Modified Fresno Test - Acute care nursing
Margo A. Halm, PhD, RN, NEA-BC, Associate Chief Nurse Executive, Nursing Research & Evidence-Based Practice - VA Portland Health Care System
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Background: Few objective measures of evidence-based practice (EBP) knowledge/skill exist. The Fresno Test, one objective method, has only been validated with medicine, physical/ occupational/speech therapy, pediatric nursing and students.
Aim: The Fresno Test was adapted and tested with cohorts of acute care nurses. Six of 14 items required revision to achieve acceptable psychometrics. The aim of this second validation study was to revise and validate a new version of the test to determine if it could distinguish EBP knowledge/skills among acute care nurses.
Methods: An expert panel engaged in multiple Delphi rounds to revise items. Individual-content validity indices (CVI) ranged from 0.83-1.0, with scale-CVI 0.92. Using a cohort design, a cross-sectional sample of 90 novice, master and expert nurses were recruited via national listservs or snowball sampling to complete the revised test. Potential participants were emailed an informational flyer about the purpose of the study and a link to the test created in web-survey software. Two doctorally prepared EBP experts independently scored tests using the standardized rubric.
Results: The Modified Fresno Test-Acute Care Nursing yielded strong psychometric properties (intra-class correlation coefficients>0.80; item discrimination indices>0.20; item-total correlations>0.30). One poorly performing item was dropped. The final test includes 13 items, with a Cronbach 0.76. Item difficulty was moderate to high. Most items discriminated well between cohorts. Mean total scores were positively correlated with age, years since graduation, years acute care experience, and formal EBP or research workshops/conferences, courses or immersions. Perceived level of EBP expertise was not associated with mean scores.
Conclusion: The validated 13-item Modified Fresno Exam-Acute Care Nursing can be used to evaluate EBP competencies of acute care nurses in academic and practice settings. It can also be used by nurse scientists to build a stronger evidence base on types of educational programs that excel in advancing the critical competency of EBP among our nursing work force.
The test is best administered through web-based software. Instructions for scoring the tests are included in its accompanying rubric. The tests is in the public domain and thus, individuals may use the tool without permission. The author does request an email communication to firstname.lastname@example.org describing how the tool will be utilized to assist in understanding how individuals and organizations are finding value in the tool within various settings. No modifications to the test items or scoring rubric are advised as changes would alter the psychometric properties of the test. The manuscript describing the test's psychometrics is currently under review for publication.
Revised files were added 1/12/2023.
|Type||Tool, Instrument, Measurement|
|Research Approach||Quantitative Research|
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