Development and Psychometric Testing of the Gerontological Nursing Clinical Reasoning Scale
Keywords:
Clinical reasoning, Gerontology, Gerontology nursing, Nursing students, Script Concordance TestAbstract
The assessing and evaluating of quality in nursing care of older adults is important to promise high standard patients’ outcomes. Reliable and appropriate instrument measured clinical reasoning skills in gerontological nursing was not readily available. The purpose of this study was to develop and validate the Gerontological Nursing Clinical Reasoning Scale in Thailand. A cross-sectional study was performed with a psychometric evaluation of this new developed scale. A pool of 18 short clinical vignettes composed of 72 items with a 5-response Likert type scale was initially developed in the format of the Script Concordance Test. The Script theory and the hypothetical-deductive theory were applied. The scale development process had six steps, including content validity and reliability assessment. Then, it was tested in 80 participants who were in equal groups of senior nursing students and registered nurses in Phayao province. The construct validity by known group technique was used. Twelve advanced practice nurses who were specialized in gerontological nursing and considered as a panellist group were involved. The scores among groups were compared by using the one-way analysis of variance with a Scheffe’s post hoc test. The 14-vignettes the Gerontological Nursing Clinical Reasoning Scale which comprised 47 items was finalized. The findings showed that the panellists, registered nurses, and nursing students had statistical different mean scores. The panellists had the highest scores, followed by the registered nurses, and nursing students, respectively. The Scale had an acceptable level of construct validity and internal consistency and could distinguish clinical reasoning skills among the three groups of nurses sampled. Nursing educators can introduce this scale to measure clinical reasoning in gerontological nursing courses but further testing with other populations is needed.
References
1. Hofler L, Thomas K. Transition of new graduate nurses to the workforce: Challenges and solutions in the changing health care environment. North Carolina Medical Journal. 2016;77(2):133-136.
2. Banning M. The think aloud approach as an educational tool to develop and assess clinical reasoning in undergraduate students. Nurse Education Today. 2008;28.
3. Hunter S, Arthur C. Clinical reasoning of nursing students on clinical placement: Clinical educators’ perceptions. Nurse Education in Practice. 2016;18:73-9.
4. Levett-Jones T, Hoffman K, Dempsey J, Jeong SY, Noble D, Norton CA, et al. The ‘five rights’ of clinical reasoning: An educational model to enhance nursing students’ ability to identify and manage clinically ‘at risk’ patients. Nurse Education Today. 2010;30(6):515-20.
5. Simmons B. Clinical reasoning: Concept analysis. Journal of advanced nursing. 2010;66(5):1151-1158.
6. McCartney M. Nurses must be allowed to exercise professional judgment. BMJ. 2017;356:j1548.
7. Goudreau J, Boyer L, Letourneau D. Clinical nursing reasoning in nursing practice: A cognitive learning model based on a think aloud methodology. Quality Advancement in Nursing Education. 2014;1(1):1-18.
8. Stayt LC, Merriman C. A descriptive survey investigating pre-registration student nurses’ perceptions of clinical skill development in clinical placements. Nurse Education Today. 2013;33(4):425-430.
9. Tapaneeyakorn V, Kosolchuenvijit J, Anonrath K, Wannasuntad S, Srikan P. Factors affecting clinical reasoning in nursing students of Boromarajonani College of Nursing Bangkok. Journal of Health Science Research. 2016;10(1):70-77.
10. Junod Perron N, Louis-Simonet M, Cerutti B, Pfarrwaller E, Sommer J, Nendaz M. Feedback in formative OSCEs: Comparison between direct observation and video-based formats. Medical Online. 2016;21:32160.
11. Halman S, Dudek N, Wood T, Pugh D, Touchie C, McAleer S, et al. Direct observation of clinical skills feedback scale: Development and validity evidence. Teaching and Learning in Medicine. 2016;28(4):385-394.
12. Orrock P, Grace S, Vaughan B, Coutts R. Developing a viva exam to assess clinical reasoning in pre-registration osteopathy students. BioMed Central Medical Education. 2014;14(1):193.
13. Kelly MA, Mitchell ML, Henderson A, Jeffrey CA, Groves M, Nulty DD, et al. OSCE best practice guidelines-applicability for nursing simulations. Advances in Simulation (London, England). 2016;1:10.
14. Zamani S, Amini M, Masoumi SZ, Delavari S, Namaki MJ, Kojuri J. The comparison of the key feature of clinical reasoning and multiple choice examinations in clinical decision makings ability. Biomedical Research. 2017;28(3):1115-1119.
15. Park WB, Kang SH, Lee YS, Myung SJ. Does objective structured clinical examinations score reflect the clinical reasoning ability of medical students? The American Journal of Medical Sciences. 2015;350(1):64-67.
16. Charlin B, Roy L, Brailovsky C, Goulet F, van der Vleuten C. The Script Concordance test: A tool to assess the reflective clinician. Teaching and Learning Medicine. 2000;12(4):189-195.
17. Lubarsky S, Dory V, Duggan P, Gagnon R, Charlin B. Script concordance testing: From theory to practice: AMEE guide No. 75. Medical Teacher. 2013;35(3):184-193.
18. Kazour F, Richa S, Zoghbi M, El-Hage W, Haddad FG. Using the Script Concordance Test to evaluate clinical reasoning skills in psychiatry. Academic Psychiatry. 2017;41(1):86-90.
19. Wan M. Using the script concordance test to assess clinical reasoning skills in undergraduate and postgraduate medicine. Hong Kong Medical Journal 2015;21(5):455-461.
20. Nseir S, Elkalioubie A, Deruelle P, Lacroix D, Gosset D. Accuracy of script concordance tests in fourth-year medical students. International Journal of Medical Education. 2017;8:63-9.
21. Duggan P, Charlin B. Introducing recent medical graduates as members of Script Concordance Test expert reference panels: What impact? MedEdPublish. 2016;5(2):32-44.
22. Cobb KA, Brown G, Hammond R, Mossop LH. Students’ perceptions of the Script Concordance Test and its impact on their learning behavior: A mixed methods study. Journal of Veterinary Medical Education. 2015.
23. Goos M, Schubach F, Seifert G, Boeker M. Validation of undergraduate medical student script concordance test (SCT) scores on the clinical assessment of the acute abdomen. BMC surgery. 2016;16(1):57-.
24. Borges PFB. Script Concordance Test: A proposal for evaluation of the management of nursing reasoning in uncertain situations. Botucatu, Portugal: Universida de Estadual Paulista; 2016.
25. Dawson T. Can script concordance testing be utilized in nursing education to accurately assess clinical reasoning skills?. Cullowhee, NC: Western Carolina University, Cullowhee, NC; 2014.
26. Deschênes MF, Goudreau J. Addressing the development of both knowledge and clinical reasoning in nursing through the perspective of script concordance: An integrative literature review. Journal of Nursing Education and Practice. 2017;7(12):29-38.
27. Peeters C, de Groot-Bolluijt W, Gobbens R, van Brunschot M, editors. Digital Script Concordance Test for Clinical Reasoning. CAA: International Computer Assisted Assessment Conference; 2014; Zeist, The Netherlands: Springer, Cham.
28. Piovezan RD, Custodio O, Cendoroglo MS, Batista NA, Lubarsky S, Charlin B. Assessment of undergraduate clinical reasoning in geriatric medicine: Application of a script concordance test. Journal of American Geriatric Society. 2012;60(10):1946-1950.
29. Ruiz JG, Tunuguntla R, Charlin B, Ouslander JG, Symes SN, Gagnon R, et al. The Script Concordance Test as a measure of clinical reasoning skills in geriatric urinary incontinence. Journal of the American Geriatric Society. 2010;58(11):2178-2184.
30. Pantulawan S, Kunavikitikul W, Nantsupawat, R, Srisuphan W. Development and psychometric testing of the Nursing Performance for Patient Safety Scale. Pacific Rim International Journal of Nursing Research. 2016:20 (1):45-59.
31 Gagnon R, Charlin B, Coletti M, Sauve E, van der Vleuten C. Assessment in the context of uncertainty: How many members are needed on the panel of reference of a script concordance test? Medical Education. 2005;39(3):284-291.
