Nurse Competence Scale: psychometric assessment in the Italian context

Introduction: The Nurse Competence Scale is a tool for evaluating nursing clinical competence. This tool has been used and psychometrically validated previously in different countries but never in Italy. Assessing the validity and reliability of the Nurse Competence Scale in the Italian context has been a strong necessity for many years.

Aim: To test the psychometric properties and evaluate the internal construct validity of the Italian version of the Nurse Competence Scale.

Methods: This study is a secondary analysis on a database of 698 bachelor nursing students who were trained in different clinical settings at two Italian universities. Internal consistency was examined with Cronbach's alpha coefficients and inter-item analysis, and construct validity was evaluated by Exploratory Factor Analysis with Oblimin rotation with Kaiser normalization, and eventually Confirmatory Factor Analysis.

Results: The results highlighted the necessity for refinements of the Nurse Competence Scale in the Italian Context. The original model of the Nurse Competence Scale (73 items) was not confirmed. The confirmatory factor analysis presented significant values of Chi-squared test = 10942.766, with degrees of freedom being 2.534 and a ratio of χ²/df = 4.318. The Comparative Fit Index value was significant 0.809 and the Normed Fit Index 0.765 was noteworthy too. The value of Root Mean Square Error of Approximation was significant 0.069. The Cronbach's α coefficient for the new scale was excellent (0.922). The exploratory factor analysis resulted in the Italian Nurse Competence Scale composed of 58 items divided into seven dimensions: using the research, professional awareness, ethical values, tutorial functions, professional leadership, educational interventions, and management of care processes.

Conclusions: The Italian version of the Nurse Competence Scale with 7 dimension and 58 items is an appropriate tool for describing and comparing self-assessed competencies by nurses. Such evaluations could constitute an important contribution to have better educational environments. Self-assessment of competencies can also raise a stronger awareness of individual educational needs.