The Just Culture Assessment Tool for Nursing Education: Reliability and Validity Study

Friday, March 27, 2020: 11:05 AM

Danielle Walker, PhD, RN, CNE
College of Nursing, Texas Christian University, Forth Worth, TX, USA
Lora Hromadik, PhD
Department of Nursing and Allied Health Professions, Indiana University of Pennsylvania, Indiana, PA, USA
Gerry Altmiller, EdD, APRN, ACNS-BC, FAAN
School of Nursing, The College of New Jersey, Ewing Township, NJ, USA
Nina P. Barkell, MSN, RN, ACNS-BC
Department of Nursing, Oakland Community College, Waterford, MI, USA
Rebecca D. Toothaker, PhD, MSNEd, RN
Nursing, Bloomsburg University, Bloomsburg, PA, USA

Purpose:

The patient safety movement has been the impetus for a paradigm shift from a culture of blame to a just culture (Kohn, Corrigan, & Donaldson, 2000). A just culture focuses on identification and improvement of systems issues while maintaining individual accountability for safe practice (Agency for Healthcare Research and Quality, 2018). Although the adoption of just culture in acute care facilities approaches 80% (Edwards, 2018), principles of a fair and just culture have not been incorporated into nursing education program policies and many nursing faculty do not seem to understand the concept of a fair and just culture (Barnsteiner & Disch (2017a).

Assessment of a nursing program’s culture is the initial step in moving toward a fair and just culture in academia (Barnsteiner & Disch 2017b). Because there was no instrument available, this study aimed to adapt the Just Culture Assessment tool (JCAT) developed for practice settings (Petschonek, Burlison, Cross, Martin, Laver, Landis & Hoffman, 2013) into a valid and reliable tool to measure just culture in nursing academia.

Methods:

The newly developed instrument, the Just Culture Assessment Tool-Nursing Education (JCAT-NE), was modeled after the original JCAT by five expert nurse educators with extensive knowledge of just culture, who served as co-principal investigators. Permission to adapt the JCAT and Institutional Review Board approval were obtained. After development, the instrument underwent rigorous review by content experts using the Content Validity Index (CVI). Once validated, the JCAT-NE was piloted with 133 pre-licensure nursing students to determine reliability.

Results:

The scale content validity index (CVI) was calculated at 1. The reliability of the instrument is strong (alpha = .75).

Conclusion:

The CVI and pilot study findings support the use of the JCAT-NE as a valid and reliable instrument to evaluate student perception of just culture in nursing academia.The JCAT-NE provides objective data about just culture in nursing academia. Program specific data can provide impetus to develop targeted interventions to positively impact the just culture of the overall program. The JCAT-NE can also provide data to benchmark nursing programs, students, and individual educators at the local, national and global level.

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