• examination;
  • graduate nurse;
  • item analysis;
  • multiple-choice;
  • paediatric intensive care;
  • psychometrics



To develop and psychometrically test the Paediatric Intensive Care Unit-Nursing Knowledge and Skills Test – a multiple-choice test for measuring the key nursing knowledge and skills required for safe, competent practice.


Intensive care graduate nurse residency or orientation programmes are key strategies in the development of safe and competent practitioners. Essential to these programmes is an evaluation of knowledge and skills. Multiple-choice examinations provide a valuable way of evaluating broad knowledge and skills; however, there has been limited work in this area to date.


Psychometric evaluation.


The instrument was administered to 79 nurses from four paediatric intensive care units in Australia and New Zealand over 18 months between 2008–2010. Internal consistency using Kuder-Richardson 20, item analysis and construct validity using the ‘known groups’ technique were explored.


Kuder-Richardson 20 reliability estimate for the 109-item test was 0·85. Instrument scores were significantly higher amongst nurses with postgraduate education and more years of paediatric intensive care experience. Item difficulty indices ranged from 0·08 to 1, with a mean item difficulty of 0·66. Item discrimination ranged from 0·2–0·8.


Testing of the instrument demonstrated encouraging psychometric properties. With additional refinement, this tool could provide educators and managers with an instrument to assist in the assessment of knowledge and skill acquisition. The instrument requires further testing in different samples of paediatric intensive care nurses to enable validation in other settings and cross-cultural comparisons.