Enhancement program development for Outcome-Based Education competency for nurse educators in Camarines Sur, Philippines

For this cross-sectional study, items were developed based on clinical expertise and the core measures for developmental care. In this study, seven experts provided content validity ratings of items for total scale and subscale fit and relevance. A content validity index was used to determine item retention. Item modifications and additions were based on expert feedback. Expert ratings provided evidence of content validity on 24 of 53 items within the five domains of developmental care. A total of 24 items were deleted, and five items with low content validity ratings were retained, because of conceptual importance, and revised. An additional 11 items were added based on expert qualitative feedback. This study provided evidence of content validity of the developmental care scale for neonates with CHD by researchers and bedside nurses caring for these neonates. Further psychometric testing is warranted to provide evidence of internal consistency reliability, construct validity, and to identify variables that influence quality of the developmental care.

The efficacy of radiotherapy and the satisfaction of patients can be significantly improved by adequately addressing their information needs. This process is impeded by the current lack of a comprehensive tool for assessing these needs. To develop an Information Needs Questionnaire for patients with breast cancer undergoing radiotherapy and to assess its reliability and validity. The initial item pool for the questionnaire was developed through a literature analysis and semi-structured interviews with 12 patients with breast cancer receiving radiotherapy. The Delphi method was employed to consult 16 experts and the questionnaire content was refined based on expert feedback and item ratings to form the first draft. A pre-investigation was conducted on 30 patients with breast cancer treated with radiotherapy to refine the item expression. From March-October 2024, item analysis, factor analyses, and reliability tests were conducted on 220 patients. This study adhered to STROBE guidelines. The final questionnaire comprised 36 items. Exploratory factor analysis revealed 5 dimensions, with all item factor loading within their respective dimensions being ≥ 0.4 and no items exhibiting multiple loadings. These five factors accounted for 72.805% of the total variance. The overall content validity index was 0.980, with item-level content validity index ranging from 0.900 to 1.000. The Cronbach's α coefficient for the entire questionnaire was 0.959, and the coefficients for each dimension ranged from 0.786 to 0.958. The Information Needs Questionnaire demonstrated excellent reliability and validity in patients with breast cancer undergoing radiotherapy. It can effectively guide medical staff to accurately assess the information needs of patients with breast cancer who are undergoing radiotherapy. Identifying the authentic informational needs of breast cancer patients throughout the entire radiotherapy process is instrumental in enabling medical staff to devise personalised and targeted information support interventions. A total of 220 participants provided perspectives on their information needs.

Simulation operations specialists (SOSs) play a critical yet ill-defined role in healthcare simulation. Despite their critical involvement in operations, orientation, and support of simulation-based education, no validated needs assessment tool existed to guide professional development. This study aimed to design and validate the Simulation Operations Needs Assessment Tool (SONAT) to identify knowledge and skills gaps, guide onboarding, and inform SOS professional development. The SONAT was developed using best practice, community, and peer-reviewed documents, including the Certified Healthcare Simulation Operations Specialist Blueprint, SimGHOSTS Capability Framework, and the Healthcare Simulation Standards of Best Practice. Messick's Unified Validity Theory guided the validation process using Lawshe's method to assess survey items. Following expert feedback and item revision, the tool was disseminated for psychometric analysis. Internal consistency was assessed using Cronbach's alpha for each section of the tool. Content validity indices (CVIs) for the final SONAT exceeded the .70 acceptability threshold (CVI = .738). A sample of 256 SOSs completed the SONAT. Internal consistency was strong across 4 domains (α = .730-.912). Respondents reported high proficiency in manikin-based and task trainer simulation but less in emerging modalities (eg, Augmented Reality/Virtual Reality). Awareness of professional standards was strong, although gaps were noted in knowledge of ethics and leadership opportunities, particularly among noncertified individuals. SONAT collects valid and reliable data when assessing SOS developmental needs across diverse roles and backgrounds. It has the potential to standardize orientation, support tailored professional development, and strengthen skillsets of the evolving SOS profession.

