Development and validation of the Environment-Technology-Task Model-based self-assessment scale for intraoperative...

This study aimed to develop and validate a self-assessment scale based on the Environment-Technology-Task Model to evaluate operating room nurses' readiness for intraoperative rescue and to evaluate its psychometric properties. A methodological study focusing on the development and psychometric validation of the scale was conducted. The initial item pool was generated through an integrative literature review (11 core articles) and field observations of 7 real intraoperative rescue videos. A 2-round Delphi consultation with 20 experts, followed by pilot testing, was carried out to refine the items. Subsequently, a survey of 280 operating room nurses was performed to evaluate construct validity using exploratory factor analysis and to assess reliability. The final 21-item scale comprised 3 dimensions: task (11 items), environment (5 items), and technology (5 items). Exploratory factor analysis confirmed the 3-factor structure, explaining 73.83% of the total variance. Content validity was satisfactory (item-level content validity index: 0.875-1.000; scale-level content validity index, averaging method: 0.932). Internal consistency was high (Cronbach α = 0.970 for the total scale; 0.962, 0.912, and 0.865 for the 3 subscales). Split-half reliability was 0.931, and test-retest reliability was 0.847 for the total scale (0.725-0.872 across the subscales). The Environment-Technology-Task Model-based scale showed high internal consistency, a theoretically coherent 3-factor structure, and acceptable-to-good temporal stability. It is the first instrument specifically designed to assess operating room nurses' intraoperative rescue readiness, and it holds practical utility for self-assessment, targeted training, and quality improvement initiatives to enhance perioperative patient safety.