Testing in Undergraduate Nursing Education

Table of Contents

Literature Review

A recent article by Carter and Dickieson (2010) explores the relationships between an assessment tool called scenario testing and students’ satisfaction with the educational process as well as their grades. The researchers used feedback forms with semi-structured questions and students’ final grades as their main data collection tools. The findings of the study reveal that scenario testing is an effective assessment method for a learning experience (Carter & Dickieson, 2010). Taking into consideration the fact that the majority of students reported having an increased level of confidence, it could be argued that scenario testing is a powerful tool for creating more secure learners. Moreover, numerous students’ comments suggest that “probing-type questions by the teachers” (Carter & Dickieson, 2010, p. 69) are conducive to the development of critical thinking skills. Therefore, scenario testing has a significant potential for transforming the current approach to nursing education.

An innovative approach to the partnership between health care facilities and educational organizations could become a viable solution for enhancing the quality of nursing students’ training. An article by Goodwin and Jenkins-Weinrub (2015) suggests that students participating in an academic practice partnership program in groups of three are more likely to report being satisfied with the experience than individual students. Moreover, placing students in triads allows them to try the roles of project leader, information specialist, and quality analyst (Goodwin & Jenkins-Weinrub, 2015). Taking into consideration the current trend of nurses pursuing higher degrees, it could be argued that more health care organizations should engage in collaborative partnerships with educational organizations in order to “prepare a well-educated workforce for crucially evolving roles” (Goodwin & Jenkins-Weinrub, 2015, p. 201).

There is ample evidence suggesting that newly employed RN graduates do not possess the skills necessary to provide high-quality health care services. An article by Rice (2015) explores the relationships between clinical competence, self-efficacy, and emotional intelligence (EI). The findings of the study reveal that a high level of EI is associated with job satisfaction, organizational citizenship, and personal achievement (Rice, 2015). Moreover, the research proved that EI is positively correlated with self-efficacy. According to Rice (2015), self-efficacy boosts the efficiency of clinical performance; therefore, all nursing programs should provide their students with methods and approaches necessary for increasing efficacy beliefs. The research results correspond with previous studies focused on the personality factors influencing the quality of clinical performance (Rice, 2015).


There are many methods for testing student’s learning in nursing education programs. However, not all assessment tools are suitable for evaluating clinical performance and “higher-level cognitive skills” (Oermann & Gaberson, 2012, p. 79) in a nursing environment. True-false tests include statements that have to be assessed by students as either true or false. These tests are extremely efficient because not only do they help students to recall specific facts, they can also assist in evaluating students” comprehension of principles. However, the opponents of true-false tests argue that they open the opportunity for guessing (Oermann & Gaberson, 2012). True-false tests could be altered to require students to provide a rationale for their choices. In this way, they could be used for assessing complex thinking in this week’s assignment.

Another type of testing that could be used at a practicum site is the matching exercise. It helps to measure students’ ability to identify different categories, classifications, and groupings (Oermann & Gaberson, 2012). The major disadvantage of matching exercises is that they put too much emphasis on recalling specific information; therefore, they do not help to measure the understanding of complex principles. Matching exercises could be altered to include an “unequal number of premises and responses” (Oermann & Gaberson, 2012, p. 81) in order to reduce the chances of guessing.

Multiple-choice tests could also be effectively applied to measuring learning outcomes in this week’s assignment. Multiple-choice tests could assess students’ knowledge in the following areas: analysis of data, comparison of different interventions, understanding of content, comprehension of principles as well as “judgments and decisions about actions to take in clinical and other situations” (Oermann & Gaberson, 2012, p. 85). However, these tests are known to be extremely difficult to construct. Multiple-choice tests might be changed to include short essays in which students could develop rationales for their answers.

Multiple-response tests have the same advantages and disadvantages that multiple-choice tests do. However, they are more versatile; therefore, they could be used for assessing “the application of nursing knowledge in simulated clinical situations and analytical thinking” (Oermann & Gaberson, 2012, p. 103). They could also be altered to include short answers developing rationales for choosing particular answers.

