Psychometrics assessment of clinical reasoning competency scale in nurses of critical care units

Abstract

BackgroundNurses play a crucial role in identifying patients’ needs and assessing their clinical conditions to provide adequate and timely interventions. However, evaluating the clinical reasoning competence of nurses requires valid, specific, and comprehensive tools. The present study aimed to translate and psychometrically assess the Persian version of the Clinical Reasoning Competence Scale (CRCS) for nurses in special care units in Iran.MethodsThis cross-sectional, multi-axis methodological study involved 630 nurses from critical care departments in 11 Iranian hospitals. The original version of the Clinical Reasoning Competency Scale for Nurses (CRCSN) was translated into Persian using the forward and backward translation method. The psychometric properties of this scale were assessed using COSMIN criteria.ResultsEach item’s content validity ratio (CVR) ranges from 0.69 to 1, the Item content validity index (I-CVI) ranges from 0.82 to 1, while the S-w was 0.95. Exploratory factor analysis revealed that the items load on three distinct dimensions—“plan setting,” “intervention strategy regulation,” and “self-instruction”—with loadings ranging from 0.621 to 0.912. These dimensions collectively explain 74.32% of the variance. Confirmatory validity was affirmed without necessitating the removal or reordering of items during the exploratory phase. The scale’s reliability was established with a Cronbach’s alpha coefficient of 0.91 and a test-retest reliability coefficient of 0.92. Factor analysis was also conducted.ConclusionThe Persian version of CRCSN has been found to be valid and reliable in critical care units. Therefore, nursing managers can confidently use this tool to evaluate the clinical reasoning competence of nurses. They can also implement appropriate strategies, such as educational interventions, to improve their clinical reasoning skills.