New tools that explore nursing students’ belief in their abilities to care for critically ill patients are helping nursing educators differentiate beginner students from students with more advanced skills, according a study recently published in Nursing Research.

Led by Glenda S. Stump with Arizona State University, the researchers looked to provide evidence for an adequate item response theory model fit to scores measuring nursing students’ self-efficacy to care for critical patients and to use the theory to provide evidence for reliable and valid interpretation of self-efficacy scores.

“Beliefs about ability influence the choices people make in many situations. Self-efficacy, or the belief in one’s ability to take actions to manage a future situation, is often considered in an academic context but can include performance of psychomotor tasks as well,” the authors wrote. “Similarly, in the current healthcare climate, where great emphasis has been placed on decreasing patient errors and risk, nurses who doubt their ability may not initiate tasks in order to avoid making mistakes.”

For the study, a Nursing Student Self-Efficacy Scale was administered to 421 nursing students. Data regarding students’ self-efficacy beliefs for psychomotor skill performance and communication skills were analyzed using the generalized partial credit item response theory model.

“Review of item information functions showed that 40 percent of the items provided high information about self-efficacy and 20% provided moderately high information,” Stump et al found. “Comparison of trait level distributions with reliability information given by the two subscales showed that the psychomotor subscale measured self-efficacy most accurately for second and third semester students and the communication subscale measured efficacy most accurately for first and second semester students.”

Comparison of scores from students at different points in the academic year provided validity evidence. This could be used to discriminate between beginning students and more advanced students possessing different levels of self-efficacy. When used for scale development, item response theory procedures can be more informative about item and test reliability than classical true score theory.

“The [ scores] can be used to give formative feedback to students as they progress through the nursing curriculum, providing guidance toward learning experiences that could improve their self-efficacy for performance of particular skills,” the authors concluded.  “Scores can be used to direct faculty attention toward areas where educational intervention or remediation may benefit the students. More importantly, accurate measurement of this construct will provide a basis upon which to evaluate accurate calibration, a vital skill for nurses.”