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Reliability and Validity of the Clinical Competency Scale for Nursing Students

Article information

Res Community Public Health Nurs. 2018;29(2):220-230
Publication date (electronic) : 2018 June 12
doi : https://doi.org/10.12799/jkachn.2018.29.2.220
Bo Young Kim1, Myeong Jeong Chae2, Yun Ok Choi,3
1College of Nursing · Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
2Department of Nursing, Kwangju Women’s University, Gwangju, Korea
3Department of Nursing, Graduate School, Yonsei University, Seoul, Korea
Corresponding author: Choi, Yun Ok College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Tel: +82-2-2228-3279, Fax: +82-2-393-2808, E-mail: miffyliker@naver.com
Received 2018 January 30; Revised 2018 May 10; Accepted 2018 May 11.

Abstract

Abstract

Purpose

This study was conducted to evaluate clinical competency of nursing students and to examine the validity and reliability of the scale.

Methods

The Clinical Competency Scale was formed through modification of Lee's Clinical Competency Scale that was originally developed in 1990. The Clinical Competency Scale was applied to 203 nursing students. Construct validity, item convergent and discriminant validity, concurrent validity, and internal consistency reliability of the scale were evaluated.

Results

Exploratory factor analysis supported the construct validity with a five factor solution; that explained 63.6% of the total variance. Concurrent validity was demonstrated with the Nursing Competence Scale (r=.78, p<.001). Cronbach’s ⍺ coefficient for the scale was .96.

Conclusion

The results of this study suggest that the Clinical Competency Scale has relatively acceptable reliability and validity and can be used in clinical research to assess clinical competency for nursing students.

Keywords: Students; Nursing; Clinical competency; Psychometrics

Comparison of Subcategories for Clinical Competency

Demographic Characteristics of Participants(N=203)

Factor Analysis of Clinical Competency Scale (N=203)

Multi-trait/Multi-item Matrix Analysis (N=203)

Correlations between Clinical Competency Scale and Nursing Competence Scale (N=203)

References

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Copyright © 2018 Korean Academy of Community Health Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Table 1.

Comparison of Subcategories for Clinical Competency

Subcategories Korean accreditation board manual of nursing education [2] Six-dimension scale of nursing performance (Six-D Scale) [10] Nursing competence [16] Outcome assessment [17] Framework for nursing [18] Competency outcomes and performance assesment (COPA) model [19]
Nursing process O O O O O
Nursing skills O O O O
Communication O O O O O O
Management O O
Leadership O O O O O
Coordinating O O
Teaching O O O
Professional development O O O O
Interpersonal relationships O O O O O
Critical thinking O O O O O

Table 2.

Demographic Characteristics of Participants(N=203)

Characteristics Categories n (%) or M±SD
Age (year) 23.57±4.11
Gender Female 192 (94.6)
Male 11 (5.4)
Academic High grades 14 (6.9)
achievement Upper middle grades 46 (22.7)
Middle grades 109 (53.7)
Low grades 34 (16.8)
Satisfaction on Dissatisfied 24 (11.8)
college life Moderate 120 (59.1)
Satisfied 49 (24.1)
Very satisfied 10 (4.9)
Stress on Not at all 5 (2.5)
college life Moderate 67 (33.0)
Somewhat 85 (41.9)
A lot 46 (22.7)

Table 3.

Factor Analysis of Clinical Competency Scale (N=203)

