The Basic Knowledge Assessment Tool , (BKAT-7S)©
For Telemetry/Progressive Critical Care Nursing
(Version Seven, 2007)
Introduction
Basic knowledge in critical care nursing is a body of knowledge beyond that required for licensure as an RN that the critical care nurse uses in order to provide safe nursing care to patients. Since safe practice is regarded as a moral and professional responsibility, basic knowledge is information that is necessary for entry into critical care nursing and represents the foundation for job performance.
A primary aim of in-service education in critical care nursing is to assure that staff nurses demonstrate an understanding of this basic knowledge. Because of on-going research studies (since 1979), publications, and the use of the BKAT over the past 29 years, it has become accepted as one standard for measuring basic knowledge in critical care nursing. To date, over 7,500 critical care nurse educators and nurse managers in the USA have requested and have received a copy of one of the BKATs to photocopy for use in their practice. Critical care nurses in over 23 different foreign countries have also requested and received a copy of one of the BKATs.
The BKAT-7S
The most recent version of the adult Telemetry/Progressive Care BKAT is Version Seven (2007). It is an 85 item paper and pencil test that measures basic knowledge. These items measure content related to the following areas of critical care nursing practice: cardiovascular, neurology, endocrine, renal, gastrointestinal/parenteral, pulmonary, and other. The category ‘other’ includes such areas as infection control, hypothermia, monitoring lines, and emotional/spiritual care. The 85 items are almost exclusively a subset of the 100 item BKAT-7 test for adult ICU.
The BKAT-7S takes approximately 40 minutes to complete. The total possible score is 85 points. Items on the BKAT-7S contains multiple choice and fill-in-the-blank questions that measure both the recall of basic information and the application of basic knowledge in practice situations. Psychosocial aspects of critical care nursing practice are integrated into specific questions in the BKAT-7S.
Content for the initial version of the BKAT was identified through a review of the literature and interviews with staff nurses and head nurses working in critical care units, and through the suggestions from two critical care physicians and a nine member panel of experts in critical care nursing practice and education.
Validity for each of the seven versions of the BKAT was established through a panel of experts. Validity has also been supported through replication of research findings related to group differences, learning theory, and variables associated with (and not associated with) scores on the BKAT.
Construct validity. The construct, basic knowledge in Telemetry/Progressive Care, was measured in four groups of nurses: USA RNs with > one year of experience (n=44), foreign-born nurses with < one year of experience in the USA (n=6), new graduate nurses from the USA (n=14), and senior USA baccalaureate (BSN) nursing students (n=12). An analysis of variance of scores on the BKAT-7S among these four groups was statistically significant, F (3,72) = 19.3, p < .001. Post hoc comparisons, using Scheffe, showed that the USA RNs with > one year of experience had higher scores than all other groups: Foreign-born nurses (p< .02, sign), the new graduates (p<.001, sign), and the BSN students (p. <.001). Not previously reported, there was no statistical difference between the foreign nurses and the new graduates (p=0.81, NS), and the foreign nurses and the BSN students (p = .81, NS). Since foreign-born nurses working in foreign countries, new USA graduates, and BSN USA students are known--by previous research findings by Toth (2003, 1984)--to score lower on the BKATs, the research findings in this study support the construct validity of the BKAT-7S. Percent correct answers were as follows: USA RNs (83.0%), foreign-born RNs with < one year of experience in the USA (72.8%), new graduates (69.21%), and BSN seniors (69.06%).
Reliability, history. Cronbach’s Coefficient Alpha (a) has been used as the measure of internal consistency for all versions of the BKAT. Reliability of the first version of the Telemetry/Progressive Care BKAT (BKAT-4S) was computed on a sample of 162 nurses working in Telemetry/Progressive care units from 10 states in the USA and was alpha=0.83. Reliability for the fifth version (BKAT-5S) was computed on a sample of 85 nurses working in Telemetry/Progressive Care from eight states in the USA and was alpha=0.82.
Reliability BKAT-7S. Reliability for this version, the BKAT-7S, is 0.85, and was computed on nurses working in Telemetry/Progressive Care from the following eleven states: Florida, Illinois, Indiana, Maryland, Mississippi, Missouri, New Hampshire, New Jersey, North Carolina, Ohio, and South Carolina.
The average score. Scores on the BKAT-7S ranged from 50 to 86 out of a possible 87 points. The mean score is for USA RNs with > one year experience in Telemetry/Progressive care is 72.3 points (83.0% correct answers) and the standard deviation is 5.9 points. Minor revisions were made following reliability testing, deleting two questions. Therefore, the length of the test is now 85 questions.
The BKAT-7S can be used prior to orientation classes in critical care nursing to identify needed content for the classes, and as a pretest and/or a posttest to measure learning in groups of nurses. It can also be used as a dependent variable to test different teaching methods for orientation classes, and as a means to identify content for in-service education programs for currently employed Telemetry/Progressive Care nurses. In addition, it has been successfully used in nursing research and for advance placement of nurses with prior experience in critical care nursing, so that they do not have to attend classes which present content that they already know. The BKAT is only one measure of basic knowledge in critical care nursing and is not to be used in screening, hiring, or firing situations. It is copyrighted Ó and may not be altered, added to, or used in part. Permission must be obtained to use the BKAT.
No one is expected to achieve 100%. Rather, it is expected that following orientation, Telemetry/Progressive Care nurses will achieve an average score on the BKAT-7S from 70 to 72 points (80 to 85% correct answers). Whether or not an average score is considered to be a passing grade depends upon which specific questions are missed; for example, being able to recognize the ECG pattern of ventricular fibrillation is critical to know in any unit. Since the BKAT is being used in a wide variety of clinical settings, which specific questions are essential to know for that setting is decided by the nurse administering the BKAT-7S.
Contact Dr. Jean C Toth, RN, MSN, PhD, (
toth@cua.edu).
Data collectors for the BKAT-7S include the following:
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Linda Alwine, RN, MSN, South Carolina
Laurie Bennett, RN, BSN, New Hampshire
Jennifer Furry, RN, BSN, CCRN, Florida
Karen Goessling, RN, BSN, MS, Missouri
Phyllis, Haas, RN, Ohio
Deborah Hickman, RN, CNS, North Carolina
Jennifer Hostutler, RN, MSN, MPA, CNS, CCRN, Ohio
Catherine Jarboe, RN, BA, Maryland
Nelda Logan, RN, C, BSN, Texas
Linda Morris, RN, PhD, APN, CCNS, Illinois
Joann Panno, RN, BC, MSN, CNS, Ohio
Donna Prouix, RN, BSN, CCRN, New Hampshire
Glyne Sommer, RN, MN, CNS, South Carolina
Iva Nell Vaughan, RN, MSN, FNP, Mississippi
Karen Weiss, RN, BSN, New Jersey
Shirley Woolf, RN, MSN, MA, CCRN, CNRN, Indiana |
The initial version of BKAT (BKAT1) was co-authored by Jean C Toth, RN, CNS, MSN, BC, PhD and by Kathleen Ritchey, RN, MSN, CNS, formerly of the Veterans Affairs Medical Center, Washington, DC. All subsequent BKATs and their versions were authored by Dr. Toth.
Other BKATs Available
BKAT-7 for Adult Critical Care (2006)
BKAT-7S for Telemetry/Progressive Care (2007)
PEDS-BKAT5 for Pediatric Intensive Care Unit (PICU)
NICU-BKAT3 for Neonatal ICU (2004)
ED-BKAT for the Emergency Department (2006)
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Last Revised 28-Feb-08 03:58 PM.
