Refinement of the Genomic Nursing Concept Inventory
Office of Research – Spokane
9/1/2013 – 8/31/2014
Completion of the Human Genome Project a decade ago signaled the beginning of the genome era of healthcare, and health professionals including nurses are challenged to prepare a workforce ready to implement care based on genome science. The blazing pace of genomic discovery means that tomorrow’s interventions at the bedside cannot be predicted, perhaps not even imagined. Nurses, representing not only the largest group of health professionals but a group particularly involved in explaining complex information to patients, require foundational understanding of basic genetic and genomic concepts. The nursing profession has embraced the challenge to prepare a workforce competent to deliver genetic- and genomic-based care, and the challenge to nurse educators is great, as little genetic content has historically been included in most nursing curricula. Most faculty have not had specific genetics education and are even less likely to be familiar with recent developments in genomics. An important facilitator of genomic nursing education is a set of competencies that outline what nurses need to be able to do to deliver genomic-based care. The competencies have been endorsed broadly by professional nursing groups in the United States and outline knowledge nurses require need to develop genetic-genomic competency. They provide a critical benchmark for nurse educators, defining content necessary to integrate in nursing curricula.
Rational curricular design should be based on what students know, compared to what they need to know. Therefore, a means to measure genomic literacy among nursing students is an important tool for nurse educators. Such a tool has been developed and offers great promise. The Genomic Nursing Concept Inventory (GNCI) is nursing’s first concept inventory, designed to measure understanding of foundational genetic and genomic concepts most critical to nursing practice. Concept inventories have become mainstays of science, technology, engineering and mathematics education to assess student understanding, measure learning gains, and evaluate teaching effectiveness. To date, the GNCI has been administered to 1100 baccalaureate nursing students, and preliminary analysis demonstrates promising psychometric features (scale difficulty 47%, item difficulty 13-84%, Cronbach’s alpha .775). Further analysis and validation is required, however, prior to offering the GNCI to nursing educators nationwide: Such analysis and validation are the purpose of this study.
This study has two aims. The first aim is to apply psychometric analysis to GNCI data accumulated to date using two psychometric models, Classical Test Theory and Item Response Theory. The goal is to better characterize inventory psychometrics, including factor structure, test-retest reliability, and individual item performance (difficulty and discrimination), and to inform inventory improvement. Aim 2 is to verify the inventory content domain and assure that concepts tested are both important to nursing practice and difficult for students to grasp. Genetic nurse educators will be invited to participate in a web-based, three-round Delphi study to rate the importance and difficulty of concepts included in the current GNCI and to identify any important and difficult concepts that may warrant consideration for inclusion. Data related to both aims will be applied to inform inventory improvement. The output of this study will be a revised inventory ready for widespread deployment to measure genomic literacy among nursing students. Nurse educators can use GNCI data to measure understanding among their students of critical genetic-genomic concepts and use that information to design targeted educational approaches and evaluate learning gains. Such a tool is needed to assure a nursing workforce prepared to deliver competent care in the genome era.