CON Undergraduate Test Construction and Delivery

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Faculty Policies

UNIVERSITY OF NEBRASKA MEDICAL CENTER COLLEGE OF NURSING
Undergraduate Test Construction and Delivery	Policy: 1310 (5.2.38)
Faculty Policies	Originating Date: May 2018
Responsible Reviewing Agency: Undergraduate Affairs Committee Responsible Approving Agency: General Faculty Organization Related Documents: Policy 2216 - Undergraduate Progression Policy 2227 - Undergraduate Testing UNMC Accommodation Policy (ADA Policy) National Council of State Boards of Nursing (NCSBN)	Revised: May 2019 Revised: May 2024 (changes) Revised: August 2025 (changes) Revised: November 2025 (changes) Revised: April 2026 (changes)

Purpose

Establishes criteria for testing construction and delivery.

Scope

This policy applies to undergraduate faculty.

Policy

Testing processes have been established to ensure consistency in testing practices for didactic course content.

Exam Construction

1. Test/exams are defined as 50 or more questions that evaluate the application of content from this course and previous coursework to patient situations. Each didactic course will give a minimum of 2 tests/exams. Nurse in Professional Practice I: Intro to Nursing, Nurse in Professional Practice II: Evidence-Based Practice and Leadership in Nursing, Nurse in Professional Practice III: Policy and Issues in Healthcare Delivery and Population-Centered Care I are exempt from this exam requirement.
2. The Cross-campus Course Coordinator group shall be responsible for ensuring the consistency of Test/exams across all divisions. This includes the determination of the number of exams per semester, total question count, and number of items per concept/exemplar and whether to include lab values within the question stem.
   1. Number of exams and total question count will be included in the course syllabus
3. The Cross-Campus Course Coordinator group will create a faculty exam blueprint for each exam per course.
   1. The blueprint will include the number and types of questions per concept, exemplar and level of assessment using Blooms Taxonomy
   2. The number of comprehensive questions will not exceed more than 10% of the unit exam
4. Category tags in the categories of concept, exemplar, Blooms level and NCLEX Category shall be entered in the exam software so that student strengths and opportunities reports can be generated. This tagging information will also be used to map curricular gaps and demonstrate areas of opportunity.
5. Faculty will create and post a student exam blueprint indicating the concepts and number of questions per concept to be shared with students at least one week before the exam.
6. Exam questions shall be peer reviewed for content applicability, spelling and grammatical errors, and appropriate distractors/responses.
7. All questions shall mirror NCLEX style questions (e.g., no true/false, negative worded questions, avoid always/never responses).
8. Exam questions should include a client scenario. The word client will be used in place of patient for all questions.
   1. Italics and all caps will not be used.
   2. Only words identified by the NCSBN will be bolded.
9. For each exam item, a rationale shall be provided.
10. Exam questions shall be retired after 5 years of use, or if exam statistics analysis does not support continued use of the question.
11. Faculty will include a minimum of 10% to a maximum of 20% Next Generation NCLEX style questions (See NSCBN)
    1. When available in the exam testing platform, exam questions will be scored using +/- scoring. If +/- scoring is not available for the type of question, then partial credit scoring is to be used.
    2. By PCC III, students will be introduced to one Next Generation NCLEX Case Study style exam question with 3 to 6 parts.
    3. PCC IV will have one Next Generation NCLEX Case Study style exam question per exam with 3 to 6 parts.
12. Time allotted for each item will be 1.5 minutes for all question types
13. Extra credit or bonus items are not allowed.
14. Randomized responses and/or question order are encouraged.
15. Questions shall not include “slang”, prejudicial statements, biases, or stereotyping.
16. Highlighting is not allowed for exam questions.

Pre-Exam

1. Exams will be posted one business day prior to the scheduled exam time so students can download the exam prior to the testing time
2. Course Coordinator will provide proctor with exam details including the password and universal resume code in case of technical issues.
3. Course Coordinator will arrange for any needed supplies during the exam (e.g., calculators, scratch paper, writing utensils, UNMC devices for testing).

Proctoring

1. Proctors must complete UNMC CON Proctor training prior to proctoring any exams.
2. Proctors must read the UNMC CON uniform Proctor Statement before each exam and complete pre-exam checks (ex. Personal items stowed, scratch paper blank and visible; testing area clean and secure).
3. Proctors shall enforce restrictions on items in the testing room. (See the student section for example.)
4. Proctors will respond to technical issues but will not answer questions related to exam content.
5. There shall be more than one proctor in the main testing room, or an alternate support person available on campus.
6. Faculty/proctors shall verify the number of students taking the exam on all testing sites.
7. Proctors shall check for exam submission via a confirmation screen prior to students leaving the testing site.
8. For ATI proctored exams, faculty must follow ATI requirements.

Exam Delivery

The University of Nebraska College of Nursing prepares students in a similar testing environment and style as the current licensure testing (NCLEX). Exams are computer based with no backward navigation enabled. This is a strategy for student success.

