Introduction: The benefits of Evidence-based practice (EBP) are widely known. Yet, it is not consistently implemented across care settings. Subjective instruments are widely used to measure EBP knowledge. However, a growing body of evidence shows a weak correlation between subjective and objective knowledge assessments (Wonder et al., 2017; Zell & Krizan, 2014). The objective of this research was to: a) test validity of the translated version of the Evidence-based Practice Knowledge Assessment in Nursing (EKAN); b) assess students’ EBP knowledge; and c) create a means for program evaluation. The EKAN was selected for its objective nature and strong psychometric properties (validity centering on 1.0, and item reliability of .98), when tested with a similar population in the United States (Spurlock & Wonder, 2015).
Method: This study implemented a descriptive, correlational design, with a cross-section sample of junior and senior nursing students from two Spanish speaking countries. The investigators obtained IRB approval (LLU IRB# 5160181) from the home institution of the PI and at host institutions in Dominican Republic and Colombia.
Subjects completed the EKAN-Spanish in paper/pencil format during a proctored data collection session. Authors used jMetrik (Meyer, 2014) software to conduct single parameter Rasch analysis to separately examine item-difficulty and subject ability.
Results: The mean score on the EKAN-Spanish exam was 5-6 correct answers out of 20 (range of 2-12). Using Rasch analysis, the Infit and Outfit statistics for all translated versions met the benchmark of being between 0.6 – 1.4, supporting validity. For Reliability, the item separation for the Spanish form was >2.0 indicating sufficient sample size, and item reliability was .94. Person reliability was .13, indicating trait restriction among the study sample, which was anticipated with the sample of baccalaureate students. These results compare similarly to the English version of EKAN. Additionally, differential item functioning (DIF) analysis produced no evidence of language-related concern on any of the EKAN’s 20 items, supporting translational accuracy.
Conclusion: This is a first step in using a unified, standards-based approach to EBP assessment. The collaborative research relationship between countries provided: a) a validated, objective EBP instrument in Spanish; b) a baseline assessment of EBP knowledge in junior- and senior-level nursing students; c) a system for annual evaluation of nursing knowledge; and, d) a research trajectory for faculty at the host institution. The validation of EKAN into Spanish now has the ability to transform EBP assessment and education in over 21 Spanish-speaking countries.

Descriptors: Evidence-Based Practice; Validity; Assessment