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Reliability and Validity of the Assessment Tool for Measuring Communication Skills in Nursing Simulation Education
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Korean J Adult Nurs : Korean Journal of Adult Nursing

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Original Article

Reliability and Validity of the Assessment Tool for Measuring Communication Skills in Nursing Simulation Education

Hee Mo Yang1, Seon Young Hwang2
Korean Journal of Adult Nursing 2016;28(1):95-105.
Published online: February 29, 2016

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Corresponding author: Hwang, Seon Young College of Nursing, Hanyang University, 222 Wangsimni-ro, Seondong-gu, Seoul 04763, Korea. Tel: +82-2-2220-0702, Fax: +82-2-2220-1163, E-mail: seon9772@hanyang.ac.kr
• Received: December 11, 2015   • Accepted: February 11, 2016

Copyright © 2016 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    This study was conducted to test whether Health Communication Assessment Tool (HCAT) developed by Campbell et al. in 2013 can be applied to assess Korean nursing students’ communication skills in simulation education.
  • Methods
    The content validity of the Korean version of HCAT (K-HCAT) was evaluated through expert's assessment and a principal component analysis was conducted for testing construct validity. The convergent validity was tested by measuring relationship between the K-HCAT and those of existing communication assessment tool for standardized patient instruction. The evaluation was done by surveying 154 senior students from four different nursing colleges.
  • Results
    The K-HCAT was condensed into 15 items from the original 22 HCAT items. Four factors were extracted from the principal component analysis; factor loadings ranged from .50 to .83; cumulative explained variance was 62.65%. Four factors were entitled as ‘relationship building’, ‘empowering’, ‘empathy/re-sponse’, and ‘education/feedback’. Cronbach's ⍺ for sub-dimensions ranged from .73 to .84. An evaluation of convergent validity showed that the scores of the K-HCAT were moderately correlated with those of an assessment tool for standardized patient instruction.
  • Conclusion
    The K-HCAT can be used as an effective tool for assessing nursing students’ communication skills in various kinds of simulation educations Further research is needed to test the consistency of the K-HCAT.
  • Key Words: Health communication; Reliability and validity; Statistical factor analysis; Patient simulation; Nursing education
Table 1.
Item Contents and Reliability of the K-HCAT (N=154)
Factor /Item Item contents M±SD Corrected item-total correction Cronbach's ⍺ if item deleted Cronbach's ⍺
Factor 1 1 Relationship Building ․ The SN introduced her-/himself to patient (and/or family) 4.68±0.56 .41 .84 .84
2 ․ The SN explained the reason for the nurse's visit in patient/family appropriate terms. 4.58±0.58 .70 .80
3 ․ The SN used positive communication including smile to encourage interaction. 4.44±0.61 .62 .81
4 ․ The SN maintained eye contact when talking with patient and/or family. 4.66±0.53 .71 .80
5 ․ The SN communicated what she/he was about to do prior to doing it. 4.65±0.59 .67 .81
10 ․ The SN used appropriate vocal tone and volume for the situation. 4.67±0.49 .70 .80
15 ․ The SN avoided healthcare jargon (vital signs, respiratory, etc.) 4.47±0.62 .53 .82
Factor 2 Empowering       .74
6 ․ The SN listened more than talked. 4.25±0.65 .33 .76
11 ․ The SN spent equal or more time on psychosocial aspects of patient/family care as on clinical (biological) aspects. 3.77±0.83 .61 .64
13 ․ The SN recognized conflict and tried to gain information and find opportunities to minimize or manage it. 3.63±0.80 .58 .64
14 ․ The SN maintained, enhanced, or developed an interpersonal relationship with the patient and/or family member (via communication and professionalism). 4.12±0.75 .58 .64
Factor 3 Empathy·Response       .75
9 ․ The SN recognized and responded appropriately to the patient's and/or family member's nonverbal (frowns, tears, hysteria, silence, etc.)and verbal behaviors. 3.72±0.68 .62 .77
12 ․ The SN inquired about the patient's/family members feelings regarding the situation. 3.83±0.77 .60 .68
Factor 4 Education·Feedback       .73
7 ․ The SN effectively educated the patient and/or family member about the procedure, disease, &/or treatment. 4.53±0.66 .44 .75
8 ․ The SN asked questions to encourage feedback and enhance clarity. 4.10±0.75 .57 .66
Total   4.27±0.32     .85
Table 2.
Result of Factor Analysis (N=154)
No. of item Factor 1 Factor 2 Factor 3 Factor 4
4 0.75      
10 0.75      
15 0.74      
3 0.72      
5 0.65      
2 0.65      
1 0.61      
14   0.83    
13   0.81    
11   0.72    
6   0.50    
12     0.80  
9     0.69  
8       0.81
7       0.52
Eigen value 4.27 2.58 1.31 1.24
Variance 28.49 17.18 8.72 8.26
Cummulative (%) 28.49 45.67 54.39 62.65

Kaiser-Meyer-Olkin test=0.72; Bartlett's test of sphericity=900.11 (p＜.001)

Table 3.
Correlations between K-HCAT and Yoo (2001)'s Communication Assessment Tool (N=154)
Variables Categories M±SD Sum±SD Yoo's tool
r (p)
K-HCAT Factor 1 5.35±0.47 32.15±2.87 .76 (＜.001)
Factor 2 3.94±0.57 15.77±2.28 .22 (.006)
Factor 3 3.77±0.59 7.55±1.18 .28 (＜.001)
Factor 4 4.31±0.56 8.62±1.12 .50 (＜.001)
Total 4.27±0.32 64.11±4.91 .74 (＜.001)

K-HCAT=korean health communication assessment tool.

