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In all cases we have filmed the best available copy. University M icrofilms International 300 N. ZEEB RD., ANN ARBOR, Ml 48106 8121838 O ’C o n n e l l , Ju n e Ela in e THE DEVELOPMENT AND VALIDATION OF A SCALE FOR MEASURING CLINICAL PERFORMANCE OF NURSING STUDENTS The Ohio State University PH.D. 1981 University Microfilms International300 N. Zeeb Road, Ann Arbor, MI 48106 Copyright 1981 by O’Connell, June Elaine All Rights Reserved THE DEVELOPMENT AND VALIDATION OF A SCALE FOR MEASURING CLINICAL PERFORMANCE OF NURSING STUDENTS DISSERTATION Presented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy in the Graduate School of The Ohio State University by June Elaine O'Connell, R.N., B.S., M.Ed. ****** The Ohio State University 1981 Reading Committee: Approved By Robert Bargar, Ph.D. Paul Klohr, Ph.D. Donald Sanders, Ph.D AdviserAdviser rn Department of Educational Foundations and Research ACKNOWLEDGEMENTS The contribution of others makes possible the writing of a dissertation. It cannot be done in isolation. Many individuals have contributed to this dissertation effort in ways that range from academic advising and scholarly critique to expressions of moral support and affection. And so, it is with "happy heart" that I acknowledge: Gram Robert Bargar Jane Lutz Barbara Chapman Henry Miller Mary Lou Docter Donald Sanders Paul Klohr Frieda Shirk John Underwood VITA July 20, 1933.......... Born - Detroit, Michigan 1954 ............. Diploma in Nursing, Henry Ford. Hospital Detroit, Michigan 1954-1967.............. Staff Nurse, Assistant Head Nurse, Medical-Surgical Supervisor, Henry Ford Hospital, Detroit, Michigan 1968 .................. B.S., Wayne State University, Detroit, Michigan 1969 .................. Director, Nursing Research Projects, Henry Ford Hospital, Detroit, Michigan 1970 .................. M.Ed, Wayne State University, Detroit, Michigan 1970-1973.............. Assistant Professor of Nursing, Capital University, Columbus, Ohio 1974-1978. ....... Associate Professor of Nursing, Capital University, Columbus, Ohio 1978-present . ........ Chairperson, Nursing, Columbus Technical Institute, Columbus, Ohio FIELDS OF STUDY Major Fields Educational Development and Research Minor Field: Curriculum Studies in Educational Development and Research. Professor Robert Bargar and Professor Donald Sanders Studies in Curriculum. Professor Paul Klohr iii TABLE OF CONTENTS Page ACKNOWLEDGEMENTS . ......................................... ii VITA . ................................................. iii LIST OF TABLES............................................... vi INTRODUCTION ................................................... 1 Chapter I. BACKGROUND OF THE PROBLEM. ............................ 1 Statement of the Problem............................. 4 Significance of the Study ............ ........ 5 Definition of Terms ......o.o.o.eo.o.. & II. DESIGN OF THE STUDY......................... 10 Methods and Procedures. ............................10 Scale Construction. .......... ....... 10 Definition of the Variable to be Scaled ....... 11 Selection of Itemso 11 Creation of the Scale Format................... 12 Editing of the Scale. ................ 12 Revision of the Scale .«»...««o....... 12 Pilot Test and Sample ........... ........ 13 Scoring of the Scale • 13 The Establishment of Scale Reliability. ....... 13 Summary of Steps in the Construction of the scale ..O...C............OO.. 14 Sample Selection. 19 Brief Description of the Two Types of Nursing Programs. ....... .................. 19 Data Collection Procedures........... 20 Instrumentation. 20 Treatment of the Data. ............................22 Limitations of the Study. ........ .......... 22 III. REVIEW OF THE LITERATURE. .............o... 23 Introduction........................................... 23 Measurement and Evaluation..................... 23 Evaluation of Clinical Performance............... 30 iv Table of Contents (Continued) Page Prediction of State Board Performance.................. 43 Methodology of Scale Construction................. 45 Summary and Discussion of the Literature .............. 49 IV. RESEARCH FINDINGS............................. 51 Subjects' Clinical Evaluation Performance and SBTPS Performance................... 51 Instrument Predictive Validity .......... ....... 57 V. SUMMARY, CONCLUSIONS, RECOMMENDATIONS............ 69 APPENDIXES A. Original 100 Item Scale - Nonedited............... 75 3. Edited and Revised Scale......................... 83 C. A Scale for Measuring the Clinical Performance of Nursing Students ................................. 90 BIBLIOGRAPHY..................................................... 95 v LIST OF TABLES Table Page 1. Kuder-Richardson Reliability Coefficients for 75 Item Scale.................................. 15 2. Xuder-Richardson Reliability Coefficients for 60 Item Scale. ..................................... 17 5. Means and Standard Deviations of Clinical Performance Evaluation Scale Score and State Board Test Pool Examination (SBTPE) Scores. Group One, Baccalaureate Nursing Program....................... 55 4. Means and Standard Deviations of Clinical Performance Evaluation Scale Score and State Board Test Pool Examination (SBTPE) Scores. Group Two, Associate Degree Nursing Program . .................. 54 5. Means and Standard Deviations of Clinical Performance Evaluation Scale Score and State Board Test Pool Examination (SBTPE) Scores. Group Three, Associate Degree Nursing Program ........ ....... 55 6. Means and Standard Deviations of Clinical Performance Evaluation Scale Scores and State Board Test Pool Examination (SBTPE) Scores. Total Groups . 56 7. Correlation of Clinical Performance Evaluation Scores with State Board Test Pool Examination Scores. Group One .. ..................... ..... 58 8. Correlation of Clinical Performance Evaluation Scores with State Board Test Pool Examination Scores. Group T w o ........................ 59 9. Correlation of Clinical Performance Evaluation Scores with State Board Test Pool Examination Scores. Group Three ...... 60 10. Correlation of Clinical Performance Evaluation Scores with State Board Test Pool Examination Scores. Total Groups ................................... 62 vi List of Tables (Continued) Table Page 11. General Linear Models Procedure Analysis of Variance of Achievement Scores by State Board Examination Sub Tests (Medical Nursing). ......... 64 12. General Linear Models Procedure Analysis of Variance of Achievement Scores by State Board Examination Sub Tests (Psychiatric Nursing). .......... 65 13. General Linear Models Procedure Analysis of Variance of Achievement Scores by State Board Examination Sub Tests (Obstetrical Nursing)........ 66 14. General Linear Models Procedure Analysis of Variance of Achievement Scores by State Board Examination Sub Tests (Surgical Nursing). ............ 67 15. General Linear Models Procedure Analysis of Variance of Achievement Scores by State Board Examination Sub Tests (Child Nursing).............. 68 vii Chapter I INTRODUCTION BACKGROUND OF PROBLEM The evaluation of nursing students in the clinical area evokes a gamut of feelings in both the nursing instructor and the nursing student. For the instructor, the feelings range from irritation and frustration to just plain, "Why am I spending so much of my time doing this? It has such little meaning," Litwack, Sakata and Wykle (1972) wrote, "that the process of evaluation in the clinical area is, perhaps, the most difficult task faced by most nursing educators," and Kennedy, (1961) wrote "instructors run off on educational leaves and never