Psychometric design and validation of a tool to assess the medication administration process through simulation in undergraduate nursing students.

BACKGROUND: Medication errors account for 38% of adverse events reported among undergraduate nursing students. Simulation provides training for nursing students in the medication administration process. However, there is a lack of reliable and valid instruments to measure its assessment. OBJECTIVES: To design and validate a new tool (MEDICORRECT) to assess undergraduate nursing students in the medication administration process using a high-fidelity simulation scenario. DESIGN AND METHODS: Study participants were fourth year undergraduate nursing students at the University of Barcelona. Phase 1 consisted of tool design and drafting, and content validity and feasibility analyses. Phase 2 covered construct validity and interrater reliability. A factor analysis was conducted, involving a principal component analysis and varimax rotation. FINDINGS: Of 21 initial items, 11 were eliminated because of low content validity ratio, 4 of which assessed cognitive skills such as administering the right medicine at the right dose, which were impossible to observe in the simulation scenario. The final version of MEDICORRECT contained 10 items. The exploratory factor analysis identified a four-factorial model explaining 67.3% of the variance. Interrater agreement measured with Kappa was greater than 0.70 for 80% of items. CONCLUSIONS: The 10 items in MEDICORRECT are relevant and feasible, have suitable psychometric properties and reflect the practical skills identified in the medication administration process. The tool excludes cognitive skills, which should be included and assessed during prebriefing.

Standardized language systems for the design of high-fidelity simulation scenarios: A Delphi study.

PURPOSE: This study aimed to identify which of the standardised Nursing Interventions Classification (NIC) activities should be used in the design of clinical cases with high fidelity simulation for educational preparation of undergraduate nursing students in non-technical skills. DESIGN AND METHODS: A three-round Delphi study was carried out: the first round with taxonomy experts, the second round with academic and clinical lecturers with limited experience in the simulation-based learning methodology, and the third round with academic and clinical lecturers having at least two years of simulation experience. The NIC interventions were grouped into two levels of competence in accordance with the undergraduate nursing degree curriculum (1st- and 2nd-year students, the "novice" level; 3rd- and 4th-year students, the "advanced" level). The NIC allows the description of nurse student competencies in multiple clinical scenarios and throughout various contexts: theory, clinical practice and simulation. FINDINGS: The experts identified 163 interventions in 8 areas as relevant and feasible, selecting 42 for the "novice" students, in Nursing Fundamentals (13) and Adult Nursing Care 1 (29), and 97 for the "advanced" students: Maternity Care and Child Health Nursing (18), Mental Health (13), Nursing Care of Older People (12), Community Health Nursing (20) and Adult Nursing Care 2 (34). In addition, 24 interventions were identified as cross-cutting, with training to be provided across all four years of the degree. CONCLUSION: A total of 163 interventions of the NIC list were selected by experts as being both relevant and feasible to nursing undergraduate education. This creates the favourable framework to design high-fidelity scenarios for the training of non-technical skills according to the competences required and in line with the health care reality. Therefore, enabling an optimal combination of theoretical education by academic lecturers with practical training by clinical lecturers and staff nurses.