Development and psychometric testing of the Ascent to Competence Scale.

AIM: This paper reports the development and psychometric testing of the Ascent to Competence Scale, an instrument designed to measure nursing students' perceptions of the quality of their clinical placement experience. BACKGROUND: The key purpose of clinical placements is to facilitate students' learning and progress toward the attainment of competence. The attainment of competence requires personal commitment and active involvement of students; support and guidance of clinical and academic staff; and clinical environments that are welcoming and inclusive of students. METHOD: The items for the Ascent to Competence Scale were identified following a critical review of the literature. Content and face validity were established by an expert panel. During 2010 the instrument was tested with third year nursing students (n=88) from one Australian university. Exploratory factor analysis with promax oblique rotation was used to determine construct validity and Cronbach's coefficient alpha determined the scale's internal consistency reliability. RESULTS: The final scale demonstrated satisfactory internal consistency (alpha 0.98). Exploratory factor analysis yielded a three-component structure termed "Being welcomed"; "Belongingness" and "Learning and competence". Each subscale demonstrated high internal consistency: 0.89; 0.96; and 0.95 respectively. CONCLUSION: The Ascent to Competence Scale provides a fresh perspective on clinical placements as it allows for the relationship between belongingness, learning and competence to be explored. The scale was reliable and valid for this cohort. Further research in different contexts would be valuable in extending upon this work. RELEVANCE TO CLINICAL PRACTICE: The Ascent to Competence Scale profiled in this paper will be of benefit to both educational and healthcare institutions. The use of a quantified yardstick, such as the Ascent to Competence Scale, is important in evaluating the efficacy of programs, placements and partnerships between higher education and health services.

The development and psychometric testing of the Satisfaction with Simulation Experience Scale.

AIM: This paper reports the development and psychometric testing of the Satisfaction with Simulation Experience Scale, an instrument designed to measure and compare differences in satisfaction levels between nursing students exposed to medium and high fidelity human patient simulation manikins. BACKGROUND: Student satisfaction is important to engaged and meaningful learning and it facilitates active and purposeful participation in simulation experiences. There are suggestions that student satisfaction may have some correlation with performance. Few studies have explored in a rigorous way the impact of manikin fidelity on nursing students' satisfaction with simulation experiences. METHOD: The items for the Satisfaction with Simulation Experience Scale were identified following a critical review of the literature. Content validly was established by use of an expert panel. During 2009 and 2010 the instrument was tested with second year (n=268) and third year nursing students (n=76) from one Australian university. Exploratory factor analysis with varimax rotation was used to determine construct validity and Cronbach's coefficient alpha determined the scale's internal consistency reliability. Differences in satisfaction levels between groups were analysed using an independent t test. Responses to an open ended question were categorised using thematic content analysis. RESULTS: The scale demonstrated satisfactory internal consistency (alpha 0.77). Exploratory factor analysis yielded a three-component structure termed Debriefing and Reflection, Clinical Reasoning, and Clinical Learning; each subscale demonstrated high internal consistency: 0.94; 0.86; 0.85 respectively. Mean satisfaction scores were high for each group. However, statistically significant differences were not apparent between second or third year students exposed to medium and high fidelity manikins. Content analysis identified 13 main categories including supplementing versus replacing clinical placements and the need for increased exposure to simulation sessions. CONCLUSION: The results of this study indicate that simulation is highly valued by students, irrespective of the level of fidelity. This raises questions about the value of investing in expensive simulation modalities. The Satisfaction with Simulation Experience Scale was reliable and valid for this cohort. Further research in different contexts would be valuable in extending upon this work.