The document discusses the importance and processes of evaluation and assessment in nursing education, detailing its role in measuring student progress and effectiveness in achieving educational goals. It explores various types of evaluations, including formative and summative assessments, along with different techniques and their purposes in enhancing student learning and instructional methods. The paper emphasizes that evaluation is a continuous process aimed at identifying strengths, weaknesses, and areas for improvement in both students and educational systems.

1. EVALUATION AND
ASSESSMENT IN
NURSING
Prof. B.KAVITHA M.SC(N)
Vice Principal
Aswini College of Nursing
Thrissur

2. INTRODUCTION
• Evaluation is part of life, in our life we need to make evaluation frequently – like which dress you want
to wear in marriage – What you want to give in gift to your friend.
• In educational scenario evaluation have important role in judging student progress to know up to what
extent student have achieved the desired set goal.
• The word ‘assess’ comes from the Latin verb ‘assidere’ meaning ‘to sit with’. Assessment can focus on
the individual learner, the learning community (class, workshop, or other organized group of learners),
the institution, or the educational system.

3.  Evaluation is such an essential part of teaching and learning. Evaluation in
education is the process of judging the effectiveness of educational experience
through careful appraisal or involves measurement but is different from it.
 Measurement is appraisal in terms of a fixed standards whereas an evaluation
implies the use of relative and flexible standards. Educational evaluation is
made in relation to the objectives that have been determined previously by
faculty, individual teacher and student.

4. DEFINITIONS
EVALUATION:
“ It is a process of making judgment that to be used as a basis for planning. It consists of
establishing goals, collecting evidence concerning growth or lack of growth towards goals,
making judgments about the evidence and revising procedures and goals in the light of the
judgments.” ___ Wiles
“ It is the process of determining to what extent the educational objective are being
realized.” ___ Ralph Tylor
“ It is a systematic examination of educational and social programs.” ____ Conbach

5. DEFINITIONS
ASSESSMENT:
“Assessment is the process of documenting, usually in measurable terms,
knowledge, skill, attitudes, and beliefs.” “Assessment in education is the
process of gathering, interpreting, recording, and using information about
pupils’ responses to an educational task.” ___ Harlen, Gipps, Broadfoot,
Nuttal,1992

6. NATURE OF EVALUATION
Evaluation in educational context implies broad programme that examines
achievements, attitude, interests, personality, traits and skills factors which are taken
into consideration. Thus cognitive, affective and psychomotor learning outcome is
measured in the evaluation process. The evaluation is a two part process. The first
part of evaluation is the determination of what is to evaluate (Goal) and the second
part is the judgment of whether the goals are being achieved.

7. PURPOSES OF EVALUATION
The overall purpose will be to provide information to enable each student to develop
according to his potential with in the frame work of educational objectives. Bloom
stated the following purposes:-
1) To discover the extent of competence through which the student have developed in
initiating, organizing and improving his/her day to day work and to diagnose his/her
strength and weakness with a view to further guidance.
2) To appraise the status of and changes in student’s behaviour.
3) To assess the student’s progress from time to time and disclose student’s needs and
possibility.

8. PURPOSES OF EVALUATION
4) To predict the student’s future in academic success.
5) To provide basis for modification of the curriculum and course.
6) To motivate students for better attainment and growth.
7) To improve instructional and measuring devices.
8) To locate areas where remedial measures are needed.

9. PURPOSES OF EVALUATION IN
NURSING EDUCATION
To determine the level of knowledge and understanding of the students at
various times.
 To determine the level of student’s clinical performance at various stage.
 To diagram each student’s strength and weakness and to suggest remedial
measures.
 To encourage student’s learning by measuring their achievement and inform
them their success.

10. To help students to acquire the attitude of and skills in self evaluation and
self directing in their study.
 To provide motivation in practicing critical thinking, the application of
principle, the making of judgment, etc.
 To estimate the effectiveness of teaching and learning technique, of
subject content and instructional media in reaching the goals.
 To gather information for administrative purpose such as selecting
students for higher courses, placement of students for advanced training, etc.

11. SCOPE OF EVALUATION
Certification Feedback
Monitoring the
program
Safeguarding
the public
Baseline for
guidance and
counselling
Placement and
promotion in
job
Development
of tools and
techniques
Appraise the
methods of
instructions.

12. CHARACTERISTICS OF
EVALUATION
1. Continuous process.
2. Includes academic and non academic subjects.
3. Procedure for improving the product.
4. Discovers the needs of an individual student and to design learning experience that will
solve their needs.
5. Correlation between the educational system and the system of evaluation.
6. Complex process which need scientific techniques and tools.

13. PRINCIPLES OF EVALUATION :
Evaluation is most effective when based on sound operational principles. The
following principles stated by Gronlund provide a framework within which the
process of evaluation may be viewed.
Determining and clarifying what is to be evaluated always has priority in the
evaluation process: The objectives must be clearly stated before evaluation is
made.
Techniques should be selected in term of the purposes to be served.
Evaluation is a means to an end and not as end itself.

14.  Comprehensive evaluation requires a variety of evaluation techniques. No single
evaluation technique is adequate to evaluate various outcome.
 Proper use of evaluation techniques require an awareness of their limitations as well
as their strength.
 Evaluation procedures must contribute to improved decisions of instruction, guidance
and administrative nature.
 Adequacy of experience should be made in terms of excellence of performance and
quality of experience.
 Record for practice should reflect the objectives of practice and give evidence to the
extent of achievement of these objectives.

15. OBJECTIVE BASED
EVALUATION

16. OBJECTIVE BASED EVALUATION
Instructional
objectives
Evaluation
Learning experience
or instruction
provided
OBE is a widely accepted
concept among teachers
It depicts the relationship
between Instructional
objectives, Evaluation &
Learning experience or
instruction provided

17. FUNCTIONS OF EVALUATION
FUNCTIONS
RELATED
TO
INSTRUCTIONS
PROCESS
•Measurement function
•Diagnostic function
•Guidance and remediations
•Motivating functions
•Assessment of final output
•Classification and placement
•Prognosis , prediction and
selection
FUNCTIONS
RELATED
TO
TOTAL
EDUCATIONAL
SYSTEM
•Improvement of inputs and
process of education
•Maximization of the
output(i.e. student
Development)

18. TYPES
OF
EVALUATION
Based on frequency
of conducting
evaluation
Summative
evaluation
Formative
evaluation
Based on nature of
measurement
Maximum
performance
evaluation
Typical
performance
evaluation
Based on method
of interpretating
result
Criterion –
referenced
Evaluation
Norm – referenced
evaluation

19. FORMATIVE EVALUATION
1.It is used to monitor the learning process of students during the period of
instruction.
2.It provides continuous feedback to both teacher and student concerning
learning successes and failure while instruction is in process.
3.Feedback to students provides reinforcement of successful learning and
identifies the specific learning errors that need correction.
4.Feedback to teacher provides information for modifying instruction and for
prescribing individual and group remedial work.

20. FORMATIVE EVALUATION
1. It aims at improvement of instruction.
2. It is concerned with the process of development of learning
3. Cornback is the first educationist who said that the greatest service
evaluation can perform is to identify aspects of the course where
education is desirable.
4. It is a positive evaluation because it attempts to create desirable learning
goals and tools for achieving such goals.

21. TYPES OF FORMATIVE
EVALUATION
1. Diagnosing- It is concerned with determining the most
appropriate method or instructional materials conducive
to learning.
2. Placement- It is concerned with finding out the position of
an individual in the curriculum from which he has to start
learning.
3. Monitoring- It is concerned with keeping track of the day

22. CHARACTERISTICS OF
FORMATIVE EVALUATION
 It is an integral part of learning process.
 It occurs frequently during the course of instruction.
 Its results are made immediately known to the learners.
 It may sometimes take teacher’s observation only.
 It reinforces learning of the students.
 It pinpoints difficulties being faced by weak learners.
 Its result can not be used for grading or placement

23. Examples Of Formative Evaluation
Monthly Test
Class Test
Periodical Assessment
Teacher’s Observation Etc.
 It helps in modification of instructional strategies including
method of teaching immediately.
 It motivates learners; as it provides them with knowledge of
progress made by them.
 It sees the role of evaluation as a process.
 It is generally teacher made test
 It does not take much time to construct

24. SUMMATIVE EVALUATION
 It is done at the end of the course of instruction to know to what extent
the objectives previously fixed have been accomplished.
 Its main objective is to assign grades to the pupils.
 It indicates the degree to which the students have mastered the course
content.
 It helps to judge the appropriateness of instructional objectives.
 It has danger of making negative effects. This evaluation may brand a
student as a failed candidate, and thus causes frustration and setback in
the learning process of the candidate.

25. THE FUNCTIONS OF
SUMMATIVE EVALUATION
Crediting- It is concerned with collecting evidence that a learner has
achieved some instructional goals in respect to a defined curriculum.
Certifying- It is concerned with giving evidence that the learner is able to
perform a job according to the previously determined standards.
Promoting- It is concerned with promoting pupils to next higher class.
Selecting- Selecting the pupil for different courses after completion of a
particular course structure.

26. CHARACTERISTICS OF SUMMATIVE
EVALUATION
 It is judgemental in character in the sense that it judges the
achievement of pupils.
 It views evaluation ‘as a product’, because its chief concern is to point
out the levels of attainment.
 It may or may not motivate the learners. Sometimes it may have
negative effects.
 It is terminal in nature as it comes at the end of the course of
instruction.
 It reinforces learning of the students who has learnt an area.
 Its result can be used for placement and grading purposes
 It does not pin point difficulties faced by the learner.
Examples of summative
evaluation
Traditional school and
university examinations. -
Standardised tests.
Teacher made tests.