Background and Purpose: Graduate nursing programs require structured processes to address clinical deficiencies while ensuring fairness and patient safety. However, existing remediation practices often lack standardization and transparency. To address this gap, a clinical remediation algorithm was developed and evaluated to assist in managing unsatisfactory clinical performance. Methods: The 26-item Graduate Nursing Student Clinical Remediation (GNS-CR) Algorithm, developed from literature and expert feedback, was reviewed by 20 invited experts in graduate nursing education. Content validity indices (CVI) were calculated at the item and scale level. Results: Item-level CVI scores ranged from .80 to 1.00, with a scale-level CVI of .923, surpassing accepted thresholds. Feedback confirmed the algorithm's clarity, logical structure, and relevance. Conclusions: The GNS-CR Algorithm demonstrated strong content validity and offers a systematic, transparent approach to clinical remediation. Future research should evaluate its effectiveness in academic and clinical settings.

The Accreditation and Certification System After Next

Introduction: Gender dysphoria is one of the significant challenges in healthcare systems, and primary healthcare providers play a key role in caring for and referring these individuals. However, their insufficient knowledge and attitudes may lead to inadequate care. Given the lack of a standard Persian tool for measuring these variables, this study aimed to psychometrically evaluate a questionnaire assessing the knowledge and attitudes of primary healthcare providers regarding gender dysphoria. Methods: This descriptive cross-sectional study was conducted in 2024 in Tabriz, involving three phases: translation, back-translation, validity, and reliability. The study sample for content validity included 15 experts, 30 healthcare providers for reliability, and 205 primary healthcare providers for construct validity. The research tool consisted of questionnaires assessing attitudes and knowledge about transgender individuals, which were translated into Persian and culturally adapted. Content validity was evaluated using content validity ratio (CVR) and content validity index (CVI), and construct validity was assessed through confirmatory factor analysis (CFA). The reliability was calculated using Cronbach’s alpha coefficient and the intra-class correlation coefficient (ICC). Results: The results of this study indicated that the overall CVI was 0.81 and the CVR was 0.93. For the knowledge section, CVI was 0.76 and CVR was 0.94, while for the attitude section, CVI was 0.85 and CVR was 0.91. In confirmatory factor analysis, the factor loadings for the attitude section were above 0.30, but some questions in the knowledge section had factor loadings lower than 0.30. The comparative fit index (CFI), goodness of fit index (GFI), normed fit index (NFI), and root mean square error of approximation (RMSEA) were 0.96, 0.90, 0.85, and 0.057, respectively, all indicating a good model fit. Additionally, the Cronbach’s alpha coefficient for the entire questionnaire was 0.86, and for the knowledge and attitude sections, it was 0.65 and 0.88, respectively. The ICC obtained from the test-retest method was 0.76, confirming the reliability of the questionnaire. Conclusion: The results of this study showed that the tool for measuring the knowledge and attitude of primary healthcare providers regarding gender dysphoria has good validity and reliability. The confirmatory factor analysis results indicated that the two-factor structure (knowledge and attitude) fits well, although some items in the knowledge section had lower factor loadings. This questionnaire can be helpful in designing educational and research programs in this area. Practical Implications: The questionnaire could be used as a screening tool in educational programs related to gender dysphoria, assessing the impact of educational interventions, and evaluating educational needs in healthcare policy-making.

Caring leadership plays a pivotal role in supporting nurses' well-being, fostering patient recovery, and advancing organizational performance. Despite its recognized importance, a validated instrument for measuring caring leadership has been lacking in the literature. This study aimed to develop a Caring Leadership Scale and evaluate its validity, reliability, and practical applicability. Guided by a conceptual framework of caring leadership, scale items were initially generated through qualitative interviews, open-ended questionnaires, and a comprehensive literature review. The Delphi technique was used to refine these items. A pilot survey informed further modifications before a large-scale survey was conducted with 2,125 frontline nurses from six tertiary hospitals across China. Item screening was carried out using classical test theory, including assessments of item discrimination, item-total correlations, and internal consistency (Cronbach's alpha). Content validity, factor structure, internal reliability, and acceptability were investigated using content validity indices, exploratory and confirmatory factor analyses, correlation coefficients, and descriptive statistics. An initial pool of 40 items across five dimensions was developed. Following two Delphi rounds and preliminary testing, 39 items were retained. Item analysis led to the elimination of 12 items that did not meet predetermined criteria. The final scale consisted of 27 items across five dimensions, rated on a 5-point Likert scale. The content validity indices were strong, with item-level CVIs ranging from 0.90 to 1.00, a scale-level content validity index universal agreement (S-CVI/UA) of 0.89, and a scale-level content validity index average (S-CVI/Ave) of 0.99. Exploratory factor analysis (EFA) supported a well-defined five-factor structure, with common factor variances ranging from 0.849 to 0.949. Confirmatory factor analysis demonstrated good model fit (RMSEA = 0.078, CFI = 0.964, NFI = 0.958, TLI = 0.959, IFI = 0.964). The average variance extracted (AVE) ranged from 0.834 to 0.925, and composite reliability (CR) ranged from 0.965 to 0.989. The scale showed moderate correlations with job satisfaction (r = 0.463-0.484, p < 0.001). Internal consistency was high, with Cronbach's alpha values between 0.962 and 0.993, and split-half reliability coefficients ranging from 0.955 to 0.982. This study presents the first validated instrument for measuring caring leadership in nursing. The final 27-item scale demonstrates robust psychometric properties, including excellent validity, reliability, and user acceptability. It offers a scientifically sound and practical tool for assessing caring leadership among nurse leaders.

