Development and psychometric testing of the Diagnostic Competency During Simulation-based (DCDS) learning tool

Background: Despite diagnostic errors impacting an estimated 12 million people yearly in the United States, educational strategies that foster diagnostic performance among nurse practitioner (NP) students remain elusive. One possible solution is to focus explicitly on competencies fundamental for diagnostic excellence. Currently, no educational tools were found that comprehensively address individual diagnostic reasoning competencies during simulated-based learning experiences. Purpose: Our research team developed and explored psychometric properties of the “Diagnostic Competency During Simulation-based (DCDS) Learning Tool.” Method: Items and domains were developed based on existing frameworks. Content validity was determined by a convenience sample of eight experts. Inter-rater reliability was determined by four faculty rating eight simulation scenarios. Results: Final individual competency domain scale content validity index (CVI) scores ranged between 0.9175 and 1.0; total scale CVI score was 0.98. The intra-class correlation coefficient (ICC) for the tool was 0.548 (p < 0.0001, 95 % confidence interval CI [0.482–0.612]). Conclusions: Results suggest that the DCDS Learning Tool is relevant to diagnostic reasoning competencies and may be implemented with moderate reliability across varied simulation scenarios and performance levels. The DCDS tool expands the landscape of diagnostic reasoning assessment by providing NP educators with granular, actionable, competency-specific assessment measures to foster improvement.