Student Grades

The issue of the importance of continuous assessment of learning during the educational process has been discussed at length by numerous educationalists and scholars (Carter & Dickieson, 2010). Even though there is no denying that feedback is essential for the facilitation of students’ learning, it is important to assess to how much focus should be placed on grades. Taking into consideration the fact that “the relationship between assessment and learning is often problematic” (Hernández, 2012, p. 489), because the former plays a formative role in the latter, it is necessary to explore the connection between different valuation methods and academic achievement. A recent article by Hernández (2012) suggests that different assessment methods could perform both formative and summative functions in higher education. According to Heywood and Trotter, continuous assessment trough the provision of grades “encourages students to learn on an on-going basis” (as cited in Hernández, 2012, p. 490). A study conducted by Hernández (2012) reveals that the majority of educators, in addition to grading progress, provide their students with comments on assessed papers. Moreover, most of the students participating in the study believe that grading plays an important pedagogic function. The results of the study are consistent with previous research and indicate that grades combined with either oral or written feedback facilitate students’ learning.

Educator-Made Tests

Many educators use test banks in order to evaluate students’ knowledge in different content areas; however, standardized tests do not always help accurately assess specific outcomes, objectives, and competencies (Gareis & Grant, 2015). Even though the preparation of educator-made tests focused on particular content domains is a time-consuming process, it could be argued that it is extremely beneficial for precise measurement of students’ learning and progress (Frost, n.d.). Taking into consideration the fact that instructors often provide students with information that is not included in their textbooks, standardized tests do not concentrate on knowledge that learners gain from other sources.

Therefore, educator-made tests more accurately assess what has been taught during a course (Gareis & Grant, 2015). Moreover, customized tests allow instructors to have more control over the format of assessment. Educators could choose between different types of tests in order to determine which of them are more suitable for evaluating comprehension of the specific material. Furthermore, customized tests allow instructors to respond to the special needs of their students (Gareis & Grant, 2015). Even though educator-made tests could be effectively used for precise evaluation of the instructional process, they cannot be applied for assessing students’ achievement across different educational institutions. Moreover, sometimes it might be difficult to choose suitable content for assessment because “the domains of achievement in nursing education involve complex understandings and integrated performances” (Oermann & Gaberson, 2012, p. 29).

Test Security

All educators are responsible for maintaining test security by making sure that nobody gains unauthorized access to them. It is essential that instructors protect test materials during the process of creation, reproduction, storing, administering, and scoring in order to prevent dishonest students from obtaining “higher scores than they deserve” (Oermann & Gaberson, 2012, p. 194). Therefore, they have to be stored in areas that can be only accessed by authorized personnel. All tests in digital format must be protected with encryption of passwords. Taking into consideration that the security of tests is essential for distinguishing real academic success from failure, it is necessary to ensure that unauthorized individuals cannot see test materials while they are being either created or reproduced. To this end, it is necessary to destroy printed drafts by “shredding pages rather than discarding them in trash or recycling receptacles” (Oermann & Gaberson, 2012, p. 194). In order to reduce the opportunities for cheating, an educator might present test items in a different order while administering tests to large groups. However, random sequencing of questions might lead to the creation of different forms of a test that are not consistent with principles of assessment (Oermann & Gaberson, 2012).


Carter, L., & Dickieson, P. (2010). Scenario testing in undergraduate nursing education: assessment for learning. The Canadian Journal for the Study of Adult Education, 22(2), 65-76.

Frost, S. (n.d.). The advantages of teacher-made tests. Web.

Gareis, C., & Grant, L. (2015). Teacher-made assessments (2nd ed.). Larchmont, NY: Eye On Education.

Goodwin, M., & Jenkins-Weinrub, E. (2015). Student triads: a collaborative approach to practicum experiences for master’s nursing students. Nurse Educator, 40(4), 199-202.

Hernández, R. (2012). Does continuous assessment in higher education support student learning? Higher Education, 64(4), 489-502.

Oermann, M., & Gaberson, K. (2012). Evaluation and testing in nursing education. New York, NY: Springer.

Rice, E. (2015). Predictors of successful clinical performance in associate degree nursing students. Nurse Educator, 40(4), 207-211.