Please use this identifier to cite or link to this item: https://doi.org/10.1016/j.nedt.2017.12.009
Title: Development and psychometric testing of a Clinical Reasoning Evaluation Simulation Tool (CREST) for assessing nursing students' abilities to recognize and respond to clinical deterioration
Authors: Liaw S.Y. 
Rashasegaran A.
Wong L.F. 
Deneen C.C.
Cooper S.
Levett-Jones T.
Goh H.S. 
Ignacio J. 
Keywords: Clinical deterioration
Clinical reasoning
Instrument development
Simulation
Issue Date: 2018
Publisher: Churchill Livingstone
Citation: Liaw S.Y., Rashasegaran A., Wong L.F., Deneen C.C., Cooper S., Levett-Jones T., Goh H.S., Ignacio J. (2018). Development and psychometric testing of a Clinical Reasoning Evaluation Simulation Tool (CREST) for assessing nursing students' abilities to recognize and respond to clinical deterioration. Nurse Education Today 62 : 74-79. ScholarBank@NUS Repository. https://doi.org/10.1016/j.nedt.2017.12.009
Abstract: Background The development of clinical reasoning skills in recognising and responding to clinical deterioration is essential in pre-registration nursing education. Simulation has been increasingly used by educators to develop this skill. Objective To develop and evaluate the psychometric properties of a Clinical Reasoning Evaluation Simulation Tool (CREST) for measuring clinical reasoning skills in recognising and responding to clinical deterioration in a simulated environment. Design A scale development with psychometric testing and mixed methods study. Participants/Settings Nursing students and academic staff were recruited at a university. Method A three-phase prospective study was conducted. Phase 1 involved the development and content validation of the CREST; Phase 2 included the psychometric testing of the tool with 15 second-year and 15 third-year nursing students who undertook the simulation-based assessment; Phase 3 involved the usability testing of the tool with nine academic staff through a survey questionnaire and focus group discussion. Results A 10-item CREST was developed based on a model of clinical reasoning. A content validity of 0.93 was obtained from the validation of 15 international experts. The construct validity was supported as the third-year students demonstrated significantly higher (p < 0.001) clinical reasoning scores than the second-year students. The concurrent validity was also supported with significant positive correlations between global rating scores and almost all subscale scores, and the total scores. The predictive validity was supported with an existing tool. The internal consistency was high with a Cronbach's alpha of 0.92. A high inter-rater reliability was demonstrated with an intraclass correlation coefficient of 0.88. The usability of the tool was rated positively by the nurse educators but the need to ease the scoring process was highlighted. Conclusions A valid and reliable tool was developed to measure the effectiveness of simulation in developing clinical reasoning skills for recognising and responding to clinical deterioration. � 2017
Source Title: Nurse Education Today
URI: http://scholarbank.nus.edu.sg/handle/10635/142978
ISSN: 02606917
DOI: 10.1016/j.nedt.2017.12.009
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