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Development and psychometric testing of the Diagnostic Competency During Simulation-based (DCDS) learning tool.

Leah Burt¹, Andrew Olson²

¹University of Illinois Chicago College of Nursing, Department of Biobehavioral Nursing Science, United States of America.

Journal of Professional Nursing : Official Journal of the American Association of Colleges of Nursing

|March 8, 2023

Summary

A new tool, the Diagnostic Competency During Simulation-based (DCDS) Learning Tool, assesses nurse practitioner students' diagnostic reasoning skills in simulations. It offers educators specific measures to enhance diagnostic performance and reduce errors.

Keywords:

Competency-based education Diagnosis Nursing education research Psychometrics Simulation training

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Area of Science:

Nursing Education
Medical Simulation
Diagnostic Reasoning

Background:

Diagnostic errors affect millions annually, highlighting a need for improved training.
Current educational strategies for nurse practitioner (NP) students lack tools for diagnostic competency development.
Simulation-based learning lacks comprehensive assessments for individual diagnostic reasoning skills.

Purpose of the Study:

To develop and evaluate the psychometric properties of the Diagnostic Competency During Simulation-based (DCDS) Learning Tool.
To provide an educational tool for assessing diagnostic reasoning competencies in NP students.
To address the gap in simulation-based learning assessment for diagnostic skills.

Main Methods:

Developed items and domains based on existing diagnostic reasoning frameworks.
Assessed content validity using a panel of eight subject matter experts.
Determined inter-rater reliability with four faculty members evaluating eight simulation scenarios.

Main Results:

The DCDS Learning Tool achieved high content validity, with individual domain CVI scores ranging from 0.9175 to 1.0 and a total scale CVI of 0.98.
Inter-rater reliability, measured by ICC, was 0.548 (p < 0.0001), indicating moderate agreement.
The tool demonstrated relevance and moderate reliability across diverse simulation contexts.

Conclusions:

The DCDS Learning Tool is a valid and moderately reliable instrument for assessing diagnostic reasoning competencies in NP students.
This tool provides NP educators with granular, actionable measures to foster diagnostic skill improvement.
The DCDS tool enhances the assessment landscape for diagnostic reasoning in simulation-based education.