Patient Assessment Competency in a Simulation Setting: Development and Validation of a New Scale for Nursing Students...

Background and Purpose: In Vietnam, the absence of a standardized, objective tool to evaluate patient assessment competency in nursing students hinders efforts to ensure clinical readiness. The study aims to develop and validate a new instrument, the Patient Assessment Competency Scale (PACS), intended to objectively evaluate the assessment competencies of undergraduate nursing students in Vietnam, specifically within a simulation-based learning environment. Methods: A two-phase study was conducted: Phase 1 involved generating items from literature and using a three-round Delphi method with five experts to establish content validity. In Phase 2, a cross-sectional study with 270 third-year nursing students assessed the scale's psychometric properties, including construct validity via confirmatory factor analysis (CFA), and reliability through internal consistency (coefficient alpha) and interrater reliability (Cohen's Kappa). Results: The final 48-item, 13-dimension PACS was developed. The scale demonstrated excellent content validity (scale level content validity index = 1.0). The CFA confirmed the 13-factor structure with an excellent model fit (χ²/df = 1.181, comparative fit index = .964, root-mean-square error of approximation = .026). The scale showed high internal consistency (coefficient alpha = .91) and strong to perfect interrater reliability (Cohen's Kappa = .80-1.00). Conclusions: The PACS is a valid and reliable observation-based instrument for objectively measuring patient assessment competency among undergraduate nursing students. As the first tool of its kind validated in Vietnam, it offers a valuable resource for nursing education, practice, and research to enhance clinical competency and bridge the education-practice gap.