27. MAXIMUM PERFORMANCE EVALUATION
& TYPICAL PERFORMANCE
EVALUATION
Maximum Performance Evaluation:
 Determines what individual can do when performing at their best.
 Evaluating the person’s abilities and individual performance during motivation
 Aptitude and achievement tests are useful in measuring maximum performance
Typical Performance Evaluation:
 Individuals performance under natural conditions i.e their typical behavior
 Individuals performance during routine and normal situation
 Attitude tests, personality inventories and observational techniques will help
measure typical behavior

28. CRITERION- REFERENCED
EVALUATION
 A criterion-referenced test is used to ascertain an individual’s status with respect to a
defined achievement domain.
 It is concerned with the performance of an individual in terms of what he can do or
the behaviour he can demonstrate.
 In this evaluation there is a reference to a criterion but there is no reference to the
performance of other individuals in the group.
 In it we refer an individual’s performance to a predetermined criterion which is well
defined.
 It is objective based test.
 It includes the entire terminal behaviour that is supposed to be shaped through the
programme .
 It is not the test of grading the students rather it is a test designed to measure the
extent to which students have mastered their learning outcomes

29. NORM- REFERENCED
EVALUATION
• A norm referenced evaluation test is used to ascertain an
individual’s status with respect to the performance of other
individual on that test.
• Here measurement act relates to some norm, group or a
typical performance.
• It is an attempt to interpret the result in terms of the
performance of certain group
• It is used by teachers to differentiate and classify among
students of some defined group like age or grade.
• In it comparison of students is relative rather than
absolute.

30. FEATURES
It is used for
discriminating students who have different
backgrounds
Classifying the students for the purpose of selection in
some course
As a guideline for students
Promoting the students in higher class
The selection of employees by the employers
Counsellors and guidance workers
Teachers to rank the students

31. CONTINOUS
COMPREHENSIVE
EVALUATION

32. CONTINOUS COMPREHENSIVE
EVALUATION
1.It is an approach that aims at assessing those attributes which cannot
be assessed through one- attempt written examination
2.The National Policy of Education 1986 also looks at student
assessment as a device for bringing about qualitative improvement in
education suggested the introduction of CCE
Evaluation
Variety of tools and
techniques are used
to assess and
evaluate the
student’s progress
Comprehensive:
Mental, emotional
and physical aspects
of the student’s
progress i.e. all-
round development
of the student
Continuous
Regular and
Continuous
throughout the year
to achieve all round
development

33. CHARACTERISTICS OF CCE
• To improve learning and diagnosis of weakness so that
remedial measures can be provided
• Both scholastic and non scholastic aspects of pupils
growth are evaluated
• It carry out the formal evaluation of the teachers in
school
• Provides the multiple techniques of evaluation
• It evaluates the total teaching –learning programmers
• It gives evidence on three different ways – self reference,
criterion – referenced, Norm-referenced

34. STEPS IN EVALUATION
DEFINING THE
ACCEPTABLE LEVEL
OF PERFORMANCE BY
WAY OF STATING
EDUCATIONAL
OBJECTIVES
DEVELOPMENT AND
USE OF APPROPRIATE
MEASURING
INSTRUMENTS TO
MEASURE LEARNING
OUTCOMES
INTREPRETATION OF
COLLECTED DATA
FORMATION OF
JUDGEMENT
REGARDING THE
FINDINGS AND
TAKING APPROPRIATE
ACTIONS

35. CRITERIA FOR SELECTION OF
ASSESSMENT
TECHNIQUE/METHOD
1.Congruent with
educational objectives
Objectivity Practicability
Constructed on wide
curricular content
Clear & Comprehensive Concise & Precise
Relevance Adequate & Appropriate Understandability
The power of
discrimination
Validity of assessment
instrument
Reliability of assessment
in instrument

36. TECHNIQUES AND TOOLS OF
EVALUATION
•Essay type questions- Extended response essay & Restricted response essay
•Short answer questions-Fill in the blank type, statement completion, Labelling a diagram & short
answer in 5- 10 words
•Objective type Questions- Multiple choice questions, multiple response questions, True & False
questions and Match the following questions
ASSESSMENT
OF
KNOWLEDGE
•Observation, checklist, Rating Scale & Anecdotal Record
•Cumulative Records, writing clinical examinations, critical Incident record& Viva Voce Oral
Examination
•Objective Structured Clinical Examination (OSCE) & Objective Structured Practical Examination
(OSPE)
ASSESSMENT
OF SKILL
•Likert Attitude scale
•Sematic differential scale
ASSESSMENT
OF ATTITUDE

37. ASSESSMENT
OF
KNOWLEDGE
Essay type questions
Short answer
Objective type

38. ESSAY TYPE QUESTIONS
1.It is a test containing questions requiring the student to respond in writing.
2. It emphasizes recall rather than recognition of correct alternatives.
3. The student prepares his/her own answers.
4.Handwriting, spellings, neatness, organization are also considered in scoring.
5.An essay test presents one or more questions or either tasks that require extended written
responses from the person being tested. -Robert Lebel & David
6.Wiedmann (1933) observed that an essay type question may use the following eleven words
signifying the simple to higher mental processes and classified as eleven major categories:
What, Who, When, Which and Where, List, Describe, Contrast, Compare, Explain, Discuss,
Develop, Summarize and Evaluate.

39. FEATURES:-
1. No answer can be considered throughout and correct.
2. The examinee is permitted freedom of response.
3. The answers vary in their degree of equality or corrections.

40. TYPES:-
EXTENDED RESPONSE-no restriction is placed on the student on the point
he/she discusses.
E.g: Explain the role nurse in health care team
RESTRICTED RESPONSE-Student will have less scope, limited nature in the
form, because he is told specifically the context in which his answer is to be made.
E.g: State the main difference between kwashiorkor and marasmus
How good nutrition prevents the pressure sore? (Specific questions are given)

41. SUGGESTION FOR CONSTRUCTING ESSAY
QUESTIONS
1. Restrict the use of essay question to those learning outcomes that cannot be satisfactorily
measured by objective items
2. Formulate the question that will call forth the behaviour specified in the learning outcomes
3. Maximum subject matter content is covered
4. Avoid the use of optional questions
5. Do not give too many lengthy questions.
6. Avoid phrases e.g. ‘Discuss briefly’.
7. Words should be clear and simple, unambiguous and carefully selected.
8. Do not allow too many choices.
9. According to level of students’ difficulty and complexity items has to be selected.
10. The limits of areas and the behaviour which you want should be clearly mentioned.

42. SUGGESTION FOR SCORING ESSAY
QUESTIONS
Prepare a outline of the expected answer in advance by point scoring system
Use the scoring method that is most appropriate
Describe how to handle factors that are irrelevant to the learning outcomes
being measured
Evaluate all answers to one questions before going to the next one
Evaluating all answers to one question at a time helps counteract another
type of error that creeps in the scoring of essay questions

43. Evaluate the answers without looking at the students name
If especially important decisions are to be based on the results, obtain two
or more independent rating
When 2 or more teacher’s correct the same test, they should agree on the
scoring procedure before the test and correct the answer scripts.
The time allowed and the marks allotted will act as a guide to the students to
answer the questions.

44. BLUFFING-A SPECIAL SCORING
PROBLEM
 Wrting something for every questions
 Stressing the importance of the topic
covered by the questions
 Agreeing with the teachers view
whenever it seems appropriate
 Being the name dropper
 Writing on the related topic and fitting
in to the questions
 Writing in general terms that can fit
many answers

45. ADVANTAGES & DISADVANTAGES
1.Tests the ability to communicate and
writing.
2.Freedom of expressing and
communicate.
3.Relatively easy & Requires short-time
for the teacher to prepare the test.
4.Applicable for all the school subjects.
5.It can assess ability to organize and
present his ideas in a logical fashion.
6.Logical thinking, critical reasoning and
systematic presentation can be evaluated.
1.Are not given complete marks as it lack
objectivity.
2.Lack of consistency in judgement and takes long
time to score.
3.Limited content sampling.
4.Contaminated by wrong spellings, handwriting,
neatness, grammar.
5.Mood of examiner.
6.First impression.
7.Improper comparison of answers(bright and dull
8.It generally test the lengthy enumeration of
memorized facts.

46. OBJECTIVE TYPE TEST
1. It is generally call for single
words, phrases, numbers, letter and
other symbols as response to items.
2.Is defined as one for which the
scoring rules are so specific that they
do not allow scorers to make
subjective inferences or judgments.
3.Objective test items are items that
can be objectively scored on which
persons select a response from a list
of options. -Weirsma & G .Jurs-
1990
1.Categorie
s of
Objective
Test
1.• Selected Response
Format
Format - Selection type
True or False
Matching Type
Multiple Choice
Constructed Response
Format
Supply type -
Enumeration -
Labeling -
Identification -
Completion type -
Simple Recall

47. Advantage
• The sampling of the objective
examination is more representatives and
so measurement is more extensive.
• Handicaps such as poor vocabulary,
poor handwriting, poor spelling, and
poor grammar and the like do not
adversely affect the ability to make
reply.
• Scoring is not subjective because the
responses are single words, phrases,
numbers, letters and other symbols with
definite value points and hence, the
personal element of the scorer is
removed.
• The objective test is better prepared
than the essay test because there are
principles to be applied in its
construction.
Disadvantages
• It is harder to prepare.
• Generally, it measures
factual knowledge only.
• It does not help in nor
encourage the
development of the ability
of the students to organize
and express their ideas.
• It encourages memory
work even without
understanding.
• It is easier to cheat in an
objective examination
than in essay examination.

