title: The development and psychometric testing of a theory-based instrument to evaluate nurses' perception of clinical reasoning competence.
abstract: OBJECTIVE
  The purpose of the study was to develop and psychometrically test the Nurses Clinical Reasoning Scale.
  
  
  BACKGROUND
  Clinical reasoning is an essential skill for providing safe and quality patient care. Identifying pre-graduates' and nurses' needs and designing training courses to improve their clinical reasoning competence becomes a critical task. However, there is no instrument focusing on clinical reasoning in the nursing profession.
  
  
  METHODS
  Cross-sectional design was used. This study included the development of the scale, a pilot study that preliminary tested the readability and reliability of the developed scale and a main study that implemented and tested the psychometric properties of the developed scale.
  
  
  METHODS
  The Nurses Clinical Reasoning Scale was developed based on the Clinical Reasoning Model. The scale includes 15 items using a Likert five-point scale. Data were collected from 2013-2014. Two hundred and fifty-one participants comprising clinical nurses and nursing pre-graduates completed and returned the questionnaires in the main study. The instrument was tested for internal consistency and test-retest reliability. Its validity was tested with content, construct and known-groups validity.
  
  
  RESULTS
  One factor emerged from the factor analysis. The known-groups validity was confirmed. The Cronbach's alpha for the entire instrument was 0·9.
  
  
  CONCLUSIONS
  The reliability and validity of the Nurses Clinical Reasoning Scale were supported. The scale is a useful tool and can be easily administered for the self-assessment of clinical reasoning competence of clinical nurses and future baccalaureate nursing graduates. Study limitations and further recommendations are discussed.
authors.affiliation: Chang Gung University of Science and Technology, Chiayi, Taiwan.
authors.forename: Shwu-Ru
authors.initials: SR
authors.lastname: Liou
authors.affiliation: Chang Gung University of Science and Technology, Chiayi, Taiwan.
authors.forename: Hsiu-Chen
authors.initials: HC
authors.lastname: Liu
authors.affiliation: Chang Gung University of Science and Technology, Kwei-shan, Taoyuan, Taiwan.
authors.forename: Hsiu-Min
authors.initials: HM
authors.lastname: Tsai
authors.affiliation: Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.
authors.forename: Ying-Huang
authors.initials: YH
authors.lastname: Tsai
authors.affiliation: Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.
authors.forename: Yu-Ching
authors.initials: YC
authors.lastname: Lin
authors.affiliation: Chang Gung University of Science and Technology, Chiayi, Taiwan.
authors.forename: Chia-Hao
authors.initials: CH
authors.lastname: Chang
authors.affiliation: Chang Gung University of Science and Technology, Chiayi, Taiwan.
authors.forename: Ching-Yu
authors.initials: CY
authors.lastname: Cheng
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002681:China; D002983:Clinical Competence / Q000592:standards*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000523:psychology*; D010865:Pilot Projects; D011594:Psychometrics / Q000295:instrumentation*; D015203:Reproducibility of Results; D013850:Thinking
keywords: clinical reasoning; instrument development; nurses; reliability; validity