| ObjectiveTo develop a clinical learning environment evaluation scale for master of nursing specialist postgraduates in line with China’s educational background.To test the reliability and validity of the scale in this study,and provide a reliable tool for quantifying the evaluation of clinical learning environment by master of nursing specialist postgraduates.Method1.Item pool development:Studies on theoretical concepts related to the clinical learning environment at home and abroad,current clinical training status of master of nursing specialist postgraduates,and assessment tools for clinical learning environment were retrieved from databases at home and abroad,and the dimensions and items of the clinical learning environment assessment scale were preliminarily formulated for master of nursing specialist postgraduates;A semi-structured interview was used to deeply mine the authentic experiences of master of nursing specialist postgraduates in the clinical learning environment as an essential basis for the formulation of the scale,forming the item pool on the scale.2.Form a pre-test scale:(1)Delphi expert consultation:a total of 18 experts from 12provinces were invited for two rounds of Delphi expert consultation to preliminarily screen the items and dimensions of the scale.(2)Pre-investigation:25 master of nursing specialist postgraduates were enrolled using purposive sampling method to examine the content and linguistic descriptions of the scale items,to make the scale more applicable to the students with master of nursing specialist postgraduates.3.Form formal scale and test reliability and validity:(1)The first questionnaire survey:From March to April 2022,A cross-sectional survey was conducted on 250 master of nursing specialist postgraduates selected using convenience sampling.The pre-test questionnaire was used to investigate.The items were further screened using item analysis to form the formal questionnaire.(2)The second questionnaire survey:From June to November 2022,a total of 310 master of nursing specialist postgraduates were selected by convenient sampling method,and was asked to complete the formal questionnaire.The reliability analysis of the scale was carried out using Cronbach’sαcoefficient,split-half reliability,test-retest reliability and composite reliability.The content validity,construct validity,convergent validity,and discriminant validity were used to test its validity.Result1.Based on the framework of learning environment,combined with the results of literature review and semi-structured interviews,a total of 4 dimensions and 57 items of the scale item pool were formed.2.(1)Expert consultations:The effective response of questionnaires during two rounds of expert consultations were 95.650%and 81.820%respectively;The authority coefficients of the two rounds of expert consultations were 0.890 and 0.914 respectively;The coordination coefficients of the two rounds of expert consultations were 0.141 and0.220 respectively.After two rounds of expert correspondence,14 items were deleted,12items were merged into 6 items,4 items were added,1 item was split,and an initial scale of 5 dimensions and 42 items was formed.(2)Pre-investigation:25 master of nursing specialist postgraduates believed that the scale items were clear in language and content,indicating that the scale was suitable for the evaluation of clinical learning environment by master of nursing specialist postgraduates.3.(1)The results of formal scale formation:The scale items were initially screened using 4 screening methods:internal consistency test,correlation coefficient method,critical ratio method,and exploratory factor analysis.A total of 6 items were deleted based on screening criteria combined with research group discussion.Finally,a scale of 36 items containing 5 dimensions was conducted for evaluation of the clinical learning environment for master of nursing specialist postgraduates.(2)The results of the scale reliability and validity test:The Cronbach’sαcoefficient of the total scale was 0.966,and that of all dimensions ranged from 0.858～0.932;The split-half reliability of the total scale was 0.897,and that of all dimensions ranged from 0.814 to 0.881;After 4 weeks,the test-retest reliability coefficient of the total scale was 0.959,and that of each dimension ranged from0.779 to 0.961;The composite reliability of each dimension was ranged within 0.859～0.932,all of which were greater than 0.70,indicating good scale reliability.The total content validity of the scale was 0.880 and the content validity of each item ranged from 0.833 to1.000;In total,5 common factors were extracted after exploratory factor analysis,with a cumulative variance contribution rate of 73.755%;Confirmatory factor analysis suggested good fitness of the 5-factor model(χ~2/df=2.072;RMSEA=0.059;GFI=0.813;NFI=0.853;IFI=0.918;TLI=0.911;CFI=0.918);In the test of convergent validity and discriminant validity,the average variance extracted of each dimension ranged from 0.449 to 0.657,the composite reliability of each dimension ranged from 0.859 to 0.932,and the correlation coefficient among the five dimensions was 0.141 to 0.281.In conclusion,the scale has good structural validity.Conclusion1.The evaluation scale of clinical learning environment for master of nursing specialist postgraduates prepared in this study includes 5 dimensions and 36 items.The five dimensions are:subject perception,department atmosphere,teaching strategy,organizational support,and physical environment.These 5 dimensions involve the individual,social,organizational,and physical fields of the clinical learning environment,which can more comprehensively evaluate the current clinical learning environment of master of nursing specialist postgraduates.2.Through two large sample tests,the evaluation scale of clinical learning environment for master of nursing specialist postgraduates has good reliability and validity.The formal scale of clinical learning environment for master of nursing specialist postgraduates includes 5 dimensions and 36 items,which can be used as a tool for evaluating the clinical learning environment of master of nursing specialist postgraduates in China. |
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