Factors Items M±SD Factor loading
F1 F2 F3 F4 F5
Nursing leadership Item 22 I inform the patient's family of the patient's needs and encourage the family to take therapeutic care for the patient's care. 3.58±0.67 .70 .27 .22 .15 .23
Item 27 I help patients identify and improve your poor health habits. 3.64±0.63 .67 .04 .12 .33 .16
Item 26 I recognize the importance and necessity of regular health screenings. 3.73±0.65 .66 .09 -.03 .38 .09
Item 25 I educate patients and families on disease prevention. 3.71±0.65 .64 .17 .06 .28 .29
Item 16 I make a safe therapeutic environment 3.68±0.63 .63 .33 .29 .17 .21
Item 23 I educate patients to identify patients' self-care skills and use them in the treatment process. 3.42±0.76 .61 .32 .31 .13 .30
Item 28 I provide the necessary information for self-care after discharge. 3.67±0.67 .61 .16 .13 .38 .21
Item 19 I acknowledge the nursing performed by the nurses and increase the morale. 3.32±0.75 .60 .33 .46 .11 .12
Item 21 I assess the nursing activities performed for the patient. 3.38±0.80 .59 .33 .36 .13 .19
Item 20 I observe that the patient's treatment plan is well implemented. 3.25±0.88 .59 .43 .38 .04 .14
Item 24 I explain to the family about the patient's treatment process and participate the family in patient care. 3.74±0.71 .58 .24 .10 .26 .24
Item 17 I consult with other health care providers when planning nursing care. 3.67±0.73 .51 .34 .28 .10 .21
Professional development Item 41 I am responsible for my actions. 3.68±0.72 .32 .75 .01 .20 .18
Item 40 I am committed to patient care with confidence and a positive attitude. 3.77±0.70 .32 .69 .23 .09 .12
Item 44 I solve problems that can not be solved by myself with the advice of a clinical supervisor and a professional nurse. 3.62±0.67 .21 .67 .06 .36 .17
Item 42 I have legal and ethical knowledge of nursing. 3.76±0.69 .19 .63 .10 .31 .22
Item 45 I accept and promote new ideas in nursing practice. 3.68±0.66 .12 .58 .19 .38 .28
Nursing skills Item 15 I know and use the principles and the use of machines and devices used in the treatment of patients. 3.73±0.67 .19 -.02 .77 .20 .16
Item 14 I know the priority of treatment in emergency situations in clinical practice and perform it proficiently. 3.74±0.66 .13 .17 .75 .12 .20
Item 13 I record the record of nursing activity performed by the patient in a scientific vocabulary. 3.83±0.66 .09 .14 .74 .06 .25
Item 9 I understand the basic principles of doctor's prescription and implement it promptly and accurately. 3.70±0.67 .24 .11 .64 .14 .27
Item 11 I perform patient preparation and nursing before and after the examination or treatment. 3.81±0.66 .36 .20 .46 .24 .31
Communication Item 32 I try to understand, understand, and give the necessary help to the individual aspects of the patient (ex. religion, habits, tastes). 3.67±0.76 .30 .21 .15 .74 .01
Item 31 I communicate with the patient and create an atmosphere that expresses fear and anxiety. 3.67±0.80 .18 .15 .11 .72 .18
Item 33 I take every nursing procedure as an opportunity to interact with the patient. 3.68±0.70 .33 .32 .15 .58 .15
Item 34 I try to meet the emotional needs of the patient. 3.76±0.68 .30 .49 .09 .53 .15
Item 30 I fully explain purpose, sequence and method before examination, treatment, and nursing treatment. 3.84±0.66 .38 .29 .23 .52 .15
Item 35 I acquire the desirable human relationship with the medical person and enhance the ability as mediator and leader. 3.63±0.72 .25 .46 .29 .51 .12
Item 43 I accept and improve constructive criticism. 3.84±0.71 .17 .46 .14 .50 .20
Nursing process Item 4 Item 5 I plan nursing care according to nursing diagnosis. I make problem identification and nursing diagnosis. 3.88±0.68 3.78±0.74 .28 .15 .20 .23 .18 .31 .16 .16 .75 .72
Item 3 I analyze meaningful data. 3.70±0.71 .23 .13 .27 .09 .70
Item 6 I plan nursing care according to the patient's condition. 3.82±0.68 .27 .20 .34 .10 .67
Item 7 I plan nursing care to meet family needs and patient needs. 3.70±0.72 .41 .22 .23 .25 .58
Eigen value 15.51 2.35 1.47 1.19 1.10
Explained variance (%) 45.6 6.9 4.3 3.5 3.3
Accumulative variance (%) 45.6 52.6 56.9 60.4 63.6
Kaiser-Meyer-OIkin (KMO)=.94; Bartlett's test of sphericity x2=6,638.14 (p＜.001)
Cronbach's ⍺ .93 .86 .84 .89 .88
Total Cronbach's ⍺=.96

Table 4.

Multi-trait/Multi-item Matrix Analysis (N=203)

Factors Items F1
 F2
 F3
 F4
 F5
 2 Standard error
r r r r r
Nursing 22 .82 .55 .50 .57 .58 .17
leadership 27 .71 .46 .41 .52 .46 .27
26 .68 .45 .30 .53 .37 .22
25 .74 .53 .42 .55 .51 .17
16 .82 .59 .53 .61 .58 .16
23 .80 .59 .58 .60 .63 .22
28 .75 .52 .42 .62 .52 .20
19 .80 .56 .62 .57 .56 .16
21 .79 .55 .54 .58 .58 .19
20 .78 .58 .55 .58 .56 .23
24 .72 .53 .41 .57 .49 .29
17 .71 .53 .48 .54 .53 .28
Professional 41 .60 .84 .33 .62 .46 .23
development 40 .60 .80 .44 .58 .48 .18
44 .57 .83 .36 .67 .44 .27
42 .54 .78 .38 .60 .47 .24
45 .55 .78 .43 .72 .52 .38
Nursing skills 15 .46 .31 .82 .39 .47 .28
14 .48 .41 .82 .41 .51 .28
13 .43 .35 .79 .34 .50 .27
9 .52 .37 .78 .43 .56 .23
11 .62 .48 .71 .53 .59 .23
Communication 32 .55 .53 .35 .79 .37 .36
31 .48 .48 .33 .75 .41 .19
33 .60 .58 .41 .79 .48 .17
34 .61 .67 .38 .80 .48 .27
30 .64 .58 .46 .77 .49 .15
35 .62 .66 .49 .79 .49 .25
43 .52 .63 .39 .64 .45 .25
Nursing process 4 .58 .50 .52 .49 .84 .16
5 .53 .49 .56 .50 .84 .22
3 .52 .41 .52 .42 .80 .15
6 .58 .51 .59 .47 .84 .15
7 .68 .55 .56 .59 .81 .17

Table 5.

Correlations between Clinical Competency Scale and Nursing Competence Scale (N=203)

Variables Nursing competence scale
Total
 NP
 INCT
 CS
 NL
 RL
 SM
 NR
 CNS
r (p) r (p) r (p) r (p) r (p) r (p) r (p) r (p) r (p)
Clinical competency .78 .60 .72 .68 .67 .53 .67 .57 .56
scale (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001)
Nursing leadership .72 .56 .67 .65 .60 .49 .66 .45 .52
(＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001)
Professional .71 .61 .64 .64 .57 .53 .60 .49 .48
development (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001)
Nursing skills .51 .27 .50 .38 .45 .38 .42 .44 .42
(＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001)
Communication .72 .55 .63 .62 .65 .46 .57 .57 .55
(＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001)
Nursing process .64 .51 .63 .53 .55 .38 .51 .50 .40
(＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001) (＜.001)

NP=nursing professionalism; INCT=integrated nursing through critical thinking; CS=communication skills; NL=nursing leadership; RL=respect of life; SM=stress management; NR=nursing research; CNS=core nursing skills.