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    Reliability and Validity of the Assessment Tool for Measuring Communication Skills in Nursing Simulation Education
    Korean J Adult Nurs. 2016;28(1):95-105.   Published online February 29, 2016
    DOI: https://doi.org/10.7475/kjan.2016.28.1.95
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    Reliability and Validity of the Assessment Tool for Measuring Communication Skills in Nursing Simulation Education
    Korean J Adult Nurs. 2016;28(1):95-105.   Published online February 29, 2016
    DOI: https://doi.org/10.7475/kjan.2016.28.1.95
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    Reliability and Validity of the Assessment Tool for Measuring Communication Skills in Nursing Simulation Education
    Reliability and Validity of the Assessment Tool for Measuring Communication Skills in Nursing Simulation Education

    Item Contents and Reliability of the K-HCAT (N=154)

    Factor /Item Item contents M±SD Corrected item-total correction Cronbach's ⍺ if item deleted Cronbach's ⍺
    Factor 1 1 Relationship Building ․ The SN introduced her-/himself to patient (and/or family) 4.68±0.56 .41 .84 .84
    2 ․ The SN explained the reason for the nurse's visit in patient/family appropriate terms. 4.58±0.58 .70 .80
    3 ․ The SN used positive communication including smile to encourage interaction. 4.44±0.61 .62 .81
    4 ․ The SN maintained eye contact when talking with patient and/or family. 4.66±0.53 .71 .80
    5 ․ The SN communicated what she/he was about to do prior to doing it. 4.65±0.59 .67 .81
    10 ․ The SN used appropriate vocal tone and volume for the situation. 4.67±0.49 .70 .80
    15 ․ The SN avoided healthcare jargon (vital signs, respiratory, etc.) 4.47±0.62 .53 .82
    Factor 2 Empowering       .74
    6 ․ The SN listened more than talked. 4.25±0.65 .33 .76
    11 ․ The SN spent equal or more time on psychosocial aspects of patient/family care as on clinical (biological) aspects. 3.77±0.83 .61 .64
    13 ․ The SN recognized conflict and tried to gain information and find opportunities to minimize or manage it. 3.63±0.80 .58 .64
    14 ․ The SN maintained, enhanced, or developed an interpersonal relationship with the patient and/or family member (via communication and professionalism). 4.12±0.75 .58 .64
    Factor 3 Empathy·Response       .75
    9 ․ The SN recognized and responded appropriately to the patient's and/or family member's nonverbal (frowns, tears, hysteria, silence, etc.)and verbal behaviors. 3.72±0.68 .62 .77
    12 ․ The SN inquired about the patient's/family members feelings regarding the situation. 3.83±0.77 .60 .68
    Factor 4 Education·Feedback       .73
    7 ․ The SN effectively educated the patient and/or family member about the procedure, disease, &/or treatment. 4.53±0.66 .44 .75
    8 ․ The SN asked questions to encourage feedback and enhance clarity. 4.10±0.75 .57 .66
    Total   4.27±0.32     .85

    Result of Factor Analysis (N=154)

    No. of item Factor 1 Factor 2 Factor 3 Factor 4
    4 0.75      
    10 0.75      
    15 0.74      
    3 0.72      
    5 0.65      
    2 0.65      
    1 0.61      
    14   0.83    
    13   0.81    
    11   0.72    
    6   0.50    
    12     0.80  
    9     0.69  
    8       0.81
    7       0.52
    Eigen value 4.27 2.58 1.31 1.24
    Variance 28.49 17.18 8.72 8.26
    Cummulative (%) 28.49 45.67 54.39 62.65

    Kaiser-Meyer-Olkin test=0.72; Bartlett's test of sphericity=900.11 (p＜.001)

    Correlations between K-HCAT and Yoo (2001)'s Communication Assessment Tool (N=154)

    Variables Categories M±SD Sum±SD Yoo's tool
    r (p)
    K-HCAT Factor 1 5.35±0.47 32.15±2.87 .76 (＜.001)
    Factor 2 3.94±0.57 15.77±2.28 .22 (.006)
    Factor 3 3.77±0.59 7.55±1.18 .28 (＜.001)
    Factor 4 4.31±0.56 8.62±1.12 .50 (＜.001)
    Total 4.27±0.32 64.11±4.91 .74 (＜.001)

    K-HCAT=korean health communication assessment tool.
    Table 1. Item Contents and Reliability of the K-HCAT (N=154)

    Table 2. Result of Factor Analysis (N=154)

    Kaiser-Meyer-Olkin test=0.72; Bartlett's test of sphericity=900.11 (p＜.001)

    Table 3. Correlations between K-HCAT and Yoo (2001)'s Communication Assessment Tool (N=154)

    K-HCAT=korean health communication assessment tool.

    Table 1.

    Table 2.

    Table 3.

    Korean J Adult Nurs : Korean Journal of Adult Nursing

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