PONE-D-20-16146

Reliability and validity study of the Spanish adaptation of the “Educational Practices Questionnaire” (EPQ).

PLOS ONE

Dear Dr. Merino,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

While all reviewers saw merit in the manuscript, a minor issues were raised. The manuscript needs a careful review of English.

Please submit your revised manuscript by Aug 20 2020 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

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We look forward to receiving your revised manuscript.

Kind regards,

César Leal-Costa, Ph. D

Academic Editor

PLOS ONE

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2. Please clarify in your Methods section whether the questionnaire is published under a CC-BY license, or whether you obtained permission from the publisher to reproduce the questionnaire in this manuscript. Please explain any copyright or restrictions on this questionnaire.

3. Please amend your current ethics statement to address the following concerns:  

a) Did participants provide their written or verbal informed consent to participate in this study?

b) If consent was verbal, please explain i) why written consent was not obtained, ii) how you documented participant consent, and iii) whether the ethics committees/IRB approved this consent procedure.

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We will update your Data Availability statement on your behalf to reflect the information you provide.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The article covers the following technical aspects:

1.- The study presents the results of primary scientific research.

2.- Results reported have not been published elsewhere.

3.- Experiments, statistics, and other analyses are performed to a high technical standard and are described in sufficient detail.

4.- Conclusions are presented in an appropriate fashion and are supported by the data.

5.- The article is presented in an intelligible fashion and is written in standard English.

6.- The research meets all applicable standards for the ethics of experimentation and research integrity.

7.- The article adheres to appropriate reporting guidelines and community standards for data availability.

The article satisfies the requirements of PlosOne magazine. On the other hand, there are some issues that require clarification from the authors, as well as some suggestions to improve the article.

Abstract

The summary is concrete and adequate. As a suggestion, if the authors consider it appropriate, the results of Cronbach's Alpha and Omega index could be added.

It is exposed that in Spain it is necessary to have validated rubrics that can show the effects of simulation. Is this only in Spain or is it also in other countries?. I propose something similar to this: "As in other countries, in Spain..."

Introduction

This section is correct. It puts the manuscript in context, includes a brief review of the key literature and defines the problem and the need.

I think the aim of the study is not precise enough. The authors’ purpose was “... to translate into Spanish and analyse the reliability and validity of the Educational Practices Questionnaire”. The first part: "Translating into Spanish", the methodology used by the authors has not only been to translate the Educational Practices Questionnaire (EPQ), but also the transcultural adaptation. In fact, both the methodology and Figure 1 describe the realization of the cross-cultural adaptation of the EPQ. I propose to modify it to: "translation and cultural adaptation".

Materials and Methods

Both the population and the methodology used are well justified. Some issues are proposed for the authors' consideration:

In the paragraph: “Others variables:… academic year”. I do not understand why this variable is included, since previously in the “Participants and setting” section, it is stated that the study is carried out from the 2018-2019 academic year. Perhaps you're referring to the nursing course does each student belong to? (1st, 2nd, 3rd, 4th year of the nursing degree)

The pilot test realization time is not well explained in the text, it is only described in the Figure 1. I suggest adding "finally a pilot test was done" in the Procedure section.

Statistical analysis

In the first paragraph, the term CFA models appears, but has not been previously described. A description of this term is given in the next paragraph.

“… Analyse the validity of the construct (CFA)…”

I recommend that you review this aspect and describe it before using it.

In the paragraph: “The following were considered acceptable values: a Crombach´s Alpha of between 0,70 and 0.9 …”. I do not understand why you put this range. If the value is greater than 0.9, how is it considered?

Discussion

In relation to the Fit Indices, the acronyms are set out in the methodology. I believe that to detail them again in the discussion is to fill in the article without providing more content.

References

It is important to check the format of the references. PLOS uses the reference style outlined by the International Committee of Medical Journal Editors (ICMJE), (Vancouver style). References such as 3, 6, 7, 10, 16, 17, 25, 29, 33, 35, 39 are incorrect. Quotations 4 and 5 are incomplete.