48. TRUE OR FALSE TEST TYPE
An objective type test presented in a form simple declarative statement, to
which the pupils respond indicating whether the statement is true or false. It
is applicable to all learning areas.
Uses:
Measuring the ability to identify the correctness of statements of facts,
definitions of terms, statements of principles, differenciating facts from
opinion and the like

49. Types of True or False Test
• Simple True or False
• Modified True or False
• True or False with correction
• Cluster True or False
• True or False with options.
• Fact or Opinion
Eg: Tetany occurs with
increased secretion of
parathyroid hormones.

50. GUIDELINES TO CONSTRUCT THE
TRUE OR FALSE TYPE TEST
 Avoid broad general statements if they are to be judged true or
false
 Avoid trivial statement and Express statement in a simple language
as possible
 Avoid the use of negative statements especially double negative
 Avoid the including two ideas in one statement, unless cause and
effect relationships are being measured
 True and false statements should be in equal strength
 Avoid long and complex sentences and reasonably short or restrict
them to have one central area.
 Be very careful about the grammatical structure of the sentences.

51. MULTIPLE-CHOICE TEST
• Is a test used to measure knowledge outcomes and other types of learning
outcomes such as comprehension and applications.
• Most commonly used format in measuring student achievements in
different levels of learning.
• Consist of three
1. Stem – represents the problem question.
2. Keyed option – correct answer
3. Distracters – incorrect options or alternative
Eg: you are caring for an elderly patient
who was told recently that he has cataracts.
Which one of the following is a cause for
cataract;
A. Aging.*
B. Arteriosclerosis.
C. Hemorrhage.
D. Iritis.

52. VARIATIONS IN MULTIPLE CHOICE
FORMAT
A. ONE CORRECT ANSWER-simplest type. One correct option and
other incorrect options.
B. BEST ANSWER-the student is told to select the best answer.
C. ANALOGY-the student is required to deduce relationship that exists
between the two first parts.
 e.g. Lack of iron content: anemia::lack of iodine content: …………… a)cretinism
b)myxoedema c)goitre
D. RESERVE TYPE-all but one answer is correct. Selection of the
incorrect answer.

53. GENERAL GUIDELINES IN CONSTRUCTING
THE MULTIPLE-CHOICE TEST
1. Make a practical test.
2. Use diagram or drawing when
asking questions about
application, analysis or evaluation.
3. Use tables, figures, or charts when
asking question to interpret.
4. Use pictures when students are
required to apply concepts and
principles.
5. When ask to interpret or evaluate
quotations, present actual
quotations
7. Avoid trivial questions.
8. Use one correct answer only.
9. Use to three to five options.
10.Be sure to use effective
distracters.
11.Increase similarity of the
options.
12.Do not use “none of the above”
when asking for best for a best
answer.
13. Avoid using “all of the above”

54. GUIDELINES IN CONSTRUCTING
THE STEM
1.The stem should be written in question form or completion form.
2. Do not leave blank at the beginning or at the middle of the stem in
completion form.
3. Clear and concise.
4. In a positive form. Avoid using negative words, if you do underline or
capitalize. Ex: Which of the following does not belong to the group? Or
which of the following does NOT belong to the group?
5. Stem is grammatically correct.

55. GUIDELINES IN CONSTRUCTING OPTIONS
1.One correct or best answer only.
2.List of options are vertical.
3.Avoid creating a pattern.
4.Options must be homogenous in content.
5.As much as possible options must be in the same length.
6.Avoid the phrase “all of the above”, “none of the above” or “I don’t know.”
GUIDELINES IN CONSTRUCTING DISTRACTERS
1. The distracters should be plausible.
2. Should be equally popular with the rest of the options.
Which of the following philosophical schools was most identified with the
Greek Philosopher Aristotle?
A. Stoicism B. Agnosticism
C. Platonism D. Empiricism
Which of the following philosophical schools was most
identified with the Greek Philosopher Aristotle?
A. Stoicism
B. Platonism
C. Agnosticism
D. Empiricism

56. USES OF MULTIPLE-CHOICE
TEST
Measuring knowledge outcomes:
• Knowledge of terminology
• Knowledge of specific facts
• Knowledge of principles
• Knowledge of methods and procedures
Measuring outcomes at the understanding and
application levels
•Ability to identify application of facts and principles
•Ability to interpret cause and effect relationships
•Ability to justify methods and procedures

57. ADVANTAGES &
DISADVANTAGES
1.
2..Measures learning outcomes.
3.• Scoring is highly objective, easy
reliable.
4.• Scores are reliable than subjective
type of test.
5.• Distracters can provide diagnostic
information.
• Time consuming
• Difficult to construct plausible
distracters.
• In some cases, there are more than one
possible answer.
• Ineffective in assessing problem solving
skills of the students.
• Not applicable in assessing the
ability to organize and express ideas.

58. MULTIPLE RESPONSE ITEMS
Multiple response or completion item
More than one of the given alternatives is correct , but there is one correct
answer to the precise questions stated in the first sentence of the item
Versatile type lending to testing of recall, reasoning and exercise of
judgement Which of the following group could be included
among Pottassium sparing diuretics?
a.Diamox
b.Burnet
c.Chlotorothiazide
d.Triamterine
e. Spirinolactone
• A&c Only,
• D&e Only,
• C&e Only

59. MATCH THE FOLLOWING
The matching exercise consist of two parallel columns with each
words, number of symbol in one column being matched to the word,
sentence or phrase in the other column
The item in the column for which a match is sought are called premises
and the item in the column from which the selection is made is called as
response
The basis for matching the response to premises is sometimes Self
Evident COLUMN A
SCHIZOPHERNIA
PSYCHOTHERAPY
MARITAL THERAPY
COLUMN B
TREATMENT
COUPLES
EMIL KRAEPILIN

60. SHORT ANSWER QUESTIONS
1.The short answer item and completion item are supply test
items that can be answered by a word, phrase, number or symbol
2.The short item use number uses direct questions & ideally, only
one answer is acceptable.
3.The students response by selection of one or more of several
given alternatives by giving words or phrases.
4.It does not call for an extensive written response and the answer
is expected as short and can be expressed in different forms.

61. PRINCIPLES FOR PREPARATION:-
i. Use precise, simple and accurate language in relation to the subject matter
area.
ii. Provide the necessary space for answers below each question asked
iii. Question can be as long as possible, but answer should be short.
iv. Each item should deal with important content area.
v. Use action oriented precise verbs.
ADVANTAGES:-
• Easy to score.
• Reliability of the score is improved.
• Quick response.
DISADVANTAGES:-
• Difficulty in construction of reliable
items.

62. COMPLETION TYPE TEST
An objective type of test that includes series of sentences which certain
important words of phrase has been omitted for the pupils to fill in a
sentence may contain one or more blanks and the sentences may be
disconnected or organized into a paragraph. Each blanks counts one point.
Example: Fill up the blanks with the correct answer.
1. The Father of educational testing is ________. Answer: Edward L.
Thorndike
2. Alfred Binet a French psychologist and also known as the _________.

63. HOW CONSTRUCT COMPLETION
TYPE OF TEST
 Omit only words that are essential to the meaning of the
statement or sentence.
 Do not omit any words in a statement. The statement may lose
its meaning.
 Make the blanks equal in length to avoid clues. Long blanks
suggest long answers, short blanks suggest short answers.

64. SIMPLE RECALL TEST
Objective type of test that sometimes require the student to supply an
answer to direct question and sometimes require him to complete a
statement where a word or phrase has been omitted.
Example Direction: Follow the directions in each of the problem below.
Write the answer to each problem in the blank provided at the left.
You may use the side of this sheet for computation.
The following are the scores of Mathematics student
1. 18, 12, 16, 10, 10, 22, 15, 13, 17, & 18. 14.90
What is the mean?
2. Who is the father of mental/modern testing? A. Benit

65. HOW TO CONSTRUCT SIMPLE
RECALL TEST
• Do not lift statement from the book verbatim
• Frame the questions so that one correct answer is possible.
• Avoid extraneous hints that give the students clues to the answer.
• Design the test items so that the blank comes at the end of the statement.
• If the item requires the pupils to compute figures in order to arrive at an
answer, always indicate the units to express the answer, whether it is feet,
inches or in seconds, minutes or hours and minutes.

66. LABELING TYPE TEST
An objective test in which the names of parts of diagrams, map, drawing or
picture are to be indicated.
How to construct the labeling type of test
• Make the diagram, map, drawing or picture to be labels very clear and
recognizable especially the parts to be labeled.
• The parts to be labeled should indicate by the arrows so that labels can be
written in a vertical column in a definite place and not on the face the
diagram, map, drawing or picture.
• Labeling can be matching type of test if the labels with some extras are
given.

