Simulation Operations Needs Assessment Tool: Development and Validation for Simulation Operations Personnel.

Onward and Upward: Introducing the Healthcare Simulation Standards of Best PracticeTM

Introduction The term “scientist” lacks a universally accepted definition, reflecting the evolving, interdisciplinary nature of scientific work and posing challenges for recognition, communication, and policy. This study aims to develop consensus-based definitions of the term “scientist” by engaging experienced scholars across diverse fields. Methods This study involved 156 scholars, each with at least 1,000 citations, recruited via convenience sampling. Fourteen scientist definitions, derived from literature and expert input, were assessed using a nine-point Likert scale via a structured google forms survey. The sample size was calculated using G*power (effect size = 0.5, power = 0.95), requiring at least 80 participants. Content Validity Index (CVI) was used for analysis. Definitions scoring ≥0.78 were accepted and included for final analysis, 0.70–0.78 were revised and re-evaluated, and <0.70 were excluded. Participation was voluntary and anonymous, ensuring ethical compliance and confidentiality. Results Of the 14 proposed definitions, six (42.9%) were excluded (CVI < 0.70), seven (50.0%) were accepted (CVI > 0.78), and one (7.1%) underwent revision (CVI 0.70–0.78). The highest-rated definitions were refined into two consensus-based versions: a short definition (“A scientist is a person who conducts research”) and a detailed one emphasizing hypothesis formulation and knowledge dissemination. Final validation yielded CVIs of 0.82 and 0.84, respectively, confirming strong expert agreement on both definitions. Conclusion This study developed two validated definitions of “scientist” emphasizing systematic research and knowledge dissemination. These definitions clarify the concept of scientific identity, providing a flexible yet rigorous framework applicable across academic, interdisciplinary, and policy-making contexts. Introduction The term "scientist" has undergone significant transformation since its inception, reflecting the dynamic nature of scientific inquiry and the evolving landscape of knowledge. This lack of clarity stems from the diverse roles and contributions of individuals in scientific fields, the evolving nature of research, and the interdisciplinary scope of modern science. Historically, figures such as Galileo and Newton were regarded as natural philosophers, a reflection of an earlier framework for knowledge production that has evolved alongside modern scientific advancements. Before twentieth century, the term "scientist" was commonly referred to as a "man of science," "natural philosopher," or by various other designations [1,2]. In contemporary contexts, scientists operate across a broad spectrum of fields, including medicine, biology, chemistry, physics, and social sciences, each employing methodologies tailored to their specific inquiries. For instance, biologists may design experiments to test hypotheses about living organisms, while social scientists might use qualitative methods to explore human behavior [3]. The Science Council defines a scientist as an individual who methodically collects and applies research and evidence to develop hypotheses, performs experiments, and shares results to advance knowledge in their field [4]. While National Cancer Institute defines a scientist as an individual with a background in science, particularly someone actively engaged in a specific area of research [5]. This diversity in practices underscores the challenge of defining "scientist" in a way that captures the breadth of their contributions. The plurality of definitions extends to global organizations and frameworks. For example, the United Nations Educational, Scientific, and Cultural Organization highlights the critical role of scientists in addressing global challenges and promoting sustainable development. This definition broadens the scope to include individuals working in multidisciplinary teams or applying scientific knowledge to public policy and societal issues. Similarly, some academic discussions focus on the characteristics of a scientist, such as curiosity, skepticism, and a commitment to evidence-based conclusions, rather than formal qualifications or job titles [6]. Unlike well-defined professions such as medicine or engineering, where specific educational pathways and professional titles (e.g., "doctor" or "engineer") confer clear identities, the term "scientist" lacks a universally recognized credentialing system. This absence can lead to underrepresentation or misrepresentation of scientific expertise, especially in interdisciplinary and collaborative contexts [7]. For example, the growing integration of data science in biology or physics illustrates the importance of understanding who qualifies as a scientist to ensure effective communication and collaboration among stakeholders. The absence of a standardized definition poses practical challenges for scientific communication, policymaking, and inclusivity. This study aims to address this gap by engaging scholars across disciplines to develop a consensus-based definition of "scientist." By recognizing the diverse and interdisciplinary contributions of scientists, such a definition could enhance collaboration, improve public understanding, and inform policies that support the scientific community. Methods Study design and participants A total of 156 scholars (out of 300 invited) participated in this study. Eligibility