Establishing Reliability and Construct Validity of High-Fidelity Simulation-Based Assessments for Procedural Skills in Nursing Education Using the Kane Validity Framework

The integration of simulation-based assessments (SBAs) in nursing education has gained significant attention globally, offering a promising approach to evaluate procedural skills and clinical competence in a controlled environment. In Ghana, however, the adoption and validation of SBAs in nursing education remain limited, with traditional assessment methods like Objective Structured Clinical Examinations (OSCEs) being predominantly used. The study investigated the construct validity of high-fidelity simulation-based assessments for evaluating procedural skills in nursing students in Ghana. Employing a quantitative, cross-sectional correlational research design, the study aims to assess the relationships between simulation performance and established clinical competence indicators, including OSCE scores and clinical practicum evaluations. Data were collected from 150 final-year nursing students across three public nursing institutions in southern and middle Ghana. The study found strong inter-rater reliability (ICC = 0.77–0.84), good internal consistency (Cronbach’s alpha = 0.83), and moderate positive correlations between simulation and OSCE scores (r = 0.45, p < 0.01), suggesting that SBAs are a valid measure of procedural competence. Furthermore, regression analyses revealed that simulation scores explained 42% of the variance in clinical practicum performance (R² = 0.42, p < 0.01), supporting their predictive validity. The study also demonstrated substantial agreement between simulation-based assessment decisions and OSCE outcomes (Cohen’s k = 0.67, p < 0.01). These findings contribute valuable evidence for the continued integration of simulation-based assessments in nursing education, offering insights into their reliability, validity, and educational impact in Ghana’s context. The results underscore the potential of SBAs to serve as a credible tool for evaluating clinical readiness in nursing students, aligning with regulatory standards and enhancing the accuracy of competence assessments.