67. ASSESSMEN
T
OF SKILL
• OBSERVATION, CHECKLIST, RATING SCALE &
ANECDOTAL RECORD
• CUMULATIVE RECORDS, WRITING CLINICAL
EXAMINATIONS, CRITICAL INCIDENT
RECORD& VIVA VOCE ORAL EXAMINATION
• OBJECTIVE STRUCTURED CLINICAL
EXAMINATION (OSCE) & OBJECTIVE
STRUCTURED PRACTICAL EXAMINATION

68. OBSERVATION
It is a old method
Observare – to keep open (Latin word)
Measurement without using any instrument or device

69.  Understanding the environment by sense organs
 External behaviour of persons in appropriate situations
 Tools such as check list and score-card, tape- recorder,
thermometers, audiometer, stop- watch, binoculars etc.
 Devices used: Anecdotal records, checklist and rating scale
Student attitude
Personal qualities and abilities
Motivation and commitments
Learning speed and style
Attainment and progress

70. Types
• Direct Observation
• Indirect Observation
• Natural
Observation •
Artificial Observation
• Participant Observation
• Non-participant Observation
• Controlled Observation - laboratory
• Uncontrolled Observation - natural situation
• Known Observation
• Unknown
Observation
• Group Observation •
Personal Observation

71. USES OF OBSERVATION
 In descriptive research
 Significant aspects of personality which express themselves in
behaviour
 Physical aspects of school buildings or students and
teachers – through physical examination, measurement,
assessment and comparison with fixed standards
 In classroom – learning behaviour
 Cumulative record – anecdotal evidence – research studies

72. MERITS OF DIRECT OBSERVATION
Record of actual behavior, so more reliable and objective
Study of individual in natural situation
Employed to all section of students
Need training and experience and all teachers can use it
Used in every situation

73. MERITS OF DIRECT OBSERVATION
Adaptable to individual and group
Frequent observation can provide continuous check on his
progress
Provide teachers with valuable supplementary information
Problems can be identified immediately and remedial measures
can be taken accordingly

74. DEMERITS OF OBSERVATION
Scope for personal prejudices and bias of the observer
May not be 100% accuracy
Difficult to observe every behaviour of the student
Reveal the overt behaviour only i.e behavior that is
expressed

75. PRINCIPLES OF OBSERVATION
Observe the whole situation
Select one student to observe at a time
Observe in all regular activities such as in
classroom and in clinical areas
Made over a period of time
Observations from several teachers should be
combined

76. REQUISITES OF A GOOD OBSERVATION
Proper planning of
observation
•Area of behaviour
•Duration of behavior
•Scope of behavior
Proper execution of
observation
•Skill and resourcefulness
•implementing the plan
properly
•Selected areas of behavior
•Decided pattern of
behaviour
Recording of observation
•Based on nature of activity
and skill of behavior,
observation can be recorded
simultaneously or after
completion the observation
Proper interpretation
Result interpret cautiously
and judiciously

77. ANECDOTAL RECORDS
An anecdotal record (or anecdote) is like a short story that educators use
to record a significant incident that they have observed.
Anecdotal notes are used to record specific observations of individual
student behaviors, skills and attitudes as they relate to the outcomes in the
program of studies. Such notes provide cumulative information on student
learning and direction for further instruction.

78. Anecdotal notes are often written as the result of ongoing observations during
the lessons but may also be written in response to a product or performance
the student has completed. Every behavior can’t be recorded, only which
reflect some significance can be recorded.
Notes taken during or immediately following an activity are generally the
most accurate.
Anecdotal notes for a particular student can be periodically shared with that
student or be shared at the student’s request. They can also be shared with
students and parents at parent–teacher–student conferences.

79. CHARACTERISTICS
 A factual description of an event in which:-
 i. How it occurred,
 ii. When it occurred,
 iii. Under what circumstances it occurred,
 iv. The treatment
 Each anecdotal should be of one incident
 Being positive and objective
 Use descriptive language

80. PURPOSES:
1) To stimulate teachers to look for information i.e. to help student in self-
adjustment.
2) The teacher is able to understand her pupil in realistic manner.
3) It provides healthy pupil-teacher relationship.
4) Helps the student to improve in their behavior, as it is a direct feedback of
an entire observed incident.
5) Can be used by students for self appraisal and peer assessment.

81. TIPS FOR ESTABLISHING AND
MAINTAINING ANECDOTAL NOTES
 Keep a binder with a separate page for each student.
Record observations using a clipboard and sticky notes.
Write the date and the student’s name on each sticky note.
Following the note taking, place individual sticky notes on the page
reserved for that student in the binder.
 Keep a binder with dividers for each student and blank pages to note
down notes. The pages may be divided into three columns: Date,
Observation and Action Plan.

82.  Keep a class list in the front of the binder and check off each student's name
as anecdotal notes are added to their section of the binder. This provides a
quick reference of the students you have observed and how frequently you
have observed them.
 Keep notes brief and focused (usually no more than a few sentences or
phrases).
 Note the context and any comments or questions for follow-up.
 Keep comments objective. Make specific comments about student strengths,
especially after several observations have been recorded and a pattern has
been observed.

83. • Record as the observations are being made, or as soon after as possible,
so recollections will be accurate.
• Record comments regularly, if possible.
• Record at different times and during different activities to develop a
balanced profile of student mathematics learning.
• Review records frequently to ensure that notes are being made on each
student regularly and summarize information related to trends in students'
learning.
• Share anecdotal notes with students and parents at conferences.

84. ADVANTAGES:-
1) Provision of insight into total behavioral incidents.
2) Use of formative feedback.
3) Economical and easy to develop.
4) Needs no special training.
DISADVANTAGES:-
1) If careless recorded, the purpose will not be fulfilled.
2) Subjectivity.
3) Lack of standardization.
4) Difficulty in scoring.
5) Time consuming

85. CUMULATIVE RECORDS
 Comparing to the progress records and personal records of the students,
cumulative records are much comprehensive.
 Other than the academic progress of the student they also give
information regarding intelligence, personality, aptitude, interests,
attitude, values, emotional maturity and conflicts, or self – adjustment,
etc.
 The interpretation of this record is subjective and difficult to an extent

86. OBSERVED CHECKLISTS
 It is an approach to monitor performance of specific skills, behaviors, or
dispositions of individual student. Checklist is basically a method of
recording whether a characteristic is present or an action is performed.
 DEFINITION: A checklist is a simple instrument consisting of prepared
list of expected items of performance or attributes, which are checked by
a evaluator for their presence or absence. A checklist enables the
observer to note whether or not a trait or characteristics is present.

87. CHARACTERISTICS:
 Can be used for formative assessments by focusing on
performance of specific skills such as writing skills,
speaking skills or action-based skills.
 Should be carefully prepared and must include all important
elements of a specific task that student must know or
perform.
 Each element should be sequentially and carefully included
and adequate weightage should be given.
 Observe one at a time and use only when assessing a
particular characteristics.

88. GUIDELINES TO CONSTRUCT:
Express each item in clear, specific, observable and in simple language.
Items can be continuous or divided into groups of related items.
The items created has to be evaluated by the experts.
Avoid negative statements. Ensure that each item has a clear response.
Review the items independently.
It must be complete and comprehensive in nature.
Leave space to record anecdotal notes or comments.
Each element should be marked as Present/Absent, inappropriately done
and an option “not applicable” can be

89. Sl no Criteria Yes No Remar
k
1 Identifies the patient and check the physician order
2 Explains the procedure to the patient and relatives
3 Assembles all articles
4 Follow the three checks of medication administration
5 Washes hands
6 Places the patient in comfortable position (sitting/semi
flowers position)
7 Remove the medication or drug from the strip without
touching the drug
8 Spread mackintosh with towel across the chest of
patient
9 Give the medication cup and glass of water to the client
10 Stay with the client until he or she swallows all
medications
11 Assist the patient to comfortable position
12 Discard the waste and replaces the articles
CHECK LIST FOR ORAL MEDICATION

90. ADVANTAGES:
• Useful in evaluating performance skills that can be
divided into a series of specific actions.
• Allow inter-individual comparisons.
• It is simple to use and record.
• Decreases the error chances.
• Useful for evaluating activities which has to be
performed.
DISADVANTAGES:
• Usefulness is limited as it does not indicate quality of
performance and can’t do overall clinical performance.
• The degree of accuracy of performance is limited if
presence or absence is used only as an attribute.
• It has limited use in qualitative observations.
• Not easy to prepare.

91. RATING SCALE
It is a term used to express opinion or judgment regarding some
performance of a person, object, situation and character.
Rating scale is an important technique of evaluation. Rating is the
assessments of a person by another person.
This is one of the oldest methods of personality assessment. There are
certain general approaches to assess personality like holistic or overall
approach, projective test approach and trait approach.

92. DEFINITION:
It refers to a scale with a set of opinion, which describes
varying degree of the dimensions of an attitude or a
phenomenon being observed.

93. TYPES
Graphical Rating Scale
Descriptive Rating Scale
Numerical Rating Scale
Comparative Rating Scale

94. A)GRAPHIC RATING SCALE
A straight line, may be
represented by descriptive
phrases at various points. To rate
the subject for a particular trait a
check mark is made at the
particular point.

95. B)DESCRIPTIVE
RATING SCALE:
This type does not use
numbers but divides the
assessment into a series of
verbal phrases to indicate
the level of performance.

96. (C) NUMERICAL
RATING SCALE
In which numbers are assigned to
each trait. If it is a seven point
scale, the number 7 represents
the maximum amount of that trait
in the individual, and 4
represents the average. The rater
merely enters the appropriate
number after each name to
indicate judgment of the person.

97. D)COMPARATIVE
RATING SCALE:
In this person makes a
judgment about an
attire/attitude/object
by comparing it with
others/ranking it.

98. CHARACTERISTICS OF RATING SCALE
• These are value judgments about attributes of one person by another person.
• These are most commonly used tools to carry out structured observations.
• These are generally developed to make qualitative judgment about qualitative
attributes.
• Provide more flexibility to judge the level of performance.

99. PRINCIPLES OF RATING SCALE:
It relates to learning objective.
Needs to be confined to performance areas that can be
observed.
Clearly defines mode of behaviour.
The behaviour should be readily observed in a number of
situations.
Allow some space in the rating scale for the rater to give
supplementary remarks.
3 to 7 rating positions may be provided.