was determined based on the scholars' substantial academic expertise, evidenced by the achievement of at least 1,000 citations within their respective fields. This criterion ensured that participants had significant research experience and were highly qualified to contribute to the formulation of a consensus-based definition of "scientist." Participants were recruited through a convenience sampling method, and data were collected via a structured survey administered through google forms. While convenience sampling was used due to the accessibility of high-citation scholars, efforts were made to ensure disciplinary diversity to mitigate potential bias. Personalized invitations were sent via email to each scholar to facilitate their inclusion in the study. Sample size determination The sample size was determined using G*power statistical software (version 3.1.9.7), employing a two-tailed goodness of fit test with an effect size of 0.5, an alpha error probability of 0.05, and a statistical power of 0.95. According to the calculations, a minimum of 80 participants were required to achieve statistically valid results. Consequently, 156 scholars were recruited to participate in the study, ensuring robust representation and adequate statistical power. Data collection Fourteen proposed definitions of "scientist," curated from existing literature and expert contributions, were presented to the enrolled scholars for evaluation (Table 1). Each definition included a Likert scale with nine response options, ranging from "strongly agree" to "strongly disagree." Responses were systematically recorded and compiled in an Excel sheet for subsequent analysis. This process facilitated the systematic capture of scholarly consensus on each definition. Table 1. Respondent Agreement on Various 'Scientist' Definitions. Proposed Definitions Options A person studying or has expert knowledge of one or more natural or physical sciences. (Oxford Dictionary) Strongly Disagree Moderately Disagree Disagree Slightly Disagree Undecided Slightly Agree Moderately Agree Agree Strongly Agree An expert who studies or works in one of the sciences. (Cambridge Dictionary) Strongly Disagree Moderately Disagree Disagree Slightly Disagree Undecided Slightly Agree Moderately Agree Agree Strongly Agree A person learned in science and especially natural science. (Merriam-Webster Dictionary) Strongly Disagree Moderately Disagree Disagree Slightly Disagree Undecided Slightly Agree Moderately Agree Agree Strongly Agree A scientist is someone who systematically gathers and uses research and evidence, to make hypotheses and test them, to gain and share understanding and knowledge. (Science Council) Strongly Disagree Moderately Disagree Disagree Slightly Disagree Undecided Slightly Agree Moderately Agree Agree Strongly Agree A scientist is someone who has studied science and whose job is to teach or do research in science. (Collins Dictionary) Strongly Disagree Moderately Disagree Disagree Slightly Disagree Undecided Slightly Agree Moderately Agree Agree Strongly Agree An expert in science, especially one of the physical or natural sciences. (Dictionary) Strongly Disagree Moderately Disagree Disagree Slightly Disagree Undecided Slightly Agree Moderately Agree Agree Strongly Agree A scientist is a person with some kind of knowledge or expertise in any of the sciences. (Vocabulary dictionary) Strongly Disagree Moderately Disagree Disagree Slightly Disagree Undecided Slightly Agree Moderately Agree Agree Strongly Agree A person who is trained in a science and whose job involves doing scientific research or solving scientific problems. (Britannica Dictionary) Strongly Disagree Moderately Disagree Disagree Slightly Disagree Undecided Slightly Agree Moderately Agree Agree Strongly Agree A person who has studied science, especially one who is active in a particular field of investigation. (National Cancer Institute) Strongly Disagree Moderately Disagree Disagree Slightly Disagree Undecided Slightly Agree Moderately Agree Agree Strongly Agree Someone who works or is trained in science. (Longman Dictionary) Strongly Disagree Moderately Disagree Disagree Slightly Disagree Undecided Slightly Agree Moderately Agree Agree Strongly Agree A person whose profession is investigating in one of the natural sciences. (Your Dictionary) Strongly Disagree Moderately Disagree Disagree Slightly Disagree Undecided Slightly Agree Moderately Agree Agree Strongly Agree A person who is engaged in and has expert knowledge of a science. (Free Dictionary) Strongly Disagree Moderately Disagree Disagree Slightly Disagree Undecided Slightly Agree Moderately Agree Agree Strongly Agree Someone whose job or education is about science. (LanGeek Dictionary) Strongly Disagree Moderately Disagree Disagree Slightly Disagree Undecided Slightly Agree Moderately Agree Agree Strongly Agree A scientist is a person who researches to advance knowledge in an area of the natural sciences. (Wikipedia) Strongly Disagree Moderately Disagree Disagree Slightly Disagree Undecided Slightly Agree Moderately Agree Agree Strongly Agree Data analysis The Content Validity Index (CVI) was employed to assess the relevance and agreement of the definitions. Definitions with a CVI below 0.70 were excluded, as they failed to meet the minimum threshold for consensus. Definitions with a CVI between 0.70 and 0.78 underwent a second round of evaluation, with refined wording sent back to the same scholars for further review. Definitions achieving a CVI above 0.78 were deemed sufficiently valid for inclusion in the final analysis [8]. These definitions formed the foundation for the development of a unified, consensus-based definition of "scientist." Ethical considerations Participation in the study was entirely voluntary, and all responses were anonymized to preserve participant confidentiality. Results Initially, out of the 14 proposed definitions of the term "scientist," six (42.9%) received a CVI score below the threshold of 0.70 and were consequently excluded from further consideration. In contrast, seven definitions (50.0%) demonstrated strong content validity with CVI scores equal to or exceeding 0.78 and were therefore retained for subsequent synthesis and analysis. Only one definition (7.1%) fell within the intermediate range, with a CVI between 0.70 and 0.78 (Table 2). Table 2. Comparison of Agreement and CVI Across Proposed Definitions of 'Scientist'. Proposed Definition Agree Disagree Undecided CVI Status Science Council Definition 146 8 2 0.94 Accepted Britannica Dictionary Definition 136 16 4 0.87 Accepted Cambridge Dictionary 130 20 6 0.83 Accepted Wikipedia Definition 125 27 4 0.80 Accepted Free Dictionary Definition 124 25 7 0.79 Accepted National Cancer Institute Definition 124 25 7 0.79 Accepted Collins Dictionary Definition 122 31 3 0.78 Accepted Oxford Dictionary Definition 120 31 5 0.77 Revised Longman Dictionary Definition 104 42 10 0.67 Excluded Your Dictionary Definition 103 48 5 0.66 Excluded Dictionary (generic) Definition 91 52 13 0.58 Excluded Vocabulary dictionary Definition 88 58 10 0.56 Excluded Merriam-Webster Dictionary Definition 81 64 11 0.52 Excluded LanGeek Dictionary Definition 79 67 10 0.51 Excluded CVI: Content Validity Index, CVI Thresholds: Accepted: ≥ 0.78, Revised: 0.70–0.78, Excluded: < 0.70 Through a rigorous, iterative evaluation process involving expert feedback, the definitions with the highest CVI scores (those above 0.78) were integrated and refined into two distinct, consensus-based definitions of the term "scientist." The first was a concise definition: “A scientist is a person who conducts research.” The second was a more comprehensive and elaborated definition: “A scientist is someone who systematically conducts or gathers and uses research to formulate hypotheses and test them, in order to gain and disseminate understanding and knowledge.” These two final definitions were subsequently circulated among the panel of scholars for a second round of evaluation, during which they were asked to rate the definitions for content validity. The short definition received a CVI of 0.82, while the more detailed definition attained a slightly higher CVI of 0.84, reflecting strong agreement among the experts. Although no additional formal qualitative feedback was solicited at this stage; minor wording adjustments were made based on informal suggestions received during this validation round. Discussion The role of a scientist extends far beyond the stereotypical image of an individual in a white coat working exclusively in a laboratory setting. Careers grounded in scientific expertise are remarkably diverse, encompassing domains such as research, education, industry, and regulatory affairs. The Science Council categorizes scientists into 10 different types, highlighting the diversity of scientific roles beyond the stereotypical lab-based researcher. It includes types such as experimental scientists, theoretical scientists, data scientists, and more, reflecting the broad spectrum of scientific work today [9]. Definitions of the term “scientist” vary, yet they generally converge on the principles of systematic inquiry, evidence-based investigation, and the pursuit of knowledge across various disciplines. For instance, the Oxford Advanced Learner’s Dictionary and the Britannica Dictionary emphasize formal training and research functions, typically within the natural sciences such as biology, chemistry, or physics [10,11]. In contrast, contemporary perspectives, such as those discussed by the American Association for the Advancement of Science in 2024, recognize a broader spectrum of scientific engagement, encompassing both professional researchers and individuals committed to understanding the world through observation, experimentation, and analysis [12]. In light of this diversity, the present study aimed to clarify and formalize the definition of a "scientist" through expert consensus. Two definitions were developed: a concise definition “A scientist is a person who conducts research”, and a comprehensive definition “A scientist is someone who systematically conducts or gathers and uses research to formulate hypotheses and test them, in order to gain and disseminate understanding and knowledge.” These definitions encapsulate the core activities and guiding principles of scientific inquiry, emphasizing both methodological rigor and the essential role of knowledge dissemination across disciplines. A key finding of this study lies in its recognition of the evolving tension between disciplinary specialization and the increasing importance of interdisciplinary collaboration. As highlighted in contemporary analyses of interdisciplinary research and development, scientists now frequently operate at the intersection of multiple fields, such as nanomedicine, where the diversity and dissimilarity of collaborators’ knowledge can significantly enhance research productivity [13]. The concise definition, "A scientist is a person who conducts research" captures this shift by avoiding constraints tied to specific disciplinary boundaries. In contrast, the more detailed definition explicitly incorporates