Objective to develop and validate a mobile app to support the care of low-risk newborns in home environments. Methods a methodological and technological study conducted between April 2022 and June 2023, in two phases: app development and content validation with experts. The app was developed based on the Scrum and Kanban methodology, using Kodular, Web Trello, and Web Canva platforms for managing team documents and activities. Content and usability validation was conducted with experts working as researchers, healthcare professionals, healthcare managers, and an IT technician. The Content Validity Index was calculated using the Delphi technique, and agreement rates above 0.80 were considered. Results the mobile app called RnNeo provides access to six menus on its main screen: breastfeeding, sleep, crying, bathing, vaccinations, and important tips. The Content Validity Index was above 0.80 among the experts, although the app’s crashing issue was unfavorable in the assessment of 16.7% of the evaluators. Based on this evidence, the app was returned to the technical professionals for appropriate adjustments and improvements. Available on the Android operating system, the app can be accessed by any user, any day and at any time. Conclusion The RnNeo app achieved acceptable agreement among the experts and demonstrates that its content and functionalities are reliable and have the potential to support caregivers of low-risk newborns in the home environment.

IntroductionCompetency in patient education is one of the main elements of nurses' professional competency. This study aimed to develop and evaluate the psychometric properties of a self-assessment scale regarding nurses’ competency in patient education.Material and methodsThis sequential exploratory mixed-methods study was conducted in two stages. The first stage explored nurses’ experiences and perceptions of competency in patient education. So, a qualitative conventional content analysis study was conducted in 2023–25 for item generation. Purposive sampling was used to recruit the participants. Competency in patient education was explained using three focused groups (n = 19), individual semi-structured interviews (n = 6), a written narrative, and a literature review.In the subsequent phase, the scale's face validity was evaluated with the involvement of 15 nurses, while the content validity ratio and content validity index were determined by eight and ten experts, respectively. Then, the exploratory factor analysis was used to determine the domains of the scale. 408 nurses were recruited by convenience sampling from all over Iran. The reliability of the scale was assessed using internal consistency, relative and absolute stability methods. As well, responsiveness, reproducibility, feasibility, and floor and ceiling effects were assessed.ResultsThe scale was developed with 33 items and four dimensions: “adherence to the patient education principles”, “attending to patient preparation and conditions”, “observing ethical and interpersonal principles”, and “professionalism in patient education”, with a total variance of 57.44%. The findings confirmed that this tool is acceptable regarding validity, reliability, and other measurement features. The S-CVI/Ave of the scale was 0.9. The reliability of the scale was confirmed with Cronbach’s alpha coefficient (α = 0.917), (intra-cluster correlation = 0.977, with 95% confidence interval = 0.953–0.989), and (standard error of measurement = 2.15). The scale’s responsiveness, reproducibility, feasibility, and floor and ceiling effects were confirmed.ConclusionThis scale was developed to assess nurses' competency in patient education.

Objectives: to describe the process of developing and validating the content of an educational-assistance technology for self-care for pregnant trans men during prenatal care. Methods: this is a methodological study with a quantitative approach that encompassed two main stages, namely: i) development of the “Pregnancy Handbook” technology; and, ii) validation of content and appearance by a committee of expert judges. In the validation stage, the Delphi technique was applied to a group of seven judges, who responded to a questionnaire using the Likert scale. To evaluate the suitability of the instrument, the Content Validity Index (CVI) and the Content Validity Coefficient (CVC) were used. Results: the educational-assistance technology evaluated achieved a satisfactory CVC (0.90) and a CVI with excellent agreement (0.94), and showed excellent agreement between the expert judges regarding its content and appearance. Conclusion: the validated educational-assistance technology brings potential in prenatal care for trans pregnant women in the context of comprehensive health care.

