Other Titles
Communication Innovation: Developing a Bilingual Communication Board Validated by Lawshe’s Content Validity Ratio [Poster Title]
Abstract
Hospitalized families with Limited English Proficiency (LEP) can encounter communication barriers during routine interactions due to limited interpreter access, increasing the risk for adverse events and reducing satisfaction. At a freestanding pediatric hospital neurology unit, 67.3% of nurses reported difficulty communicating basic needs and 60% felt dissatisfaction with current LEP communication methods. To address these challenges and enhance communication, a bilingual communication board, featuring English and Spanish captions alongside illustrative icons, was developed and validated.
Experts, identified as nursing staff and Spanish and English-speaking caregivers, evaluated each icon and caption for clarity and accuracy using a four-point scale. Analysis using Lawshe’s Content Validity Ration (CVR), a quantitative method to assess content validity in instrument development, identified 14/60 items below the validity threshold, prompting targeted revisions and revalidation. This iterative process emphasized the importance of aligning professional translation with real world caregiver understanding, quantifying user feedback to enhance the tool. Repeated validation cycles ensured that all items met acceptable CVR values, confirming content validity and usability.
After validation, pilot testing demonstrated marked improvements: complete intake and output documentation rose from 20% to 94%, 80% of nurses reported improved communication satisfaction, and 100% of families reported improved communication with staff. The use of Lawshe’s CVR provided a statistically grounded, evidence-based approach to content validation, ensuring linguistic and cultural accuracy. This framework offers a replicable model for developing validated communication tools in linguistically diverse healthcare environments.
Notes
References:
Kiblinger T, Gettis M, Brown AM. Facilitating communication in a pediatric surgery center: Implementation of an interactive communication board. J Doctoral Nurs Pract. 2022;15(1):18-25. doi:10.1891/JDNP-2021-0045
Lawshe CH. A quantitative approach to content validity. Personnel Psychol. 1975;28(4):563-575. doi:10.1111/j.1744-6570.1975.tb01393.x
Stephen JM. Pediatric nurses' experiences in caring for non-English speaking patients and families. J Transcult Nurs. 2021;32(6):690-696. doi:10.1177/1043659620986607
Schiaffino M, Nara A, Mao L. Language services in hospitals vary by ownership and location. Health Aff (Millwood). 2016;35(8):1399-1403. doi:10.1377/hlthaff.2015.0955
Tam I, Gist L, Patel A, Fisher E, Rhee KE. The parent's perspective: A focus group study on Spanish interpreter services for hospitalized children. Acad Pediatr. 2022;22(1):98-106. doi:10.1016/j.acap.2021.07.011
Sigma Membership
Non-member
Lead Author Affiliation
Cook Children's Medical Center, Fort Worth, Texas, USA
Type
Poster
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Quantitative Research
Keywords:
Instrument and Tool Development, Health Equity or Social Determinants of Health, Implementation Science, Communication, Limited English Proficiency
Recommended Citation
Palau, Natalie and Valenta, Amy, "Communication Innovation: Developing a Bilingual Communication Board Validated by Lawshe’s CVR" (2026). International Nursing Research Congress (INRC). 31.
https://www.sigmarepository.org/inrc/2026/posters_2026/31
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-07-26
Communication Innovation: Developing a Bilingual Communication Board Validated by Lawshe’s CVR
Toronto, Ontario, Canada
Hospitalized families with Limited English Proficiency (LEP) can encounter communication barriers during routine interactions due to limited interpreter access, increasing the risk for adverse events and reducing satisfaction. At a freestanding pediatric hospital neurology unit, 67.3% of nurses reported difficulty communicating basic needs and 60% felt dissatisfaction with current LEP communication methods. To address these challenges and enhance communication, a bilingual communication board, featuring English and Spanish captions alongside illustrative icons, was developed and validated.
Experts, identified as nursing staff and Spanish and English-speaking caregivers, evaluated each icon and caption for clarity and accuracy using a four-point scale. Analysis using Lawshe’s Content Validity Ration (CVR), a quantitative method to assess content validity in instrument development, identified 14/60 items below the validity threshold, prompting targeted revisions and revalidation. This iterative process emphasized the importance of aligning professional translation with real world caregiver understanding, quantifying user feedback to enhance the tool. Repeated validation cycles ensured that all items met acceptable CVR values, confirming content validity and usability.
After validation, pilot testing demonstrated marked improvements: complete intake and output documentation rose from 20% to 94%, 80% of nurses reported improved communication satisfaction, and 100% of families reported improved communication with staff. The use of Lawshe’s CVR provided a statistically grounded, evidence-based approach to content validation, ensuring linguistic and cultural accuracy. This framework offers a replicable model for developing validated communication tools in linguistically diverse healthcare environments.
Description
This project validated a bilingual communication board designed for hospitalized families with Limited English Proficiency. Using Lawshe’s Content Validity Ratio, with feedback from nurses and families, iterative revisions produced a validated tool to support improved communication.