the systematic formulation and testing of hypotheses, along with the dissemination of knowledge, thereby reinforcing the structured and communicative nature of scientific inquiry. These elements align closely with UNESCO’s 2019 call for stronger science-society engagement and underscore the ethical responsibilities inherent in modern scientific practice [14]. The study’s findings also contribute to ongoing debates surrounding professional identity within the scientific community. In contrast to regulated professions such as medicine, the absence of a universal credentialing system for scientists complicates formal recognition, particularly in non-academic and interdisciplinary contexts. This ambiguity is reflected in the National Cancer Institute’s pragmatic definition of a scientist, which emphasizes active participation in research rather than reliance on formal titles or qualifications [15]. By anchoring the term “scientist” in core research activities rather than occupational labels, the consensus-based definitions proposed in this study offer a more inclusive framework. This approach accommodates emerging roles in fields such as data science and applied research, thereby addressing the risk of under recognition in collaborative and cross-sector environments. The dual definitions, concise and comprehensive, offer flexibility for different contexts, a strategy aligned with the Science Council’s emphasis on methodological diversity [4]. The detailed definition’s focus on systematic inquiry and dissemination aligns with studies of interdisciplinary science, where “impassioned commitment” to shared goals drives innovation [13]. Simultaneously, the availability of a concise definition enhances clarity in public discourse and science communication, while the more detailed version provides the specificity necessary for institutional contexts such as policy development, research funding, and professional accreditation. Notably, the study’s findings also challenge enduring stereotypes of the “lone genius” scientist by highlighting the inherently collaborative and iterative nature of scientific practice. Contemporary frameworks, such as those emerging from computational biology, suggest that scientific identity is increasingly dynamic, pluralistic, and shaped by collective knowledge production [16]. The process undertaken in this study, involving successive refinement and expert validation of definitions, closely mirrors the recursive logic of the scientific method itself. This methodological alignment is particularly salient in fields like nutritional epidemiology, where the replication of findings remains a persistent challenge and iterative inquiry is essential for refining evidence [17]. Despite the methodological rigor and expert involvement, several limitations should be acknowledged. First, the study employed convenience sampling, which may introduce selection bias and limit the generalizability of the findings. Although participants were selected based on a minimum citation threshold to ensure scholarly expertise, this criterion may have inadvertently excluded emerging researchers or experts with significant practical contributions who have not yet achieved high citation metrics. Second, the use of an online survey format may have constrained participant engagement, as scholars with limited availability or preference for alternative formats may have been underrepresented. Additionally, response bias cannot be ruled out, as those with a particular interest in the topic or in defining scientific identity may have been more inclined to participate, potentially skewing the results. Future refinements of the definition should also consider voices from non-academic scientific contexts including those in industry, policy, and community-based science who are increasingly central to addressing complex global challenges. Conclusion By engaging experienced scholars across disciplines, this study establishes two validated definitions of “scientist” that emphasize systematic research activity and knowledge dissemination. These definitions offer a structured yet adaptable framework for understanding scientific identity, balancing clarity with flexibility. They help address the ambiguity surrounding the term “scientist,” providing a foundation for improved communication, interdisciplinary collaboration, and evidence-informed policy development. Importantly, they remain open to future refinement as scientific practice continues to evolve. Declarations Conflicts of interest: The authors have no conflicts of interest to disclose. Ethical approval: Not applicable. Patient consent (participation and publication): Not applicable. Funding: The present study received no financial support. Acknowledgements: None to be declared. Authors' contributions: JG, MM, SB, BS, VS, ASN, SHM, HAH, AGH, ADS, RAK, WRR, AB, GB, SS, SN, CJ, PL, MSS, ZK, MC, AM, SK, FCT, FB, FRK, MAM, AA, VK, DH, PM, VRM, MSA, EA, and RV were significant contributors to the conception of the study, voting for the items. FHK, BAA, and AMM were involved in the literature review, manuscript writing, and data analysis and interpretation. FHK and AMM Confirmation of the authenticity of all the raw data. All authors have read and approved the final version of the manuscript. Use of AI: ChatGPT-3.5 was used to assist in language editing and improving the clarity of the manuscript. All content was reviewed and verified by the authors. Authors are fully responsible for the entire content of their manuscript. Data availability statement: Not applicable.

