「初心者レベル」看護師におけるICU 看護基礎知識評価試験案の作成 : 古典的テスト理論に基づく項目分析 <原著論文>

本研究の目的は,「初心者レベル」看護師用のICU 看護基礎知識評価試験案を作成し,各問題項目の項目特性を確認して,最終試案作成に向けた示唆を得ることである.先行研究による知見を基に試験案を作成し,看護師等養成所の最終学年生113 名,第1学年生48 名の協力を得て,連結可能匿名化によるパイロットテストを国試前後に実施した.古典的テスト理論に基づく項目分析の結果,テスト理論上の適合項目は国試前54 項目,国試後74 項目だった.このうち国試前・後で一致したテスト理論上の適合項目は52 項目,救済項目は3項目,再検討項目は1項目だった.国試前・後で一致した項目困難度が0.85 以上の問題は,ICU 看護において基本的で重要な問題だった.同様に,項目困難度が0.25 未満の問題は,術後管理と人工呼吸器による呼吸管理に関するICU 看護において重要な内容だった.これらの問題は,修正・削除候補と判断できるが,統計的な項目特性に限らず,内容面に立ち入った検討が課題となった.

We have developed a written examination for newly graduated nurses to assess whether they have the basic knowledge required for novice nurses in intensive care units (ICUs). The purpose of this study was to inspect the characteristics of each item of the evaluation test at the tentative plan phase. This study developed the evaluation test on the basis of a previous study.

Data were collected by a pilot study of 113 third-year and 48 first-year students at nursingdiploma schools. It was then carried out by linkable anonymity, before and after the national licensing examination for nurses.

In this study, as a result of item analysis on the basis of a classic test theory, there were 54 fit items by investigation before the national licensing examination for nurses, and 74 fit items by investigation after the national licensing examination for nurses. Of these, the items that were in accord before and after the national licensing examination for nurses, were 52 items of fitness, 3 items of reliefand 1 item of revision.

Of these items in accord, the items whose difficulty showed more than 0.85 were contents which were basic and important for ICU nursing. Similarly, items whose item difficulty showed less than 0.25 were important contents about the nursing care of patients requiring respirator control and postoperative patients in ICU nursing. Those items were regarded as candidates for modification/ deletion, but required consideration of content validity as well as statistical characteristic items.