Development and validation of assessment instruments for cervical collar and spinal board placement in simulated environments for nursing students in the care of polytrauma patients

• Published in: BMC medical education Vol. 24; no. 1; pp. 1080 - 13
• Main Authors: Perpiñá-Galvañ, Juana, Montoro-Pérez, Néstor, Gutiérrez-García, Ana Isabel, José-Alcaide, Lourdes, García-Aracil, Noelia, Juliá-Sanchis, Rocío, Escribano, Silvia
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 01-10-2024; BioMed Central; BMC
• Subjects: Adult; Advanced trauma life support care; Allied Health Personnel; ATLS; Care and treatment; Check Lists; Clinical Competence - standards; Content Validity; Death; Delphi Technique; Educational Measurement; Emergency medical care; Emergency nursing; Emergency treatment; Female; Guidelines; Health sciences; Hospitals; Humans; Male; Medical personnel; Methods; Multiple trauma; Multiple Trauma - therapy; Nurses; Nursing care; Nursing education; Nursing Students; Patients; Pedagogy; PHTLS; Physicians; Professional Training; Psychometrics; Quantitative psychology; Questionnaires; Rating of; Reliability; Reproducibility of Results; Sample Size; Self Efficacy; Simulated Environment; Simulation; Simulation Training; Students; Students, Nursing; Study and teaching; Teaching; Teaching Experience; Teaching Methods; Trauma; Trauma care; Validity; Wounds and injuries; Young Adult; Spain; Validity; Emergency treatment; Multiple trauma; ATLS; Advanced trauma life support care; PHTLS; Reliability
• ISSN: 1472-6920; 1472-6920
• DOI: 10.1186/s12909-024-06061-2

Multiple trauma injuries are the leading cause of death and disability in people under the age of 45 and require prompt and specialised care. However, medical and nursing education programmes do not always include specific training in emergency pre-hospital care, resulting in a lack of basic practical skills in trauma management.
To develop and validate two instruments for assessing nursing students' competence in cervical collar and spinal board application in simulated pre-hospital emergency scenarios.
This is an instrumental study that involves the development of two assessment instruments and the evaluation of their psychometric properties in a sample of 392 nursing students. Content validity was assessed using expert judgement, by calculating the content validity ratio (CVR) for each item and the scale level content validity index average (S-CVI/Ave) for the instruments. Exploratory factor analysis using the MINRES extraction method and Promax rotation was performed to analyse the performance of the items and structure of the rubrics. Internal consistency was analysed using the Omega coefficient and inter-rater agreement was assessed using Cohen's Kappa coefficient.
Initially, two rubrics were obtained: one with six items for cervical collar placement (S-CVI/Ave = 0.86) and one with nine items for spinal board placement (S-CVI/Ave = 0.81). Both had a single-factor structure, with all items having factor loadings greater than 0.34 for the cervical collar rubric and 0.56 for the spinal board rubric, except for item 2 of the cervical collar rubric (λ = 0.24), which was subsequently removed. The final cervical collar rubric (five items) had an overall internal consistency of 0.84 and the spinal board rubric had an overall internal consistency of 0.90, calculated using the Omega statistic. The weighted Kappa coefficient for each item ranged from acceptable (0.32) to substantial (0.79). These results show that we have successfully developed two sufficiently valid instruments to assess the immobilisation competencies proposed in the objective of the study.
Whilst further research is needed to fully establish their psychometric properties, these instruments offer a valuable starting point for evaluating nursing students' competence in cervical collar and spinal board application in simulated pre-hospital scenarios.