Self-debriefing in healthcare simulation: An integrative literature review

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.

Standard Operating Protocols (SOPs) direct to perform the procedures methodically. The current study was carried out to develop SOP for nasogastric tube (NG) feeding. A preliminary draft of the protocol was developed by reviewing relevant literature. Current practices the nursing personnel regarding NG feeding were also observed. Focus group discussions were conducted to assess the problems faced by them and to seek their suggestions to overcome these problems while performing the procedure. Four Delphi rounds amongst the experts were conducted to validate the protocol following which Content Validity Index (CVI) was calculated. For each item of the protocol the Content Validity Index (CVI) was100%. Nurses were demonstrated the procedures as per developed SOP. Following this, 20 observations were recorded using an observation checklist. The internal consistency was calculated using Cronbach’s Alpha coefficient. The Cronbach’s Alfa of the protocol was 0.83. The present study has thus provided a protocol that is valid, feasible, internally consistent and acceptable by the nurses

BackgroundCritical reflection is vital for enhancing nursing competencies and patient care. This study aimed to validate and evaluate the psychometric properties of the Persian version of the critical reflection competency scale (CRCS-P) for clinical nurses.MethodsThis methodological study was conducted among clinical nurses in Ardabil, Iran, from July to September 2024. Participants included 201 nurses with at least six months of clinical experience. Psychometric properties were assessed following COSMIN guidelines, including content validity, construct validity through confirmatory factor analysis (CFA), and reliability testing.ResultsThe CRCS-P demonstrated strong content validity, with Content Validity Index (CVI) scores ranging from 0.80 to 0.92. CFA results indicated robust construct validity, with fit indices showing CMIN/DF = 1.349, RMSEA = 0.034, GFI = 0.941, CFI = 0.989, NFI = 0.958, and AGFI = 0.921. Internal consistency was confirmed with a Cronbach’s alpha of 0.862 and McDonald’s omega coefficient of 0.871, and test-retest reliability yielded an Intraclass Correlation Coefficient (ICC) of 0.806.ConclusionThe CRCS-P is a valid and reliable tool for assessing critical reflection competencies among clinical nurses in Iran. This instrument can facilitate the integration of reflective practices into nursing education and professional development, ultimately enhancing patient care outcomes.

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.

Inpatient nursing care satisfaction is an important indicator of medical care quality. However, no reliable and validated tool is currently available in Taiwan to measure the satisfaction of inpatients with nursing care. This pilot study developed a reliable and validated scale for measuring inpatient nursing care satisfaction in Taiwan. First phase: literature review and expert focus group discussion constructs the content of the questionnaire to be used to assess inpatient nursing care satisfaction. Second phase: experts were requested to validate questionnaire content. Third phase: convenience sampling was used to recruit 766 inpatients from 6 hospitals to complete the validated questionnaire. The data collected from the questionnaire were analyzed using item analysis, construct validity, and internal consistency. The results of analysis were used to determine the reliability and validity of the developed scale. The 20-item Taiwanese inpatient nursing care satisfaction scale was developed, with a CVI (content validity index) of expert validity of .97, item discrimination CR (critical ratio) of 28.61-50.25 (p < .001), and item-total correlation of .68-.84 (p < .001). Two factors, including "professional knowledge & skill" and "environmental control" were extracted by exploratory factor analysis after the deletion of 5 items, with item factor loadings ranging from .61 to .84. The factors explained 71.40% of total variance. The internal consistency of the two categories of Cronbach's α was .94-.97 coefficient and the overall internal consistency coefficient was .97. This study confirms the validity of the developed Taiwanese inpatient nursing care satisfaction scale and suggests that this instrument is reliable for measuring the satisfaction of inpatients with nursing care in Taiwan.

