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Delphi Validation of a Pain Management E-Learning Module for Critical Care Nurses in Saudi Arabia

*Abeer Mohammed F Almutairi orcid  -  College of Nursing, Lincoln University, Saudi Arabia
Faridah Mohd Said  -  Faculty of Nursing, Lincoln University College, Malaysia
Open Access Copyright (c) 2026 by the Authors, Published by Department of Nursing, Faculty of Medicine, Universitas Diponegoro
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

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Abstract

Background: Critical care nurses play a central role in pain management; however, persistent knowledge and competency gaps continue to affect patient outcomes globally, including in Saudi Arabia. Despite the growing adoption of e-learning in nursing education, no context-specific, expert-validated module exists for critical care pain management in this context.

Purpose: This study aimed to develop and content-validate a context-specific e-learning module on pain management to enhance critical-care nurses’ competency in a regional health cluster in Saudi Arabia.

Methods: A three-round modified Delphi technique was employed. An initial needs assessment was conducted through a literature review and expert focus group input. It was then refined over three rounds with a panel of five multidisciplinary critical care specialists with 7 to 23 years of experience. Experts rated content relevance on a four-point scale. Content validity was assessed using the Content Validity Ratio (CVR) and the Content Validity Index (CVI), with retention thresholds set at CVR ≥ 0.99 and I-CVI ≥ 0.80.

Results: The Delphi process achieved 100% of retention across all rounds. Of the 25 initial content items, 24 met the CVR and I-CVI cutoffs (CVR = 1.00, I-CVI = 1.00) and were retained. One item, “Non-pharmacological interventions” (CVR = 0.60), was excluded. The final curriculum comprised six modules totaling 2.5 hours, covering pain basics and assessment; clinical aspects of pain; pharmacological management; interdisciplinary practice; case-based application; and assessment of knowledge and skills. New items suggested by the experts and included in the final curriculum were risk stratification, complication monitoring, and documentation protocols. The final scale-level CVI was 1.00.

Conclusion: This Delphi study produced an expert- and content-validated e-learning module on critical care pain management. Although strong content validity was established, the small panel size and single-region representation limit generalizability. Following pilot testing and outcome evaluation, this e-module could be used as an effective educational intervention to improve knowledge and potentially clinical practice related to pain management.

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Keywords: Critical care nursing; Delphi technique; e-learning; pain management; Saudi Arabia

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