Problem Statement: There is no instrument that measures composite cognition consisting of lower-level cognition, higher-level cognition, and critical thinking related to the care of combat casualties.

Conceptual Frameworks: Bloom’s taxonomy with Krathwohl’s (2002) revised taxonomy and critical thinking theory are the frameworks for this study. Composite cognition, a new construct, consists of three elements: lower-level, higher-level, and critical thinking cognition.

Methods: The CCI measures the three subscales of composite cognition: lower- and higher-level and critical thinking cognition. Seventy-five multiple choice questions were developed based on scenarios using conditions seen in combat: hypovolemic shock, tension pneumothorax, and cardiac tamponade. This criterion-referenced instrument was reviewed by an expert panel to establish item-objective congruence, content validity, and readability. The instrument was administered to 32 military registered nurses using a test-retest method to establish validity and reliability.

Findings: Content validity was established through expert review; congruency percentage was 93%; item-objective congruence was .8026. Test-test reliability was established with a Pearson r of .857. A Kuder-Richardson of .91 established test dependability. Mean item difficulty was .57 on the pre-and post-tests. Point-biserial technique was used to evaluate item discrimination.

This project  is supported by a TSNRP grant titled “Educational Intervention on Combat Trauma Care”.