Is the Nursing Work Index Measuring Up?
Bibliographic record
Abstract
BACKGROUND: The Nursing Work Index (NWI) provided the foundation for three published instruments, each presented as a valid measure of the nursing practice environment. Aiken and Patrician [Aiken, L. H., & Patrician, P. A. (2000). Measuring organizational traits of hospitals: The Revised Nursing Work Index. Nursing Research, 49, 146-153] revised the NWI to the Revised Nursing Work Index (NWI-R), reporting four conceptually derived subscales. Lake [Lake, E. T.(2002). Development of the Practice Environment Scale of the Nursing Work Index. Research in Nursing and Health, 25,176-188] used factor analysis to empirically derive five subscales with a composite overarching practice environment factor. Estabrooks et al. [Estabrooks, C. A., Tourangeau, A. E., Humphrey,C. K., Hesketh, K. L., Giovannetti, P., Thomson, D., et al. (2002). Measuring the hospital practice environment: A Canadian context. Research in Nursing and Health, 25, 256-268] reported a single empirically derived factor solution that represented the nursing practice environment. OBJECTIVE: To examine the validity of three instruments (based on the NWI) as measures of the nursing practice environment. METHODS: The measurement models underlying the three instruments were reconstructed from the information provided by each author in published manuscripts and then were estimated using structural equation modeling (SEM), the chi-square test of model fit, and data from the 1998 Canadian Nurse Survey. RESULTS: Each of the three underlying measurement models was factor analytic in design (multiple indicators of each concept) and failed significantly when compared with the data (Aiken & Patrician; chi2 = 939.12, p <.001, df = 50; Lake, chi2 = 17,872.73, p <.001, df = 319; Estabrooks et al., chi2= 38,590.29, p <.001). This lack of model fit with the data raises questions about the validity of these instruments as measures of the nursing practice environment. DISCUSSION: The nursing practice environment is complex and has been examined inadequately by factor-analytic approaches, largely because insufficient attention has been paid to implicit underlying theory. The development and testing of robust theory using powerful research methods available to examine causal relationships in complex theoretical models will advance understanding of constructs such as the nursing practice environment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.016 | 0.097 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.005 | 0.010 |
| Science and technology studies | 0.001 | 0.006 |
| Scholarly communication | 0.004 | 0.006 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.004 |
| Insufficient payload (model declined to judge) | 0.005 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".