Psychometric evaluation of the United States-adapted perceived perioperative competence scale-revised: A national survey

Background: Nursing competence is integral to ensuring patient safety, especially in high-risk environments such as the operating room. Instruments which facilitate self-assessment of specialty specific nursing competence allow nurses to gain important insights into their practice to facilitate continuous growth in their professional practice. Currently, there are no psychometrically tested tools to assess perioperative competence applicable to the United States context. Objective: Test the psychometric properties of the Perceived Perioperative Competence Scale-Revised in the United States context. Methods: A cross-sectional survey design was used. Perioperative nurses were recruited via four professional associations and the survey was administered online. Construct validity of the six-dimensional Perceived Perioperative Competence Scale-Revised was tested using a multidimensional item response theory model known as the graded response model. Measurement invariance was assessed relative to years of perioperative experience. Internal consistency was estimated using McDonald's Omega and Cronbach's alpha reliability coefficients. Results: Responses from a total of 1,581 participants were analyzed in the psychometric analysis. The six-dimensional graded response model of the Perceived Perioperative Competence Scale-Revised displayed satisfactory model fit for the sample (Chi-square(df) = 5,699.09(725); root mean square error of approximation = 0.066, 90% confidence interval: 0.064, 0.067; comparative fit index = 0.955; Tucker-Lewis index = 0.952; standardized root mean squared residual = 0.045). Scalar invariance was established when assessing the psychometric equivalence of the scale across years of perioperative experience (<10 years, >= 10 years) (Chi-square(df) = 5,785.29 (1,573); root mean square error of approximation = 0.058, 90% confidence interval: 0.057, 0.060; comparative fit index = 0.959; Tucker-Lewis index = 0.959). Reliability across the six subscales ranged from alpha = 0.87 - 0.94 and Omega = 0.93 - 0.97. Conclusions: Results suggest that the Perceived Perioperative Competence Scale -Revised is suitable to use with perioperative nurses practicing in clinical settings in the United States. Measurement invariance testing indicates the scale is measuring the same construct and is being interpreted in a conceptually similar manner across groups based on years of perioperative experience.