Turkish adaptation of the clinical reasoning evaluation simulation tool (CREST-TR): a validity and reliability study

To enhance the clinical reasoning skills of nursing students, it is essential to assess their level of clinical reasoning using valid and reliable measurement tools. The aim of this study was to adapt Clinical Reasoning Evaluation Simulation Tool to Turkish by ensuring its translation-back translation and content validity, testing its psychological properties, including the construct validity and reliability, and evaluating its usability.

This methodological study was conducted in three phases. The first phase involved examining the language and content validity of the tool. The second phase focused on assessing the construct validity and reliability of the tool with 26 third-year and 26 fourth-year nursing students enrolled at faculty of nursing of a state university who undertook the simulation-based assessment. The third phase involved evaluating its usability by six educators.

After the linguistic validation of the tool, the content validity index (CVI) was calculated as 0.91 based on the opinions of five field experts. Following exploratory factor analysis, items 1 and 8 with factor loadings below 0.30, were excluded from the tool. The first item pertained to the domain of "considering the patient situation", while the eighth item involved to domain of "taking actions" using the "ISBAR" framework for effective communication. The tool was validated as a unidimensional consisting of seven domains and eight items with factor loadings ranging from 0.58 to 0.76. Confirmatory factor analysis revealed that all fit index values showed satisfactory fit. AGFI (0.852) and SRMR (0.058) values were found to have acceptable fits, while χ²/SD (1.091), GFI (0.911), NFI (0.909), NNFI (0.986), CFI (0.991) and RMSEA (0.042) values provided good fits. Cronbach's alpha for the total tool was 0.88. The usability of the tool was positively evaluated by educators, although one educator disagreed regarding its ease of interpretation, clarity of descriptors, and user-friendliness.

The Turkish version of the Clinical Reasoning Evaluation Simulation Tool was found to be a valid and reliable tool. This tool provides a concrete and objective evaluation of nursing students' clinical reasoning levels during simulation by instructors. In addition, the tool provides feedback on aspects that need improvement in line with the students' clinical reasoning performances.

Not applicable.