1. Unit and final exams are proctored and administered in a secure environment.
2. Unit and final exams will be given using the UNMC specified exam/evaluation software. Quizzes (e.g., iRAT, gRAT, med math) are exempt from this requirement.
3. Exams will be taken on either a student’s device, a UNMC College of Nursing issued device, or at a campus testing site. Student requirements for pre-exam preparation are proscribed in Policy 2227 - Undergraduate Testing.
   1. Students who are not able to take the exam as scheduled are expected to notify the course coordinator as soon as possible prior to the scheduled start time for the exam.
   2. Exams start on time and students are expected to be present.
      1. Students who arrive more than 5 minutes late will need to work with the course faculty to either reschedule or complete the exam.
      2. Students who begin the exam after the start time will need to complete the exam at the same time as the rest of the class who began on time, unless otherwise determined by the course faculty.
   3. If students experience an urgent issue (e.g., technical issues or illness) during the exam, they are required to notify the exam proctor immediately.
   4. Students who are unable to complete the exam once started will be required to make-up/retake the exam and may be given an alternate format exam.
   5. Students can leave the exam room during the exam only with proctor permission.
   6. Students are required to upload their exam file upon completing the exam and prior to leaving the exam room. Exams not uploaded may receive a zero for that exam.
   7. Incorrect exam responses are shared with students via the review option in the exam/evaluation software immediately following the exam.
   8. If a passing score is not achieved, students will be required to meet with course faculty to review incorrect exam responses.
   9. Students have the right to seek clarification about exam items and must contact faculty within 72 hours after the completion of the exam.
4. Make-up exams will be scheduled by the course coordinator and will follow the guidelines published in the course syllabus.
   1. If a student misses more than two scheduled exams per course without provider documentation, the student will be subject to an alternate format exam for all make-ups and a required meeting with course faculty.
   2. If more than 10% of the class fails to take the exam on time, exam grade posting will be delayed until more than 90% of the class has taken the exam.
   3. An alternate exam format may include essay, short answer, and multiple choice. The test/exam shall be worth the same number of points as the original.
   4. The date and time for a make-up exam will be determined by the course coordinator/instructor. See CON Policy 2216 - Undergraduate Progression.
5. Students are only allowed items needed for testing at their computer. See Students policy 2227 for specific examples. Faculty reserve the right to inspect any items that are at the testing location with the student.
   1. Needed testing items necessary for testing will be provided by CON personnel.
      1. Scratch paper provided by the proctor and used during the exam is not an official document and will not be considered in determining a student’s exam grade. Proctors will collect all scratch paper and dispose of appropriately.
      2. Unit and final exams and exam questions are to remain in the testing environment.
   2. Device attachments (i.e., chargers) can be used only for the sole purpose of completing the exam.
   3. No excessive attire is allowed during testing. Students must submit a written request for an attire exception to the assistant dean on the student’s division. Written documentation of the approved exception must be shared by the student with CON personnel as needed.

Accommodations

1. Students are required to adhere to the Accommodation Policy (ADA Policy) that is listed in the UNMC Student Policies and Procedures (see policy in related documents).
2. Students with accommodations must present their official letter of accommodations from the UNMC Accessibility Services Office to each new course coordinator for each semester.
3. The accommodation letter should be submitted a minimum of two weeks prior to any exam for which accommodations are requested.
4. Faculty will prepare only the accommodation materials and resources as specified in student letter.
5. Faculty will work with On-line Testing Coordinator and any other personnel needed to facilitate testing accommodations for students (e.g., low distraction room, additional testing time).
6. On campuses that use affiliated university testing services, complete the accommodated testing form.
7. Students testing via a paper copy will use a specified excel form to record exam answers. Once the exam is completed, the student will transfer the exam answers to the exam software, or the excel form data will be uploaded into the exam software by College of Nursing personnel. Transferring of the exam answers is not included in the allotted exam time.

Post-Exam

1. Course Coordinator/ Faculty will review the exam statistics, determine any scoring adjustments needed, and make any adjustments to the exam in the exam/evaluation software.
2. Course coordinator will strive to keep exam KR-20 value between 0.50 and 0.85. Any value outside of this range requires immediate attention before the exam is redeployed. Examples of appropriate actions to take in this situation would be meeting with BSN Director or representative from the CON Testing Taskforce to discuss mandatory changes or revisions to the exam questions. (See Exam Review Table below)
3. During the review immediately following the exam, students are allocated a limited time to review missed questions. The review time is calculated as total questions divided by 10.
4. A “truncated” strengths and opportunities category performance report (no test questions) from the testing platform may be provided to students upon request.
5. Students are allowed to review an exam one time individually with the course instructor or coordinator outside of the immediate exam review.
   1. For courses that are taught cross-campus, when the course instructor is not located on their campus, students may review the exam with the assigned exam staff or faculty.
6. Exam reviews can be conducted online or via Zoom if monitored by another proctor in person.
7. Course Coordinator will transfer all exam grades to the learning management system from the exam/evaluation software within 72 hours.

Exam Review Table

Average Score:	Low Score:	High Score:	KR20:
Item Difficulty (ρ value)	Point Biserial (PBCC) < 0.10	Point Biserial (PBCC) 0.10-0.29	Point Biserial (PBCC) > 0.30
90-99% Easy	Poor discrimination, deemed “easy”, suggest review/revision	Fair discrimination, may deem “easy”, may review/revise	Keep, good discrimination
50-90% Average	Poor discrimination, average difficulty, may review/revise	Fair discrimination, average difficulty, may review/revise	Keep, good discrimination
30-50% Slightly Difficult	Add PBCC to ρ value, if <0.6 suggest review/revision	Add PBCC to ρ value, if 0.6 – 0.8 may review/revise	Add PBCC to ρ value, if >0.8, keep, good discrimination
< 30% Difficult	Poor discrimination, highly suggest review/revision	Fair discrimination, suggest review/revision	Good discrimination, may be too difficult, suggest review/revise

Key

		Start revisions here, items with highest need, priority items
		Second area of need, revisions here if no items in orange boxes
		These items are valid and reliable, no revisions required

Item Analysis Results Table

Category	Tally	Action
Questions with 100% correct		Suggest maximum of 10% of exam, over 10% suggest review/revision, includes mastery questions
Items adjusted		Rationale
Next Generation NCLEX		Rationale