Psychometric Validation of the Spanish SET-M Using Bootstrap Exploratory Graph Analysis in Nursing Students From Argentina and Spain

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Abstract
Introduction: The Evaluation of Learning and Performance standard of the International Nursing Association for Clinical Simulation and Learning proposes evaluating all simulation-based experiences. Over the years, multiple instruments have been designed to evaluate simulation. The Simulation Effectiveness Tool—Modified (SET-M) was developed by Leighton and colleagues in English in 2015. This tool has been translated and validated in different languages and cultures, presenting stable psychometric properties. Although a Spanish validation of the instrument has been found, it was conducted with medical students after participating in telesimulation. To date, no validation has been found for its use after face-to-face simulation with Spanish-speaking nursing students. This study aims to validate the psychometric properties of the SET-M in advanced nursing bachelor's students engaged in face-to-face simulation from 2 Spanish-speaking countries. Methods: A multicenter, cross-sectional, analytical, and psychometric validation study was conducted. The sample consisted of 232 students from the final 2 years of their Bachelor's Degree in Nursing at 2 privately managed universities, 1 in Argentina and the other 1 in Spain. The bootstrap Exploratory Graphical Analysis (EGA) approach was used to determine the structural consistency and stability of the items. Results: An EGA identified 4 communities with adequate stability and structural consistency values. Furthermore, the SET-M was found to be invariant among nursing students in Argentina and Spain. Conclusions: The Spanish version of the SET-M demonstrated adequate psychometric properties, confirming its validity and reliability for assessing simulation-based education effectiveness in undergraduate nursing students in Argentina and Spain. This study provides a valuable tool for self-assessment in simulation education within Spanish-speaking contexts.

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