Development and content validation of a comprehensive nursing care assessment rubric (CNAR) in simulation

IF 2.5 Q2 NURSING

Teaching and Learning in Nursing Pub Date : 2026-10-01 Epub Date: 2026-07-03 DOI:10.1016/j.teln.2026.06.011

Weng Ian Phoenix Pang PhD, MN, RN, Haobin Yuan PhD, MSc, BSc

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引用次数: 0

Abstract

Background

Simulation is a staple of nursing education, yet assessment often relies on scenario-specific checklists. While useful for beginners, checklists can foster a task-oriented approach that fragments care and increases faculty workload due to the need for constant tool development. There is a critical need for a standardized instrument that evaluates not only physical skills but also the integration of safety, communication, and clinical judgment across diverse adult medical-surgical scenarios.

Purpose

This study aimed to develop and establish the content validity of the Comprehensive Nursing Care Assessment Rubric (CNAR), a standardized, process-oriented tool designed to assess comprehensive nursing care competencies, specifically targeting physical assessment and clinical judgment, in simulation-based learning environments.

Methods

A methodological research design was employed. Phase 1 involved constructing a 54-item rubric based on established clinical guidelines and nursing competency frameworks. Phase 2 involved rigorous content validation by a panel of 5 expert nursing academics. Experts rated item relevance on a 4-point Likert scale and provided qualitative feedback. Item-level (I-CVI) and Scale-level (S-CVI/Ave) Content Validity Indices were calculated.

Results

The rubric demonstrated exceptional content validity, achieving an overall S-CVI/Ave of 0.99. Qualitative thematic analysis using Braun and Clarke’s framework led to substantive revisions, including refining the history-taking process for medication safety, expanding symptom assessment parameters, and incorporating physiological integrity. Crucially, the domain of clinical judgment was validated as a core component of the assessment.

Conclusion

The CNAR is a content-valid instrument. Focusing on universal nursing competencies rather than case-specific tasks, it provides educators with a sustainable and standardized approach to evaluating student performance.

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模拟中综合护理评估准则（CNAR）的开发和内容验证

模拟是护理教育的主要内容，但评估往往依赖于特定场景的检查清单。虽然对初学者很有用，但检查表可以培养一种面向任务的方法，这种方法可以分散关注，并且由于需要不断开发工具而增加教师的工作量。迫切需要一种标准化的仪器，不仅可以评估身体技能，还可以评估安全、沟通和临床判断在不同成人医疗外科场景中的整合。目的本研究旨在开发和建立综合护理能力评估量表（CNAR）的内容效度。CNAR是一种标准化的、面向过程的工具，旨在评估基于模拟学习环境的综合护理能力，特别是针对身体评估和临床判断。方法采用方法学研究设计。第一阶段包括基于已建立的临床指南和护理能力框架构建一个包含54个项目的标准。第二阶段包括由5名护理专家学者组成的小组进行严格的内容验证。专家们用4分李克特量表对项目相关性进行评级，并提供定性反馈。计算项目级（I-CVI）和量表级（S-CVI/Ave）内容效度指数。结果该标题表现出卓越的内容效度，总体S-CVI/Ave为0.99。使用Braun和Clarke的框架的定性主题分析导致了实质性的修订，包括完善药物安全性的历史记录过程，扩展症状评估参数，并纳入生理完整性。至关重要的是，临床判断领域被验证为评估的核心组成部分。结论CNAR是一种含量有效的仪器。它侧重于普遍的护理能力，而不是具体的个案任务，为教育工作者提供了一个可持续的和标准化的方法来评估学生的表现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Teaching and Learning in Nursing NURSING-

CiteScore

2.60

自引率

10.50%

发文量

119

审稿时长

37 days

期刊介绍： Teaching and Learning in Nursing is the Official Journal of the National Organization of Associate Degree Nursing. The journal is dedicated to the advancement of Associate Degree Nursing education and practice, and promotes collaboration in charting the future of health care education and delivery. Topics include: - Managing Different Learning Styles - New Faculty Mentoring - Legal Issues - Research - Legislative Issues - Instructional Design Strategies - Leadership, Management Roles - Unique Funding for Programs and Faculty