In the main text, reference numbers should appear in square brackets [] and not in parentheses. Also, there are some small errors in citations. Example: in paragraph 1, section “Variables and resource of information”. “…integrated in clinical simulation (Jeffries and Rizzolo, 2006).” is in the APA format style.

Figures

In order for the figure to be better understood by itself, it would be good to explain the acronyms that appear on the figures.

Example: figure 1. T1, T2, RTV, etc.

Tables

Tables are self-explanatory. In table 1 the description of the confidence interval is missing at the bottom of the table.

In the methodology reference is made to "Other Variables", I cannot find in the text or in any table the description of the variables: age, sex, teaching shift, academic year, whether they were working, work shift and whether they had previous work experience in the health field. It would be good to make a table with the results obtained.

Reviewer #2: Thank you for giving me the opportunity to review this article. The manuscript is well written and relevant in an educational context (Spanish) where clinical simulation is booming. Congratulations for the excellent work done in adapting the questionnaire to the Spanish context.

Introduction:

As the authors say, it is necessary to have tools to evaluate the effectiveness of the sessions from the point of view of students and facilitators. In your work you carry out an adaptation of a scale on the perception of the participants about the simulation. You say that in Spain there are no validated instruments to evaluate simulated practices, however, this aspect is not completely correct.

There are various scales that have been used in the Spanish educational context to assess student satisfaction with simulation, the assessment of debriefing-DASH- and even the acquisition of skills. Some examples that you can cite in the introduction and/or in the discussion section are the following:

1. Linguistic Validation of the Debriefing Assessment for Simulation in Healthcare in Spanish and Cultural Validation for 8 Spanish Speaking Countries (Muller-Botti et al., 2020)

2. Clinical Simulation as a Learning Tool in Undergraduate Nursing: Validation of a Questionnaire (Alconero-Camarero et al., 2016)

3. To assess the competences of the students, scales such as Clinical Simulation in Nursing Assessment Questionnaire (CLISINAQ) and the Knowledge Management Scale (KMS) have been used in Spain (Díaz Agea, Megías Nicolás, et al., 2019; Sánchez Expósito et al., 2018)

4. To evaluate satisfaction with a simulation methodology, a specific questionnaire was designed for that method (Díaz Agea, Ramos-Morcillo, et al., 2019)

I recommend removing the bold highlighting from the text.

Methods and results.

In the analysis of the internal structure, the authors first present the CFA with the original structure of the scale (4 oblique dimensions). Subsequently, they perform an EFE to analyze the one-dimensional and two-dimensional structure. This is very confusing. It is normally recommended to make sequential use of both types of analysis, whenever the sample size allows it. It is a matter of dividing the sample randomly into two subsamples and exploring the factorial structure underlying the items in the first sample (with an exploratory factor analysis), and then trying to confirm that structure in the other half of the sample, this time by confirmatory factor analysis. The authors must justify why they have carried out the internal structure analyzes first by carrying out a CFA with the original structure of the questionnaire (4 oblique dimensions), and why they then carry out an EFE to analyze the one-dimensional and two-dimensional structure of the questionnaire.

On the other hand, the authors comment that the fit of the model with the original structure of the scale (4 oblique dimensions) in the CFA was good. However, there are fit indices <0.90 and the RMSEA> 0.06. The authors must justify these results or indicate that the model fit was acceptable and not good.

References

Alconero-Camarero, A. R., -Romero, A. G., Sarabia-Cobo, C. M., & Arce, A. M.-. (2016). Clinical simulation as a learning tool in undergraduate nursing: Validation of a questionnaire. Nurse Education Today, 39, 128-134. https://doi.org/10.1016/j.nedt.2016.01.027

Díaz Agea, J. L., Megías Nicolás, A., García Méndez, J. A., Adánez Martínez, M. de G., & Leal Costa, C. (2019). Improving simulation performance through Self-Learning Methodology in Simulated Environments (MAES©). Nurse Education Today, 76, 62-67. https://doi.org/10.1016/j.nedt.2019.01.020

