Psychometric design and validation of a tool to assess the medication administration process through simulation in undergraduate nursing students

Background: Medication errors account for 38% of adverse events reported among undergraduate nursing students. Simulation provides training for nursing students in the medication administration process. However, there is a lack of reliable and valid instruments to measure its assessment.

Objectives: To design and validate a new tool (MEDICORRECT) to assess undergraduate nursing students in the medication administration process using a high-fidelity simulation scenario.

Design and methods: Study participants were fourth year undergraduate nursing students at the University of Barcelona. Phase 1 consisted of tool design and drafting, and content validity and feasibility analyses. Phase 2 covered construct validity and interrater reliability. A factor analysis was conducted, involving a principal component analysis and varimax rotation.

Findings: Of 21 initial items, 11 were eliminated because of low content validity ratio, 4 of which assessed cognitive skills such as administering the right medicine at the right dose, which were impossible to observe in the simulation scenario. The final version of MEDICORRECT contained 10 items. The exploratory factor analysis identified a four-factorial model explaining 67.3% of the variance. Interrater agreement measured with Kappa was greater than 0.70 for 80% of items.

Conclusions: The 10 items in MEDICORRECT are relevant and feasible, have suitable psychometric properties and reflect the practical skills identified in the medication administration process. The tool excludes cognitive skills, which should be included and assessed during prebriefing.