This document discusses different types of test items used in nursing education, including short-answer and essay questions. Short-answer items include fill-in-the-blank and completion questions that test for factual information. When writing short-answer items, the question should require a single unique answer. Essay items require students to develop their own answers and can test higher-level learning. Essay items can be restricted-response or extended-response. Scoring of essay items should be done anonymously using rubrics or ideal answers to ensure reliability and validity of scoring.

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Chapter 6
Short-Answer
(Fill-in-the-Blank)
and Essay
&Oermann Gaberson
Evaluation and Testing in Nursing Education
4th edition

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Short-Answer (Fill-in-the-Blank)
♦ Answered by word, phrase, or number
♦ 2 types: question and completion
(fill-in-the-blank)
♦ Less affected by guessing than true-false
♦ Tests mainly for factual information
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Writing Short-Answer Items
♦ Word the question to require a single
unique answer
♦ Think of intended answer first
♦ Avoid clues to correct answer
♦ Avoid verbatim statements from a text
♦ If using sentence-completion variety, place
blank at the end of the sentence
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Completion Example
What congenital cardiac defect results in
communication between the pulmonary artery
and aorta? ____________
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Completion Example
Three physiological changes that occur with
aging are:
1._________
2._________
3._________
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Fill-in-the-Blank Example
You are caring for a patient who weighs 156 lb.
She is ordered 20 mcg/kg of an IV medication.
The correct dose in micrograms is ___________.
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Essay Items
♦ Requires students to develop their own
answers to questions
♦ Opportunity to:
– Select content to discuss
– Present ideas in own words
– Develop original and creative response to
question
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Uses of Essay Items
♦ Testing
– Complex learning outcomes
– Higher-level learning, not recall
– Content not appropriate for objectively
scored items
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Levels of Essay Items
♦ Low level
– Similar to short-answer
– Precise answer
♦ Example
Describe three signs of increased intracranial
pressure in children under 2 years old.
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Levels of Essay Items
♦ High level
– Responses are not limited as with low level
♦ Example:
Defend the statement “Access to health care is a
right.”
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Types of Essay Items
♦ Restricted response
♦ Extended response
→ Difference is based on extent of freedom in
responding to essay item
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Restricted-Response Essay Item
♦ Limit answer by
– Specifying content to be discussed
– Restricting amount of discussion allowed
• “Answer in one paragraph” or “one page”
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Examples
1. Define patient-centered care. Limit your
response to one paragraph.
2. Compare metabolic and respiratory
acidosis. Include the following in your
response: definitions, precipitating factors,
clinical manifestations, diagnostic tests, and
interventions.
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Example
3. A patient is 76 years old and 1 day
postoperative femoral popliteal bypass graft.
Name a major complication the patient could
experience at this time. List two nursing
interventions for this patient during the
initial recovery period with related evidence.
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Extended-Response Essay Items
♦ Less restrictive
♦ Opportunity for students to choose content
for answer, integrate learning from multiple
sources, organize ideas
♦ Assess higher-level learning
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Writing Essay Items
♦ Assess knowledge of content, not writing
ability
♦ Frame the problem so that students know
what to write about
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Example
1. Select an article describing a nursing
research study. Critique the study, specifying
the criteria used. Based on your evaluation,
describe how the research findings could be
used in clinical practice.
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Example
2. In the clinic you note that patients who are
uninsured receive fewer diagnostic tests and
less comprehensive care than patients with
similar health problems who are insured.
Analyze these differences in care and related
issues.
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Issues With Essay Tests
♦ Limited ability to sample course content
♦ Low reliability of scoring
♦ Item-to-item carryover effect
– Impression of quality of one response carries over
to next question
– Read all responses to one item before evaluating
next one
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Issues With Essay Tests (cont’d)
♦ Test-to-test carryover effect
– Impression of student carried from one test to next
♦ Halo effect
– Teacher’s general impression of a student
influences scoring of test
♦ Essay tests should be scored anonymously
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Issues With Essay Tests (cont’d)
♦ Effect of writing ability
– Rating influenced by sentence structure,
grammar, spelling, punctuation
– Longer answers often receive higher scores
regardless of content
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Issues With Essay Tests (cont’d)
♦ Rater drift
– Essay tests read early may be scored higher than
those read near the end
– Rater drift: stray from scoring criteria
– Read papers in random order
– Read each answer twice before scoring
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Issues With Essay Tests (cont’d)
♦ Usability
– Allow more time for students to answer and
teacher to score
♦ Student choice of essay items
– May affect measurement validity
• Students taking different tests
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Scoring Essay Items
♦ Two methods
– Holistic (global-impression)
– Analytical
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Holistic Scoring
♦ Read entire answer and evaluate its overall
quality
♦ Ways to score
– Relative standard
– Model answer
– Scoring rubric
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Analytical Method
♦ Identify elements required in ideal answer
♦ Each element must be included in answer
♦ Evaluate and score each element separately
rather than overall response
– Scoring rubric
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Scoring Essay Items
♦ Identify method of scoring
♦ Construct ideal answer and how to score it
♦ Evaluate:
– Content
– Organization
– Process
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Ideal Answer
♦ Write ideal answer while drafting essay item
– Save for use in scoring
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Scoring Essay Items
♦ Check your ideal answer
– Read random sample of papers
– Score answers to one item at a time
• Compare responses across students
♦ Alter ideal answer and scoring criteria if
needed
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Scoring Essay Items (cont’d)
♦ Use same scoring system for all papers
♦ Read each answer twice before scoring
♦ Read students’ responses in random order
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Scoring Essay Items (cont’d)
♦ Read anonymously
♦ Cover scores to previous answers
♦ If possible, have colleague read and score
– Improves reliability
♦ Adopt policy on scoring writing ability
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Prepare Students for Essay Tests
♦ Ask thought-provoking questions
♦ Use sample essay items to review content
before test
– Discuss ideal answers with students
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Prepare Students for
Essay Tests (cont’d)
♦ Students practice responding to sample items
in small groups
– Pass answers to next group to critique
– Have students score responses
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