Understanding Nurses' Perceptions of Communication Between Nurses and Physicians using Construct Modeling

Monday, July 11, 2011: 10:55 AM

Mary Bourke, RN, MSN, PhD
School of Nursing, Indiana University, Kokomo, IN
Paula McKinney, RN, MSN
Administration, Howard Regional Hospital, Kokomo, IN
Michaelene Andersen, RN, MSN
PET/Oncology, Howard Regional Hospital, Kokomo, IN
Carolyn Harlan, BSN, RN
Physician Practice, Howard Regional Hospital, Kokomo, IN
Annette Malston, RN, RVT, RDCS
Outcomes Manager, Howard Regional Hospital, Kokomo, IN
Maria Pantaleo, RN, MSN
Howard Regional Hospital, Kokomo, IN

Learning Objective 1: Understand how Construct Modeling is used to identify the dimensions of a construct under study and therefore, a guide for instrument development.

Learning Objective 2: Synthesize how Rash Model diagnostics are used to evaluate the effectiveness of instruments developed for measurement.

Purpose: A partnership was formed between a large regional hospital and nursing faculty from a large university. The partnership-facilitated research was created for the purpose of improving evidence based care. A communication team was formed that included one nursing faculty member and five staff nurses. AIMS: Communication between physicians and nurses was identified as an area that needed improvement to enhance patient care. Therefore, the team developed an instrument based on Construct Modeling, identifying dimensions of communication within the context of a hospital. The identified dimensions were used as a guide in the creation of items for the instrument. Construct modeling includes the following: the construct map, the design plan, the outcome space, and measurement model. Several iterations of the instrument were developed after consultation with peers. Usability testing was performed and changes were made based on feedback.

Methods: A final version of the survey was distributed to RN’s who volunteered to participate. IRB approval was obtained. 

Results: The population used for this study were RN’s currently working at the regional hospital. A research day was used as a convenient way to reach many nurses allowing them the opportunity to voluntarily participate in the research.


This study used Rasch Model diagnostics and analysis to evaluate an instrument that measured nursing staff perceptions of communication between nurses and doctors. Rasch analysis allowed a more appropriate analysis of the data and provided detailed information about the psychometric properties of the instrument. Tool diagnostics were performed as follows: category frequencies and average measures, as well as, threshold estimates, probability curves, and category fit statistics. Validity was articulated within the context of the Rasch model. Person and item reliability indexes were clarified in relation to defining reliability of the instrument and interpretation of the data.