Psychometric Properties of the Clinical Competence Questionnaire

Tuesday, July 12, 2011: 9:10 AM

Shwu-Ru Liou, PhD, RN
School of Nursing, Chang Gung Institute of Technology at Chiayi Campus, Chiayi, Taiwan
Ching-Yu Cheng, PhD
School of Nursing, Chang Gung Institute of Technology, Chiayi, Taiwan
Mei-Yu Pan, MSc
School of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan

Learning Objective 1: The learners will be able to list categories of nursing competence.

Learning Objective 2: The learners will be able to design curriculums and teaching strategies based on students’ clinical competence.

Purpose: Low competence and high stress from new environment may be factors for high turnover of new graduates. Yet, scale to measure clinical competence is scarce. The purpose of the study was to examine psychometric properties of a clinical competence scale. Research question is “what are the reliability and validity of the clinical competence scale?”

Methods: The study was a repeated-measure interventional design using 340 nursing students (96% response rate) doing their last clinical practicum at a two-year nursing program in Taiwan. Data were gathered before and after the practicum. Mean age of the students was 22.8 and 13.7% were currently employed. The Clinical Competence Questionnaire (CCQ) was modified from the Clinical Internship Evaluation Tool based on evaluation criteria for nursing students. Higher score on the 47-item 5-point CCQ indicates higher level of competence. Cronbach alpha and item-total correlation were used for reliability while principal component analysis was for validity. Parallel analysis was done to determine number of factors for the CCQ. Data collected before practicum was used since the intervention affected students’ competence.

Results: The Cronbach alpha for the CCQ was 0.98; mean item-total correlation was 0.72 (ranged 0.54-0.82). By requesting 5 factors resulting in the parallel analysis, 70.8% of the variance of clinical competence was explained. Factors were named clinical skills related to medication, infection control, and gastrointestinal care (15 items, alpha=0.97); nursing values including ethics, caring, diversity, excellence, and integrity (13 items, alpha=0.95); clinical skills related to chest, surgical, and blood-related care (6 items, alpha=0.92); patient management skills including nursing process and education (9 items, alpha=0.93); and safety (4 items, alpha=0.89). Factors were intercorrelated (r=0.49-0.79).

Conclusion: The CCQ is reliable and valid and can be used to understand nursing students’ clinical competence. Factors having low score can be enhanced by education and practice.