A stepwise methodological approach to develop and validate the digital and technological self-efficacy scale for healthcare workers among nurses and nursing students

Aims: To develop and validate the Digital and Technological Self-Efficacy Scale (Digitech-S) for healthcare workers among nurses and nursing students. Background: Digital and technological solutions (DTS) significantly impact working life in healthcare and educational settings. DTS-related self-efficacy might be defined the individual's confidence in proficiently performing digital and technological tasks, even when faced with challenges. Its assessment might guide educators in orienting focused interventions to enhance the self-efficacy of nurses and nursing students. Thus far, the assessment of DTS-related self-efficacy is currently undermined by the lack of valid and reliable measurements. Design: A stepwise methodological approach was employed in two main phases. Phase one focused on tasks guided by literature for generating items reflecting DTS. Phase two encompassed three steps: A content validity step, a first cross-sectional data collection for Mokken scaling analysis (MSA) performed to reduce the number of items toward a unidimensional structure and with a hierarchical approach, and a confirmatory factor analysis including the group (nurses vs. nursing students) as a covariate (MIMIC) to cross-validate the unidimensional structure and assess the measurement invariance using a second cross-sectional data collection round. A Multi-Group Confirmatory Factor Analysis (MG-CFA) was also conducted to test for configural, metric, scalar, and strict invariance across the two groups. Results: Phase one resulted in 36 items derived from a literature review, which was reduced to 33 after the content validity process. 660 responders (nurses = 388; nursing students = 272) were included in the sample analyzed with MSA, and 13 items were hierarchically selected for the subsequent data collection (Rho reliability = 0.95; Hs = 0.67; Hi ranging from 0.55 to 0.72). MIMIC models were performed on 421 responders (nurses = 268; nursing students = 153), and three items that caused non-invariance between nurses and nursing students were identified and removed from the final version (Cronbach's alpha = 0.928). The MG-CFA demonstrated configural and metric invariance, suggesting a consistent factor structure and factor loadings across both groups, but scalar and strict invariance were not fully achieved. Conclusions: The Digitech-S is a 10-item scale showing a unidimensional and stable structure, which could be used for educational and research purposes.