from 0 to 2 points. Two teams of resuscitation experts and two teams of pediatric residents performed the same simulated pediatric resuscitation. Each team was scored by six raters using the STAT. Intraclass correlation coefficients (ICC) were calculated to assess inter-rater reliability. Overall performance and domain scores between expert and resident teams were compared using repeated measures of analysis of variance to assess construct validity.

Results

ICCs for overall performance were 0.81. Domain ICCs were: basic skills 0.73, airway/breathing skills 0.30, circulation skills 0.76, human factors 0.68. Expert versus resident average scores were: overall performance 84% vs. 66% (p = 0.02), basic skills 73% vs. 55% (p < 0.01); airway 80% vs. 75% (p = 0.25), circulation 90% vs. 69% (p = 0.02), human factors 89% vs. 66% (p = 0.02).

Conclusions

The STAT's overall performance, basic skills, circulation, and human factors domains had good to excellent inter-rater reliability, discriminating well between expert and resident teams. Similar performance in the airway/breathing domain among all teams magnified the impact of a small number of rater disagreements on the ICC. Additional study is needed to better assess the airway/breathing domain.     

Development of the Handicap Assessment and Resource Tool (HART)

An important determinant of whether people can live in community settings is the absence of significant handicap. People with considerable disabilities can live without handicap if they have adequate supports. Handicap, rather than disability, limits peoples' residence options. Disability assessment tools are commonly used to guide where people can live--these assess neither the resources available nor the personal-care handicap present. The Handicap Assessment and Resource Tool (HART) was designed to provide information about the personal-care issues (clothing, hygiene, nutrition, mobility, safety, residence and supports) relevant to choice of residence. The HART was tested by occupational therapists who are frequently expected to provide recommendations regarding disabled clients' residence options. It is a client-centred tool that addresses key occupational performance components of personal care. Pilot testing in hospital and community settings shows the HART is a comprehensive and practical tool that is acceptable to users and clients.     

Development of an HIV Assessment Tool

The objective of this study was to establish the validity and reliability of a visual analog scale that rates HIV-related symptom severity and general well-being. Three groups of subjects completed the HIV Assessment Tool (HAT): uninfected subjects (n=53); people with HlV infection (n=60), and people with CDC-defined AIDS (n=43) according to the 1987 criteria. Test-retest reliability was .96 and Cronbach's alpha was .92. Face, content, and construct validity were established. Significant differences were found between healthy subjects and those with HIV or AlDS supporting discriminant validity. Correlation of the Karnofsky performance status with the HAT was significant (r=.51, p <.001) which demonstrated concurrent validity. Factor analysis helped identify general well-being, general symptoms, and HIV-specific symptoms. The instrument can be used to relate HlV symptoms to disease progression, and to evaluate the effectiveness of nursing interventions     

Development and validation of the Headache Needs Assessment (HANA) survey

OBJECTIVE: To develop and validate a brief survey of migraine-related quality-of-life issues. The Headache Needs Assessment (HANA) questionnaire was designed to assess two dimensions of the chronic impact of migraine (frequency and bothersomeness). METHODS: Seven issues related to living with migraine were posed as ratings of frequency and bothersomeness. Validation studies were performed in a Web-based survey, a clinical trial responsiveness population, and a retest reliability population. Headache characteristics (eg, frequency, severity, and treatment), demographic information, and the Headache Disability Inventory were used for external validation. RESULTS: The HANA was completed in full by 994 adults in the Web survey, with a mean total score of 77.98 +/- 40.49 (range, 7 to 175). There were no floor or ceiling effects. The HANA met the standards for validity with internal consistency reliability (Cronbach alpha =.92, eigenvalue for the single factor = 4.8, and test-retest reliability = 0.77). External validity showed a high correlation between HANA and Headache Disability Inventory total scores (0.73, P<.0001), and high correlations with disease and treatment characteristics. CONCLUSIONS: These data demonstrate the psychometric properties of the HANA. The brief questionnaire may be a useful screening tool to evaluate the impact of migraine on individuals. The two-dimensional approach to patient-reported quality of life allows individuals to weight the impact of both frequency and bothersomeness of chronic migraines on multiple aspects of daily life.     

