ENHANCING PROFESSIONAL NURSING AND MIDWIFERY EXAMINATIONS

OUTCOME THROUGH EDUCATION-CLINICIAN SYNERGY

TEST CONSTRUCTION AND ADMINISTRATION

Test Construction

(I) Learning Objectives

After the end of this session, the participants should be able to:
i. Define the Concept of Test
ii. Describe Test Construction
iii. Compare and contrast the domains of learning in test construction
iv. Outline the Steps in Test construction
v. Describe how a test blueprint or test plan is used in cognitive test development to
align the test to the content domain and learning objectives

(II) Introduction: Test is the most widely used approach of all assessment methods; testing has
been the centre of discussion and debate among educators for years. We may use the
evidence to make statements about student competence or make decisions about the next
aspect of teaching for particular students. Testing consists of four primary steps: test
construction, test administration, scoring and analysing the test. Each of these steps can result
in various test forms and elicit a variety of valuable outcomes.

(III) What is a Test? A Test or Assessment is an…

•is the art and science of knowing what students know. A process of gathering and judging
evidence to decide whether a person has achieved an outcome. It provides “evidence” of
students’ knowledge, skills, and attitudes.

Types of Test
Broad Categories
Formative – Short term assessment such as classroom assessment techniques (CAT)
Summative– Long term assessment such as comprehensive final exams

Other Types of Test

• Diagnostic Test: These tests are used to diagnose how much you know and what you know.
They can help a teacher know what needs to be reviewed or reinforced in class. They also
enable the student to identify areas of weakness.

• Aptitude Test: An aptitude test is an exam used to determine an individual's skill or

propensity to succeed in a given activity. 

• Proficiency Test: check learner levels about general standards. They provide a broad
picture of knowledge and ability.

• Placement Test: used to place students in the appropriate class or level. 

Achievement Test: Achievement or progress tests measure the students’ improvement in

their syllabus. These tests only contain items which the students have been taught in class.
There are two types of progress tests: short-term and long-term.

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 Short-term progress tests check how well students have understood or learned the material
covered in specific units or chapters. They enable the teacher to decide if remedial or
consolidation work is required.
Long-term progress tests check the learners’ progress over the course. They enable the
students to judge how well they have progressed. Administratively, they are often the sole
basis of decisions to promote to a higher level.

(IV) Test Construction

Definition: Test construction or Test development refers to the science and art of planning,
preparing, administering, scoring, statistically analysing, and reporting results of tests1
OR
Test construction is a process of gathering, interpreting, and using the information on student
learning to inform instructional decisions and the extent to which students have met the
intended learning outcomes (i.e., how well they have done)2.

The primary goal of assessment via examination is to accurately measure student

achievement of desired knowledge and competencies, which are generally articulated through
learning objectives3.

Three Fundamental Principles of Test Construction

a) Standardisation
This is the process of benchmarking by conducting the test on a representative population to
see the typically obtained scores. This helps set benchmarks and enables test takers to
compare their scores to the standard scores.

b) Validity
Validity indicates how well an assessment is measuring what it is supposed/claim to measure.
Approaches to Validity
i. Face Validity: is the extent to which a test is subjectively viewed as covering the concept
it purports to measure. It refers to the transparency or relevance of a test as it appears to
test participants.
ii. Content Validity: Content validity assesses whether a test is representative of all aspects
of the construct.
iii. Construct Validity: evaluates whether a measurement tool represents the thing we are
interested in measuring. It’s central to establishing the overall validity of a method.
iv. Criterion Validity: evaluates how closely your test results correspond to the results of a
different test.

c) Reliability
Reliability tells you how consistently a method measures something. You should get the
same results when you apply the same method to the same sample under the same
conditions. If not, the method of measurement may be unreliable. There are four main types
of reliability. Each can be estimated by comparing different sets of results produced by the
same method.
i. Test-retest reliability: measures the consistency of results when you repeat the same test
on the same sample at a different point in time. You use it when you measure something
that you expect to stay constant in your sample.
ii. Interrater reliability: (also called interobserver reliability) measures the degree of
agreement between different people observing or assessing the same thing. For example,
when researchers collect data, you use it to assign ratings, scores or categories to one or
more variables.

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 iii. Parallel forms reliability: measures the correlation between two equivalent versions of a
test. You use it when you have two different assessment tools or sets of questions
designed to measure the same thing.
iv. Internal consistency: assesses the correlation between multiple items in a test intended
to measure the same construct.

(V) Steps in Test Construction

Step 1: Planning of Test
 Determining the Objectives of the Test
 Determining the maximum time allotment and maximum marks

Step 2: Preparation of Test Design

Essential Factors to Consider in Design
 Weight to Objectives: Indicates what objectives are to be tested and what weight has
to be given per objective 

 Weight to Content: Indicates the various aspects of the content to be tested and the
weight to be given

 Weight to Form of Questions: Indicates the forms of questions to be included in the

test and their weight

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  Weight to Difficulty Level:  Indicates weight to be given to different levels of
questions 

Step 3: Preparation of the blueprint

 Blueprinting is one method of constructing exams to ensure alignment with course
goals and objectives.
 It has several advantages, one of which is assisting you in constructing multiple
items (such as for a question bank) that differ yet assess the same objective at the
same level.
 The Domains/Levels of Assessment guide the blueprint

Bloom's Taxonomy comprises three learning domains:

 Cognitive is for mental/intellectual skills (Knowledge)
 Affective is for growth in feelings or emotional areas (attitudes, values, interests, and
learners' appreciation.
 Attitude)
 Psychomotor is for manual or physical skills (Skills).

