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Measuring grade inflation: a clinical grade discrepancy score.

Anna L Paskausky1, M Colleen Simonelli2

  • 1William F. Connell School of Nursing, Boston College, 140 Commonwealth Ave., Chesnut Hill, MA, USA; Pioneer Valley Family Medicine, Baystate Health, USA.

Nurse Education in Practice
|March 8, 2014
PubMed
Summary

Nursing education faces grade inflation, where student scores exceed performance. A new "clinical grade discrepancy score" indicates significant inflation, potentially impacting patient safety.

Keywords:
Clinical competenceGrade inflationGradingNursing education

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Area of Science:

  • Nursing Education
  • Academic Integrity
  • Patient Safety

Background:

  • Grade inflation in nursing programs raises pedagogical and safety concerns.
  • It is defined as awarding higher scores than student performance warrants.
  • This issue can potentially compromise patient safety by misrepresenting clinical competency.

Purpose of the Study:

  • To evaluate the relationship between licensure exam-style final written exams and faculty-assigned clinical grades in undergraduate nursing students.
  • To identify evidence of grade inflation within a private undergraduate nursing program.
  • To develop and validate a new measurement for grade inflation, the clinical grade discrepancy score.

Main Methods:

  • A descriptive correlational study was conducted with 281 undergraduate nursing students.
  • The study compared scores from licensure exam-style final written exams with faculty-assigned clinical grades.
  • A novel metric, the clinical grade discrepancy score, was developed to quantify grade inflation.

Main Results:

  • Evidence suggests the presence of grade inflation in the studied nursing program.
  • The clinical grade discrepancy score proved to be an effective indicator of grade inflation severity.
  • A moderate to low correlation (0.357) was found between exam scores and clinical grades.
  • 98% of clinical grade discrepancy scores were positive, indicating likely grade inflation.
  • Approximately 70% of scores showed a discrepancy of at least one letter grade (10 points) between exam and clinical assessments.

Conclusions:

  • Grade inflation is likely present in the evaluated nursing program.
  • The clinical grade discrepancy score is a valuable tool for identifying and measuring grade inflation.
  • Further exploration of grade inflation's prevalence and its implications for patient safety is warranted.