100. PRINCIPLES OF RATING SCALE:
All raters should be oriented to the specific scale as well as
the process of rating in general.
The rater should be unbiased and trained.
Consider evaluation setting, feedback and student
participation.
Have experts and well informed raters.
Change the ends of scale so that good is not always at the top
or bottom.
Assure that rater autonomy will be maintained.

101. ADVANTAGES:
• Easy to administer and score.
• Its easy to make and less time consuming.
• Easily used for large group.
• Also used for quantitative methods.
• May also be used for assessment of interest, attitude, personal
characteristics.
• Used to evaluate performance and skills.
DISADVANTAGES:
• Difficult to fix up rating.
• Chances for subjective evaluation, thus the scales may become
unscientific.

102. CRITICAL INCIDENT
REPORTING
Incident: In a health care facility, such as a hospital, nursing home, or assisted
living, an incident report or accident report is a form that is filled out in order
to record details of an unusual event that occurs at the facility, such as an injury
to a patient.
Critical Incident: An occurrence or set of events inconsistent with routine
operation. It is an unplanned event within the scope of this procedure that
causes, or has the potential to cause, an injury or illness and damage to
equipment, buildings, plant or the natural environment.

103. The purpose of the incident report
is to document the exact details of the occurrence while they are
fresh in the minds of those who witnessed the event.
This information may be useful in the future when dealing with
liability issues stemming from the incident

104. Near Miss
Adverse Events
Sentinal Events
TYPES OF INCIDENT

105. NEAR MISS
This is where the incident did not result in harm, loss, or damage,
but could have, this is referred to as a ‘Near Miss’. This may be
clinical or non-clinical.
Near-miss reporting is just as important in highlighting weaknesses
in systems, policies/procedures, and practices.
If near misses are reported and learned from and any necessary
corrective action is taken, they can help to prevent actual incidents of
harm, loss or damage from occurring.
Near misses should be reported within 24hrs of working days.

106. ADVERSE EVENTS
Adverse Incident (Clinical) An event or circumstance arising during
clinical care of a patient that could have or did lead to unintended or
unexpected harm’.
Adverse Incident (Non-Clinical) ‘An event or circumstance that could
have or did cause unexpected or unwanted harm, loss or damage to any
individual(s) involved (including patients but not related to clinical care,
staff, visitors etc) or damage to/loss of property/ premises in the hospital.
It should be reported within 2 hrs.
INCIDENT REPORTING (STAFF)
 It is a requirement of all Hospital staff that they report any incident,
accident or potential incident which has caused or has the potential to
cause harm, loss or damage to any individual involved or loss or damage
in respect of property premises for which the hospital is responsible.

107. HOW TO REPORT AN INCIDENT
● Obtain the proper forms from your institution. Each institution has a
different protocol in place for dealing with an incident and filing a report.
● Start the report as soon as possible. Write it the same day as the
incident, if possible, because if you wait a day or two your memory will
start to get a little fuzzy. You should write down the basic facts you need
to remember as soon as the incident occurs, and do your report write-up
within the first 24 hours afterward.
● Provide the basic facts. Your form may have blanks for you to fill out
with information about the incident. If not, start the report with a sentence
clearly stating the following basic information given in the Incidence
form.

108. ● Write a first person narrative telling what happened. For the meat of
your report, write a detailed, chronological narrative of exactly what
happened when you report to the scene. Use the full names of each
person who is included in the report, and start a new paragraph to
describe each person's actions separately.
● Be thorough. Write as much as you can remember - the more details,
the better. Don't leave room for people reading the report to interpret
something the wrong way. Don't worry about your report being too long
or wordy. The important thing is to report a complete picture of what
occurred.
● Be clear. Don't use flowery, confusing language to describe what
occurred. Your writing should be clear and concise. Use short, to-the-
point, fact-oriented sentences that don't leave room for interpretation.

109. Be accurate. Do not write something in the report that you aren't sure
actually happened.
● Be honest. Even if you're not proud of how you handled the situation,
it's imperative that you write an honest account. If you write something
untrue it may end up surfacing later, putting your job in jeopardy and
causing problems for the people involved in the incident.
● Submit your incident report. Find out the name of the person or
department to whom your report must be sent. When possible, submit an
incident report in person and make yourself available to answer further
questions or provide clarification.

110. PERSON RESPONSIBLE FOR THE
IMMEDIATE MANAGEMENT OF THE
INCIDENT
The person responsible for the immediate management of
the incident (e.g. the nurse in charge of the ward at the time
an incident occurs), should undertake an immediate
assessment of the situation, in order to determine any
immediate treatment and/or ongoing care needs of the
affected person, and/or the extent of any loss/damage to
property and any other immediate action required (e.g.
removal and isolation of faulty equipment).
The situation/scene should be made safe.

111. ROOT CAUSE ANALYSIS
Root Cause Analysis’ is a structured investigation process that aims to
assist in the identification of the root or underlying cause(s) of a
particular event or problem by determining WHY the failure occurred
and the actions necessary to prevent or minimize the risk of recurrence.
A ‘Root Cause’ is a failure in a process that, if eliminated, would
prevent an adverse incident from occurring.
Training for the relevant staff on incident grading/investigation and
root cause analysis will be provided as part of the risk management
training program.

112. FAIR BLAME CULTURE
In an organization as large and complex as the Hospital, things will sometimes go
wrong. The wrong assessment should not be one of blame and retribution, but of
learning, a drive to reduce risk for future patients and staff.
Blame cannot, and should not, be attributed to individual healthcare professionals.
Identifying and addressing dysfunctional systems is, therefore, the key to reducing
the risk of harm for many patients and staff through incident form.
It is understood that fear of disciplinary action and subsequent sanctions may
discourage the staff from reporting incidents and, therefore, continues to be
developed within a culture of ‘fair blame’.
The Management approach following incidents will therefore focus on ‘what went
wrong, and not who went wrong’.

113. PRACTICAL EXAMINATION
Practical examination is concerned with the assessment of practical performance
skills & practice competency acquired by a student during the course of a
particular programme.
Purposes of Practical Examination
To assess the practical skills
To assess the development in affect domain
 To assess the student’s problem solving skills
To assess the recording & reporting skills
To assess multiple performance task such as
assessment, planning, implementation, communication

114. Are integral part of nursing examinations
Practical exams are accompanied by oral examinations
It is the combination of test methods like rating scales, checklists etc
Marking sheets, checklist and rating scales are prepared in advance to
improve the reliability of scoring
All students are evaluated on same criteria by same examiners
STEPS:
Assessing
the patient,
Formulatin
g the
nursing
diagnosis
according
to priority,
Planning
the care,
Implementi
ng the care
and
Evaluating
the care.

115. ADVANTAGES
1.It provide an opportunity to assess the skills & competency.
2.It provide an opportunity to the examiner for assessing the use of
compartmentalized knowledge.
3. An examiner also get an opportunity to assess the communication &
interpersonal skills.
DISADVANTAGES
1.It not considered an objective method of assessment.
2.It time consuming process. It not feasible for large group. Sometime it
considered as unethical to expose patients for examining students.

116. ORAL EXAMINATIONS
Are face to face examination between examiner and
examinee
Theoretical oral examination and practical
examination
Viva voce is a Latin phrase literally meaning with
living voice, but is most often translated as by word of
mouth.
Furthermore, viva voce is also is termed as an oral
examination which consists of a dialogue between the
examiner and a student where the examiner ask question
and the student replies.
The examiner may ask short open questions, multiple
choice questions or a series of other type of questions not
necessarily related to each other.

117. Viva Voce
In nursing, viva voce is generally used to supplement the practical examination
where two examiners, i.e. internal and external, ask several questions related to a
particular subject matter.
The viva voce might form a part of the validated assessment for a course, assessed
by an oral examination.
In these situations, the viva voce is a useful tool that in authenticating that the
student has got enough knowledge in the subject matter.
Search

118. Purposes of Viva Voce
To assess student's ability to communicate with another person.
•To supplement the information obtained through other evaluation techniques.
•To use stimulation methods like role play and telephone conversation.
•To identify and analyse the student's presence of mind.
•To evaluate the student's spontaneity and mannerism.
•To acquire soundness of knowledge through various forms of question.
•To diagnose the student's limitation and weakness and take remedial action.

119. Principles to Conduct Viva
Voce
 The viva should not be limited to a single topic but should cover a range of
different issues to avoid the results of the viva being skewed by selecting a
topic which the candidate can answer exceptionally well or about which
he/she knows nothing of. All questions should be strictly relevant to the
purpose of the viva.
 Do not use long preambles to questions. Examiners should talk as little as
possible during the viva.
 The chair of the examiners must remain in charge of the session and must
deal appropriately with any problem candidate or difficult situation.
 When the last question is being asked, allow the student to complete his/her
answer and end the session formally.
 Viva voce examinations should not normally exceed 30 minutes.
 Candidates should be examined individually.
 Candidates should be given adequate notice of the possibility of being called
to attend a viva, and this should normally not be less than 24 hours.

120. Advantages of a Viva Voce
Provide direct contact with the candidates to assess their
communication, presentation skills and overall impression.
•Provide opportunity to mitigate circumstances into accounts.
•Provide flexibility in moving the candidates from strong to
weak points.
•Makes students formulate replies without cues, and the
reaction is observed for a specific stimulus.
•Facilitates simultaneous assessment by two or more
examiners.
•Provides an opportunity for the examiner to get feedback on
the performance of the students and the university.

121. Disadvantages of a Viva
Voce
Lacks standardization, objectivity and
reproducibility of the result.
Permits favoritism and cannot be used for
future references.
Suffers from undue influence of irrelevant
factors.
Costly in terms of professional time.

