Reliability and validity of the Lasater Clinical Judgment Rubric – Brazilian Version

Morais, Sheila Coelho Ramalho Vasconcelos; Nunes, Janaina Gomes Perbone; Lasater, Kathie; Barros, Alba Lúcia Bottura Leite de; Carvalho, Emilia Campos de

doi:10.1590/1982-0194201800038

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Acta Paulista de Enfermagem

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Original Article • Acta Paul Enferm 31 (3) • May-Jun 2018 • https://doi.org/10.1590/1982-0194201800038 copy

Reliability and validity of the Lasater Clinical Judgment Rubric – Brazilian Version

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To evaluate the reliability and validity of the Lasater Clinical Judgment Rubric - Brazilian Version in a sample of nursing students.

Methods

Methodological design study conducted at a public institution of higher education in the southeast region of Brazil. Preliminarily, was analyzed the clarity of behaviors described by eight students in each level of the 11 dimensions of the instrument. Next, was collection of data on the evaluation of psychometric properties with self-application by 179 students. Participants were grouped in junior (1^st and 2^nd terms n=115) and senior (3^rd and 4^th terms n=64) students. The following psychometric properties were analyzed: discriminant validity, reliability and dimensionality.

Results

Through the Brazilian version of the rubric were differentiated the two groups of students (p-value <0.05) in the 11 dimensions evaluated. Stability was verified by test-retest (Intraclass Correlation Coefficient – ICC: 0.88). Internal consistency was obtained for the global instrument (Cronbach’s alpha: 0.899) and for phases of Noticing (α=0.75), Interpreting (α=0.64), Responding (α=0.78) and Reflecting (α=0.63). Dimensionality validity by confirmatory factorial analysis (CFA) obtained results of composite reliability (CR) above 0.7, and average variance extracted (AVE) higher than 0.5 in all phases. The discriminant validity of the factorial model by the Fornell-Larcker criterion and cross loadings confirmed the theoretical structure of the rubric original version.

Conclusion

The evaluation of the psychometric properties of the Brazilian version of the rubric showed evidence of reliability and construct validity of the instrument for measuring the development of nursing students’ clinical judgment.

Psychometry; Nursing education; Nursing students; Validation studies

Evaluated dimension	Grade/term		p-value*
Evaluated dimension	Juniors	Seniors	p-value*
1.Focused observation	2.68±0.81 ^§	3.36±0.65 ^§	<0.001
2.Recognizing deviations from expected patterns	2.53±0.68 ^§	3.17±0.52 ^§	<0.001
3.Information seeking	3.04±0.84 ^§	3.58±0.53 ^§	<0.001
Noticing	8.25±1.86^#	10.11±1.20 ^§	<0.001
4.Prioritizing data	2.68±0.78 ^§	3.17±0.58 ^§	<0.001
5.Making sense of data	2.61±0.75 ^§	3.19±0.43 ^§	<0.001
Interpreting	5.29±1.30 ^§	6.36±0.78 ^§	<0.001
6.Calm confident manner	2.74±0.75 ^§	3.28±0.60 ^§	<0.001
7.Clear communication	2.92±0.76 ^§	3.56±0.50 ^§	<0.001
8.Well planned intervention/flexibility	2.99±1.02 ^§	3.69±0.47 ^§	<0.001
9.Being skillful	2.74±0.69 ^§	3.20±0.44 ^§	<0.001
Responding	11.39±2.44^#	13.73±1.30^#	<0.001
10.Evaluation/self-analysis	2.79±0.74 ^§	3.33±0.54 ^§	<0.001
11.Commitment to improvement	3.17±0.70 ^§	3.47±0.53 ^§	<0.013
Reflecting	5.97±1.24 ^§	6.80±0.84 ^§	<0.001
Total	30.9 ± 5.7^#	37 ± 2.85^#	<0.001

Fornell-Larcker criterion
	Noticing	Interpreting	Responding	Reflecting
Noticing	0.81
Interpreting	0.65	0.85
Responding	0.68	0.69	0.77
Reflecting	0.44	0.58	0.65	0.85

Cross loadings
	Noticing	Interpreting	Responding	Reflecting
Dim1	0.76	0.50	0.50	0.25
Dim2	0.83	0.58	0.53	0.35
Dim3	0.85	0.51	0.61	0.45
Dim4	0.46	0.80	0.46	0.40
Dim5	0.63	0.91	0.69	0.57
Dim6	0.46	0.41	0.70	0.40
Dim7	0.52	0.56	0.83	0.52
Dim8	0.60	0.62	0.81	0.53
Dim9	0.51	0.52	0.75	0.55
Dim10	0.44	0.51	0.61	0.87
Dim11	0.30	0.48	0.49	0.83

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[1] Corresponding author. Sheila Coelho Ramalho Vasconcelos Morais. http://orcid.org/0000-0001-9831-0338. Email: sh25crvm@gmail.com