REPRESENTATIONAL AND CONTENT VALIDITY OF A CLINICAL REASONING INSTRUMENT IN BULGARIAN NURSING PRACTICE
Keywords:
clinical reasoning, representational validity, content validity, psychometric analysis, nursesAbstract
Clinical reasoning is a fundamental component of nursing practice, ensuring high-quality and safe patient care. The ability to reliably and validly assess these competencies is crucial for the educational process and professional development of nurses. This study focuses on the adaptation and validation of a clinical reasoning questionnaire in the Bulgarian context, with a specific emphasis on measuring the content and representational validity of the instrument. The research includes students and professionals from various medical universities in Bulgaria to evaluate the suitability of the questionnaire for assessing clinical reasoning competencies among nurses. The aim of this study is to evaluate the representational and content validity of the adapted Bulgarian version of the clinical reasoning questionnaire developed by Liou et al. (2015). Methods and methodology. The study involves 238 participants, including nursing and midwifery students from different universities in Bulgaria. To assess the content and representational validity of the adapted clinical reasoning questionnaire, the following statistical methods were employed: descriptive statistics, content validity index (CVI), and assessment of representational validity. These methods provided a comprehensive approach to validating the questionnaire and confirmed its suitability for evaluating clinical reasoning among Bulgarian nurses. The results indicate a high level of agreement among experts regarding the content validity of the items, with a content validity index of 0.96. The questionnaire demonstrates good psychometric characteristics and is applicable for assessing clinical reasoning among Bulgarian nurses. Conclusion. The results of the study highlight the potential of the adapted instrument for measuring clinical reasoning and its usefulness in medical education and practice in Bulgaria.
References
Андонова, А. (2022). Формиране на професионално значими компетентности в процеса на обучение на студентите от медицински специалности. Управление и образование, Университет „Проф. д-р Асен Златаров“, Бургас, 18(5), 7–10. Дарачева, Е., Карашмалъкова, Г., Обрейкова, М., & Бейсимова, Ю. (2024). Изследване професионалната компетентност на медицинските сестри при приложение на парентерална терапия. Управление и образование, 20(5), 41–46. Кючукова, С., Андонова, А., Тодорова, Т., & Танев, М. (2023). Приложимост на метода „Връстници обучават връстници“ в университетското образование. Управление и образование, 19(5), 111–115. Милчева, Х. (2019). Креативен стил в обучението на здравните специалисти. Лакс бук. Министерство на здравеопазването. (2011). Наредба № 1 от 8 февруари 2011 г. за професионалните дейности, които медицинските сестри, акушерките, асоциираните медицински специалисти, зъботехниците и здравните асистенти могат да извършват по назначение или самостоятелно (обн. ДВ, бр. 15 от 18 февруари 2011 г.; изм. ДВ, бр. 50 от 1 юли 2011 г.; изм. и доп. ДВ, бр. 61 от 2 август 2022 г.). https://lex.bg/bg/laws/ldoc/2135718392 Bacheva, M. (2023). PILOT STUDY: ADAPTATION AND VALIDATION OF A TOOL FOR ASSESSING CLINICAL REASONING IN NURSING STUDENTS. KNOWLEDGE - International Journal, 61(4), 821–829. Retrieved from http://ikm.mk/ojs/index.php/kij/article/view/6497 Banning, M. (2008). A review of clinical decision making: Models and current research. Journal of Clinical Nursing, 17(2), 187–195. https://doi.org/10.1111/j.1365-2702.2006.01791.x Banning, M. (2008). Clinical reasoning and its application to nursing: Concepts and research studies. Nurse Education in Practice, 8(3), 177–183. https://doi.org/10.1016/j.nepr.2007.06.004 Berkow, S., Virkstis, K., Stewart, J., Aronson, S., & Donohue, M. (2011). Assessing individual frontline nurse critical thinking. Journal of Nursing Administration, 41(4), 168–171. https://pubmed.ncbi.nlm.nih.gov/21430465/ Dzhedzheva, P. (2023). Проблемно базирано обучение в подготовката на медицински сестри за формиране на критично мислене. В Proceedings from Fourth International Conference Nursing care – a contribution to the quality of life (стр. 262–270). Medical University of Varna, Affiliate Sliven.
Gonzalez, L., Nielsen, A., & Lasater, K. (2021). Developing students' clinical reasoning skills: A faculty guide. Journal of Nursing Education, 60(9), 485–493. https://doi.org/10.3928/01484834-20210708-01 Hristova, T., & Todorova, T. (2021). Important professional competence applied in pre-graduation practice. Knowledge – International Journal, 45(2), 419–423. Jacobson, S. (2004). Evaluating instruments for use in clinical nursing research. In M. Frank- Stromborg & S. J. Olsen (Eds.), Instruments for clinical health-care research (3rd ed., pp. 3-19). Jones and Bartlett Publishers. Jensen, G. M., & Givens, D. (2002). Clinical reasoning: Linking theory to practice and practice to theory. Neurology Report, 23(4), 137-144. Ovid Technologies (Wolters Kluwer Health). doi: https://doi.org/10.1097/01253086-199923040-00009 Joung, J., & Han, J. W. (2017). Validity and reliability of a Korean version of nurse clinical reasoning competence scale. Journal of the Korea Academia-Industrial Cooperation Society, 18(4), 304-310.Wu Y, Ding Y, Tanaka Y, Zhang W. Risk factors contributing to type 2 diabetes and recent advances in the treatment and prevention. Int J Med Sci. 2014 Sep 6;11(11):1185-200. doi: 10.7150/ijms.10001. PMID: 25249787; PMCID: PMC4166864 Lawshe, C. H. (1975). A quantitative approach to content validity. Personnel Psychology, 28(4), 563-575. https://doi.org/10.1111/j.1744-6570.1975.tb01393.x Leal, P., Poeira, A., Mendes, D. A., Batalha, N., Franco, H., Nunes, L., et al. (2024). Teaching and learning clinical reasoning in nursing education: A student training course. Healthcare, 12(12), 1219. https://doi.org/10.3390/healthcare12121219 Levett-Jones, T., Hoffman, K., & Dempsey, J. (2010). 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, 30(6), 515-520. https://doi.org/10.1016/j.nedt.2009.10.020 Liou, S. R., Liu, H. C., Tsai, H. M., Tsai, Y. H., Lin, Y. C., Chang, C. H., & Cheng, C. Y. (2015). The development and psychometric testing of a theory-based instrument to evaluate nurses' perception of clinical reasoning competence. Journal of Advanced Nursing, 72(3), 707-717. https://doi.org/10.1111/jan.12831 Lombard, M., Snyder- Duch, J., & Bracken, C. C. (2010). Practical resources for assessing and reporting intercoder reliability in content analysis research projects. http://matthewlombard.com/reliability/ Tian, J., Atkinson, N. L., Portnoy, B., & Lowitt, N. R. (2010). The development of a theory-based instrument to evaluate the effectiveness of continuing medical education. Academic Medicine, 85(9), 1518–1525. https://doi.org/10.1097/ACM.0b013e3181eac3fb. Todorova, D. (2021). Organizational aspects of the work of medical specialists working in emergency medical care in the Republic of Bulgaria (Dissertation). Stara Zagora. Wild, D., Grove, A., Martin, M., Eremenco, S., McElroy, S., Verjee-Lorenz, A., & Erikson, P. (2005). Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaptation. Value in health, 8(2), 94-104.
