Psychometric Evaluation of the Knowledge, Skills and Attitudes - Part I: Patient-Centered Care Scale (KSAI-PCCS): A Pilot Study

Abstract

Recognition that adverse events are a significant cause for morbidity and mortality has led to a rise in global efforts to improve patient safety. Adaptations are needed in healthcare institutions and at the educational preparatory level for all healthcare providers. One change surrounds the significance of patient-centered care, an important concept new to healthcare over the last decade. The problem concerns the ability of healthcare educators to effectively measure knowledge, skills, and attitudes of student nurses in relation to the Quality and Safety Education for Nurses (QSEN) patient-centered care competencies. The primary purpose of this study was to test the psychometrics of the Knowledge, Skills, and Attitudes Part I—Patient-centered Care Scale (KSAI-PCCS) instrument. A secondary purpose was to examine the perceived knowledge, skills, and attitudes of prelicensure nursing students specific to QSEN Core Competency: Patient-Centered Care. The knowledge of reliability and validity of the new instrument is critical for continued evaluation of patient-centered care from the nursing student’s perspective. The study was a cross-sectional non-experimental concurrent mixed-methods design that used non-probability convenience sampling and a web-based self-report survey. The learning framework was informed by a post-positivist worldview grounded in social constructivist and objectivist epistemology. The conceptual framework was informed by the theoretical perspectives of QSEN and Watson’s Caring Model. The KSAI-PCCS is a 54-item instrument with three subscales: Knowledge (19 items), Skills (17 items), and Attitudes (18 items)—KSA. The instrument subjectively measures the three domains of patient-centered care competencies for nursing practice. The instrument was administered to 208 prelicensure nursing students using a test-retest method to establish preliminary reliability and validity. Validity was supported through expert review panel processes. Instrument reliability was established with Cronbach’s alpha of .85 to .92 (pre to posttest; n = 12) and .96 to .97 (pre to posttest; n = 21). Item-total correlations of the KSA subscales were evaluated for acceptability and potential scale reduction. Paired samples t-test were utilized with reported significant results. Principal component analysis was also utilized; however, future testing is recommended with a larger sample. This study establishes preliminary reliability and validity to use in future refined studies exploring QSEN competencies.