Development and psychometric evaluation of the basic electrocardiogram interpretation self-efficacy scale

Purpose: Research suggests that nurses and nursing students lack competence in basic electrocardiogram (ECG) interpretation. Self-efficacy is considered to be paramount in the development of one's competence. The aim of this study was to develop and psychometrically evaluate a scale to assess self-efficacy of nursing students in basic ECG interpretation. Materials and methods: Observational cross-sectional study with a convenience sample of 293 nursing students. The basic ECG interpretation self-efficacy scale (ECG-SES) was developed and psychometrically tested in terms of reliability (internal consistency and temporal stability) and validity (content, criterion and construct). The ECG-SES’ internal consistency was explored by calculating the Cronbach's alpha coefficient (α); its temporal stability was investigated by calculating the Pearson correlation coefficient (r) between the participants’ results on a test–retest separated by a 4-week interval. The content validity index of the items (I-CVI) and the scale (S-CVI) was calculated based on the reviews of a panel of 16 experts. Criterion validity was explored by correlating the participants’ results on the ECG-SES with their results on the New General Self-Efficacy Scale (NGSE). 1 Construct validity was investigated by performing Principal Component Analysis (PCA) and known-group analysis. Results: The excellent reliability of the ECG-SES was evidenced by its internal consistency (α = 0.98) and its temporal stability at the 4-week re-test (r = 0.81; p < 0.01). The ECG-SES’ content validity was also excellent (all items’ I-CVI = 0.94–1; S-CVI = 0.99). A strong, significant correlation between the NGSE and the ECG-SES (r = 0.70; p < 0.01) showed its criterion validity. Corroborating the ECG-SES’ construct validity, PCA revealed that all its items loaded on a single factor that explained 74.6% of the total variance found. Furthermore, known-groups analysis showed the ECG-SES’ ability to detect expected differences in self-efficacy between groups with different training experiences (p < 0.01). Conclusion: The ECG-SES showed excellent psychometric properties for measuring the self-efficacy of nursing students in basic ECG interpretation.

Effects of two teaching strategies on the relationship between nursing students’ self-efficacy and performance in BLS/AED

Purpose: Nurses and nursing students are often first responders to in-hospital cardiac arrest events; thus they are expected to perform Basic Life Support (BLS) and use an automated external defibrillator (AED) without delay. The aim of this study was to explore the relationship between nursing students’ self-efficacy and performance before and after receiving a particular training intervention in BLS/AED. Materials and methods: Explanatory correlational study. 177 nursing students received a 4-h training session in BLS/AED after being randomized to either a self-directed (SDG) or an instructor-directed teaching group (IDG).1 A validated self-efficacy scale, the Cardiff Test and Laerdal SkillReporter® software were used to assess students’ self-efficacy and performance in BLS/AED at pre-test, post-test and 3-month retention-test. Independent t-test analysis was performed to compare the differences between groups at pre-test. Pearson coefficient (r) was used to calculate the strength of the relationship between self-efficacy and performance in both groups at pre-test, post-test and retention-test. Results: Independent t-tests analysis showed that there were non-significant differences (p-values > 0.05) between groups for any of the variables measured. At pre-test, results showed that correlation between self-efficacy and performance was moderate for the IDG (r = 0.53; p < 0.05) and the SDG (r = 0.49; p < 0.05). At post-test, correlation between self-efficacy and performance was much higher for the SDG (r = 0.81; p < 0.05) than for the IDG (r = 0.32; p < 0.05), which in fact was weaker than at pre-test. Finally, it was found that whereas the correlation between self-efficacy and performance increased from the post-test to the retention-test to almost reach baseline levels for the ILG (r = 0.52; p < 0.05), it slightly decreased in this phase for the SDG (r = 0.77; p < 0.05). Conclusion: Student-directed strategies may be more effective than instructor-directed strategies at promoting self-assessment and, therefore, may help to improve and maintain the relationship between nursing student self-efficacy and actual ability to perform BLS/AED.