Validation of the Chinese version of the psychological safety in high-fidelity simulation scale: a culturally compatible methodological study

Currently, there is a lack of a specialized scale in China for assessing the psychological safety of nursing students engaged in High-fidelity Simulation (HFS). The aim of this study was to translate the Psychological Safety in High-Fidelity Simulation Scale (PSHFSS) into Chinese and evaluate its psychometric properties. The translation and cross-cultural adaptation strictly followed the TRAPD (Translation, Review, Adjudication, Pretesting, and Documentation) protocol. A cross-sectional survey was conducted using the Chinese version of the PSHFSS (CV-PSHFSS) with convenience sampling of nursing students. Psychometric evaluation of the CV-PSHFSS was based on Classical Test Theory and Item Response Theory. A total of 522 participants was analyzed, with item-level content validity index (CVI) ranging from 0.8 to 1.0 and a scale-level CVI of 0.96. Confirmatory factor analysis yielded a goodness-of-fit test of 2.5, root mean square error of approximation of 0.054, the goodness-of-fit index of 0.963, comparative fit index of 0.982, and incremental fit index of 0.982. Cronbach’s α coefficients for the dimensions of dealing with uncertainty, being exposed, being unsupported, interpersonal risk, and the overall scale were 0.820, 0.885, 0.888, 0.896, and 0.927, respectively. Meanwhile, the McDonald’s omega coefficients for the same dimensions—dealing with uncertainty, being exposed, being unsupported, interpersonal risk, and the overall scale—were 0.821, 0.882, 0.890, 0.897, and 0.925, respectively. The intraclass correlation coefficient (ICC) of the CV-PSHFSS was 0.925, and that of the items ranged from 0.715 to 0.855. Infit mean-square (MNSQ) values ranged from 0.69 to 1.24, and outfit MnSQ values ranged from 0.69 to 1.37. Point-measure correlations were between 0.59 and 0.77. Item difficulty measures ranged from − 0.55 to 0.85 logit, while individual psychological safety ranged from − 5.15 to 4.95 logit. Differential items functioning contrast ranged from − 0.24 to 0.28 logits, with all p-values exceeding 0.05. The CV-PSHFSS has satisfactory reliability and validity among Chinese nursing students. Nursing educators are encouraged to use this scale to assess students’ psychological safety in HFS, thereby improving learning outcomes and engagement.