Development of a Pediatric Simulation-Based Scenario and Performance Checklist for Medication Administration Competencies

Abstract

The purpose of this study was to develop a pediatric simulation-based scenario and performance checklist on administering medication to a toddler to include physiological, cognitive, and socioemotional developmental dimensions of this age group, and test the psychometric properties of the pediatric simulation-based scenario and performance checklist used to evaluate competency of students enrolled in a baccalaureate nursing program.The methods involved development of a simulation-based scenario and performance checklist. The scenario was developed by the author using Erikson’s developmental theory, Piaget’s cognitive theory, physiological development, and medication guidelines on how to administer medications to children. Performance checklist was developed using Cazzell’s pediatric medication administration objective structured clinical evaluation, cognitive, socioemotional, and physiological developmental considerations for a toddler.Five pediatric nursing experts assessed the scenario for face validity and the checklist for face and content-related validity. The nursing experts viewed videos and scored 84 baccalaureate students administering medications to a child manikin in a simulated environment with the performance checklist at two time points (3 months apart). Percent agreement, inter-rater reliability and intra-rater reliability were then determined for the total checklist score and for each item. The scenario demonstrated good face validity and the performance checklist had good content-related validity with S-CVI/AV = .94 according to five pediatric experts. Overall percent agreement across raters was 85 percent among all five raters for Time 1 assessment and 84 percent agreement for Time 2 assessment among four raters. The intraclass correlation coefficient (ICC) of the total scores were .629 for Time 1 assessments and .660 for Time 2 assessments, indicating good inter-rater reliability. Intra-rater reliability was found to be consistent with an ICC range of value of .932 to .975. This study presents a valid and reliable simulation-based scenario and performance checklist with developmental considerations for a toddler that is unique and will assist nurse educators to evaluate pediatric medication administration competencies through simulation. Keywords: medication errors, nursing education, simulation, checklist