Development and psychometric testing of a Clinical Reasoning Evaluation Simulation Tool (CREST) for assessing nursing students' abilities to recognize and respond to clinical deterioration
- Authors: Liaw, Sok , Rashasegaran, Ahtherai , Wong, Lai , Deneen, Christopher , Cooper, Simon J. , Levett-Jones, Tracy , Goh, Hongli , Ignacio, Jeanette
- Date: 2018
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 62, no. (2018), p. 74-79
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- Description: Background The development of clinical reasoning skills in recognising and responding to clinical deterioration is essential in pre-registration nursing education. Simulation has been increasingly used by educators to develop this skill. Objective To develop and evaluate the psychometric properties of a Clinical Reasoning Evaluation Simulation Tool (CREST) for measuring clinical reasoning skills in recognising and responding to clinical deterioration in a simulated environment. Design A scale development with psychometric testing and mixed methods study. Participants/Settings Nursing students and academic staff were recruited at a university. Method A three-phase prospective study was conducted. Phase 1 involved the development and content validation of the CREST; Phase 2 included the psychometric testing of the tool with 15 second-year and 15 third-year nursing students who undertook the simulation-based assessment; Phase 3 involved the usability testing of the tool with nine academic staff through a survey questionnaire and focus group discussion. Results A 10-item CREST was developed based on a model of clinical reasoning. A content validity of 0.93 was obtained from the validation of 15 international experts. The construct validity was supported as the third-year students demonstrated significantly higher (p < 0.001) clinical reasoning scores than the second-year students. The concurrent validity was also supported with significant positive correlations between global rating scores and almost all subscale scores, and the total scores. The predictive validity was supported with an existing tool. The internal consistency was high with a Cronbach's alpha of 0.92. A high inter-rater reliability was demonstrated with an intraclass correlation coefficient of 0.88. The usability of the tool was rated positively by the nurse educators but the need to ease the scoring process was highlighted. Conclusions A valid and reliable tool was developed to measure the effectiveness of simulation in developing clinical reasoning skills for recognising and responding to clinical deterioration. © 2017
Ethical issues in health-care inquiry: a discussion paper
- Authors: Ignacio, Jeanette , Taylor, Beverley
- Date: 2013
- Type: Text , Journal article
- Relation: International journal of nursing practice Vol. , no. 19 (Supplement S1) (2013), p. 56-61
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- Description: This paper is a discussion of the possible ethical dilemmas that may arise in both qualitative and quantitative research despite stringent methodological protocols. Three categories of ethical issues will be elaborated on, namely, researcher–participant relations, informed consent and confidentiality and privacy. These are of note because ethical dilemmas most often arise in these areas. Both qualitative and quantitative research types may thus present with problems associated with any, or a combination, of these categories. Methodological rigour will also be discussed as a vital component of any research study. Critics of the qualitative approach have often suggested that the innate lack of methodological rigour has resulted in the preponderance of ethical issues in qualitative studies. Qualitative studies, similar to quantitative studies, have mechanisms that guarantee rigour, quality and trustworthiness. These checks are at par with those of quantitative research but based on different criteria. Both types of research, then, can be considered equal in terms of methodological rigour, regardless of the nature. As no research approach can be perfectly free from threats of ethical issues, it is the researcher's responsibility to address these in ways that will be less harmful to the participants, bearing in mind ethical problems can arise at any time during the research endeavour.