course material

1. developing standardized tests
Response 5Please respond to colleages paper and add 1 new item to each paper please.You
will be asked or may even volunteer to participate in developing standardized tests.
Standardized tests have come under scrutiny for their validity and appropriateness.
Examine, compare and contrast two standardized tests used in nursing. Discuss how they
differ in their goals? Discuss how they are used? How is validity achieved? How is security
maintained? The most common tests are the ATI, NCLEX, APTITUDE, TEAS, HESI.. Mary
please describe HESI and NCLEX. Jennifer please describe ATI and EBI – Educational
Benchmarking INC. Post some useful links for your peers. Original posting due 4/5
responses due 4/12. Do not forget to respond to the work of some of your peersThere is
information on the NLN website about “ high Stakes Testing” is important for all to read. Go
to www.nln.org and explore the testing sitesResponse to JenniferOne of the most vivid
memories I have of my accelerated BSN program is studying for a test, every-single-day. In
nursing education, not only is one tested on material taught in various courses and
specialties, one also participates in a standardized test at the end of the program in order to
graduate and then go on to take the most important exam of them all, the NCLEX-RN. This
exam at the end of the program is frequently referred to as an exit exam, which can be
viewed as a high-stakes exam; it is supposed to determine your success rate in the NCLEX-
RN. High-stakes tests, as defined by the American Educational Research Association,
American Psychological Association, and National Council on Measurement in Education
(American Educational Research Association, 1999) is “ a test used to provide results that
have important, direct consequences for examinees, programs, or institutions involved in
the testing” (Spurlock, 2013). The direct consequences for these students would be that
they are held back from graduation and sitting for the nursing boards exam. Some nursing
education programs have implemented progression policies and high-stakes tests to
maintain desirable pass rates by preventing students at risk for failure from taking the
NCLEX-RN (Spurlock, 2013). Desirable pass rates are not what this is all about. Ensuring the
students are learning and truly retaining the knowledge are the key concepts that no one
seems to be focusing on; rather all the attention is placed on these exit exams and the
NCLEX-RN results. Perhaps there is poor instructional quality, disruptive or inadequate
learning environments and lack of effective learning resources (Spurlock, 2013). Also of
note, making important educational decisions based on high-stakes test scores directly
conflicts with the ethics of acceptable test use, as described by the Joint Committee on
Testing Practices- 2004 (Spurlock, 2013). There are several test preparation companies

2. available to the nursing programs with the goal of successful results in the high-stakes
exams. Two companies I will be exploring are: Assessment Technologies Institute (ATI) and
Skyfactor, formerly known as Educational Benchmarking Inc. (EBI).ATI is test-prep
company in Kansas focusing on nursing exams and education. On their website, they boast
their “ real understanding for what it takes to become a nurse” , because a nurse helped
start the company. It goes on to discuss how nursing students are all different and how their
learning systems are designed to teach the way each individual learns. They offer test-prep
for every step of the way through nursing school and yield results “ closer to 100% than any
other education system in the market (https://www.atitesting.com/About.aspx). In
contrast, Skyfactor is a company that focuses on student retention and program
assessments. Evaluation of the student and the program are performed; personalized action
plans are put into place to ensure success of both the student and the program they are
attending. Their website describes their assessment method as direct and indirect, meaning
standardized exams directly measure student performance while indirect measures are
collected through surveys, interviews or course evaluations; through the combination of the
two measures, a campus can determine a holistic view of student achievement and gauge
the efficacy of campus services, initiatives and processes (https://skyfactor.com/nursing-
education/). Both companies have the success of the student as their top priority. However,
it is interesting to see the different approaches and their means to the end goal of high
performance in testing. Skyfactor creates a personalized plan for the student and identifies
risks early enough to connect them with the appropriate resources that will help yield
