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Validation of the End-of-Life Nursing Education Consortium Knowledge Assessment Test: An Abbreviated Version

Lange, Jean W. PhD; Shea, Joyce DNSc; Grossman, Sheila C. PhD; Wallace, Meredith PhD; Ferrell, Betty R. PhD, FAAN

Journal of Hospice & Palliative Nursing: September-October 2009 - Volume 11 - Issue 5 - p 284-290
doi: 10.1097/NJH.0b013e3181b4cc54

The need for improved nursing knowledge about end-of-life care is well documented; however, efficient measures to evaluate knowledge attainment from end-of-life training programs are lacking. The authors tested a 50-item version of an original 109-item knowledge assessment tool developed by the End-of-Life Nursing Education Consortium. Items with highest item-to-total correlations were selected to represent each of the nine domains in the original instrument. One hundred forty-one graduate and undergraduate nursing students pretested the shorter version. Thirty graduate students also completed the original version. Item analysis, equivalence, and internal consistency estimates were conducted to evaluate the validity of the 50-item version. Scores on the 109-item and 50-item versions were highly correlated (r = 0.92), and the total scale internal consistency estimate for the 50-item version surpassed the 0.80 standard (Kudar Richardson [KR] 20 = 0.84). Item difficulty and discrimination indices suggest that the revised version should discern knowledge attainment across varied achievement levels. Pretest scores were well below the 80% target for mastery among graduate students in practice and support the ongoing need for end-of-life education. The results support the utility of the shorter version to assess baseline end-of-life knowledge. Further testing is needed to demonstrate its usefulness in end-of-life program evaluation.

Author Affiliations: Jean W. Lange, PhD, is Professor, Fairfield University School of Nursing, CT.

Joyce Shea, DNSc, is Assistant Professor, Fairfield University, CT.

Sheila C. Grossman, PhD, is Professor, Fairfield University, CT.

Meredith Wallace, PhD, is Associate Professor, Yale University, New Haven, CT.

Betty R. Ferrell, PhD, FAAN, is Professor, City of Hope, Duarte, CA.

The authors acknowledge the financial support provided by the Gustavus and Louise Pfeiffer Research Foundation.

Address correspondence to Jean W. Lange, PhD, Fairfield University School of Nursing, 1073 N Benson Rd, Fairfield, CT 06824 (

© 2009 The Hospice and Palliative Nurses Association