Simulation effectiveness tool modified (SET-M): adaptation and validation for Brazil

Bergamasco, Ellen Cristina; Cruz, Diná de Almeida Lopes Monteiro da

doi:10.1590/1518-8345.4282.3437

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Revista Latino-Americana de Enfermagem

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Original Article • Rev. Latino-Am. Enfermagem 29 • 2021 • https://doi.org/10.1590/1518-8345.4282.3437 copy

Simulation effectiveness tool modified (SET-M): adaptation and validation for Brazil^* * Paper extracted from doctoral dissertation “Adaptation and validation of the Simulation Effectiveness Tool - Modified (SET-M) for Brazil”, presented to Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brazil. This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) - Finance Code 001, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

to adapt the Simulation Effectiveness Tool - Modified (SET-M) to Portuguese and to verify validity and reliability indexes.

Method:

methodological study using ISPOR, Confirmatory Factor Analysis, correlation between the adapted instrument/Simulation Design Scale - Student Version/Individual Practice Assessment and reliability (test-retest and internal consistency indexes). Convenience sample with a total of 435 Nursing undergraduate and graduate students.

Results:

Simulation Effectiveness Tool - Modified Brazilian Version obtained an average score between 2.36 to 2.94. The Confirmatory Factor Analysis had a factor load > 0.30 for 17 of the 19 items. Cronbach’s alpha ranged between 0.729 and 0.874. McDonald’s omega was 0.782. There was no correlation between Simulation Effectiveness Tool - Modified Brazilian Version and the Simulation Design or Individual Practical Assessment. There was a positive correlation between the Simulation Effectiveness Tool - Modified Brazilian Version and the participants’ age. The scores of the volunteers in the simulations were significantly higher than those of the observers in three domains.

Conclusion:

the SET-M Brazilian Version, maintaining the 19 items and four domains of the original scale, was made available for use in Brazil to evaluate the effectiveness of the simulation, recommending studies with different samples.

Descriptors:
Simulation Technique; Validation Study; Effectiveness; Surveys and Questionnaires; Nursing Education; Simulation Training

Stage	Analysis	Number of participants (n)
II - Construct Validity	Confirmatory Factor Analysis	240
	Reliability - Internal consistency of domains - Cronbach's alpha
	Reliability - Internal Instrument Consistency - McDonald's Omega
	Stability - Test and Retest Method - Intraclass Correlation Coefficient	34
	Correlations between variables - Kendall's correlation coefficient - Age and training time (Pearson's Correlation Coefficient) - Year of the undergraduate course, type of participation in the simulated activity and number of participations as an observer or volunteer	435
III - Criterion Validity	Spearman's Correlation Test - Correlation between the scores of SET-M Brazilian Version and - Simulation Design Scale - Student Version (SDS-SV) - Individual Practical Assessment (IPA) held at the Venous Access Care Workshop.	21

Latent Variable	Factor Load	Standard error	Estimate divided by standard error	p
Domain 1 - Pre-briefing
Item 1. Prebriefing increased my confidence.	0.527	0.042	12.475	< 0.001
Item 2. Prebriefing was beneficial for my learning.	0.388	0.048	8.053	< 0.001
Domain 2 - Learning				< 0.001
Item 3. I am better prepared to respond to changes in my patient's condition.	0.382	0.033	11.618	< 0.001
Item 4. I developed a better understanding of the pathophysiology.	0.494	0.033	15.180	< 0.001
Item 5. I am more confident of my nursing assessment skills.	0.425	0.033	12.875	< 0.001
Item 6. I felt empowered to make clinical decisions.	0.494	0.037	13.187	< 0.001
Item 7. I developed a better understanding of medications. (Leave blank if no medications in scenario).	0.445	0.036	12.498	< 0.001
Item 8. I had the opportunity to practice my clinical decision making skills.	0.449	0.039	11.404	< 0.001
Domain 3 - Trust
Item 9. I am more confident in my ability to prioritize care and interventions.	0.408	0.029	14.060	< 0.001
Item 10. I am more confident in communicating with my patient.	0.348	0.025	13.724	< 0.001
Item 11. I am more confident in my ability to teach patients about their illness and interventions.	0.426	0.033	12.748	< 0.001
Item 12. I am more confident in my ability to report information to health care team.	0.398	0.028	14.199	< 0.001
Item 13. I am more confident in providing interventions that foster patient safety.	0.406	0.025	16.320	< 0.001
Item 14. I am more confident in using evidence-based practice to provide nursing care.	0.401	0.033	12.003	< 0.001
Domain 4 - Debriefing				< 0.001
Item 15. Debriefing contributed to my learning.	0.116	0.031	3.707	< 0.001
Item 16. Debriefing allowed me to verbalize my feelings before focusing on the scenario.	0.349	0.050	6.996	< 0.001
Item 17. Debriefing was valuable in helping me improve my clinical judgment.	0.311	0.033	9.348	< 0.001
Item 18. Debriefing provided opportunities to self-reflect on my performance during simulation.	0.385	0.046	8.376	< 0.001
Item 19. Debriefing was a constructive evaluation of the simulation.	0.216	0.041	5.207	< 0.001

Covariance	Load	Standard error	Estimate divided by standard error	p
Domain 1 - Pre-briefing
Domain 2 - Learning	0.643	0.062	10.451	< 0.001
Domain 3 - Trust	0.577	0.061	9.448	< 0.001
Domain 4 - Debriefing	0.320	0.100	3.191	0,001
Domain 2 - Learning
Domain 3 - Trust	0.922	0.024	39.202	< 0.001
Domain 4 - Debriefing	0.575	0.060	9.574	< 0.001
Domain 3 - Trust
Domain 4 - Debriefing	0.617	0.062	9.875	< 0.001

Item	Cronbach's alpha if the item is deleted	Correlation of the item with the total	Correlation of the item with the corrected total	Final correlation if the item is deleted
Domain 1 - Pre-briefing - Cronbach's alpha 0.792
Item 1	0.664	0.926	0.743	Not applicable
Item 2	0.664	0.897	0.743	Not applicable
Domain 2 - Learning - Cronbach's alpha 0.823				Not applicable
Item 3	0.533	0.688	0.599	0.533
Item 4	0.612	0.748	0.678	0.612
Item 5	0.595	0.727	0.656	0.595
Item 6	0.606	0.743	0.67	0.606
Item 7	0.678	0.765	0.75	0.678
Item 8	0.527	0.686	0.588	0.527
Domain 3 - Cronbach's alpha 0.874				0.527
Item 9	0.635	0.750	0.677	0.635
Item 10	0.608	0.732	0.652	0.608
Item 11	0.659	0.778	0.703	0.659
Item 12	0.744	0.834	0.803	0.744
Item 13	0.739	0.826	0.793	0.739
Item 14	0.686	0.789	0.739	0.686
Domain 4 - Debriefing- Cronbach's alpha 0.758				0.686
Item 15	0.448	0.580	0.546	0.448
Item 16	0.530	0.784	0.588	0.530
Item 17	0.523	0.702	0.579	0.523
Item 18	0.644	0.800	0.740	0.644
Item 19	0.617	0.741	0.730	0.617

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding author: Ellen Cristina Bergamasco E-mail: ellen.bergamasco@einstein.br https://orcid.org/0000-0003-3761-8835