positive results. ATI provides students with skills lessons, pharmacology flashcards, etc. It
appears to be useful as extra information to prepare for the test, besides what is received in
the nursing program. ATI also offers NCLEX-RN prep and resources for nursing faculty such
as assistance in nursing curriculum development.In standardized testing, validity is an
important component because it refers to whether or not a test measures what it was
intended to measure. There are several forms of validity that are assessed: objective,
construct and content. All three forms correspond to parts of an exam that must be in line
with it’ s original intention, for example, when looking at content validity, one examines the
content provided in the class and exam and how the student responded to the topic in the
exam. Validity in standardized tests is a key component that must not be overlooked. Just as
important is the security and integrity of the exam. Due to the pressure of high scores and
exemplary student performances, many institutions have been stooped as low as cheating
and helping students achieve high grades. Any unusual rises in student performance should
be questioned and monitored for foul-play. Some instructors were discovered after
changing answer sheets or preventing low-scoring students from taking exams (Samuels,
2011). This unfortunate reality is due to the unrealistic expectations of both teachers and
students. For many teachers, their whole performance evaluation is based on student’ s test
grades; poor grades are attributed to a poor performance by the teacher. This system is
obviously broken and needs fixing. Teachers and students alike should feel safe, supported
and encouraged to perform well. The anxiety and stress brought on by standardized testing
has not changed in many years and does not seem to be changing anytime soon. Perhaps it
is up to the new generation to fight the big fight and remove standardized testing from

3. having so much influence on students and teachers. Until then, companies like ATI and
Skyfactor will continue to profit on test prep and their guarantee’ s of student
success.Helpful websites:Website with information about ATI (Assessment Technologies
Institute) https://www.atitesting.com/About.aspxWebsite with information about
Skyfactor (formerly known as EBI- Educational Benchmarking
Inc.)https://skyfactor.com/nursing-education/References:Samuels, C. (2011, August 15).
Experts divide on responses to cheating. Education Week. Retrieved April 3, 2016.Spurlock,
D. (2013). The Promise and Peril of High-Stakes Tests in Nursing Education. Journal of
Nursing Regulation, 4(1), 4-8. Retrieved April 1, 2016.Response to Mary BobekA High
Stakes Exam is any test used to make important decisions about students, educators, and/or
schools for the purpose of accountability (Glossary, 2014). It is important to maintain the
integrity of a High Stakes Exams such as the SAT, GMAT, MCAT, NCLEX, etc. because these
assessment forms are addressing a candidates’ ability to perform within certain roles.
However, from a student’ s perspective, a lot of pressure to succeed is placed on a single
exam which may prompt evolved cheating practices and thus may skew test validity.In one
instance of high-tech cheating, a Medical College Admissions Test (MCAT) candidate used a
pinhole camera to capture images of the test items. The items were transmitted to a co-
conspirator who tricked three tutors into answering the test items. The answers were then
fed back to the candidate via an open phone line (CSB News, 2011; Garcia, 2011).The NLN
(2012) feels that these types of exams are not only to evaluate student achievement, but to
also support student learning, and evaluate and improve teaching effectiveness. The goal of
a test is to effectively gauge abilities so student support to decrease anxiety and pressure
from high stakes testing is also important. The NLN has developed the “ Fair Testing
Guidelines for Nursing Education” to provide a supportive framework for educators and
students (NLN, 2012). Two examples of High Stakes Exams that are used to assess nursing
students are the NCLEX and the HESI.NCLEXThe National Council Licensure Examination
(NCLEX) is the board certification exam for registered nurses. It is administered by
computerized adaptive testing (CAT) which means each candidate’ s examination
experience is tailored to their educational and critical thinking abilities (NCSBN, 2013). The
process functions by estimating a candidate’ s level of understanding by analyzing
previously answered questions. Subsequent questions presented are chosen based upon the
level of difficulty of previously answered questions within the different test plan categories.