122. OSCE/OSPE
It is a modern type of examination often used in various professional disciplines including
nursing.
An OSCE is designed to test clinical skill performance such as communication, clinical
examination, nursing procedure by a student in clinical area where the student is asked to
perform a particular task on a patient and is evaluated by the examiner.
An OSPE is designed to assess competence in skill performance such as chemical analysis,
identification of equipment and interpretation of results, etc. at different stations in a lab set
up.

123. OBJECTIVE STRUCTURED
PRACTICAL EXAMINATION OSPE
Objective Structured Practical Examination (OSPE) is a
new pattern of practical examination. In OSPE each
component of clinical competence is tested uniformly and
objectively for all the students who are taking up a
practical examination at a given place.

124. CHARACTERISTICS
•Objective: Because examiners use a checklist for
evaluating the trainees.
•Structured: Because every trainee sees the same
problem and performs the same tasks in the same time
frame.
• Clinical: Because the tasks are representative of those
found in real clinical situations.
•An examination.
PURPOSE
•Provide feedback on performance.
•Evaluate on the basis of clinical skills.
•Measures minimal competencies.

125. STEPS TO ORGANIZE AN OSPE
In order to organize an OSPE one has to set objectives of practical experiences in a
given discipline related to a particular subject such as practical examination in medical
surgical nursing each student is supported to,
1. Demonstrate practical skills: this may be done by assisting a student to,
a. Monitor and record oral temperature.
b. Convert 39 degree to F.
c. Attach a heart monitor to a patient.
d. Test urine for sugar.
e. Start an IV drip on a patient.
2. Make correct and accurate observations: this may be done by assigning a student to,
a. Interpret type of fever from the given graph.
b. Identify the type of arrhythmia from the ECG graph provided.
c. Differentiate between normal and abnormal ECG.
These questions may not require the examiners to observe the student in action. These
questions can be answered on a paper which can be collected later for evaluation.

126. 3. Analysis and interpret data: this is one of the important skill components to be judged
for the continuity of patient care. The nurse has to perform this task where she may come
across normal and abnormal data in relation to patient’s investigation reports. The student
asked to interpret,
a. Hemogram: normal or abnormal.
b. Liver function test reports.
c. Renal function test reports.
d. Laboratory reports.
1. Identify patients problems: in order to organize her work the nurse has to identify the
patient’s problems and set priority so as to clear to the immediate needs of the patient,
such as to identify,
a. Dyspnoea on the basis of her observations.
b. Rigor following blood transfusion.
c. Coning following lumbar puncture.
d. CSF Rhinorrhea following head injury.

127. 2. Plan of alternative nursing interventions in a given situation: in order to
provide need based care the nurse plan’s alternative nursing interventions, as
in case of air way obstruction the student nurse is expected to,
a. Keep the patient in side lying position.
b. Do oropharyngeal suction.
c. Check and record vital signs.
d. Start oxygen inhalation if required.
e. Keep the things ready for endotracheal intubation.
f. Assist the doctor in intubating the patient.
In order to assess certain practical skills, the OSPE is organized in the form
of several stations through which the candidate rotate to complete one full
round.

128. TYPES OF STATIONS
Sl No. Stations Question Method of scoring
1 Procedure station Check and record BP Observed and scored by the
examiner A using checklist
2 Question station List 5 factors which help in
maintaining BP
Answer on a sheet provided
3 Procedure station Take oral temperature and record it Observed and scored by the
examiner B
4 Question station Convert 39 degree C to F by using
formula
Answer on a sheet provided
5 Procedure station Test the urine albumin and record it Observed and scored by the
examiner C
6 Question station List 5 causes of
albuminuria Nursing Path
Answer on a sheet provided

129. HOW TO SCORE STUDENTS
IN OSPE?
1.For each specific skill, a checklist is prepared by breaking the skill being tested
into essential steps and scores is assigned to each step which is proportional to
the importance of the steps related to a particular procedure.
2.The objectivity in assessment is achieved by getting each component tested at
one particular station by the same examiner and have the students rotate through
all the students.
3.The time allowed is same for all the stations 3-5 minutes is the length of time
allocated to each station.

130. ADVANTAGES
1.Helps us to observe and assess student for different professional and clinical skills.
2.Enables us to have an overall view of the student’s performance.
3.Simulations of real life situations.
4. Controlled and safe. Nursing Pa
5.Feedback from actors (simulators).
6.Ready availability when required.
7.Stations can be tailored to level of skill to be assessed.
8.Scenarios that are distressing to real patients can be simulated.

131. DISADVANTAGES
1.It is subjective as the student’s score depends on the whims, fancies and
moods of the examiner.
2.It is time consuming and there is a lack of standardized conditions in bedside
which affects student’s score.
3.The idealized ‘textbook’ scenarios may not mimic real life situation.
4.May not allow assessment of complex skills.
5.Cost.
6.Training issues in setting up the stations.

132. STUDENT'S INSTRUCTION REGARDING
OSPE
1.Write your roll no. in bold figures and display it on your white coat
so that the examiner can identify the candidate.
2.Student’s are asked to report at a particular time, all of them are
collected in a room or hall and explained the procedure of
examination.
3.Student’s may be given instructions that they will rotate around
station (numbered 1 – 6) spending 3 minutes at each station.

133. CONCLUSION
Because OSCE have been shown to be feasible and have
good reliability and validity, their use has become
widespread as the standard for performance based
assessment, particularly an undergraduate examinations.

134. OBJECTIVE STRUCTURED CLINICAL
EXAMINATION ( OSCE)
DEFINITION OF OSCE
“A multi dimensional practical examination of clinical skills , as a tool for
assessing clinical competence”
PURPOSES OF OSCE
1.Use in both formative and summative assessment in health profession
education
2.Identify objective performance criteria for the skill being examined
3.structured the performance criteria in checklist to facilitate the identification of
desired clinical skill
4.A requirement for accreditation in many health professional programs

135. USES OF OSCE
• Interpersonal and
communication skills
• History-taking skills
• Physical examination of specific
body systems
• Mental health assessment
• Clinical decision making,
including the formation of
differential diagnosis
• Clinical problem-solving skills .
Interpretation of clinical findings and
investigations.
Management of a clinical situation,
including treatment and referral
Patient education .
Health promotion.
Acting safely and appropriately in an
urgent clinical situation.
Basic and advanced nursing care
procedure practices.

136. ORGANIZING THE OSCE
• The OSCE examination consists of about 10-15 stations, each of which requires
about 4-5 minutes. The number of stations and time spent on each station may vary
based on needs of evaluation.
• All stations should be capable of being completed in the same time.
• The students are rotated through all stations and have to move to the next station at
the signal.
• As the stations are generally independent, students can start at any procedure stations
and complete the cycle
•Thus, using 15 stations of 4 minutes each, 15 students can complete the examination
within 1 hour.
• Each station is designed to test a component of clinical competence.

137. PROBLEMS OF USING OSCE IN
THE INDIAN SCENARIO
• Lack of feasibility due to time constrains.
• Shortage of training for use of OSCE.
• Shortage of observers/examiners.
• Lack of interest in examiners.
• Lack of enforced guidelines for practical examination by
universities number of students examined and format of evaluation
used

138. ADVANTAGES OF OSCE
1.More valid than the traditional approach to clinical examinations.
2.Examiners can decide in advance what is to he tested and can then design the
examination to test these competencies.
3.Examiners can have better control on the content and complexities.
4. Emphasis can be moved away from testing factual knowledge to testing a wide
range of skills including advanced clinical skills.
5.More reliable because variables of the examiner and the patient are removed to a
large extent.
6. The use of checklists by examiners and the use of multiple choice questions
results in a more objective examination.
7. More practical because it can be used with a large numbers of students.

139. DISADVANTAGES OF OSCE
Demanding for both examiners and patients.
 Examiners are required to pay close attention to students repeating the
same task on a number of occasions.
The time involved in setting up the examination is greater than for the
traditional examination.
CONCLUSION
The OSCE has several distinct advantages. In view of these, the
nurse educators can adopt it as an objective method for clinical
evaluation. This will help the students to improve their clinical
competence. The emphasis is on assessing what students can do
rather than what they know. Therefore, O S C E gives direction for
attaining the ultimate aim of the teaching- learning process

141. ATTITUDE
Attitude is defined as the predisposition to respond to an idea or object. For instance,
in marketing it relates to the consumer’s predisposition to respond to particular product
or service
Attitudes are Composed of
 • Beliefs about the subject
 • Emotional feeling (like or dislike)
 • Readiness to respond behaviorally
 • It is complex and not fully understood
 • It can be changed but they tend to persist
 • It tends to focus on beliefs
 • None of the existing devices is very accurate
Indicators of Attitude
How do we know if someone has positive
attitude towards Ice Cream.
➢Behaviour (She rats it)
➢Affective reaction (She likes eating it)
➢Self report (She tells us she likes it)
➢Peer report (she tells us she likes it)
➢Physiological measures (heart rate)

142. SEMANTIC DIFFERENTIAL SCALE
Semantic differential scale or the S.D. scale developed by Charles
E. Osgood, G.J. Suci and P.H. Tannenbaum (1957),
Is an attempt to measure the psychological meanings of an object
to an individual.
is a scale used for measuring the meaning of things and concepts.

143. This scale is based on the presumption that an object can have different dimensions
of connotative meanings which can be located in multidimensional property space, or
what can be called the semantic space in the context of S.D. scale.
This is a rating scale that can measure respondent attitudes towards ideas, concepts,
items, people, and events. -When the evaluator employ semantic differential questions
the data gathered can give a powerful picture of the respondent’s attitude toward the
subject being studied.
The scale is set up using polar adjectives at each end.

