Objective Knowledge Assessment in Nursing Education: An Update on the Evidence-Based Knowledge Assessment in Nursing (EKAN) Instrument

Providing effective, evidence-based nursing care requires an assortment of knowledge, skills, and attitudes related to locating, evaluating, and integrating research evidence into nursing practice. Ideally, the development of evidence-based practice (EBP) knowledge, skills, and attitudes begins early in one’s professional preparation for nursing. Prelicensure nursing education programs have accepted the challenge of preparing students with the knowledge, skills, and attitudes for EBP but have lacked an effective, objective way to measure educational outcomes students achieve from these efforts. Though several tools are available to measure students’ attitudes toward EBP, existing instruments to measure EBP knowledge (one component of competence) are limited and rely predominantly on self-reports of achievement. Other instruments are designed for specific populations such as medical students (Anderson, & Stickley, 2002; Frohna, Gruppen, Fliegel, & Mangrulkar, 2006; Illic, 2009; Ramos, Schafer, & Tracz, 2003), and have yet to be tested in nursing. The National Council Licensure Examination for Registered Nurses (NCLEX-RN) is the current standard for prelicensure nursing competency assessment for entry into practice in the United States. Yet this exam does not test students’ knowledge of EBP principles per se (NCSBN, 2009), leaving nursing education programs with virtually no method to evaluate the effectiveness of their curricular revision and instructional activities at their school or to compare their students’ achievement with other programs nationally or internationally.

To bridge this measurement gap, the Evidence-based Knowledge Assessment in Nursing (EKAN) instrument was developed to objectively measure nursing students’ knowledge of EBP principles. The EKAN is based on the Quality and Safety Education for Nurses (QSEN) competencies and the American Association of Colleges of Nursing (AACN) Essentials of Baccalaureate Education for Professional Nursing Practice. These frameworks articulate the requisite knowledge, skills, and abilities for the entry-level, generalist roles of caregiver and coordinator of care to enable the safe, high quality care associated with EBP (AACN, 2008; Cronenwett et al., 2007). The QSEN competencies and AACN Essentials have resulted in widespread curricular redesign and developmental progression models to promote competency acquisition for different levels of nursing education (AACN, 2013; Barton, Armstrong, Preheim, Gelman, & Andrus, 2009; Brady, 2011). The creation of an instrument based on these models provides a reliable and valid way for faculty to measure EBP competency achievement in prelicensure nursing education. Using the EKAN, educators can more effectively evaluate not only student-level knowledge, but also curricular content and teaching strategies along with needs for faculty development to support student learning.

This presentation will provide an overview of the EKAN instrument development process and findings from a multi-site instrument validation pilot study. The use of item-response theory (IRT) modeling, specifically Rasch modeling, enables the EKAN to accommodate testing for a variety of nursing program types, settings, and student populations. Rasch modeling enables discrimination of student ability and item difficulty with greater instrument stability across samples (Tavakol & Dennick, 2013), presenting an opportunity for a global initiative to enhance education and promote best practice.

Through the use of a common instrument, educators around the world can explore ways to continue to enhance student performance by collaborating on innovative ways to develop programs, teaching strategies, and faculty. Interactive discussion among session participants will focus on identifying innovative and unique strategies to foster student EBP knowledge development and how attendees might become involved in further research with the EKAN.