Development and Initial Evaluation of Psychometric Properties of a Pain Competence Assessment Tool (PCAT)

Competency-based education is now considered the best approach for pain educational programs provided for pre and postgraduate healthcare providers (HCPs). To demonstrate learners’ progression, an assessment tool that aligns with this educational approach and targets different HCPs is needed. A Pain Competence Assessment Tool (PCAT) was developed based on the pain management core competencies that align with the International Association for the Study of Pain interprofessional pain curriculum. The PCAT is an online competency-based assessment tool for HCPs that consists of 5 case scenarios followed by 17 key-feature questions. HCPs and trainees completed the PCAT through a series of studies to assess its psychometric properties. The preliminary evaluation suggested that the PCAT had adequate content validity. Apart from 6 questions, the PCAT questions demonstrated homogeneity and acceptable reliability, and substantial stability. No ceiling or floor effect was found. A significant difference was detected between the HCPs' and trainees’ scores. The PCAT scores strongly correlated with other variables reflecting different competence levels. The PCAT scores showed significant changes in the baseline scores compared to scores after attending an educational intervention. The PCAT offers a first-of-its-kind tool for assessing HCPs' competence (ie, knowledge and its application) in managing chronic pain. Future research is needed for further validation and adaptation of the PCAT.PerspectiveThe Pain Competence Assessment Tool (PCAT) offers a first-of-its-kind tool for assessing clinicians' core competencies that overlap between different professions and support the clinicians’ capacity to successfully manage chronic pain in the real world focusing on the patient-centered perspective rather than the profession-specific perspective.     

Spanish adaptation and validation of the Cultural Competence Assessment Tool (CCATool) for undergraduate nursing students

Aim

To analyse and validate a contextually adapted version of the Papadopoulos’ Cultural Competence Assessment Tool (CCATool) for Spanish undergraduate nursing students.

Background

Globalization has driven and intensified international migration. Thus, nurses must treat patients of many different cultural origins. Accordingly, both cultural competence and an appropriate tool with which to evaluate it are required.

Methods

The CCATool questionnaire was adapted for use in a Spanish context and was evaluated through a questionnaire completed by 262 undergraduate nursing students. Seven days later, the same students completed the questionnaire, without any intervention, and a subgroup of 144 students completed the questionnaire for a third time after taking a course in Transcultural Care. The reliability, sensitivity and stability of the questionnaire were assessed.

Results

The reliability of the questionnaire obtained an adequate Cronbach's alpha of 0.81. Stability was assessed at seven days, using the intraclass correlation coefficient, which showed good/excellent results. Moreover, the questionnaire was able to detect the changes related to the nursing educative programme, thus highlighting a good sensitivity of the tool.

Conclusion

Cultural competence is an essential element of nurses’ education, and instruction in this area should begin as soon as possible. In addition, an appropriate evaluation system is required. For this purpose, the present study describes and analyses a valid, reliable tool for use with undergraduate nursing students in Spain.

Implications for nursing and health policy

Health and education policies must be sensitive to the ethnic and cultural differences of the patients who are cared for, and address the situations that cause difficulties in care. Hospitals and health centres must offer good care to patients from diverse cultures, so one of the necessary situations is the training and evaluation of the cultural competence of health professionals.     

Infant Positioning Assessment Tool: Transcultural adaptation and validation for Portuguese Preterm Neonates

AimCross-cultural adaptation and validation of the Infant Positioning Assessment Tool for Portuguese Preterm Neonates.BackgroundTherapeutic positioning provides postural support, with immediate and long-lasting impacts on development. Some studies have suggested the importance of applying positioning-related instruments.MethodsA scoping review identified the Infant Positioning Assessment Tool, which was used in a methodological and cross-cultural study. Its psychometric validation was performed in a nonprobability preterm neonates sample (n = 90). Internal consistency and item sensitivity were assessed by using Cronbach's alpha coefficient and asymmetry and kurtosis coefficients, respectively. The following empirical indices were used to assess convergent validity (CV): chi-square over degrees of freedom (df), a goodness-of-fit index (GFI), a normed-fit index (NFI), an incremental-fit index (IFI) and root mean square error of approximation (RMSEA), an average extracted variance index, and composite reliability (CR).ResultsConfirmatory factor analysis of the factorial model showed an insufficient goodness-of-fit adjustment for the first model, with six items. One item was removed, and the resulting second model was adjusted to five items and showed more acceptable results (X2(9) = 52.70; p < 0.001; X2/df = 5.85; n = 90; GFI = 0.86; NFI = 0.64; IFI = 0,68; CFI = 0,67; RMSEA = 0.234); CR = 0.74 and CV = 0.50.ConclusionThe Portuguese version of the Infant Positioning Assessment Tool, with five items, proved to be a sensitive, valid, and reliable instrument for observing positioning of newborns, which is why its use in neonatal units is suggested.     