144. Osgood and others did produce a list of some adjective pairs
for attitude research purposes and concluded that semantic
space is multidimensional rather than unidimensional.
They made sincere efforts and ultimately found that three
factors, viz., evaluation, potency and activity, contributed most
to meaningful judgements b y respondents.

145. This scaling consists of a set of bipolar rating scales, usually of 7 points,
by which one or more respondents rate one or more concepts on each
scale item.

146. PROCEDURE
Various steps involved in developing S.D. Scale are as follows :
First of all the concepts to be studied are selected. The concepts are usually chosen by personal
judgement, keeping in view the nature of the problem.
The next step is to select the scales bearing in mind the criterion of factor composition and the
criterion of scale’s relevance to the concepts being judged (it is common practice to use at least
three scales for each factor with the help of which an average factor score has to be worked out).
One more criterion to be kept in view is that scales should be stable across subjects and concepts.
Then a panel of judges are used to rate the various stimuli (or objects) on the various selected
scales and the responses of all judges would then be combined to determine the composite scaling.

147. TIPS FOR DOING LAYOUT FOR
SEMANTIC DIFFERENTIALS
 To avoid fatigue or boring the respondent, do not use more than 20
lines, and 10-12 adjective pairs is better.
 Do not put all the "good" adjectives on one side, as it might bias
the responses
 Provide clear instructions for the respondent so that they put their
marks in the right place.

148. ADVANTAGES
S.D. has a number of specific advantages.
It is an efficient and easy way to secure attitudes from a large s ample.
These attitudes may be measured in both direction and intensity.
The total set of responses provides a comprehensive picture of the
meaning of an object, as well as a measure of the subject doing the rating.
It is a standardized technique that is easily repeated, but escapes many of
the problems of response distortion found with more direct methods.

149. ATTITUDE SCALE
1. To assess the attitude or belief of an individual
2. Designed to measure attitudes of a subject or group of subject towards issues,
institution, and groups of people.
3. “An attitude may be defined as a learned emotional response set for or against
something” Barr, David, Johnson Meanings of attitude
4. Thurstone defines an attitude as the degree of positive or negative affect associated
with some psychological objects.
5. Concept attitude denotes the “sum total of a man’s inclinations and feelings,
prejudices or bias, ideas, tears about any specific topic.”
6. Attitude continuum extending from favourableness through neutral to
unfavourableness.

150. ATTITUDE SCALE
According to frerman (1965) there are three assumption upon attitude scale;
The scale should deal with a controversial question
An individual’s feelings and insights is regard to the question will determine his
responses to various statements
The statements can be scaled regarding the degree to which the favour are opposed to
question under consideration Assumptions

151. CHARACTERISTICS
1. It provides for quantitative measure on a uni-dimensional scale of
continuum.
2. It uses statements from the extreme positive position to extreme
negative position.
3. It generally uses a five point scale as: Strongly agree(SA), Agree(A),
Undecided(U),Disagree(D) and Strongly disagree(SD). The individual
gets the score as the sum of item credits.
4. It is usually standardized and norms are worked out
5. It disguises the attitude object rather than directly asking about the
attitude on the subject

152. PURPOSE
In educational research , these scales are used especially for
finding the attitudes of persons on issues like co-education,
religions education, democracy in schools etc depending upon
the need of the situation. Some Attitude Scales Methods of
measuring attitudes indirectly, used for research purposes are;
Thurstone Technique
Likert’s Method of summated Rating
Guttman’s scale

153. THURSTONE’S TECHNIQUE
1. Attitude is accepted as an uni-dimensional linear continuum.
2. A large number of statements of various shades of favourable and unfavourable opinions.
3. large number of judges exercising complete detachment sort out into eleven piles ranging from the
most statements to the most favourable ones.
4. First category each judge places the statements considers most favourable to the object.
5. Second ,those considered next most favourable.
6. Eleventh category considers most unfavourable .
7. Tabulations are made which indicate the number of judges who placed each item in each category.
8. Calculating cumulated proportions for each item and ogives are constructed.
9. Median of the frequency distribution in which the scores range from 0 to 11
10. Thurstone’s technique is also known as the technique of ‘equal appearing intervals’ statements Scale
value

155. LIKERT’S SCALE
Subject’s response to each item may be considered as his or her rating of attitude on a 5- point
scale.
Strongly agree(SA), Agree(A), Undecided(U),Disagree(D) and Strongly disagree(SD). The
individual gets the score as the sum of item credits.
Collection of a number of statements about the subject.
Items that to be either definitely favourable or definitely unfavourable to the attitude
All favourable statements are scored from the maximum to minimum.
From a score of 5 to 1or 5 for strongly agree and so on 1 for strongly disagree.
Total of these scores on all items measures a respondents favorableness. Eg : scale consists of
30 items , the following score values 30*5=150 ( most favourable response) 30*3=90 (neutral
attitude) 30*1=30 (most unfavourable attitude) It is thus known as a method of summated
ratings.
Subject’s response to each item may be considered as his or her rating of attitude on a 5- point
scale and the total score is obtained after all these weights are summated , the method is known
as SUMMATED RATINGS .

156. GUTTMAN SCALE
 Guttman applied this model in 1941 that each statement has an idea relationship of one
type or another with the exacting measurement of the attitude.
 Study in investigating a youngsters attitude to career.
 The item in the questionnaire which following.
 1. Military career is an attractive and progressive career. yes no
 2. Multinational companies pay a heavy salary yes no
 Any set of items that produces a pattern of responses is called Guttman Scale.

157. PROCEDURES
(i) As a first step, the researcher collects a large number of statements
which are relevant to the attitude being studied and each of the statements
expresses definite favourableness or unfavourableness to a particular point
of view or the attitude and that the number of favourable and unfavourable
statements is approximately equal.
(ii) After the statements have been gathered, a trial test should be
administered to a number of subjects. In other words, a small group of
people, from those who are going to be studied finally, are asked to
indicate their response to each statement by checking one of the categories
of agreement or disagreement using a five point scale as stated above.
(iii) The response to various statements are scored in such a way that a
response indicative of the most favourable attitude is given the highest
score of 5 and that with the most unfavourable attitude is given the lowest
score, say, of 1.

158. PROCEDURES
(iv) Then the total score of each respondent is obtained by adding his
scores that he received for separate statements.
(v) The next step is to array these total scores and find out those statements
which have a high discriminatory power. For this purpose, the researcher
may select some part of the highest and the lowest total sc ores, say the top
25 per cent and the bottom 25 per cent. These two extreme groups are
interpreted to represent the most favourable and t he least favourable
attitudes and are used as criterion groups by which to evaluate individual
statements. This way we determine which statements consistently correlate
with low favourability and which with high favourability.
(vi) Only those statements that correlate with the total test should be
retained in the final instrument and all others must be discarded from it .

159. ADVANTAGES
(a) It is relatively easy to construct the Likert-type scale because Likert-type scale can
be performed without a panel of judges.
(b) Likert-type scale is considered more reliable because under it respondents answer
each statement included in the instrument.
(c) Each statement, included in the Likert-type scale, is given an empirical test for
discriminating ability and the Likert-type scale permits the use of statements that are not
manifestly related (to have a direct relationship) to the attitude being studied.
(d) Likert-type scale can easily be used in respondent-centred and stimulus-centred
studies i.e., through it we can study how responses differ between people and how
responses diff er between stimuli.
(e) Likert-type scale takes much less time to construct, it is frequently used by the
students of opinion research.

160. LIMITATIONS
we can simply examine whether respondents are more or less favourable to a topic,
but we cannot tell how much more or less they are.
There is no basis for belief that the five positions indicated on the scale are equally
spaced. The interval between ‘strongly agree’ and ‘agree’, may not be equal to t he
interval between “agree” and “undecided”. This means that Likert scale does no t rise
to a stature more than that of an ordinal scale,
One further disadvantage is that often the total score of an individual respondent has
little clear meaning since a given total score can be secured by a variety of answer
patterns. It is unlikely that the respondent can validly react to a short statement on a
printed form in the absence of real-life qualifying situations. Moreover, there
“remains a possibility that people may answer according to what the y think they
should feel rather than how they do feel.”

161. LIMITATIONS OF ATTITUDE
SCALE
An individual may conceal his real attitude and express
socially acceptable opinions only.
An individual may not really know how he feels about a social
issue.
An individual may not be able to express his attitude towards
a situation in abstract.
It is unlikely that the statements are of equal value in forness
or againstness

162. CLINICAL EVALUATION METHOD
INTERNAL
ASSESSMENT
SELF REPORTING
AND SELF
ASSESSMENT

163. CHARACTERISTICS OF
GOOD EVALUATION
INSTRUMENT

164. CHARACTERISTICS
OF
GOOD EVALUATION
INSTRUMENT
Validity
Reliabili
ty
Objecti
vity
Adequa
cy
Discrim
ination
Power
Practica
bility
Compar
ability
Utility

165. VALIDITY
The validity of a test may be defined as the accuracy with which the
test measures what it purports to measure.
According to Garrett, “The validity of a test depends upon the fidelity
with which it measures what it intends to measure”
Every test is constructed for some specific purpose, and it is valid only
for that purpose.

166. TYPES
OF
VALIDITY
1. Face Validity – It implies that a test measures superficially what the test-maker
desires to measure, and not what it actually measures. This type of validity has very
little significance.
2. Content Validity – It refers to the degree to which a test sample
the content area which is to be measured.
3. Predictive Validity – It refers to the extent to which a test can
predict the future performance of individuals.
4. Concurrent Validity – It refers to the relationship between scores on a measuring
tool and a criterion available at the same time. The concurrent validity differs from
predictive validity only on time dimension.
5. Construct Validity – It refers to the extent to which a test reflects, constructs
presumed to underlie the test performance and also the extent to which it is based on
theories regarding these constructs.

