Findings from an Instrument Validation Study to Measure Perceived Competence and Confidence of Clinical Nurse Educators

Background: The importance of the clinical component in nursing education has been well acknowledged. The transition of clinicians into the role of nurse educators is reported to be challenging, however, little is known about clinical nurse educator skill development after recruitment. This study has been conducted to develop and validate the instrument Clinical Nurse Educator Skill Acquisition Assessment (CNESAA). In phase one, the CNESAA was piloted and tested for reliability and validity. The instrument was modified according to exploratory factor analysis results. In this phase two, the conceptual model of CNESAA was tested again to validate the modifications made in phase one.

Objective:To test and validate the conceptual model of the CNESAA with 24 items and five subscales.

Method:Instrument validation method through confirmatory factor analysis, following the exploratory factor analysis that was conducted in phase one. Data were collected through surveys and analysed using IBM SPSS - AMOS software version 22.

Participants: 212 clinical nurse educators who were teaching nursing students at bachelor (4-year) and collegial (3-year) degrees of nursing in the current academic year (2014-2015).

Settings:12 institutions across three main geographical regions in Vietnam participated in this phase two.

Results:

Demographics:

There were 155 (73.1%) females and 57 (26.9%) males. One hundred forty-eight participants had background in nursing (69.8%), 61 participants (28.8%) were physicians and the remaining (n=3, 1.4%) had background in other disciplines in health. The participants aged from 22 to 59, with a mean age of 33.69 (D=8.35) and had 8.15 years of experience (SD=7.43) on average in the role of a clinical nurse educator.

Confirmatory factor analysis:

There was no missing data as a result of compulsory questions in the survey. The initial model of CNESAA suggested by explanatory factor analysis in the phase I with 24-item and five sub-scales has been tested. Model fitness was evaluated using minimum discrepancy statistic (CMIN/DF=2.261) with 236 degrees of freedom. High communalities for all 24 items were observed (.65-.88). High comparative fit index was achieved (CFI=.921). Goodness of Fit Index GFI was of .82, Root Mean Square Error of Approximation RMSEA of .077, Adjusted Goodness of Fit Index AGFI of .771. Although the GFI and AGFI were slightly below the threshold, the model does not suggest any cross-loadings between sub-scales and there were no significant standardised residual co-variances. As the purpose of this analysis was to test the conceptual model rather than seeking a model fit, these values are acceptable for a newly developed instrument. Average variance extracted AVE ranging from .56 to .68 (from standardised solution) for all sub-scales demonstrated convergent validity. Reliability was also established with high composite reliability for all sub-scales (CR=.79-.90).

 Conclusion:

The conceptual model of CNESAA developed and modified in phase one was validated. The instrument CNESAA is found to be reliable and valid to measure perceived competence and confidence of clinical nurse educators in the Vietnamese settings and potentially in similar contexts.