The evaluation of nursing students by patients instrument (ENSPA): Development and validation

Background: Patient participation is increasingly used in different aspects of healthcare due to its positive outcomes. Still, instruments for involving patients in the evaluation of nursing students during their internship are scarce. Objectives: To develop and validate an instrument that enables patients to evaluate nursing students during their internship. Design and methods: A 3-phased validation process was conducted: (1) development of an instrument through literature and patient interviews; (2) content and response process validation by use of cognitive interviews and pilot-testing; (3) testing construct validity and reliability of the instrument which was completed by 244 hospitalized patients. Settings and participants: Patients from a variety of wards in a general hospital were recruited for the different phases. In phase 1, 17 interviews and 47 thought shower sessions with patients were performed. In phase 2, 9 cognitive interviews and pilot testing by 4 patients evaluating actual nursing students were used to refine the instrument. In phase 3, 380 patients were eligible to participate. Of these patients, 317 completed the instrument. A sample of 244 completed instruments was useful to perform the psychometric analyses. To assess the test-retest reliability, 50 patients completed the instrument twice with a 4 hour time interval. Results: The 19-item Evaluation of Nursing Students by Patients instrument (ENSPa) is designed. The ENSPa-instrument comprises 7 items that assess whether the patient can place trust in the student, 5 items evaluating person-oriented skills, 4 items appraising caring and 3 items to grade the integrity and honesty of the nursing students. Each item is scored both for importance and rating. The instrument shows high reliability and consistency ratings. Conclusions: The ENSPa-instrument is a valuable instrument for collecting data on the performance and skills of nursing students during their internship from the patient's perspective. By receiving structured feedback from patients, important learning opportunities are created for nursing students.