Development of a social cognitive career theory scale for measuring the intention to select surgery as a career

What information does an international group of professionals and egg donors consider relevant and morally necessary for prospective egg donors to provide valid informed consent? Participants considered 80% of all concrete information items (CIIs) to be relevant (e.g. all legal aspects) and 67% to be morally necessary. Studies indicate that egg donors are not always adequately informed and have expressed a desire for more comprehensive information. This highlights the need for a comprehensive guideline of essential information for prospective egg donors. This modified Delphi study used a survey in an iterative process of three rounds to reach a consensus on what information items are relevant and morally necessary for a valid informed consent of candidate egg donors. Invitations to participate were sent out in November 2023 and the final round closed in November 2024. The 35 participants were experienced egg donors and professionals from a range of disciplines (social and medical sciences, bioethics, psychology, fertility medicine and law) from 14 countries. The survey consisted of 13 categories and 133 CIIs, which participants scored for relevance via a 4-point Likert scale and moral necessity on a dichotomous scale (yes/no). Content Validity Index (CVI) was calculated for measuring relevance and percentage of agreement for moral necessity. A comment section was available. Consensus was indicated as an I-CVI (CVI per item) of 0.78 or higher. The same cut-off was used to indicate consensus for moral necessity. For 27 out of 133 CIIs, the I-CVI was lower than 0.78. The percentage of moral necessity was below 0.78 for 44 CIIs. Four CIIs reached a I-CVI of 1: all experts thought it was relevant for a candidate donor to know (i) the need to undergo ovarian stimulation and (ii) a retrieval procedure, as well as (iii) her legal rights over the donated eggs after the retrieval procedure and (iv) her legal right to withdraw consent. The latter is the only CII that scored 100% on moral necessity. The CII with the lowest I-CVI is 'The family type and characteristics of the potential recipients of the donor eggs' (0.32). The CII with the lowest percentage of agreement for moral necessity was 'An egg donor's social circle might give negative feedback/opinions on the donation' (36.36%). In several categories (e.g. 'Physical side-effects and risks'), almost all CIIs reached a consensus among experienced egg donors, bioethicists, and humanities and social sciences experts, while hardly any CII reached a consensus among fertility experts, lawyers, and academic medical doctors. Despite our efforts, we were unable to obtain input from registered nurses and midwives. Not all participants remained engaged through all the iterative rounds, which may weaken the results of the study. However, the dropout rates between rounds in this study were within the acceptable 20-30% range. Our results give fertility professionals a standard of essential information to make sure that prospective egg donors are adequately informed and know what to expect when they decide to donate. It also gives researchers a potential standard to evaluate the quality of the information provision in fertility clinics. This study is funded by the Special Research Fund, Bijzonder Onderzoeksfonds of Ghent University (BOFSTG2020000901). The authors declare that they have no competing interests. N/A.

