Validity and Internal Consistency of a Rubric for Cervical Collar Placement in Nursing Students

Background/Objectives: The assessment of clinical competencies in nursing education requires valid and reliable instruments, especially for essential procedures such as the placement of a cervical collar in the care of polytrauma patients. The objective of this study was to analyse the psychometric properties of a rubric designed to assess the placement of cervical collars in nursing students in a low-fidelity clinical simulation environment. Methods: A quasi-experimental, cross-sectional study was conducted with 186 undergraduate nursing students, organised into 61 groups, over three academic years (2021-2024). An eight-item rubric was applied, with a four-level Likert scale (1-4). Interrater reliability was analysed using Cohen's Kappa index (0.418-0.796), internal consistency using Cronbach's alpha (alpha = 0.753), and the internal structure of the instrument using exploratory factor analysis, applying Varimax orthogonal rotation. Results: Inter-rater reliability showed values ranging from moderate to substantial, with greater agreement observed in items related to the selection of the collar and the position of the medical team, and moderate agreement in those related to technical manoeuvres and immobilisation. The rubric showed adequate overall internal consistency (α = 0.76), with good to very good consistency values in six of the eight items. Exploratory factor analysis identified a two-dimensional structure with a dominant procedural factor (four items) and a second factor associated with clinical judgement (four items). Conclusions: The validated rubric has adequate levels of reliability and internal consistency for evaluating the placement of cervical collars by nursing students. Its application can promote more objective and structured evaluation processes in clinical simulation for nursing students, contributing to the development of essential skills in the care of polytrauma patients.