Development and validation of the Patient Assessment of Chronic Illness Care (PACIC)

RATIONALE: There is a need for a brief, validated patient self-report instrument to assess the extent to which patients with chronic illness receive care that aligns with the Chronic Care Model-measuring care that is patient-centered, proactive, planned and includes collaborative goal setting; problem-solving and follow-up support. SAMPLE: A total of 283 adults reporting one or more chronic illness from a large integrated health care delivery system were studied. METHODS: Participants completed the 20-item Patient Assessment of Chronic Illness Care (PACIC) as well as measures of demographic factors, a patient activation scale, and subscales from a primary care assessment instrument so that we could evaluate measurement performance, construct, and concurrent validity of the PACIC. RESULTS: The PACIC consists of 5 scales and an overall summary score, each having good internal consistency for brief scales. As predicted, the PACIC was only slightly correlated with age and gender, and unrelated to education. Contrary to prediction, it was only slightly correlated (r = 0.13) with number of chronic conditions. The PACIC demonstrated moderate test-retest reliability (r = 0.58 during the course of 3 months) and was correlated moderately, as predicted (r = 0.32-0.60, median = 0.50, P < 0.001) to measures of primary care and patient activation. DISCUSSION: The PACIC appears to be a practical instrument that is reliable and has face, construct, and concurrent validity. The resulting questionnaire is in the public domain, and recommendations for its use in research and quality improvement are outlined.     

非计划拔管风险评估工具的研究

目的：研制非计划拔管的风险评估工具,识别高风险患者,减少非计划拔管的发生。方法采用德尔菲法研制非计划拔管的风险评估工具,并采用此工具对684例留置管道的住院患者进行评估,分析信度、效度、灵敏度、特异性、ROC曲线下面积,结合约登指数分析最佳临界值。结果经过2轮专家咨询形成非计划拔管的风险评估工具,包括8个评价条目。专家的权威程度（Cr）为0.71,内部一致性信度Cronbach’sα系数为0.818;条目平均内容效度比为0.94,各条目与总分的相关性分析均 P＜0.01;ROC曲线下面积为0.902,P＜0.01;当临界值取为15.5,灵敏度为0.853,特异度为0.824,此时约登指数最大为0.677。结论本研究所研制的非计划拔管评估工具信度、效度较好,特异性和灵敏度较高,筛选非计划拔管高风险患者的准确性较高。本研究为护士评估非计划拔管风险提供了科学工具。     

Development of a Specialty-wide Web-based Medical Knowledge Assessment Tool for Resident Education

Medical knowledge is one of six core competencies identified by the Accreditation Council for Graduate Medical Education. The authors present a tool for assessment of medical knowledge developed by the Council of Emergency Medicine Residency Directors. This tool is Internet based and consists of more than 50 online tests that emergency medicine residents are able to access. Test results are available to a resident's residency, along with the mean and standard deviation of all takers of that particular test. The result is a collaborative specialty-wide approach to the common problem of formatting tests to assess medical knowledge. The tool has been widely accepted by both residents and residencies.     

Transcultural validation of the Risk Assessment and Predictor Tool (RAPT) to predict discharge outcomes after total hip replacement

ObjectiveTo assess the relevance of the RAPT (Risk Assessment and Prediction Tool), among a cohort of patients undergoing total hip arthroplasty (THA).MethodProspective study of a cohort of patients evaluated before and after THA. The difference between the postoperative orientation predicted by the RAPT and the real one is assessed. Clinical, environmental and psychosocial criteria that could significantly change the orientation are discussed.ResultsOne hundred and thirty-four patients (94 women and 40 men) were included. The average age was 71.6 (±10) years. Primary hip osteoarthritis was the indication for surgery in 78% of cases. The average length of stay in the surgery ward was 10 (±3) days. It was significantly higher for patients referred to a rehabilitation ward (P < 0.0001). Sixty-six percent of patients were referred to a rehabilitation ward and 34% returned directly home. The average length of stay in rehabilitation ward was 27 (±13) days. The validity of the RAPT as a help decision tool has been confirmed. Thus, a low RAPT score was significantly associated with more frequent referral to a rehabilitation ward, conversely, a high RAPT score is significantly related to more frequent direct return to home.ConclusionThis study confirmed the usefulness of the RAPT to help in patient orientation decision after total hip arthroplasty. The patient preference remains the main variable for orientation after THA. By the way, the patient preference must not be integrated into the RAPT, but need to be collected and be discussed with the patient.