Study question What information does an international group of professionals and egg donors consider relevant and morally necessary for prospective egg donors to provide valid IC? Summary answer Participants considered 80% of all concrete information items (CIIs) to be relevant (e.g. all legal aspects) and 67% to be morally necessary. What is known already Disclosure of relevant and adequate information is essential for IC in medical procedures like egg donation. However, studies have indicated that egg donors are not always adequately informed and disclosure practices have been deemed inadequate. Donors have expressed a desire for more comprehensive information about the potential risks associated with donation, as well as more information on psychosocial issues. This highlights the need for a comprehensive guideline of essential information for prospective egg donors. No international study to date has determined what information professionals and egg donors consider relevant and morally necessary for prospective donors. Study design, size, duration This modified Delphi study used a survey in an iterative process of three rounds to reach a consensus on what information items are relevant and morally necessary for a valid IC of candidate egg donors. Invitations to participate were sent out in November 2023 and the final round closed in November 2024. Participants/materials, setting, methods The 35 participants were experienced egg donors and professionals from a range of disciplines (social and medical sciences, bioethics, psychology, fertility medicine and law) from 14 countries. The survey consisted of 13 categories and 118 CIIs, which participants scored for relevance via a 4-point Likert scale and moral necessity on a dichotomous scale (yes/no). Content Validity Index (CVI) was calculated for measuring relevance and percentage of agreement for moral necessity. A comment section was available. Main results and the role of chance Consensus was indicated as an I-CVI (CVI per item) of .78 or higher. The same cut-off was used to indicate consensus for moral necessity. For 27 out of 134 CIIs, the I-CVI was lower than 0.78. The percentage of moral necessity was below 0.78 for 44 CIIs. Four CIIs reached a I-CVI of 1: all experts thought it was relevant for a candidate donor to know 1) the need to undergo ovarian stimulation and 2) a pick-up procedure, as well as 3) her legal rights over the donated eggs after the pick-up procedure and 4) her legal right to withdraw consent. The latter is the only CII that scored a 100% on moral necessity. The CII with the lowest I-CVI is “The family type and characteristics of the potential recipients of the donor eggs” (0,32). The CII with the lowest percentage of agreement for moral necessity was “An egg donor’s social circle might give negative feedback/opinions on the donation” (36,36%). In several categories (e.g. 'Physical side-effects and risks') almost all CIIs reached a consensus among experienced egg donors, bioethicists, and humanities and social sciences experts, while hardly any CII reached a consensus among fertility experts, lawyers, and academic medical doctors. Limitations, reasons for caution Despite our efforts, we were unable to obtain input from registered nurses and midwives. Not all participants remained engaged through all the iterative rounds, which may weaken the results of the study. However, the dropout rates between rounds in this study were within the acceptable 20-30% range. Wider implications of the findings The final results give professionals a standard of essential information to make sure that prospective egg donors are adequately informed and know what to expect when they decide to donate. It also gives researchers a potential standard to evaluate the quality of the information provision in fertility clinics. Trial registration number No

This study aimed to develop an evaluation index system for hand surgery rehabilitation nursing using the Delphi method. A survey questionnaire on evaluation indicators for hand surgery rehabilitation nursing was developed, and 18 professionals including orthopedic surgeons, orthopedic nursing, and rehabilitation departments were selected. The survey was conducted using the letter method, and a database was established to screen the items, forming a hand surgery rehabilitation nursing evaluation scale. The expert's positive coefficient, authority coefficient, and coordination coefficient were analyzed, and the mean, standard deviation, coefficient of variation, and weight coefficient were calculated. Based on the correlation assignment results, the Item-level Content Validity Index (I-CVI), Scale-level Content Validity Index (S-CVI), average S-CVI, Probability of random consistency (Pc), and corrected I-CVI Kendall's coefficient of concordance (K*) were determined. In the first round of expert inquiry, a total of 18 questionnaires were distributed, and 15 valid questionnaires were collected, with an effective response rate of 83.33%. In the second round, 15 questionnaires were distributed and 15 valid questionnaires were collected, with an effective response rate of 100%. The two rounds of expert evaluations yielded judgment scores of 0.91 and 0.95, with proficiency levels of 0.83 and 0.87 and authority coefficients of 0.87 and 0.91, respectively. The Kendall's W values for the two rounds were 0.313 and 0.224, respectively, with a statistically significant difference (p < 0.01). After screening, 23 indicators were retained, with a coefficient of variation ranging from 0.072 to 0.166. Among the third-level indicators, 12 had an I-CVI of 1.00, 4 had an I-CVI of 0.93, and 7 had an I-CVI of 0.87. The overall S-CVI was 0.80, with an average S-CVI of 0.95. The K* values for the 23 indicators ranged from 0.8662 to 1.0000. The evaluation index system for hand injury rehabilitation nursing based on the Delphi method is highly scientific, and is expected to be used to guide the clinical evaluation of hand injury rehabilitation nursing.

Outcome Based Education (OBE) is an education system that focuses on learning outcomes that are measurable, directed, and relevant to the needs of the industrial world in the Industrial Age 4.0. The purpose of this study is to offer the application of the OBE system in designing and developing curriculum at the College of Theology in order to bridge the gap between the abilities or competencies of graduates and the needs of the modern Christian community. The method used in this research is a literature study, which is to collect library data sources and previous research, then explore them to be presented to support this research. The results of this study show that the OBE system is very effective in improving the quality and quality of education, producing graduates who are competent in their fields and preparing them to face challenges in the Industrial Age 4.0. The implementation of the OBE system into curriculum development at Theological College will certainly help improve the quality of education, be able to compete with other universities, and raise Theological College’s reputation. The conclusion of this research is that the OBE system is feasible to be applied in developing the curriculum used by Theological College.