Development of an instrument to measure deliberate practice in professional nurses

Abstract

Purpose: This paper describes the development of the Deliberate Practice in Nursing Questionnaire (DPNQ) and the reliability and validity characteristics of the instrument.

Methods: A cross-sectional, descriptive study assessed the DPNQ in a sample of critical care registered nurses (RN). It was conducted at one large Midwestern teaching hospital. A medical intensive care unit (ICU), a surgical ICU, and a trauma/burn ICU participated. Instrument construction involved item development based on a literature review, an existing deliberate practice questionnaire and existing parameters of deliberate practice in nursing. Content reliability and validity were established by expert panel review and survey testing. Probit analysis of survey data was used to develop a composite score for the DPNQ.

Results: Expert panel review revealed an inter-rater agreement (80% reliability) of .92-.96 and a content validity index of 0.94. The final DPNQ consists of 24 items with six subcategories and a composite score of 96. Cronbach's alpha coefficient for the DPNQ in this study was .660 (standardized, .703). The instrument was further validated with the Nurse Competence Scale. Deliberate practice was significantly, positively correlated with competence (rs=.366, p=001).

Conclusions: Findings from the expert panel provided guidance for development and revision of the DPNQ. Survey testing of the instrument revealed a promising measure of deliberate practice with good reliability and validity characteristics. Identification of a relationship between deliberate practice and competence confirms existing evidence in other domains, providing further validation. Understanding deliberate practice provides a unique way to examine nursing expertise.

Keywords: Competence; Deliberate practice; Expertise; Instrument development; Nursing.