Evaluation in Nursing Education - 5328

Felicia Coleman, Stacy Gallegos, Stephanie Crowe

Fall 2014

What competency is
being assessed by this
question?

Critical Thinking MCI

Multiple Choice Items Quick Guide

Advantages

Multiple Choice Items (MCI) are used to test a broad range of learning outcomes and assess various
cognitive levels. MCI serves as an objective measurement of student achievement and can be utilized
by the teacher for data analysis. Relevance of MCI is guided by specific learning outcomes.

-Provides accurate
and efficient
scoring

-Serves as practice
for
licensure/certificait
on
Guidelines for STEM
-Clearly present the problem in question or
completion format.
-Avoid extraneous information; unless intended
for learning outcome.
-Do not use stem to teach. The goal is to assess
learning outcomes.
-Eliminate key words that may provide as a cue
to correct answer.
-Avoid negatively phrased wording; construct
item to ask for correct answer rather than
incorrect response.
-Avoid ending stem with completion format with
a or an these words provides cues to the
student.
-Develop incomplete stem format with
alternative at the end of sentence.

-Time consuming
to develop
-susceptible to
student guessing
the answer

Can this question be

revised to allow the
student to use critical
thinking?

Is this particular item

important for safe
entry-level practice?

Using the Nursing Process to ask Critical Thinking Questions

Limitations

-Asses a variety of
desired learning to
meet course
objetives

-More difficult to
write/develop

Just recalling information is not

enough. Student should use recall
and analysis to answer the question.
Tests banks are valuable resources,
but make sure they meet criteria by
asking three questions:

Guidelines for OPTIONS

-Develop options or alternatives that are

clear, concise, and similar in length detail and
complexity.

Examples included
1. Assessment - A nurse assesses a patient that has (diagnosis). What additional information and data
should the nurse obtain?
2. Analysis A patient who has (diagnosis), says to the nurses (insert comment). The nurse should recognize
this statement indicates (insert comment).
3. Planning Which of these actions should be the priority in the care plan for a patient who has (diagnosis)?
4. Implementation - A patient has been prescribed (medication). A nurse should inform the patient to be
aware and report the following side effects.
5. Evaluation A nurse instructs a patient about (Diagnosis, procedure or medication). Which statement by
the patient indicates the patient has (correct/incorrect) understanding?

-Option should contain same number of

parts, and grammatically consistent with
each other and the stem.
-Keep options succinct; particularly keep
options shorter than one line and shorter
than the stem.
-Develop options that are homogenous;
sample the same domain of learning or
content area.

-To avoid reading time move repeated words

to the stem.
-To provide plausibility, construct items that
are homogenous.
-Acceptable to use 3 and/or 4 option items on
a test; key is to write a plausible distractor.

Basic Style Guide

-Write all items in the present tense. Avoid passive voice
-Use consistent punctuation.
-Dont ask, what should you do? Ask What should the nurse do
-Use should, not would.

The impact of NCLEX

Determines which graduates will be allowed to practice nursing
Influences nursing programs that prepare graduate nurses
The pass rate may influence the way in which students prepare to enter their chosen profession

DEVELOPMENT OF NCLEX
Practice analysis used to define a professional practice in terms of the actual activities that a new
practitioner must be able to perform
- The practice analysis is performed on a 3 yr cycle and the test plans are changed based on the findings.
- The test plans include four categories of client needs: Safe Effective Care of Environment, Health
Promotion and Maintenance, Psychosocial Integrity, and Physiological Integrity.
The test plans also include processes that are fundamental to the practice of nursing: Nursing Process,
Caring, Communication and Documentation, and Teaching/Learning
Characteristics of NCLEX
-Cognitive levels: applying knowledgeNCLEX items are designed to measure higher-order thinking ability
Critical thinking ability: items are developed to require students to apply problem solving and critical
thinking ability, prioritize situations, make judgments based on criteria, or combine elements to make a
decision.
Alternate Formats: alternate items includefill in the blank, point and click, multiple response,
chart/exhibit, and drag and drop

-Use consistent terms: patient or client, prescription or order, physician or health care provider
-Be careful with signs and symptoms: Sign is an objective finding that is observed by examiner. Symptom is
subjective indication perceived by client.
-Label all laboratory values and vital signs, use both Fahrenheit and Centigrade when reporting temperature

References:

McDonald, M.E. (2014). The Nurse Educators Guide to

Assessing Learning Outcomes ( 3rd ed.). Burlington, MA:
Jones & Bartlett Learning