32. Lineberry M, Kreiter CD, Bordage G. Threats to validity in the use and interpretation of script concordance test scores. Medical Education. 2013;47(12):1175-1183.
33. Fournier JP, Demeester A, Charlin B. Script Concordance Tests: Guidelines for construction. BioMed Central Medical Informatics and Decision Making. 2008;8(1):18.
34. Charlin B, Gagnon R, Lubarsky S, Lambert C, Meterissian S, Chalk C, et al. Assessment in the context of uncertainty using the script concordance test: More meaning for scores. Teaching and Learning in Medicine. 2010;22(3):180-186.
35. Duggan P, Charlin B. Summative assessment of 5th year medical students’ clinical reasoning by Script Concordance Test: Requirements and challenges. BMC Meical Education. 2012;12(29).
36. Mathieu S, Couderc M, Glace B, Tournadre A, MalochetGuinamand S, Pereira B, et al. Construction and utilization of a script concordance test as an assessment tool for dcem3 (5th year) medical students in rheumatology. BioMed Central Medical Education. 2013;13(1):166.
37. Boulouffe C, Doucet B, Muschart X, Charlin B, Vanpee D. Assessing clinical reasoning using a script concordance test with electrocardiogram in an emergency medicine clerkship rotation. Emergency Medicine Journal. 2014;31(4):313-316.
38. Humbert AJ, Besinger B, Miech EJ. Assessing clinical reasoning skills in scenarios of uncertainty: Convergent validity for a Script Concordance Test in an emergency medicine clerkship and residency. Academic Emergency Medicine. 2011;18(6):627-34.
39. Charlin B, Tardif J, Boshuizen HP. Scripts and medical diagnostic knowledge: Theory and applications for clinical reasoning instruction and research. Academic Medicine. 2000;75(2):182-190.
40. Nouh T, Boutros M, Gagnon R, Reid S, Leslie K, Pace D, et al. The Script Concordance Test as a measure of clinical reasoning: A national validation study. American Journal of Surgery. 2012;203(4):530-534.
41. Uy RC, Sarmiento RF, Gavino A, Fontelo P. Confidence and information access in clinical decision-making: An examination of the cognitive processes that affect the information-seeking behavior of physicians. AMIA Annual Symposium Proceedings. 2014;2014:11341140.
42. Gagnon R, Charlin B, Lambert C, Carriere B, Van der Vleuten C. Script Concordance Testing: More cases or more questions? . Advances in Health Science Education: Theory and practice. 2009;14(3):367-375.
43. Wilson AB, Pike GR, Humbert AJ. Analyzing script concordance test scoring methods and items by difficulty and type. Teaching and Learning in Medicine. 2014; 26(2):135-145.
2. Banning M. The think aloud approach as an educational tool to develop and assess clinical reasoning in undergraduate students. Nurse Education Today. 2008;28.
3. Hunter S, Arthur C. Clinical reasoning of nursing students on clinical placement: Clinical educators’ perceptions. Nurse Education in Practice. 2016;18:73-9.
4. Levett-Jones T, Hoffman K, Dempsey J, Jeong SY, Noble D, Norton CA, et al. The ‘five rights’ of clinical reasoning: An educational model to enhance nursing students’ ability to identify and manage clinically ‘at risk’ patients. Nurse Education Today. 2010;30(6):515-20.
5. Simmons B. Clinical reasoning: Concept analysis. Journal of advanced nursing. 2010;66(5):1151-1158.
6. McCartney M. Nurses must be allowed to exercise professional judgment. BMJ. 2017;356:j1548.
7. Goudreau J, Boyer L, Letourneau D. Clinical nursing reasoning in nursing practice: A cognitive learning model based on a think aloud methodology. Quality Advancement in Nursing Education. 2014;1(1):1-18.
8. Stayt LC, Merriman C. A descriptive survey investigating pre-registration student nurses’ perceptions of clinical skill development in clinical placements. Nurse Education Today. 2013;33(4):425-430.
9. Tapaneeyakorn V, Kosolchuenvijit J, Anonrath K, Wannasuntad S, Srikan P. Factors affecting clinical reasoning in nursing students of Boromarajonani College of Nursing Bangkok. Journal of Health Science Research. 2016;10(1):70-77.
