Testing the Reliability and Validity of the Tiffen Decision Making Tool

Decision making is the process of collecting, interpreting and evaluating information to make a decision and it is a required competency in the education and training of nurse practitioners. However, there is a lack of an accepted method for evaluating these skills. The inability to evaluate these skills hinders understanding how decision making can be best taught and learned as an individual makes the progression from a student to a novice practitioner and then expert practitioner. The purpose of this study was to develop a tool for measuring decision making along this continuum. A descriptive, comparative study was used to examine the psychometric properties of the instrument. Content validity of the instrument was assessed through expert nurse educators and practitioners who had experience teaching or researching decision making. Construct validity was examined by comparing TDM scores across a diverse sample of nurse practitioner students, novice nurse practitioners and experienced nurse practitioners. In addition, the reliability of the TDM was explored by measuring the inter-rate reliability of the scoring system as well as the stability of the TDM scores over a month period. The TDM was found to differentiate between the data collection abilities of students as compared to experienced practitioners however practitioners were not found to have a greater ability to correctly diagnose the patient cases. Scores on the TDM were found to be stable over a month period. The ability to evaluate a nurse practitioner’s decision making in a controlled and standardized environment could provide useful information for the education, practice, licensure and accreditation of nurse practitioners.