Item development process and analysis of 50 case-based items for implementation on the Korean Nursing Licensing...

Area of Science:

• Nursing Education
• Health Professions Education
• Assessment and Evaluation

Background:

• The Korean Nursing Licensing Examination (KNLE) requires high-quality assessment items.
• Developing case-based items that integrate nursing knowledge is crucial for evaluating clinical reasoning.
• Existing assessment methods may not fully capture the complexity of integrated nursing practice.

Purpose of the Study:

• To enhance the quality of items on the KNLE.
• To develop and evaluate case-based items reflecting integrated nursing knowledge.
• To propose a methodology for future KNLE item development.

Main Methods:

• A cross-sectional observational study was conducted.
• Test item development involved expert workshops, brainstorming, and content validity verification.
• Item appropriateness was evaluated using classical test theory and item response theory on 741 nursing students.

Main Results:

• Fifty case-based items integrating 34 elements of nursing knowledge were developed.
• The mock examination showed low reliability (0.40) with an average score of 57.4.
• Item analysis revealed challenges in item difficulty and discrimination, with only 11 items having a discrimination index above 0.30.

Conclusions:

• Low reliability may stem from test timing and inappropriate item difficulty.
• The study provides a methodological framework for creating future case-based items for the KNLE.
• Further refinement of item characteristics is needed to improve assessment quality.