167. METHOD OF DETERMINING
VALIDITY OF A TEST
Correlating it with another test
Correlating with teacher rating
Analyzing the test to ensure that due weightage has been given to
content and objective.
Item-analysis
Employing a range of method

168. RELIABILITY
Reliability of a test is the consistency with which the test
measures whatever it does measure.
A reliability test is a thrust worthy test.
A reliability test should yield essentially the same (or almost
same) scores when administered a second time to the same pupils,
provided no learning or forgetting has taken place between the
periods of the two testing.
The degree of reliability is usually denoted by a coefficient of
correlation / reliability coefficient

169. Reliability
depends on
the following
factors:
Appropriateness and definiteness of
the task.
Consistency, stability,
alertness or fatigued state of
the pupil who takes the test.
Consistency and objectivity of the
scorer of the test Reliability

170. Method
of
Determining
Reliability
1. Test-Re-Test Method :- The same test is administrated twice to the
same group of students with a given time interval between the two
administration of the test. With the help of these two sets of scores,
correlation is computed to find the stability.
2. Parallel Form Method :- Used only in case where two
forms of the test have been prepared. It is truly equivalent
tests – with same number of items, uniformity in content, etc
3. Split-Half-Method :- It is the method of splitting the test
into two half and finding the correlation between the two.
4. Rational Equivalent Method :- The method utilizes two
forms of tests with inter-changeable corresponding items and
inter item correlations. Method of Determining Reliability

171. OBJECTIVITY
A test is objective if the score
assigned by different but equally
competent score is not affected
by the judgment, personal
opinion or bias of the scorers.
Objectivity is the opposite of
subjectivity.
Objectivity is a pre-requisite of
reliability and therefore of
validity
Objectivity of a test may be
increased by:
Using more objective-type test items
Making essay type test-tests more
exact and clear
Preparing a marking scheme or
scoring key.
Setting realistic standards
Using the average score of two
independent examiners who
evaluated the test.

172. DISCRIMINATION POWER
A test should be able to discriminate the respondents on the basis of the
phenomena measured.
 • Here Bad items are eliminated and good items are retained.
 • A good item is one which is attempted successfully by 50% children.
 • A good item must discriminate between superior children and backward
children.
 • Suppose an item is successfully answered by all children, that item is a bad
item with no discrimination power

173. METHOD OF DISCRIMINATION
POWER
 Divide the group which pilot sampling is applied into two groups, upper and lower
groups.
 Take the item, say, item number one, and find out how many of upper group have
done it correctly.
 Find out how many of the lower group have done it correctly
 Convert the difference in the number of correct responses from two groups into an
index, using the formula D.P = U- L/N , U and L are the number of correct responses
in the upper and lower groups, N is the number of cases in each group
 If discrimination power is very low and very high it is eliminated
 The discrimination power ranging between 0.4 to 0.8 are included in the test. Now
the test is ready

174. Practicability:
If all the criteria is satisfied to conduct a test, but from the practical point of view, it may not be possible
to conduct such a test. Economy of time, effort, number of personnel and finance required also has to be
of utmost concern for the planner of a test.
Comparability :
 A test possesses comparability when the scores obtained by administering can be interpreted in items of
a common base that has a natural or accepted meaning.
 Two methods for establishing comparability are: (a) Making available equivalent forms of a test (b)
Making available adequate norms
Utility :
A test has utility if it provides the test conditions that would facilitate realization of the purpose for
which it is meant. For achieving utility it is essential that the test is constructed in the light of well-
through-out purpose and its interpretations are used in obtaining desirable results

175. Objective - Basedness
 Evaluation is making judgement about some phenomena or performance on the basis of some pre-
determined objectives.
 Therefore a tool meant for evaluation should measure attainment in terms of criteria determined by
instructional objectives. This is possible only if the evaluator is definite about the objectives, the degree
of realization of which he is going to evaluate.
 Therefore each item of the tool should represent an objective.
Comprehensiveness:
It refers to the degree to which a test contains a fairly wide sampling of items to determine the objectives
or abilities so that the resulting scores are representatives of the relative total performance in the areas
measured.
Adequacy :
 Adequacy of a test means sufficiency and suitability of that test.
 A good test should include items measuring the objectives and content.

176. CONSTRUCTION AND
ADMINISTRATION OF ACHIEVEMENT
TEST
Planning
an
Achieveme
nt test Developing
Test
Design
Design for
a Unit Test
Guidelines
for
preparing
test
designs
Preparation
of
Blueprint
for Test
Organizati
on of the
test
Preparation
of the
scheme for
Evaluation

177. Planning an
Achievement
Test
Maximum time:-
40-45 mts
Maximum marks:-
20- 25 marks
Nature of the
test:- test
conducted at the
end of a terms, a
semester or a
session
Developing test
design
 The objective
 Content
 Form of question
 Weightage of
difficulty levels

178. WEIGHTAGE TO
INSTRUCTIONAL OBJECTIVES
Sl.No Objective Mark
s
Percenta
ge
1 Knowledge 10 20
2 Understandi
ng
20 40
3 Application 8 16
4 Analysis 5 10
5 Synthesis 5 10
6 Evaluation 2 4
Total 50 100
WEIGHTAGE TO CONTENT
AREAS
Sl.n
o
Subun
it
mark
s
Percenta
ge
1 I 15 20
2 II 10 40
3 III 10 16
4 IV 5 10
5 V 10 10
Total 50 100

179. Weightage To Form Of Questions
Sl.N
o
Form Of
Questions
No. Of
Question
s
Mark
s
Percentage
1 Objective Type 25 25 50
2 Short Answer
Type
5 15 30
3 Long Answer
Type
1 10 20
Total 31 50 100
Weightage To Difficulty Level
Sl.No Level Of
Difficulty
Marks Percentage
1 Easy 10 20
2 Average 30 60
3 Difficult 10 20
Total 50 100

180. Scheme of option: No option
Scheme of sections: Sec A & B .Sec –A includes all objective type and
Sec-B include short answer and Essay type
Guidelines for preparing test designs are
Should reflect the predetermined objectives
No rule regarding the number of subunits and
number of questions under each form
Weightage of content depends on the total content
area
Weightage to form of questions depends on the
nature of content and possibility of coverage
60% of item of average difficulty with 20 % on either
side is distributed to the student level
Modern trend is to avoid option

181. PREPARATION OF BLUE PRINT FOR
TEST
Blue print for the test is prepared as three dimensional chart including
the distribution of questions, objective wise, content wise and form
wise
Test Blue Prints For Unit On Oxygenation
Content Knowledge/
Comprehensi
on
Level Of
Knowledge
Application
Analysis
Synthesis
Evaluation Total
Items
Principles 2 2 2 6
Factor affecting 3 3 4 10
Pathophysiolog
y
3 3 4 10
Assessment 1 3 4 2 10
Nursing
measure
3 3 4 10
Evaluation of 1 1 2 4

182. CONSTRUCTION OF ITEM:
Blue print dives very definite idea regarding the number of
questions to be set from each subunits, their form and scope
While setting the questions and final selection, try to
maintain the weightage of difficulty level suggested by the
design
Check whether sufficient time is their to answer all the
questions

183. ORGANIZATION OF TEST
Preliminary details such as name of the examination, max. mark and
time, instructions for answering the questions should be given at
appropriate place
Psychologically arrange the questions in order of difficulty level
Hierarchical order of the objectives as given in the taxonomy of
objectives is the indication of difficulty level
Information item is easier than understanding item which is again easier
than application item

184. PREPARATION FOR SCHEME OF
EVALAUTION
Make scoring strictly in accordance with predesigned
scheme of evaluation
In case of objective- type items, a scoring key
showing number of the questions and its correct
answer is to be prepared.
Point method is used to evaluate short answer type
Point method or rating method is used to evaluate
the essay questions

185. TEST ADMINISTRATION
Steps to be followed in administration of group tests are
Motivate the students to do their best
Follow the directions closely
Keep time accurately
Record any significant events that influence the test scores
Collect the test materials promptly

186. PRINCIPLE
The guiding principles in test administration are
All students should be given fair chance to demonstrate their achievements of the
learning outcomes being measured
Physical and psychological conducive environment should be provided
Avoid being anxious and tense during the test which might interfere their test
performance
Reassure the students by word and deed that these test will improve their learning
Assure them that time limit are enough to complete their tests
Thus assure that test is going to improve learning and time limits are adequate

187. THINGS TO AVOID
Do not talk unnecessarily before the test
Keep interruptions to a minimum during the test
Avoid giving hints to pupils who ask about
individual items
Discourage cheating

188. BIBLIOGRAPHY
 Neeraja K P. Textbook Of Communication And Education Technology For Nurses.1ST edition.
New Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 2011. PAGE NO: 659- 702
 Sankaranarayanan B. Learning & Teaching Nursing. Calicut: Brainfill Publications;2003 PAGE
NO: 175
 R.Sudha Nursing education principles and concepts ,jaypee publications 1st edition page no ;357-
362
 Basavanthappa B.T. Nursing Education. 2ND edition. New Delhi: Jaypee Brothers Medical
Publishers (p) Ltd; 2009. PAGE NO:126-154
 Pramilaa R. Nursing communication and educational technology. 1st edition. New Delhi: Jaypee
brothers medical publishers (p) Ltd; 2010. PAGE NO: 142-156
 Online Library.wiley.com/journal/10.1111/(ISSN)1467- 9752
 www.ncbi.nlm.nih.gov.pubmed