Developing a model of competence in the operating theatre: psychometric validation of the perceived perioperative competence scale-revised.

Aim: This paper describes the development and validation of the Revised Perioperative Competence Scale (PPCS-R).

Background: There is a lack of a psychometrically tested sound self-assessment tools to measure nurses' perceived competence in the operating room.

Methods: Content validity was established by a panel of international experts and the original 98-item scale was pilot tested with 345 nurses in Queensland, Australia. Following the removal of several items, a national sample that included all 3209 nurses who were members of the Australian College of Operating Room Nurses was surveyed using the 94-item version. Psychometric testing assessed content validity using exploratory factor analysis, internal consistency using Cronbach's alpha, and construct validity using the "known groups" technique. During item reduction, several preliminary factor analyses were performed on two random halves of the sample (n=550).

Results: Usable data for psychometric assessment were obtained from 1122 nurses. The original 94-item scale was reduced to 40 items. The final factor analysis using the entire sample resulted in a 40 item six-factor solution. Cronbach's alpha for the 40-item scale was .96. Construct validation demonstrated significant differences (p<.0001) in perceived competence scores relative to years of operating room experience and receipt of specialty education.

Conclusions: On the basis of these results, the psychometric properties of the PPCS-R were considered encouraging. Further testing of the tool in different samples of operating room nurses is necessary to enable cross-cultural comparisons.