Díaz Agea, J. L., Ramos-Morcillo, A. J., Amo Setien, F. J., Ruzafa-Martínez, M., Hueso-Montoro, C., & Leal-Costa, C. (2019). Perceptions about the Self-Learning Methodology in Simulated Environments in Nursing Students: A Mixed Study. International Journal of Environmental Research and Public Health, 16(23), 4646. https://doi.org/10.3390/ijerph16234646

Muller-Botti, S., Maestre, J. M., del Moral, I., Fey, M., & Simon, R. (2020). Linguistic Validation of the Debriefing Assessment for Simulation in Healthcare in Spanish and Cultural Validation for 8 Spanish Speaking Countries. Simulation in Healthcare, Publish Ahead of Print. https://doi.org/10.1097/SIH.0000000000000468

Sánchez Expósito, J., Leal Costa, C., Díaz Agea, J. L., Carrillo Izquierdo, M. D., & Jiménez Rodríguez, D. (2018). Ensuring relational competency in critical care: Importance of nursing students’ communication skills. Intensive and Critical Care Nursing, 44, 85-91. https://doi.org/10.1016/j.iccn.2017.08.010

Reviewer #3: 1. The study presents the results of original research. Yes

2. Results reported have not been published elsewhere. No

3. Experiments, statistics, and other analyses are performed to a high technical standard and are described in sufficient detail.

Yes, the statistical analyzes are robust, detailed, and very well-grounded.

But, consider this - always use the same rule to report numbers ex: 0, 43, or 0,425 (tenths or hundredths) .

4. Conclusions are presented in an appropriate fashion and are supported by the data. Yes, conclusions are robust and consistent with the results and presented in an appropriate fashion way.

5. The article is presented in an intelligible fashion and is written in standard English.

Yes, the article is presented in a clear, rigorous, and easy to read. But the manuscript needs a careful review of English (USA).

6. The research meets all applicable standards for the ethics of experimentation and research integrity.

Yes.

7. The article adheres to appropriate reporting guidelines and community standards for data availability. The article follows the appropriate reporting guidelines and community standards for data availability.

Yes, but the titles and graphics of the tables can be improved.

The manuscript has great relevance for the teaching practice in nursing. Objectives and methodology are consistent with the object of study and the study complies with all formal and ethical standard requirements.

The sample is robust and adequate, and the treatment and statistical analysis of the data is also robust, detailed and very well based on recent evidence, so it allows conclusions to be drawn, also robust and secure.

But the manuscript needs a careful review of English (USA).

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6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No

Reviewer #3: No

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

PONE-D-20-16146R1

Reliability and validity study of the Spanish adaptation of the “Educational Practices Questionnaire” (EPQ).

PLOS ONE

Dear Dr. Merino,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Oct 09 2020 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols

We look forward to receiving your revised manuscript.

Kind regards,

César Leal-Costa, Ph. D

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

Reviewer #3: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Dear authors,

The article has improved considerably. The authors have made the changes eloquently. There are only 2 details more to be considered:

1.- In my opinion, in the Abstract the objective is incomplete in relation to the general work. (translation and cultural adaptation).

2.- There is a lack of homogenization in the pagination of some references. Most of them show the complete initial and final number, but the references: 1, 14, 15, 40, 43, 44, 45. They show an abbreviated model.

Thank you very much for your efforts.

kind regards.

Reviewer #2: The authors have adequately responded to the reviewer's concerns. The changes proposed by the reviewer have been partially complied with.

Reviewer #3: The authors improved the manuscript according to the three reviewers' recommendations, so the manuscript can now be accepted as is.

Also, the manuscript presents a robust validation study of a relevant instrument to support nurse teaching practice in Spain.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No

Reviewer #3: No

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

Reliability and validity study of the Spanish adaptation of the “Educational Practices Questionnaire” (EPQ).

PONE-D-20-16146R2

Dear Dr. Merino,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org.

If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

Kind regards,

César Leal-Costa, Ph. D

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: