The tremendous growth of computer technology is evident in many aspects of our society today. In nursing education, use of this technology is expanding to include computer application for both learning and testing purposes.
At the Eastern Maine Medical Center School of Nursing the1 computer is used for test item storage. The capability for retrieval and revision of items from the computerized bank provides the faculty with a mechanism for construction of examinations which 'contain appropriate content while saving an immeasurable amount of faculty and secretarial time.
Prior to 1980, the faculty involved in teaching each of the eight nursing courses had maintained a file of test items on index cards. Construction of a test involved selection and typing of appropriate questions from the bank. Major revisions in course content or in individual test items required retyping of from one page to a complete examination. With four nursing courses being offered during any one semester, this was a time-consuming and costly process.
In 1980, the Educational Support Services at Eastern Maine Medical Center acquired a word processing system (IBM Displaywriter). All current test items from the nursing courses were then stored on disks and print-outs were available for faculty use in construction of individual tests. Faculty requested the testbank items using question numbers to designate the order in which questions should appear on the examination.
As the faculty became comfortable with the computerized testbank, it became apparent that with modification it could become an even more valuable resource. Items had not been indexed or classified in an efficient or orderly manner, making it necessary to search through the print-out for specific content areas. Revisions and additions had been added at the end of the test bank, resulting in a long and unwieldy document. The remainder of this article will explain how a nursing faculty developed an efficient testing system which promises to have increasing benefits to both faculty and students in the future.
Storage and Retrieval System
A classification system has been developed to store test items. Subject headings are determined by faculty based on course content. Operator time for search and retrieval is decreased by keeping subject headings broad and limited in number. For example, the original headings of myocardial infarction, arrhythmias, congestive heart failure, and peripheral vascular disease were replaced by the broad concept heading of oxygenation. The subject headings and directions for their use are listed in the front of the testbank manual. It is important that both faculty and operator be familiar with designated subject headings in order to facilitate item retrieval.
The testbank consists of three data storage systems - a fist of subject headings, the situation document, and the testbank document. The situation document contains case studies identified by numbers. The case studies were developed for use with specific test items. The use of the situation document eliminates duplication of the case study text with each test item. The testbank document contains test items, one item per page. The page number is also the item identification number.
In developing an examination faculty members request appropriate subject headings, case studies by situation number, and the identification numbers. Although the majority of items are multiple choice; true and false, completion and matching items may also be stored.
The operator creates a test file for each examination. The operator inputs the identification number, subject heading, number order (numerical order of items on the examination) and the situation code.
Deletion of either outdated or invalid items occurs annually. When the deletion of an item occurs, that page number is not used again. This assures accuracy in retrieval of test items. New questions are added at the end of the document.
After using the testbank for a semester, the faculty have found that it saves time and assures accuracy in test development. Faculty members need only to identify and select test items under the appropriate subject headings rather than review the total test bank manual.
Orientation is the key element in the success of the computerized testbank system. Faculty members must be oriented to its capability and their responsibilities with the system. They must be kept informed of changes, capabilities, and problems with the system; while being encouraged to identify additional uses of the system.
An additional use of the IBM Displaywriter is the dictionary function. This function allows the operator to check for spelling errors in non-medical words inputted to the word processor. The capability exists for a 500 word medical dictionary to be created and implemented by the faculty. To facilitate this process the Medical Center's official list of medical terms and abbreviations could be used. In this way the dictionary would be useful to other departments using the word processor. There would be less dependence upon the judgment of the word processor operators to determine the correct spelling of medical terms used in written materials.
Currently the items are stored by subject headings. The potential exists for them to be stored by levels of learning such as knowledge, application, or evaluation. This would enhance monitoring student's individual progress in a systematic way. Results of the individual student's test performance could be filed and cross-referenced with the computerized testbank system. The system could create a diagnostic profile of the student's performance on each test, for example, the percent correct on knowledge, application and/or evaluation items. An individualized program of assistance could be developed to address the student's weak areas. This type of a program would require a system of test item analysis. This capability is not available with the word processor, but can be purchased as a service from the local university or from a commercial micro computer program.
In summary, the computerized testbank system at Eastern Maine Medical Center School of Nursing is still evolving. The potential for future use with individualized diagnostic and treatment programs, as well as evaluation of levels of learning, is an exciting prospect for nursing education.
- Chan, S.W. (1983). Computerized item banking and on-line test construction for medical and professional education. National Medical Audiovisual Center, 1-105.
- Cheung, B. (1979). Put test questions on a computer. Nursing Mirror, 11, 26-28.
- Johnson, S. and Maher, B. Monitoring science performance using a computerized question banking system. British Journal of Educational Technology, 1982, 2, 97-106.