Formative online multiple-choice tests in nurse education: An integrative review

Predictors of classroom exams, standardized exams, and nursing licensure exams in U.S. and international undergraduate RN and PN nursing programs: a scoping review

OBJECTIVES

This scoping review aimed to identify and summarize the findings in the literature on established predictors (not mere correlations) of classroom exams, standardized exams, and nursing licensure exams in US and international undergraduate registered nurse and practical nurse programs.

METHODS

PubMed, CINAHL, ERIC ProQuest, PsycINFO, and Cochrane databases were searched for articles from 2008 to 2024 following a formal scoping review protocol. A three-person team followed the PRISMA reporting guidelines.

RESULTS

The review included 79 articles with a significant predictive relationship. Most articles focused on licensure exams. Predictors were grouped into categories for classroom, standardized, and licensure exams.

CONCLUSIONS

While the findings yielded many predictors, standardized test scores, course grades, and GPA were the three most common predictors for the exam types overall. This scoping review can help nursing faculty decide which predictors likely apply to their nursing students to improve classroom, standardized, and licensure exam success.

The effect of formative assessment on students' clinical knowledge, skills and self-efficacy levels

AIM

This research aims to examine the effect of using formative assessment methods in clinical education on students' knowledge, skills and self-efficacy levels.

BACKGROUND

Formative assessment is used as a method designed to identify areas where students fall short and provide feedback for improvement. Formative assessment and feedback represent fundamental characteristics of quality teaching in higher education and play a decisive role in learning in nursing education. Although educators observe students performing practical tasks during clinical education, evaluation is not made by a structured control list. Therefore, just as nursing students are evaluated with "Skill Checklists" in the OSCE exam, there is a need to evaluate nursing skills during patient care in the clinical field.

DESIGN

The study was designed as a pre-test post-test randomized controlled experimental study.

METHOD

Before the research, both groups filled out the self-efficacy form. The experimental group received formative assessment throughout the course. At the end of the semester, all students were given a skills test and asked to fill out the self-efficacy form again. Finally, a knowledge test was administered to the entire class.

RESULTS

The average knowledge score of the experimental group is higher than the control group. It was determined that there was a statistical difference of 16.54 points in the average skill scores between the groups. Posttests showed significant differences in skills such as breathing-cough exercise, basic glycemic measurement, subcutaneous injection and blood collection skills.

CONCLUSION

It was determined that the formative assessment method increased nursing students' knowledge, skills and self-efficacy levels regarding basic nursing skills.

The impact of comprehensive licensure review on nursing students' clinical competence, self-efficacy, and work readiness

This study aims to assess the effectiveness of comprehensive licensure reviews and adaptive quizzing assignments on nursing students' clinical competence, self-efficacy, and work readiness-an under-researched topic. Additionally, it seeks to explore the mediating effect of self-efficacy in the relationship between students' clinical competence and work readiness. A quasi-experimental (pre- and post-test), single-group design was employed. The study was conducted in a public university in Saudi Arabia and included a total of 293 senior nursing students in their last year of the bachelor program. An intervention was developed based on the blueprints of the Saudi Nursing Licensing Exam and NCLEX-RN and consisted of a weekly 3-h synchronous comprehensive licensure review bundled with 23 adaptive quizzing assignments over 15 weeks. Data were collected prior to and after the intervention using three scales: clinical competence, self-efficacy, and work readiness. The mean scores of clinical competence, self-efficacy, and two subscales of work readiness (work competence and social intelligence) increased significantly post-intervention. Self-efficacy (β = 0.353, p < 0.001) and clinical competence (β = 0.251, p < 0.001) influenced work readiness (F [5, 226] = 21.03, p < 0.001) and accounted for 31.8% of the explained variability in work readiness. In the mediation analysis, clinical competence had a significant and indirect effect on work readiness through self-efficacy (B = 0.464, p < 0.001, 95% CI 0.250 to 0.699). The proportion of mediation indicated that 37.2% of the total effect of clinical competence on work readiness was due to the indirect effect of self-efficacy. Comprehensive licensure review and adaptive quizzing assignments improve students' perceptions of clinical competence and self-efficacy. Such interventions could ease the transition of senior nursing students to clinical practice.

First steps of learning analytics in a blended learning general practice curriculum at Saarland University - a quantitative approach

Objectives

Medical education has been revolutionized by the growing importance of digital learning. Little is known about students' online study behaviour and its relationship with exam performance. This quantitative study analyses and describes students' digital learning behaviours in a blended learning curriculum for General practice at Saarland University, Germany. It also examines the relationship between digital learning behaviour and exam performance.

Methods

Cohort and individualized AMBOSS® user data from 195 students at Saarland University was analysed quantitatively. Performance in course-specific multiple-choice question sessions and user data of the integrated online learning activities were correlated with each other and with General practice exam grades. Anonymized data from 10,534 students from 35 other German universities served as the reference cohort. Differences in digital learning behaviour between the groups were calculated using Mann-Whitney-U-Test for non-normally distributed data.

Results

Students in the blended learning course used integrated content more frequently than the reference cohort (U=48777, p<0.001). The number of digital learning cards read correlated moderately with digital formative assessment performance (ρ=0.331, p=0.005 and ρ=0.217, p=0.034). Formative assessment scores and exam results correlated strongly in the summer semester cohort (ρ=0.505, p<0.001), and moderately in the winter semester cohort (ρ=0.381, p<0.001).

Conclusion

There is a difference in the usage of online learning activities when they are purposefully integrated into a curriculum. Digital learning activities including formative assessment may serve as valuable, constructively aligned exam preparation. This is relevant for medical educators when planning future blended learning curricula and portfolio systems, as it may save financial and human resources.