10. Junod Perron N, Louis-Simonet M, Cerutti B, Pfarrwaller E, Sommer J, Nendaz M. Feedback in formative OSCEs: Comparison between direct observation and video-based formats. Medical Online. 2016;21:32160.
11. Halman S, Dudek N, Wood T, Pugh D, Touchie C, McAleer S, et al. Direct observation of clinical skills feedback scale: Development and validity evidence. Teaching and Learning in Medicine. 2016;28(4):385-394.
12. Orrock P, Grace S, Vaughan B, Coutts R. Developing a viva exam to assess clinical reasoning in pre-registration osteopathy students. BioMed Central Medical Education. 2014;14(1):193.
13. Kelly MA, Mitchell ML, Henderson A, Jeffrey CA, Groves M, Nulty DD, et al. OSCE best practice guidelines-applicability for nursing simulations. Advances in Simulation (London, England). 2016;1:10.
14. Zamani S, Amini M, Masoumi SZ, Delavari S, Namaki MJ, Kojuri J. The comparison of the key feature of clinical reasoning and multiple choice examinations in clinical decision makings ability. Biomedical Research. 2017;28(3):1115-1119.
15. Park WB, Kang SH, Lee YS, Myung SJ. Does objective structured clinical examinations score reflect the clinical reasoning ability of medical students? The American Journal of Medical Sciences. 2015;350(1):64-67.
16. Charlin B, Roy L, Brailovsky C, Goulet F, van der Vleuten C. The Script Concordance test: A tool to assess the reflective clinician. Teaching and Learning Medicine. 2000;12(4):189-195.
17. Lubarsky S, Dory V, Duggan P, Gagnon R, Charlin B. Script concordance testing: From theory to practice: AMEE guide No. 75. Medical Teacher. 2013;35(3):184-193.
18. Kazour F, Richa S, Zoghbi M, El-Hage W, Haddad FG. Using the Script Concordance Test to evaluate clinical reasoning skills in psychiatry. Academic Psychiatry. 2017;41(1):86-90.
19. Wan M. Using the script concordance test to assess clinical reasoning skills in undergraduate and postgraduate medicine. Hong Kong Medical Journal 2015;21(5):455-461.
20. Nseir S, Elkalioubie A, Deruelle P, Lacroix D, Gosset D. Accuracy of script concordance tests in fourth-year medical students. International Journal of Medical Education. 2017;8:63-9.
21. Duggan P, Charlin B. Introducing recent medical graduates as members of Script Concordance Test expert reference panels: What impact? MedEdPublish. 2016;5(2):32-44.
22. Cobb KA, Brown G, Hammond R, Mossop LH. Students’ perceptions of the Script Concordance Test and its impact on their learning behavior: A mixed methods study. Journal of Veterinary Medical Education. 2015.
23. Goos M, Schubach F, Seifert G, Boeker M. Validation of undergraduate medical student script concordance test (SCT) scores on the clinical assessment of the acute abdomen. BMC surgery. 2016;16(1):57-.
24. Borges PFB. Script Concordance Test: A proposal for evaluation of the management of nursing reasoning in uncertain situations. Botucatu, Portugal: Universida de Estadual Paulista; 2016.
25. Dawson T. Can script concordance testing be utilized in nursing education to accurately assess clinical reasoning skills?. Cullowhee, NC: Western Carolina University, Cullowhee, NC; 2014.
26. Deschênes MF, Goudreau J. Addressing the development of both knowledge and clinical reasoning in nursing through the perspective of script concordance: An integrative literature review. Journal of Nursing Education and Practice. 2017;7(12):29-38.
27. Peeters C, de Groot-Bolluijt W, Gobbens R, van Brunschot M, editors. Digital Script Concordance Test for Clinical Reasoning. CAA: International Computer Assisted Assessment Conference; 2014; Zeist, The Netherlands: Springer, Cham.
28. Piovezan RD, Custodio O, Cendoroglo MS, Batista NA, Lubarsky S, Charlin B. Assessment of undergraduate clinical reasoning in geriatric medicine: Application of a script concordance test. Journal of American Geriatric Society. 2012;60(10):1946-1950.