Therefore, the exam items range from 75-265 over a six-hour time period and fulfills all test
plan requirements. More difficult questions are more heavily weighted so the test continues
until a pass or fail threshold is achieved.GoalThe Goal of the NCLEX is to measure the
competencies needed to perform safe and effective care as an entry-level registered nurse
(NCSBN, 2013). “ Client Needs” make up the framework of this exam because it provides a
standard structure to guide all nursing actions across all settings. The categories that
compose Client needs are: Safe and Effective Care Environment, Health Promotion and
Maintenance, Psychosocial Integrity, and Physiological Integrity.UsesThe NCLEX
examination is used to, “ assess the knowledge, skills and abilities that are essential for the
entry-level nurse to use in order to meet the needs of clients requiring the promotion,
maintenance or restoration of health” (NCSBN, 2013). The test measures the candidates’

4. ability to apply complex thinking into safe and effective nursing practice.ValidityThis exam
maintains high validity by testing to what it is designed to measure: that the candidate is
prepared to practice safely and effectively as an entry-level registered nurse. The
developers accomplish this by first conducting an analysis that collects data on current
practice. According to the NCSBN,” twelve thousand newly licensed registered nurses are
asked about the frequency and importance of performing 141 nursing care activities”
(NCSBN, 2013). These nursing practices are then analyzed by the frequency of performance,
relationship to client safety, and location. The passing standard of the NCLEX is also re-
evaluated every three years due the fact that nursing is a dynamic carrier and practice
standards may change (National, 2016).The CAT format of testing as mentioned above also
gives this exam a high validity by selectively managing the number of easy and difficult
items that candidates receive. “ Easy” items for high-performing candidates do not
exemplify the range of ability and “ difficult” items for low-performing candidates may
result in guessing, which can skew results (National, 2016). Therefore, by individualizing
the test on candidate ability, the exam can truly measure the candidates potential to provide
safe and effective entry level nursing care.SecuritySecurity is maintained for the NCLEX
from multiple angles. First, the candidate must be eligible to sit for the exam. To be eligible,
the candidate must have graduated from an approved pre-licensure RN program and must
register for the exam. Once eligible, the candidate is sent an Authorization To Test (ATT)
email which allows the candidate to schedule their exam. According to Garcia and Woo
(2011), the secure online registration system to sit for the NCLEX ensures only one
registration exists per person at any given time. Security is maintained at the testing centers
which are approved by the NCSBC. Proctors of the exam must undergo training and up to 40
hours of practice before they administer an examination (Garcia, 2016). While taking the
exam, continuous video monitoring and full sound videos are captured for all
candidates.HESIThe Health Education Systems, Inc. (HESI) is a testing company specializing
in tests for nursing schools in preparation for the NCLEX (HESI, 2016) The test items are
critical thinking questions that are used to measure students’ knowledge of nursing
content and ability to apply concepts to clinical practice. Specifically, the HESI Exit exam is a
160-item comprehensive exam, of which 10 items are pilot items, that is usually given the
final semester or quarter of a nursing program (Zweighaft, 2013).GoalThe goal of the HESI
Exit exam is to assess students’ risk for NCLEX failure and allow for remediation of
deficient areas, thus improving the probability of students’ passing the NCLEX. According
to Zweighaft (2013), as HESI Exit exam scores decreased, the percentage of NCLEX failures
significantly increased. Thus, with preparation for the HESI, assessment of the material, and
subsequent identification of weaker content areas, a student may improve their chances of
passing the NCLEX.UsesAccording to Loop (2016), the HESI is a practice exam, intended on
preparing nursing students to eventually take the NCLEX. The results of the HESI Exit exam
help students and their schools to identify strong and weak areas in knowledge and in the
