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Updated: Jun 17, 2026
10:39
Qualitative and Quantitative Validation of Tools with Rating Scales Aimed at Assessing the Quality of University Service-Learning
Published on: August 29, 2025
Assessing the quality of multiple-choice test items.
Sandra L Clifton1, Cheryl L Schriner
1School of Nursing, Lourdes College, 6832 Convent Blvd, Sylvania, OH 43560, USA. cschriner@lourdes.edu
Nurse Educator
|December 17, 2009
Summary
Nursing education must ensure critical thinking is assessed. This study evaluated nursing exams to confirm test items measure higher cognitive levels, crucial for developing critical thinking skills in students.
Area of Science:
- Nursing Education
- Educational Assessment
- Cognitive Psychology
Background:
- Nursing education emphasizes critical thinking development.
- Faculty must ensure assessments align with higher cognitive processing.
- Evaluating existing examination methods is essential for educational improvement.
Purpose of the Study:
- To assess the cognitive learning levels of multiple-choice test items on final nursing examinations.
- To analyze the frequency of items across different cognitive levels within adult health courses.
- To examine the relationship between item difficulty, cognitive level, discrimination values, and distracter performance.
Main Methods:
- Analysis of multiple-choice test items from 3 adult health nursing courses.
- Determination of cognitive learning levels for each test item.
- Comparison of item difficulty and discrimination values against cognitive learning levels.
Main Results:
- Assessment of cognitive processing levels in nursing examination items.
- Analysis of item difficulty and discrimination in relation to cognitive demand.
- Evaluation of distracter performance and its impact on item effectiveness.
Conclusions:
- Findings highlight the importance of aligning nursing test items with higher cognitive processing.
- Recommendations for improving test item quality to better assess critical thinking.
- Implications for nursing faculty in designing and evaluating examinations.
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