Cultural Adaptation and Validation of the Japanese Version of the Psychological Safety in High-Fidelity Simulation...

Background/Objectives: Psychological safety is essential for effective learning in high-fidelity simulation (HFS); however, no validated Japanese instrument currently exists to measure psychological safety among nursing students. This study aimed to translate the Psychological Safety in High-Fidelity Simulation (PS-HFS) scale into Japanese (PS-HFS-J) and evaluate its psychometric properties. Methods: Following COSMIN guidelines, the PS-HFS was translated through forward and back translation, reviewed by an expert panel, and tested for face validity via pilot testing. The scale's reliability and validity were subsequently examined in 263 undergraduate nursing students using confirmatory factor analysis (CFA), Cronbach's alpha, and intraclass correlation coefficients (ICC). Results: CFA confirmed a good fit of the original four-factor model (CFI = 0.990, TLI = 0.988, RMSEA = 0.026). The scale demonstrated excellent internal consistency (Cronbach's α = 0.906 overall) and strong test-retest reliability (ICC range: 0.859-0.914). Content validity indices were also high (I-CVI = 0.80-1.00, S-CVI/Ave = 0.94). Conclusions: The PS-HFS-J is a reliable, valid, and culturally adapted instrument for assessing psychological safety in Japanese nursing education. It can support educational research, curriculum development, and faculty training, contributing to safer and more effective simulation-based education. Future studies should examine its applicability across diverse educational levels and clinical contexts.