Item analysis of the individual pretest–posttest questions would also be useful to identify the validity of the
questions and patterns of incorrect responses in this population.
Questions used to focus on areas for further educational interventions could be identified; however, this analysis would require a larger sample size in a future project.
Generalization of the study findings to a broader population of nursing home staff is limited by the small
sample size and the lack of participation by all nurses who administer medications in the project institutions.
Further evaluation of an evidence-based educational program, such as Masspro (2007), is needed.
This evaluation could include both a larger representative sample of nursing homes with nurses of varied educational preparation and the mandatory attendance of all nursing staff who administer medications.
Findings could then be generalized across a range of nursing home settings.