Cross-Cultural Adaptation and Psychometric Evaluation of the Arabic Clinical Reasoning Scale Among Nursing Students.

Background: Clinical reasoning is a vital competency for safe nursing practice, yet no validated Arabic instrument exists to assess this skill among nursing students in Saudi Arabia. Aim: This study aimed to translate, culturally adapt, and psychometrically evaluate the Arabic version of the Clinica...

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Published in:Nursing Reports Vol. 16; no. 7; pp. 214 - 235
Main Authors: Kunjan, Minimole Kalarickal, Seethalakshmi, Avudaippan, Arulanantham, Zechariah Jebakumar, Nagalakshmi, Sethuraman
Format: research tables/charts Journal Article
Published: MDPI Jul2026
Online Access:View this record in EBSCOhost
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      dt: Jul2026
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      pub: MDPI
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        10.3390/nursrep16070214
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        atl: Cross-Cultural Adaptation and Psychometric Evaluation of the Arabic Clinical Reasoning Scale Among Nursing Students.
      aug:
        au:
          Kunjan, Minimole Kalarickal
          Seethalakshmi, Avudaippan
          Arulanantham, Zechariah Jebakumar
          Nagalakshmi, Sethuraman
        affil: Department of Nursing Foundation, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai 600116, India
      sug:
        subj:
          Instrument Adaptation
          Instrument Validation
          Psychometrics Evaluation
          Cultural Competence
          Clinical Reasoning Evaluation
          Students, Nursing
          Human
          Validation Studies
          Saudi Arabia
          Construct Validity
          Exploratory Research
          Factor Analysis
          Test-Retest Reliability
          Intraclass Correlation Coefficient
          T-Tests
          Content Validity
          Internal Consistency
          Student Attitudes
          Self Report
          Descriptive Statistics
          Male
          Female
          Cross Sectional Studies
          One-Way Analysis of Variance
          Data Analysis Software
          Young Adult
          Scales
          Male
          Female
      ab: Background: Clinical reasoning is a vital competency for safe nursing practice, yet no validated Arabic instrument exists to assess this skill among nursing students in Saudi Arabia. Aim: This study aimed to translate, culturally adapt, and psychometrically evaluate the Arabic version of the Clinical Reasoning Scale (CRS) and to investigate clinical reasoning among Saudi nursing students. Methods: This methodological instrument validation study with a cross-sectional survey component was conducted in Saudi Arabia between January 2024 and May 2025 among nursing students. The Arabic Clinical Reasoning Scale (CRS-A) was translated and culturally adapted in accordance with the WHOQOL Group guidelines for instrument translation. Content validity was assessed by 10 experts, and construct validity was evaluated using exploratory factor analysis (n = 365). The response rate was 98.65%. Internal consistency was evaluated using Cronbach's alpha (n = 365), and test–retest reliability (n = 30) was measured with the Intraclass Correlation Coefficient (ICC) over a two-week period. Descriptive statistics, one-way analysis of variance (ANOVA), and independent sample t-tests were also performed. Results: The tool's content validity (S-CVI = 0.98) was confirmed by a panel of experts. The CRS-A demonstrated excellent temporal stability (ICC = 0.95, p < 0.001) and internal consistency (Cronbach's α = 0.935). The exploratory factor analysis showed that the 16 items' factor loadings ranged from 0.542 to 0.807, and three factors accounted for 64.33% of the total variance. Students self-reported agreement with clinical reasoning abilities (mean scores: 3.81–4.18). No significant differences in clinical reasoning were found by age (p = 0.102) or gender (p = 0.226), but significant differences were found by Cumulative Grade Point Average (CGPA) (p < 0.001). Conclusions: The Arabic Clinical Reasoning Scale demonstrated preliminary psychometric performance for measuring clinical reasoning among Arabic-speaking student nurses. It provides educators with a valuable tool for identifying learning needs and evaluating educational interventions.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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