Abstract
Background. The Next Generation NCLEX (NGN) added 5 new item types. A dilemma nursing faculty continue to face in incorporating these new item types is how to approach testing to ensure that tests are fair and valid. Based on published NCSBN materials, faculty developed a scoring guide for NGN and traditional item types. This study investigated the validity of the proposed scoring model, which faculty believed most replicated the NCLEX approach.
Method. Data was collected using a retrospective design from the computer testing records of students in a medical-surgical nursing course in an ADN program. Study variables included course grades and for each examination, the number of questions, number of points, item types, scoring of item types, and student grades. After analyzing the original tests, each test was then regraded using different scoring models. The alternate scoring models were based on reports of how the item types were being scored at other institutions, expert recommendations, and faculty discussion on social media. The final analysis evaluated correlations between course grades, NCLEX performance, and standardized course testing.
Results. Analysis showed significant variations in exam and course grades based on the scoring model. Partial scoring based on the question score and not individually scored options appears to more precisely measure student knowledge. For 2 of 4 tests, there were significant grade variations based on option scoring. This difference carried over and cumulatively led to the impact of the alternative grading systems on course grades. A scoring model that did not offer partial credit resulted in significantly different end-of-course outcomes, with a 157% increase in the number of students who would have failed (F= 24.825, p < .001). The original grading model had the strongest correlation with the NCLEX predictor test and NCLEX performance.
Discussion. While nursing programs cannot replicate the exact scoring methods used by NCSBN, it is important that programs have consistent test scoring methods. Faculty used the results of this study to refine a test scoring model that is used across the curriculum, feeling that this method of scoring is the closest approximation to the NCLEX-RN. Nursing faculty will find this information useful in understanding the concept of test scoring with various item types and assist them to deliver nursing course examinations whose results fairly and accurately assess student knowledge.
Notes
References:
Betts, J., Muntean, W., Kim, D., & Kao, S. C. (2022). Evaluating different scoring methods for multiple response items providing partial credit. Educational and Psychological Measurement, 82(1), 151-176.
Hensel, D. (2024). Developing and Using Tests. Teaching in Nursing and Role of the Educator, 315.
Hensel, D. (2022). Fair testing and incorporating next-generation NCLEX items into course examinations. Nurse Educator, 47(6), 352-353.
Sigma Membership
Delta Xi
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Retrospective
Research Approach
Quantitative Research
Keywords:
Testing Strategies, Curriculum Development, Faculty Development, Nursing Examinations, National Council Licensure Examination for Registered Nurses, NCLEX, Next Generation NCLEX, NGN
Recommended Citation
Harding, Mariann M. and Bonaduce, Samantha Jo, "Evaluating the Validity of Item Scoring in Course Examinations" (2026). International Nursing Research Congress (INRC). 21.
https://www.sigmarepository.org/inrc/2026/presentations_2026/21
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-07-22
Evaluating the Validity of Item Scoring in Course Examinations
Toronto, Ontario, Canada
Background. The Next Generation NCLEX (NGN) added 5 new item types. A dilemma nursing faculty continue to face in incorporating these new item types is how to approach testing to ensure that tests are fair and valid. Based on published NCSBN materials, faculty developed a scoring guide for NGN and traditional item types. This study investigated the validity of the proposed scoring model, which faculty believed most replicated the NCLEX approach.
Method. Data was collected using a retrospective design from the computer testing records of students in a medical-surgical nursing course in an ADN program. Study variables included course grades and for each examination, the number of questions, number of points, item types, scoring of item types, and student grades. After analyzing the original tests, each test was then regraded using different scoring models. The alternate scoring models were based on reports of how the item types were being scored at other institutions, expert recommendations, and faculty discussion on social media. The final analysis evaluated correlations between course grades, NCLEX performance, and standardized course testing.
Results. Analysis showed significant variations in exam and course grades based on the scoring model. Partial scoring based on the question score and not individually scored options appears to more precisely measure student knowledge. For 2 of 4 tests, there were significant grade variations based on option scoring. This difference carried over and cumulatively led to the impact of the alternative grading systems on course grades. A scoring model that did not offer partial credit resulted in significantly different end-of-course outcomes, with a 157% increase in the number of students who would have failed (F= 24.825, p < .001). The original grading model had the strongest correlation with the NCLEX predictor test and NCLEX performance.
Discussion. While nursing programs cannot replicate the exact scoring methods used by NCSBN, it is important that programs have consistent test scoring methods. Faculty used the results of this study to refine a test scoring model that is used across the curriculum, feeling that this method of scoring is the closest approximation to the NCLEX-RN. Nursing faculty will find this information useful in understanding the concept of test scoring with various item types and assist them to deliver nursing course examinations whose results fairly and accurately assess student knowledge.
Description
Focus: Academic
Status: Completed Work/Project
This study investigated methods of scoring nursing examinations with NGN questions to validate that the proposed scoring model yields a fair, accurate reflection of student knowledge. Analysis showed significant variations in exam and course grades based on the scoring model. A partial scoring model that weights items individually as opposed to collectively appears to allow for more precise measurements of students’ knowledge.