Development and psychometric testing of the Reality Shock Scale for newly graduated nurses

Aim This study aimed to develop and psychometrically test a Reality Shock Scale for newly graduated nurses. Design An instrument development and validation study. Method A four-phase structure was used: (1) determining the conceptual foundation (2) creating the items, (3) preliminary evaluation of items and (4) refining the scale and evaluating psychometric properties. The scale was evaluated in terms of content and construct validity. To assess its reliability, the scale was tested for internal consistency and a test-retest approach was applied. The psychometric characteristics of the scale were tested with 1310 newly graduated nurses working in different positions at 19 hospitals. Data were collected over the period January 2018-July 2019. Results Prior to the creation of the scale items, a scan of the literature was carried out, after which individual face-to-face, semi-structured in-depth interviews were held with the newly graduated nurses. The scale's Content Validity Index was 0.97. A 47-item scale containing four subdomains (Relations and Cooperation, Professional Knowledge, Responsibilities, Performance) was developed as a result of the analyses; the scale explained 48.4% of total variance. The confirmatory factor analysis confirmed the scale's four-factor construct. Cronbach's alpha was calculated as .95 for the overall scale. Conclusion The Reality Shock Scale that was developed is a valid and reliable measure that can be used to determine the extent to which newly graduated nurses experience reality shock. Impact The developed tool makes it possible to determine the reality shock experienced by newly graduated nurses and influencing factors. Thus, educational institutions as well as health institutions have the means to develop policies to prevent reality shock experienced among newly graduated nurses.