First Advisor

Dunemn, Kathleen

First Committee Member

Aldridge, Michael

Second Committee Member

Casey, Kathy

Third Committee Member

Pool, Natalie

Degree Name

Doctor of Philosophy

Document Type

Dissertation

Date Created

8-2024

Department

College of Natural and Health Sciences, Nursing, Nursing Student Work

Abstract

Advanced practice provider (APP) fellowship programs are comprehensive programs designed for physician assistants (PAs) and nurse practitioners (NPs) to acquire the necessary knowledge and skills to deliver safe, high-quality care in their specialized areas of practice (Advanced Practice Provider Fellowship Accreditation TM, 2023). An APP fellowship program’s mission is to guide the APP fellow to an expected level of confidence in meeting core competencies within a specific specialty (Klimpl et al., 2019; Reville & Foxwell, 2021). The assessment of competence is often a complex process. Simulation has become a learning modality across the globe in medical, nursing, and pharmacy in undergraduate, graduate, and post-graduate training to manage the most complex clinical situations (Padilha et al., 2018; Seybert et al., 2019; Weersink et al., 2019). As APP fellowship programs germinate, there is a growing need to provide a valid instrument to measure competence within simulation. Advanced practice provider fellowship programs utilize structured simulation as an assessment methodology of clinical competence. Faculty of these programs must have access to a valid instrument to provide both formative and summative assessments to APP fellows. The International Nursing Association for Clinical and Simulation Learning (2021) provided standards of best practice for patient simulation training including evaluation of learning and performance with the utility of a valid, reliable instrument. The purpose of this exploratory study was to design, develop, and assess the content validity index of a modified Advanced Practice Provider Queen’s Simulation Assessment Tool (APP-QSAT) based on best evidence and resources available for the assessment of a simulation activity for APPs within a fellowship program. This research study had the opportunity to review data from nine content experts within the field of simulation. The exploratory nature was appropriate due to no published instrument that specifically addressed the population of APPs within an acute care setting could be discovered. The APP-QSAT consists of the following domains: primary assessment, diagnostic actions, therapeutic actions, communication, and overall performance. Thirty items were analyzed by nine content experts on a 4-point Likert scale from 1—Not at all relevant/clear to 4—Very relevant/clear on the content validity index tool. After two rounds of content validation with the nine content experts, the APP-QSAT demonstrated having excellent content validity with an item-level content validity index of 1.00. A modified kappa of 1.00 was also analyzed to exclude chance agreement among the content experts. The APP-QSAT is a modifiable template designed to measure competence for APPs in acute care settings, particularly within APP fellowships. The APP-QSAT aims to capture the full spectrum of clinical competence including not only technical skills but also critical thinking, decision-making, communication, and interprofessional collaboration. Limitations of the study reflected the lack of reliability studies performed on the APP-QSAT and was a small sample population of content experts. Despite the limitations, this study provided a valid instrument to provide formative and summative assessments for learners.

Abstract Format

html

Extent

136 pages

Local Identifiers

Nicastro_unco_0161D_11259.pdf

Rights Statement

Copyright is held by the author.

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