Purpose: The purpose of this project is to evaluate the validity of a clinical performance examination used as one element of an external degree nursing program.  The Unitary Concept of Validity Model proposed by McCallin (2006) is used to guide the study.

Method and Design:   All elements of exam design, implementation and continued development were evaluated for construct irrelevant variance and construct under-representation.  Data sources include: current test administration practices and scoring protocols; research projects done during the life of the examination to evaluate its psychometric rigor; and statistics based on a random sample of 1309 examinations administered over a one year timeframe.  An interpretive argument which addresses inferences and assumptions related performance assessment is presented as a summative appraisal of performance examination validity.

Findings:  Overall examination validity is acceptable. The core concepts being tested are representative of all domains of nursing practice required of new graduates. The examination is constructed and administered in a manner reflecting fairness, appropriate administration, and scoring. 

Conclusions & Implications:  There is sufficient evidence from the data to support use of the clinical examination for its intended purpose, which is to establish eligibility for nursing licensure.  Clinical performance examinations are one way to demonstrate accountability in nursing education.  The external degree model does provide a plausible and scalable alternative to tradition educational models for addressing the nursing shortage.