Factor Analysis of the Transcultural Self-Efficacy Tool (TSET)
Jeffreys, Marianne R., Dogan, Enis, Journal of Nursing Measurement
The factor structure of the Transcultural Self-Efficacy Tool (TSET) was analyzed using data from 272 culturally diverse undergraduate nursing students. The TSET is a questionnaire designed to measure students' confidence for performing general transcultural nursing skills among diverse client populations. Using the most recent imputation techniques for missing data, researchers demonstrate how common exploratory factor analysis (CEFA)-(as opposed to principal components analysis)-can (and should be) used in examining the factorial composition of the tool. Standard errors for factor loadings were computed and utilized in deciding whether a given item loaded significantly on a factor and whether the difference between the factor loadings of two or more items on the same factor were statistically significant. The CEFA, comprised of 69 of the 83 items, yielded four factors-"Knowledge and Understanding," "Interview," "Awareness, Acceptance, and Appreciation," and "Recognition"-with internal consistency ranging from .94 to .98. Reliability of the total instrument was .99. It was concluded that the present CEFA study continues to support that the TSET assesses the multidimensional nature of transcultural self-efficacy while also differentiating between three types of learning: cognitive, practical, and affective. The benefits of this support allow the researcher/ educator to move beyond mere assessment to the design, implementation, and evaluation of diagnostic-prescriptive teaching strategies for cultural competence education.
Keywords: transcultural self-efficacy; cultural competence; factor analysis; missing data imputation; standard error of factor loadings; evaluating cultural competence education
Nurse educators have the potential to lead the quest for culturally congruent health care by implementing creative, evidence-based educational activities that promote positive, cultural competence learning outcomes for culturally diverse students and health care professionals (Jeffreys, 2002, 2005, 2006). The future development of diagnostic-prescriptive strategies is contingent on the future development of reliable and valid instruments. Unfortunately, today's nursing educational instruments and methods for evaluating educational innovations are limited (Diekelmann & Ironside, 2002) and will continue to severely limit evaluation unless psychometrically valid instruments guided by conceptual frameworks are developed. Moreover, the ongoing and updated evaluation of existing instruments incorporating new, advanced statistical techniques is glaringly absent.
The Transcultural Self-Efficacy Tool (TSET) is a valid, reliable tool effectively used to measure changes in transcultural self-efficacy (TSE) perceptions following educational interventions with nursing students and nurses (Adams & Nevel, 2010; Amerson, 2010; Burrell, 2010; Davis, 2006; Dolgan, 2001; Edmonds, 2006; Forgacs, 2001; Jeffreys, 2000, 2006, 2010b; Jeffreys & Smodlaka, 1996, 1998, 1999a, 1999b; Lim, Downey, & Nathan, 2004; Parsons & Reif, 2010; Platter, 2005; Toney, 2004; Velez, 2005, 2010), has been adapted into a physician version for use in Australian medical schools (A. Shadbolt, personal communication, October 29, 2004), has been adapted into a multidisciplinary health care provider version for use with multidisciplinary health provider groups (Jeffreys, 2010a; Marrone, 2010), has been used to evaluate/guide curriculum in California medical and dental schools (Wilson & Houghtaling, 2001), and has been requested by researchers worldwide in various disciplines. Based on the literature and the results of a two-phase evaluation study, the 83-item TSET was originally designed to measure and evaluate students' confidence for performing general transcultural nursing skills among diverse populations. Using data from 1,260 culturally diverse undergraduate nursing students, the factor analysis of the TSET was explored using a principal components analysis (PCA) with the varimax rotation, yielding nine factors (Jeffreys & Smodlaka, 1998). …