Introduction: Standardized tests in speech therapy mostly focus onlanguage structure rather than the use of language in social context. So, there is a clear need for instruments to assess pragmatic aspects of language. Children’s CommunicationChecklist (CCC) and its revised version, CCC-2, was developed to address this need, however, its psychometric features are unknown in Iran. The current study aims to adapt CCC-2 in Persian by providing its content validity and two types of reliability, internal consistency and test-retest. Materials and Methods: This study is anon-experimental validation study. In the process of determining content validity, back translation by three linguists and speech, language therapists (SLT) was used. Also, 28 parents of seven to nine years old children with normal language development involved to judge about the simplicity and comprehensibility of the items. The translated form, then, was sent to 10 linguists and SLTs to judge about its content and then content validity index (CVI) were computed for each item .Internal consistency and test-retest reliability were determined by asking the parents of 100 children between seven and nine years old to complete the form. Results: All items but four were calculated with a CVI higher than .85. After revision, those four items improved their scores. Content validity index was higher than .75. Internal consistency of each item was calculated between .66 and .74. Test-retest reliability was calculated higher than .90 after two weeks interval. Conclusion: Results show that Persian adaptation of CCC-2 possesses acceptable content validity and reliability in 7 to 9 year-olds. Its psychometric values, however, need to be improved by conducting further studies on larger sample sizes and across other ranges of age. Keywords: CCC-2, adaptation, validity, reliability, pragmatics, Persian

Translation, Cross-Cultural Adaptation, and Validation of the Persian Version of the Harris Hip Score

Objective We tried to translate the English version of the Falls Efficacy Scale, Swedish version [FES(S)] into Chinese and test the reliability and validity of the Chinese version of FES(S) in patients after stroke. Methods Totally 145 patients after stroke were recruited and were investigated by the Chinese version of FES (S). The result underwent analysis of reliability and validity. Results The internal consistency coefficient of the Chinese version of FES(S) were 0.896. The Cronbach's α coefficient of two dimensions, which were Activity of Daily Living Ability and Instrumental Activity of Daily Living, were 0.863 and 0.872. The split half coefficient was 0.653, test-retest reliability was 0.743. The content validity index(CVI) was calculated according to related formulas, which was 0.896~1.000, the average CVI of all items was 0.925, CVI of each item was above 0.8. Factor analysis got two factors, which explained 40.852% of the total variance. Except for item 5, other items showed factor loading >0.4 for its common factor. Conclusions The Chinese version of FES (S) has been proved to be reliable and valid. It can be used as a valid tool for assessing stroke patients with risk for falls and self-confidence. Key words: Falls Efficacy Scale (Swedish version); Reliability; Validity

Medical device-related pressure ulcers/injuries (MDRPU/Is) are a serious concern in health care. To develop and assess the psychometric testing of a questionnaire to measure nursing students' attitudes about the care and prevention of MDRPU/Is. Based on a review of the literature, a 26-item questionnaire was developed; face validity was assessed by ten (10) nursing students. The modified Lawshe's model was used, and both the content validity index (CVI) and content validity ratio were calculated. Items with a CVI more than 0.63 were retained. The minimum optimal CVI for the new instrument was 79%. Qualitative assessments were performed by 10 experienced faculty members. One-hundred-and-eighty seven (187) nursing students participated in the construct validity testing of the 11-item questionnaire. The Kaiser-Meyer-Olkin test of sampling adequacy and Bartlett's test of sphericity were performed. Following analysis of the main components and the varimax rotation, the factor analysis was determined. Internal consistency (Cronbach's alpha) and test-retest were determined using Pearson's correlation and intraclass correlation coefficient to evaluate reliability. During the face validity phase of the initial 26 items, 7 items had impact scores less than 1.5. After calculating the CVI and content validity ratio for all items, 8 items did not achieve the desirable score. After performing exploratory factor analysis on the remaining 11 items, the Kaiser-Meyer-Olkin test value was 0.789, and Bartlett's test of sphericity was 0.0001, which was statistically significant. Internal consistency of items (Cronbach's alpha of 0.77) showed that all items had a high correlation. The reliability of test-retest was significant using an intraclass correlation coefficient of 0.75 and Pearson's correlation coefficient of 0.86 at P < .005. In this sample of nursing students, the Attitude Towards Medical-device Related Pressure Ulcers/Injuries Questionnaire was valid and reliable. Studies including licensed clinicians are needed to confirm these results.

