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Nursing Education National League for Nursing - About the NLN

Click here for a printable PDF of the Fair Testing Guidelines.

NLN Fair Testing Guidelines for Nursing Education

Developed by the NLN Presidential Task Force on High-Stakes Testing, the Fair Testing Guidelines for Nursing Education are based on the League's core values of caring, integrity, diversity, and excellence, and on widely accepted testing principles. Fair, in this context, means that all test-takers are given comparable opportunities to demonstrate what they know and are able to do in the learning area being tested (Code of Fair Testing Practices in Education, 2004).

These guidelines have been formulated within the context of an overall need for testing. We acknowledge that faculty are fully committed to assessing students' abilities and to assuring that they are competent to practice nursing. Faculty are also cognizant that current approaches to learning assessment are limited and imperfect.

The NLN supports the belief that tests and evaluative measures are used not only to evaluate student achievement, but, as importantly, to support student learning, and evaluate and improve teaching and program effectiveness. Within this framework, the standards for testing in high stakes situations are consistent with general practices for ethical and fair testing practices.

The NLN Fair Testing Guidelines for Nursing Education value students' perspectives and backgrounds, and acknowledge the role of faculty in their implementation.

  1. General Guidelines

    1. Faculty have an ethical obligation to ensure that both tests and the decisions based on tests are valid, supported by solid evidence, consistent across their programs, and fair to all test takers regardless of age, gender, disability, race, ethnicity, national origin, religion, sexual orientation, linguistic background, testing style and ability, or other personal characteristics.

    2. Faculty have the responsibility to assess students' abilities and assure that they are competent to practice nursing, while recognizing that current approaches to learning assessment are limited and imperfect.

    3. Multiple sources of evidence are required to evaluate basic nursing competence. Multiple approaches for assessment of knowledge and clinical abilities are particularly critical when high-stakes decisions (such as progression or graduation) are based on the assessment.

    4. Tests and other evaluative measures are used not only to evaluate students' achievements, but, as importantly, to support student learning, improve teaching and guide program improvements.

    5. Standardized tests must have comprehensive testing, administration, and evaluation information readily available to faculty before they administer, grade, distribute results, or write related policies for test results. Faculty have the responsibility to review and incorporate these materials in communications to students about standardized testing and its consequences.

    6. Faculty and schools of nursing have an ethical obligation to protect every student's right to privacy by maintaining appropriate confidentiality related to the testing process and to test results.

  2. Test Development and Implementation

    1. Selecting Appropriate Tests

      1. Standardized tests must show evidence of reliability, content and predictive validity, and evidence of fairness and equity as shown by test performance across test-taking subgroups based on culture, race, or gender.

      2. Tests should be appropriate to their purpose and have good technical quality.

      3. Tests should be screened for offensive content or scenarios.

      4. Tests should be reviewed regularly for content accuracy and relevance to practice.

      5. Test vendors should provide technical manuals that provide information on the test's blueprint, test development procedures, psychometric testing, and norms.

    2. Informing Test Takers

      1. Students should be notified as early as possible about the nature and content of the test and any consequences of taking the test (i.e., how test scores will be used).

      2. Students should be informed about the test's different modalities (print, web, verbal) and available accommodations.

      3. A process should be implemented to document that students have read, understood, and accepted the guidelines.

    3. Administering and Scoring Tests

      1. Detailed test administration procedures should be clearly outlined ahead of time and adhered to (time frame, use of books/notes).

      2. Scoring procedures for evaluative measures (clinical performance, simulation, case analysis, etc.) should be delineated.

      3. Interrater reliability should be regularly assessed.

      4. Psychometric analysis should be used when possible to assure that the test is valid and internally consistent.

      5. Methods of protecting the integrity of test items for standardized tests or other forms of testing, in which the items will be used in more than one context, should be clearly defined.

    4. Reporting/Interpreting Test Results

      1. Detailed norming information on standardized tests should be provided.

      2. On tests used for predictive purposes, periodic evaluation of predictive validity should be included.

      3. More than one mode of learning assessment should be used to make high stakes decisions.

  3. Recommendations to Achieve a Fair Testing Environment

    1. Convene a culturally and demographically representative group of faculty, students, and administrators to review your program's current high stakes testing plans and policies.

      Through the input of a diverse group of people affected by testing policies, new understanding about high stakes tests and their consequences can be mutually discovered. All members of your review group should feel free to share their knowledge about the tests, their perceptions of how tests are used and their intended purposes, and the consequences of any change to testing policy.

    2. As a faculty, undertake a thoughtful and comprehensive review of the factors leading to the development and implementation of high stakes testing in your program.

      Program quality encompasses more than what is measured by licensure exam pass rates. The nursing education literature and stories from students and faculty alike reveal that high stakes tests are often quickly implemented in response to both internal and external pressures. And the feeling of having done something can unintentionally divert faculty attention from other systems-related issues that bear on NCLEX-RN pass rates and other measures of program quality. Factors such as admissions policies, instructional effectiveness, remediation and study requirements, and course-level assessments are all valid aspects of the educational process for review and improvement.

    3. Invite faculty or other experts with experience using high stakes tests to provide feedback on how high stakes tests are best used within the context of national guidelines, ethical considerations, and regulatory requirements.

      Faculty members from other disciplines such as psychology, educational assessment, and psychometrics, many available locally (even within the same college or university), may have a longer history of using high stakes tests in their educational practice. This could also be an opportunity to seek legal review of testing policies. This step is often overlooked during policy development but is increasingly important as schools seek to avoid costly and time consuming legal battles, and the negative publicity that ensues.

    4. Until more formal studies are done, seek out and learn the practices of schools that have not needed to implement high-stakes testing, or that use tests in non-high stakes ways, but still achieve excellent NCLEX-RN pass rates.

      Across the nation — likely in every state — there are nursing education programs that maintain high NCLEX-RN pass rates. These programs admit very diverse students from a range of educational backgrounds, provide outstanding educational experiences, and have high retention rates. Students graduate from these programs, successfully pass the licensing exam, and enter the nursing workforce well prepared. Much could be learned about the effective practices and characteristics of these schools; their strengths are worthy of study and possible replication.

    5. Develop a communications plan for students and faculty that conveys essential information about your testing policy and practices.

      Reassure students and faculty that local testing policies are aligned with NLN Fair Testing Guidelines, that there is strong psychometric support for using tests in fair and effective ways, and that testing policy, like other components of the overall assessment plan, considers the input of a variety of constituents, including students, faculty, and program leaders.


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Nursing Education
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