educational program as well. It allows students to review weak areas before taking the
NCLEX as well as allows schools to integrate areas and reevaluate future teaching plans
(HESI, 2016). Thus, schools are able to identify weaker areas in their curriculum as well and
adjust accordingly.ValidityThe HESI Exit exam maintains a high testing validity by

5. beginning with test items that are written by nurse experts, educators, practitioners, and
researchers which are then submitted to Elsevier for editing. According to Elsevier (2016),
item and test statistics are used for exam creation and maintenance. This allows for exit
exams that consistently match the blueprint and best practices in testing. Also, course
syllabi from nursing schools across the U.S. are reviewed by Elsevier’ s test item creators at
least three times a year to ensure that current content is included. The test items are then
piloted on various HESI exams and are edited again based on item analysis data. The
validity has been established by nine studies which have found that the HESI Exit exam is
96.36% to 99.16% accurate in predicting NCLEX success (Zweighaft, 2013).SecuritySecurity
is maintained by the HESI administrators by a multifactorial approach. According to
Elsevier, one-third of each exam is refreshed up to three times a year, maintaining the
security of test banks. Proctors are required at all exam sessions. The HESI, similar to the
NCLEX, is also a computer based exam and can only be accessed through a secure web
browser that locks out other applications on the computer. Exam questions and options are
randomized and most exams have two or more parallel versions. HESI exams have
restricted IP addresses which allow exam connection only from designated computers. New
test items are continuously being evaluated and before each exam, each student must agree
to access the exam in a responsible, secure manner and protect their personal user name
and password (Elsevier, 2016).High Stakes Tests such as the NCLEX and HESI are designed
to predict entry level nursing success and safe practice. They both hold a high validity
supported by empirical data analysis and both successfully meet their assessment goals
while maintaining a high level of security. The HESI can be additionally used as a supportive
tool to show weak student knowledge levels, thus improving success probability on the
NCLEX which may decrease anxiety and pressure related to the nursing board
exam.Additional
Linkshttps://www.ncsbn.org/Role_of_Security_in_Todays_Testing_Programs.pdfhttps://w
ww.ncsbn.org/2013_NCLEX_RN_Detailed_Test_Plan_Candidate.pdfhttps://www.ncsbn.org/
1216.htmhttps://www.nln.org/docs/default-source/advocacy-public-policy/fair-testing-
guidelines.pdf?sfvrsn=2https://evolve.elsevier.com/…/pdf/Elsevier_HESIExam_ab4.pdfRef
erencesGarcia, M., M.ed, & Woo, A., PhD. (2011). The Role of Security in Today’ s Testing
Programs. CLEAR Exam Review, XXII(2), 16-19. Retrieved March 24, 2016, from
www.ncsbn.org/Role_of_Security_in_Todays_Testing_Programs.pdf.Elsevier. (2016). HESI
Exam Security. Retrieved March 29, 2016, from
https://evolve.elsevier.com/…/pdf/Elsevier_HESIExam_ab4.pdfLoop, E. (2016). What is the
Difference Between the HESI & NCLEX Exam? Retrieved March 29, 2016, from
https://education.seattlepi.com/difference-between-hesi-nclex-exam-4114.htmlNational
Council of State Boards of Nursing. (2016). Computerized Adaptive Testing (CAT) | NCSBN.
Retrieved March 24, 2016, from https://www.ncsbn.org/1216.htmNCSBN. (2013). 2013
NCLEX-RN® Detailed Test Plan [Pamphlet]. Chicago, IL: National Council of State Boards of
Nursing.https://www.ncsbn.org/2013_NCLEX_RN_Detailed_Test_Plan_Candidate.pdfNLN.
(2012). Fair Testing Guidelines for Nursing Education. Retrieved March 31, 2016, from
https://www.nln.org/docs/default-source/advocacy-public-policy/fair-testing-
guidelines.pdf?sfvrsn=2The Glossary of Education Reform. (2014, August 18). High-Stakes

6. Test Definition. Retrieved April 01, 2016, from https://edglossary.org/high-stakes-
testing/The HESI Exam and the NCLEX. (2016). Retrieved March 29, 2016, from
https://www.easynclex.com/hesi-nclex.htmlZweighaft, E. L. (2013). Impact of HESI
Specialty Exams: The Ninth HESI Exit Exam Validity Study. Journal of Professional Nursing,
29(2), S10-S16. Retrieved March 31, 2016, from
https://www.professionalnursing.org/article/S8755-7223(12)00135-4/pdf