Abstract
As the largest front-line healthcare workforce, active clinical leadership among nurses is vital for ensuring high-quality patient care and an effective response to the growing needs of healthcare. A number of Clinical Nurse Leadership scales were found in current literature, but none of them were suitable or consistent with the current study context. Hence, the aim of this study was to develop a context specific Registered Nurses' Clinical Leadership Scale for Bangladesh and evaluate its psychometric properties. An inductive mixed-methods design used in this study as well the specific factor structure of the Scale. The development and psychometric evaluation of the Clinical Nurse Leadership Scale involved a two-phase, eight-step process, beginning with an extensive literature review and culminating in the examination of content validity, face validity, a pilot evaluation, and construct validity using exploratory factor analysis. Internal consistency was confirmed by Cronbach’s α coefficient, using data from 627 clinical registered nurses. Contrasted group analysis was performed for known-group validity testing, and test-retest reliability was assessed for stability.
The Registered Nurses Clinical Leadership Scale demonstrated an acceptable level of construct validity and excellent internal consistency. Factor analysis identified 9 components for 92 items, accounting for a total variance of 52.06%. The overall Cronbach’s alpha was 0.96 and ranged from 0.84 to 0.92, across 9 components. These were: assessment and evaluation, patient-centered intervention, imply quality and safety, caring relationship, interdisciplinary collaboration, skills of communication, professional values in caring, decision making or problem-solving and professional development. There was statistically significant difference between low and high-performance contrasted group’s result (p<.01). The test-retest result also found significantly high correlation between the test one and two on the scores of the scale (r = 0.92; p<.001). Thus, the final version of the Registered Nurse Clinical Leadership Scale (RN-CLS), consisting of 92 items across nine factors demonstrated high validity and reliability.