The purpose of this study was to develop the Avoidance of Daily Activities Photo Scale (ADAP Shoulder Scale) to measure shoulder pain-related avoidance behavior in patients with shoulder pain and evaluate and report the structural validity and internal consistency of the scale. Potential daily activities involving the shoulder were selected from the activities and participation domain of the International Classification of Functioning, Disability and Health. The selected activities were presented to an expert panel, health care professionals, and patients with shoulder pain with the question "How much do you think it is important to ask patients with shoulder pain about this activity?" Activities attaining a content validity index (CVI) ≥ 0.8 were represented using a digitally colored photograph. Activity photographs were evaluated by health care professionals and patients with shoulder pain. Photographs with a CVI ≥ 0.8 were included in the scale. To evaluate structural validity and internal consistency of the scale, exploratory factor analysis was performed to determine the presence of any scale domain. Cronbach alpha was calculated to indicate the internal consistency of each domain. Of the 107 preselected activities, 21 attained a CVI ≥ 0.8. Eighteen photographs (CVI ≥ 0.8) were included in the scale after being analyzed by 120 health care professionals and 50 patients with shoulder pain. Exploratory factor analysis (N = 156) showed that the ADAP Shoulder Scale consists of 3 domains: free movement, high effort, and self-care. The internal consistencies of the domains were 0.92, 0.89, and 0.92, respectively. The ADAP Shoulder Scale included 15 photographs distributed in 3 domains. All domains had a high internal consistency. The scale is easily applicable, well understood, and relevant for shoulder pain. The ADAP Shoulder Scale can be used to rate shoulder pain-related avoidance behaviors.

The objective of the current study was to translate and test psychometric properties of the Premenstrual Symptoms Screening Tool (PSST) in Iran. Using a standard "forward-backward" procedure, the English version of PSST was translated into Persian. A random sample of university students aged 18years and over completed the questionnaire in Tehran, Iran. Psychometric properties of the Iranian version of PSST were assessed by performing reliability (internal consistency) and validity analyses [Content Validity Ratio (CVR) and Content Validity Index (CVI)]. In all, 925 female students took part in the study. Of these, 284 (30.7%) had premenstrual syndrome (PMS) and 119 (12.9%) had premenstrual dysphoric disorder (PMDD). Reliability of the PSST as measured by internal consistency was found to be satisfactory (Cronbach's alpha coefficient, 0.93). The content validity as assessed by CVR and CVI were desirable (0.7 and 0.8, respectively). The Iranian version of PSST seems to be a reliable and valid measure of detecting PMS and PMDD in Iranian young female populations.

Given that there are many Iranian women who have never had a Pap smear, this study was designed to develop and validate a measurement tool based on the Protection Motivation Theory to assess factors influencing the Iranian women's intention to perform first Pap testing. In this psychometric research, to determine the Content Validity Index (CVI) and the Content Validity Ratio (CVR), a panel of experts (n=10) reviewed scale items. Reliability was estimated through the Intraclass Correlation Coefficient (n=30) and internal consistency (n=240). Also, factor analysis (exploratory and conformity) was performed on the data of the sample women who had never had a Pap smear test (n=240). A 26-item questionnaire was developed. The CVI and CVR scores of the scale were 0.89 and 0.90, respectively. Exploratory factor analysis loaded a 26-item with seven factors questionnaire (perceived vulnerability and severity, fear, response costs, response efficacy, self-efficacy, and protection motivation (or intention)) that jointly accounted for 72.76% of the observed variance. Confirmatory factor analysis indicated a good fit for the data. Internal consistency (range 0.70-0.93) and test-retest reliability (range 0.72-0.96) of sub-scales were acceptable. This study showed that the designed instrument was a valid and reliable tool for measuring the factors influencing the women's intention to perform their first Pap testing.