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Computerized Adaptive Testing For Nursing Education

By Nancy Lydia Kimmel R.N., Ph.D., C.H.M.M.

Those who are graduate nurses and those who are going into nursing school will soon be sitting for their national boards known as the NCLEX, or taking the N.E.T, the HESI or the TEAS. The state nursing board examinations are computerized and set up to test the candidate’s skill level. In order to pass the NCLEX. the candidate must demonstrate the level of skill required to practice the art of nursing safely in their state. In order to determine this level of skill, the NCLEX. is formatted to adapt to the testers knowledge base.

This type of computerized adaptation is termed, “computerized adaptive testing” or CAT. This type of testing is not new. It has been in use for many years. This is the method that the Graduate Entrance Exams (GRE.) have been using. To better understand how computerized adaptive testing works, think about taking a test where all of the questions are very easy. This type of test does not really test the ability of the tester that knows the material thoroughly. Therefore the tester’s true mastery of the subject is not assessed. Some of the nursing entrance tests are also test via computerized adaptive testing.

It is similar to being in class, where the teacher is asking questions. As the student answers the questions, the level of difficulty continues to increase, until the student reaches a point where they cannot answer a question, then the level of difficulty decreases, and the cycle begins again. This type of testing then does away with the redundancy of questions wherein the level of each is on a plateau, but rather poses questions that challenges the tester’s ability to the point that their true ability of their mastery of the subject matter can be assessed.

Therefore, those student’s, sitting for the NCLEX who are answering easier questions, may find themselves answering more questions than those students who are able to answer the harder questions and thereby have fewer questions. One could say that computerized adaptive testing is geared to each individuals own knowledge base. After each question the tester is scored. Each following question will be chosen to match their skill based on how they answered the previous question. There is a statistical program built into the main program that estimates the tester’s knowledge proficiency. There is a pre-set statistical data base that dictates the percentage of questions that are needed for a graduate nurse to pass or to fail.

“The CAT usually ends when the amount of measurement error around the ability estimate reaches an acceptable level. Low levels of measurement error are required for high-stakes certification tests and indicate that the test would likely produce a similar score if re-administered immediately afterwards. It is not known exactly when the test will shut off or how many questions have to be completed. The computerized adaptive testing usually presents a variable number of questions, and a minimum and maximum number is pre-set.”

Therefore, if the graduate nurse answers incorrectly the easy questions, as well as the more difficult questions, they will be less likely to sit for the entire six hours and their test may shut off after the minimum of seventy five questions. It is the seventy five questions that many graduate nurses are fearful of receiving, because they think that they have failed the NCLEX. If the tester has a good solid knowledge base and has prepared for the test by practicing NCLEX questions, then the seventy five questions shut off is actually a good sign. The score is based upon the level of difficulty that is achieved. This is the methodology that the NCLEX uses to test the nursing school graduates.

The HESI, The N.E.T. and The T.E.A.S. will shut off at a specific length of time, which is usually a 3 hour test. So not all of the questions that one student has, will the other student have. The most important preparation is to begin studying soon and to begin with the right materials that will help you to pass. You can begin to study for your Nurse Entrance Test at the Nurses Learning Center, where you can get immediate access to over 1000 questions and answers, tests are available 24 hours, 7 seven days per week, and you only have to pay a one time fee. This material is set up just like the HESI, The N.E.T. and The TEAS.

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