Ma SC, et al. – Authors performed this study to develop an online computerized adaptive testing (CAT) to check person being bullied and verify whether item response theory–based CAT can be applied online for nurses to measure exposure to workplace bullying. According to the findings obtained, the CAT–based Negative Acts Questionnaire–Revised (NAQ–R) reduces respondents’ burden without compromising measurement precision and increases endorsement efficiency. They suggested the online CAT for assessing nurses using the criteria at -0.7 and 0.7 (or <30 and <60 in summed score) to identify bully grade as 1 of the 3 levels (high, moderate, and low). They also recommended that the bullied nurse can get help from a psychiatrist or a mental health expert at an earlier stage.

Methods

• An aggregate of nine hundred sixty-three nurses were enrolled and responded to the 22-item Negative Acts Questionnaire-Revised (NAQ-R).
• All non-adaptive testing (NAT) items were calibrated with the Rasch rating scale model.
• 3 scenarios (i.e., NAT, CAT, and the randomly selected method to NAT) were manipulated to compare their response efficiency and precision by comparing
  • Item length for answering questions, person measure,
  • Correlation coefficients,
  • Paired t tests,
  • Estimated standard errors (SE) between CAT and the random to its counterpart of NAT.

Results

• Results of this study suggested that the NAQ-R is a unidimensional construct that can be applied for nurses to measure exposure to workplace bullying on CAT.
• It was observed in the findings that CAT required fewer items (=8.9) than NAT (=22, an efficient gain of 60% =1–8.9/22).
• Results revealed that nursing measures derived from both tests (CAT and the random to NAT) were highly correlated (r = 0.93 and 0.96) and their measurement precisions were not statistically different (the percentage of significant count number less than 5%) as expected, but CAT earns smaller person measure SE than the random scenario.
• The present data indicated that the prevalence rate for nurses was 1.5% (=15/963) when cutting points set at -0.7 and 0.7 logits.