Missed nursing education activities and their reasons: A development and validation study
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Updated: Nov 9, 2026

Using Learning Outcome Measures to assess Doctoral Nursing Education
Published on: June 21, 2010
Visintini Erica1, Beriotto Carla2, Giacomini Francesco3
1Department of Biomedicine and Prevention, University of Rome TorVergata, Rome, Italy.
Aim/Objective:
To develop the Missed Nursing Education Survey (MNE_S) and evaluate its initial measurement properties in assessing missed educational activities and their underlying reasons as perceived by nurse educators (NEs).
Background:
Missed Nursing Education (MNE) refers to educational activities required in nursing education that are omitted or delayed. Despite its conceptual development, evidence on its measurement remains limited.
Design:
A developmental and validation study guided by the COnsensus-based Standards for the selection of health Measurement INstruments.
Methods:
Two sequential phases (2021-2025) involved a national sample of 409 NEs and additional samples of 19 NEs and 109 third-year nursing students from two purposively selected Nursing Degree Programmes.
Results:
The MNE_S comprised Part A (26 items), assessing missed or delayed educational activities and Part B (21 items), identifying their perceived underlying reasons. Both parts showed good acceptability. Mokken analysis indicated moderate scalability for Part A (H = 0.461), while exploratory factor analysis suggested a four-factor structure for Part B, although subsequent confirmatory analysis provided limited support for this solution. The most frequently missed activities concerned clinical involvement, research and self-study, whereas student-facing activities were generally less frequently missed. Student-Related Barriers were the most frequently reported reasons. Both parts showed high internal consistency, while test-retest reliability findings suggested temporal stability of mean scores, although based on a small sample (n = 19). Higher MNE scores were associated with less favourable NE perceptions of student satisfaction, willingness to re-enrol and achievement of expected professional competencies.
Conclusions:
The MNE_S provides initial evidence supporting its measurement properties and may help identify missed educational activities and their perceived underlying reasons. Further validation in independent samples and diverse educational contexts is required.
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