Using Lawshe's Content Validity Index for
Validity Evidence in Clinical Simulation

Caring for multicultural patient populations in clinical education is needed (Curtis, 2019). A lack of intercultural competence in health professions education can lead to myriad of adverse outcomes, including health disparities for patients from diverse cultures (Kaihlanen 2019). This becomes increasingly important for acute care setting, because of the short interaction time between physician and patients, challenges in developing the patient-physician relationship and making the spot decision for life-threatening situations (Tiwary, 2019).

The Lawshe Content Validity Index (CVI) is a commonly used method to assess content validity in questionnaire development, including for a clinical cultural competency questionnaire. The CVI helps determine the relevance and representativeness of items in relation to the construct being measured. To calculate the Lawshe CVI, a panel of experts familiar with the construct being assessed (in this case, clinical cultural competency) would independently rate each item of the questionnaire for its relevance and representativeness. The ratings are typically done on a scale (e.g., 3-point or 4-point scale) indicating the level of agreement with the item's content. The Lawshe CVI is calculated by determining the proportion of experts who rate an item as relevant or representative (typically with a cutoff value of 0.78 or higher). If a sufficient number of experts (e.g., at least 80% or more) rate an item as relevant, it is considered to have content validity. We can use the CVI to help improve validity evidence of clinical simulation practices.