Paper
Friday, 21 July 2006
This presentation is part of : Obtaining Evidence of Reliability and Validity for Computerized Examinations Used in Graduate and Undergraduate Nursing Programs
The development of computerized, comprehensive exams for nurse practitioner programs
Karen K. Olson, FNPC, PhD, FAANP, College of Nursing, Texas A&M University-Corpus Christi, Corpus Christi, TX, USA, Pamela B. Stewart, MSN, RN, APRN-BC, Department of Family Medicine, Scott & White Clinic, College Station, TX, USA, Carolyn Merriman, APRN, MS, BC, Family/Community Nursing, East Tennessee State University, Johnson City, TN, USA, and Ainslie Nibert, RN, PhD, Health Education Systems, Inc. (HESI), Houston, TX, USA.
Purpose:  Undergraduate nursing faculties have increasingly used computerized exit exams since the introduction of the NCLEX-RN computer adaptive test (CAT) in 1994. However, no similar scientifically-constructed exams have been prepared for use in graduate nursing programs leading to advanced practice nursing (APN) certification. To address this disparity, East Tennessee State University and Texas A & M University – Corpus Christi faculty collaborated with Health Education Systems, Inc. (HESI) to produce a computerized, comprehensive exam for family nurse practitioner (FNP) students.
Methodology:  The American Nurses Credentialing Center (ANCC) Test Content Outline was used to create the FNP exam blueprint. Teacher-made test items were edited and new questions were written using the HESI model for writing critically thinking test items. Item analysis data were collected during the 2004-2005 academic year. The HESI Predictability Model (HPM), a proprietary mathematical model, was used to produce scores in ANCC-delineated categories, including life-span, problem areas, and FNP domains of practice. 
Effectiveness/Evaluation:  The FNP exam was found to be highly reliable, with a KR-20 of 0.978. Validity will be further substantiated by correlating students’ HESI scores with their course grades, grade point averages, and FNP certification exam outcomes. Individual scoring reports offered a study map useful in certification exam preparation, and a summary report offered an overview of aggregate performance.
Summary:  Increasingly, schools of nursing are seeking reliable and valid computerized student evaluation tools that can also be used as evidence-based measures of curricular outcomes. However, exams of this type have not been previously published for use in graduate programs.  Collaboration among faculties from two universities and HESI resulted in the first of a series of computerized, comprehensive examinations designed for NP programs.

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