program outcomes.
Every nursing course, both classroom theory and clinical, publishes a syllabus and course learning packet for each semester. The syllabus specifies the grading criteria and grading scale, course requirements and broad objectives organized into the four role areas of professional nursing delineated by the Differentiated Essential Competencies of Graduates of Texas Nursing Programs. The learning packets contain the unit content outlines, which stem from the content objectives that are derived from the course objectives. Classroom theory exams test content from the content outlines and specific objectives.
Test items for theory exams are multiple-choice items, as well as alternate item format questions, constructed by the faculty within the taxonomy levels of knowledge, comprehension, application and analysis (Appendix 11). The percentage of questions within each domain increases to more complex domains with each Level of nursing course. Classroom testing is conducted in a controlled, monitored environment using paper scantron sheets. Makeup exams are given by appointment with the Level Coordinator within one day after the student returns to class. The option is available to faculty to give the same test or to give a different test. The makeup test scores, therefore, are not usually included in the computerized analysis. The tests are all reviewed by the faculty immediately after computerized analysis of percentage of correct answers, discriminating power among high and low scores, and individual itemized answers are available; usually the same day.
Students are able to review the test and obtain their unadjusted score immediately after completing the exam. They move to an adjacent test review room, also monitored and
controlled, where they can compare their answers with the test key. Each student has the opportunity to submit written comments on items for which they question the answer and give their rationale as to why they think another answer may be better. The faculty then reviews each of these comments at the same time they review the statistical analysis data. Based on consideration of all the information, an individual test item may be omitted or multiple answers may be accepted. Any changes to the correct answers are then related to the students at the next class period. Students with concerns about scoring consult with the level coordinator, who addresses concerns individually. Policies and procedures for testing are located in both the A.D.N. Faculty Handbook and the Nursing Programs Student Handbook.
Standardized testing given at each level exposes the student to the practice of computerized testing. Scores from proctored tests are compared against the program type norms and the national norms. Students who do not achieve the 50th percentile of the program type must remediate with non-proctored tests or other learning activities on the content in question. In Level IV, the RN Comprehensive exam is used as a portion of the course grade.
There is statistical predictive data relating to the probability of passing the board exams that allows this score to be used as a numerical score in the course grade.
Each theory course has a companion clinical course. Although they are separate course numbers, the clinical is considered an integral component to the classroom. Therefore,
progression requirements are that both the clinical and theory courses are successfully completed in the same semester.
Clinical skills are evaluated not only in the clinical setting but also in laboratory
simulation testing. Students perform the skills and are evaluated based on a set of criteria that are set forth in the clinical learning packet. Performance is either pass or fail. Failure may require complete retesting after remediation or a short paper addressing the area of concern. If
students are not successful in demonstrating safe practice with the tested skills, they are put on a contract which defines the issue, requires specific remediation steps, and states that they must demonstrate competency in that area in the clinical setting for the remainder of the program of study or be subject to dismissal from the program.
The Weekly Clinical Evaluation tool is used to evaluate the student’s competencies in the clinical setting. It is a student and instructor evaluation of progress toward completion of the course objectives and thus a shared responsibility. The student supplies the form weekly to the clinical instructor with their own evaluation and comments already entered. The clinical
instructor enters the faculty assessment and comments about the student’s performance for that week. The forms, along with any care plans or other written work, are returned to the student within one to two weeks. The summative evaluation of each semester utilizes this form and is shared with the student at the final clinical evaluation conference.
The weekly assessment is rated against criterion-referenced definitions developed by K.
Krichbaum from criterion published by K. Bondy in the Journal of Nursing Education in 1983.
The faculty approved levels of competence as course outcomes for each level of the program.
There are 25 competencies grouped into the four roles of the nurse. The form also records the type of client(s) the student cares for each week.
Each clinical written assignment is scored against a predetermined list of criteria and rankings delineated in individual course syllabi. Written papers often require subjective
evaluation within certain parameters. To maintain consistency among faculty, each semester at least one student paper is graded independently by the entire teaching faculty for that Level.
The grades are compared to evaluate inter-rater reliability. Discrepancies are discussed and noted for further comparison, and a recheck later in the semester. Anecdotally, most faculty seek another opinion when a particular selection of written work is challenging to grade.
Group presentations in the final level are evaluated as they occur by a panel of faculty.
packets. Presentations are scored as pass or fail. Failures are remediated by individual papers covering the unsatisfactory areas.
At the beginning of each semester, all evaluation methods and tools are reviewed with the students. Instructions for completion of assignments and the use of the tools are also in every learning packet. Successful completion of a clinical semester is graded as Pass/Fail and is noted on the student’s Final Clinical Evaluation summary sheet as “S” or “U” for satisfactory or unsatisfactory.
Criterion 4.6: The curriculum and instructional processes reflect educational theory,