29. Ruiz JG, Tunuguntla R, Charlin B, Ouslander JG, Symes SN, Gagnon R, et al. The Script Concordance Test as a measure of clinical reasoning skills in geriatric urinary incontinence. Journal of the American Geriatric Society. 2010;58(11):2178-2184.
30. Pantulawan S, Kunavikitikul W, Nantsupawat, R, Srisuphan W. Development and psychometric testing of the Nursing Performance for Patient Safety Scale. Pacific Rim International Journal of Nursing Research. 2016:20 (1):45-59.
31 Gagnon R, Charlin B, Coletti M, Sauve E, van der Vleuten C. Assessment in the context of uncertainty: How many members are needed on the panel of reference of a script concordance test? Medical Education. 2005;39(3):284-291.
32. Lineberry M, Kreiter CD, Bordage G. Threats to validity in the use and interpretation of script concordance test scores. Medical Education. 2013;47(12):1175-1183.
33. Fournier JP, Demeester A, Charlin B. Script Concordance Tests: Guidelines for construction. BioMed Central Medical Informatics and Decision Making. 2008;8(1):18.
34. Charlin B, Gagnon R, Lubarsky S, Lambert C, Meterissian S, Chalk C, et al. Assessment in the context of uncertainty using the script concordance test: More meaning for scores. Teaching and Learning in Medicine. 2010;22(3):180-186.
35. Duggan P, Charlin B. Summative assessment of 5th year medical students’ clinical reasoning by Script Concordance Test: Requirements and challenges. BMC Meical Education. 2012;12(29).
36. Mathieu S, Couderc M, Glace B, Tournadre A, MalochetGuinamand S, Pereira B, et al. Construction and utilization of a script concordance test as an assessment tool for dcem3 (5th year) medical students in rheumatology. BioMed Central Medical Education. 2013;13(1):166.
37. Boulouffe C, Doucet B, Muschart X, Charlin B, Vanpee D. Assessing clinical reasoning using a script concordance test with electrocardiogram in an emergency medicine clerkship rotation. Emergency Medicine Journal. 2014;31(4):313-316.
38. Humbert AJ, Besinger B, Miech EJ. Assessing clinical reasoning skills in scenarios of uncertainty: Convergent validity for a Script Concordance Test in an emergency medicine clerkship and residency. Academic Emergency Medicine. 2011;18(6):627-34.
39. Charlin B, Tardif J, Boshuizen HP. Scripts and medical diagnostic knowledge: Theory and applications for clinical reasoning instruction and research. Academic Medicine. 2000;75(2):182-190.
40. Nouh T, Boutros M, Gagnon R, Reid S, Leslie K, Pace D, et al. The Script Concordance Test as a measure of clinical reasoning: A national validation study. American Journal of Surgery. 2012;203(4):530-534.
41. Uy RC, Sarmiento RF, Gavino A, Fontelo P. Confidence and information access in clinical decision-making: An examination of the cognitive processes that affect the information-seeking behavior of physicians. AMIA Annual Symposium Proceedings. 2014;2014:11341140.
42. Gagnon R, Charlin B, Lambert C, Carriere B, Van der Vleuten C. Script Concordance Testing: More cases or more questions? . Advances in Health Science Education: Theory and practice. 2009;14(3):367-375.
43. Wilson AB, Pike GR, Humbert AJ. Analyzing script concordance test scoring methods and items by difficulty and type. Teaching and Learning in Medicine. 2014; 26(2):135-145.
Downloads
Published
2019-06-19
How to Cite
1.
Srikan P, Tachvises S. Development and Psychometric Testing of the Gerontological Nursing Clinical Reasoning Scale. PRIJNR [Internet]. 2019 Jun. 19 [cited 2024 Nov. 18];23(3):243-57. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/148791
Issue
Section
Original paper
License
Copyright: The Pacific Rim International Journal of Nursing Research, Thailand Nursing & Midwifery Council has exclusive rights to publish, reproduce and distribute the manuscript and all contents therein.
.png)