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 Domains of Learning/Levels of Assessment

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 \Example of a blue print cognitive domain

Step 4: Writing of Items

 The test writer writes items according to the blueprint.
 The difficulty level has to be considered while writing the items
 It should be checked whether all items can be answered within the time allotted.
 Arrange questions in the order of difficulty level
Bloom’s Taxonomy-Action Verbs

Examples of Cognitive Domain:

 Remembering: List different types of fruit
 Understanding: Explain why they are classified as fruits
 Applying: Diagram the parts of your favourite fruit
 Analysing: Compare each fruit characteristics that make it different from others
 Evaluating: Determine and justify which fruit is healthiest
 Creating: create a drink using three fruits that would be considered highly
healthiest
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 Examples of Affective Domain
 Receiving: Be an audience member of another student’s presentation, and then write a
summary.
 Responding: Present on a subject in front of the class, and answer questions from
peers about their presentation.
 Valuing: Write an opinion piece on any issue, explaining one’s stance and reasons for
that stance.
 Organisation: Organise and compare different cultural value systems, evaluating the
differences between them and why these differences may have arisen.
 Characterisation: A group project, including group work on any assignment.

Examples of Psychomotor Domain

 Perception (awareness): the ability to use sensory cues to guide motor activity. This
ranges from sensory stimulation, through cue selection, to translation, e.g. Deciding if
food is safe to eat based on how it smells
 Set: readiness to act. It includes mental, physical and emotional sets, e.g. Students
know exactly what to do when asked to ''line up.''
 Guided response: the early stages in learning a complex skill that includes imitation
and trial and error. Adequacy of performance is achieved by practicing, e.g. Learning
how to cook a meal by following a recipe book or video
 Mechanism (basic proficiency): the is the intermediate stage in learning a complex
skill. Learned responses have become habitual, and the movement can be performed
with some confidence and proficiency, e.g. Sets up laboratory equipment, Operates a
slide projector
 Complex overt response (Expert): is concerned with the skilful performance of motor
acts that involve complex movement patterns, e.g. demonstrates correct form in
swimming, demonstrates skill in driving an automobile
 Adaptation: Skills are well developed, and the individual can modify movement
patterns to fit unique requirements e. g modifies instructions to meet the needs of the
learners.
 Origination refers to creating a new movement pattern to fit a particular situation or
specific problem. Learning outcomes at this level emphasise creativity based upon
highly developed skills, e.g. creates a dance step, makes a musical composition  and
designs a new dress style                 

Step 5: Preparation of Scoring Key and Marking Scheme

 In the case of objective type items where the answers are in the form of some letters
or other symbols, a scoring key is prepared
 In the case of short answer and essay types questions, the marking scheme is prepared
 In preparing the marking scheme, the examiner has to list out the value points to be
credited and fix up the mark to be given to each value point.

(VI) Consideration for Test Construction 

Some points to consider when deciding which, when, and how often to use a particular
question type include:
 Workload: Some questions require more front-end workload (i.e., time-consuming to
write), while others require more back-end workload (i.e., time-consuming to mark).

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  Depth of knowledge: Some question types are better at tapping higher-order thinking
skills, such as analysing or synthesising, while others are better for surface level
recall.
 Processing speed: Some question types are more easily processed and can be more
quickly answered. This can impact the timing of the test and the distribution of
students’ effort across different knowledge domains.
All test items should:
 Assess the achievement of learning outcomes for the unit and/or course
 Measure essential concepts and their relationship to that unit and course
 Align with your teaching and learning activities and the emphasis placed on concepts
and tasks
 Measure the appropriate level of knowledge
 Vary in levels of difficulty (factual recall and demonstration of knowledge,
application and analysis, and evaluation and creation)

Categories of Test Items: There are two general categories for test items
1. Objective Items – students select the correct response from several alternatives or supply
a word or short phrase answer. These items are easier to create for lower-order Bloom’s
(recall and comprehension) while still designing for higher-order thinking test items (apply
and analyse). Objective test items include:
a)Multiple choice: provide an excellent pre-assessment indicator of student knowledge and a
source for a post-test discussion.
Use Multiple Choice Questions to Assess:
 Information recall
 Application
 Evaluation
 Understanding concepts
Advantages
 easy to score,
 increase reliability,
 may lower test anxiety,
 requires little instruction, and
 manageable for beginning learners who can't produce a lot.
 Can cover lots of content areas on a single exam
Disadvantages
 Often test literacy skills: “if the student reads the question carefully, the
answer is easy to recognise even if the student knows little about the subject.”
 Provide unprepared students with the opportunity to guess, and with correct
guesses, they get credit for things they don’t know
 Expose students to misinformation that can influence subsequent thinking
about the content
 Take time and skill to construct (especially good questions).
Tips for developing for MCQs
 Avoid using the same correct answer option for each question
 Keep answer options to a minimum. Too many become confusing
 Keep question text clear and to the point
 Try to keep all answers the same length
 Avoid using “all of the above” - too obvious
 Avoid using “none of the above.”
 Keep distractors plausible
 Randomise answer options - will prevent candicates from memorising the letters

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  When using numbers, keep answer options in a logical order
 Avoid using double negatives
 Repeating words/phrases such as “Did you know” - keep this in the question only.
Poor example:
A nurse is assessing a client who has pneumonia. Which of these assessment findings
indicates that the client does not need to be suctioned?
a) Diminished breath sounds
b) Absence of adventitious breath sounds
c) Inability to cough up sputum
d) Wheezing following bronchodilator therapy
Good example:
Which of these assessment findings, if identified in a client who has pneumonia, indicates
that the client needs to be suctioned?
a) Absence of adventitious breath sounds
b) Respiratory rate of 18 breaths per minute.
c) Inability to cough up sputum.
d) Wheezing before bronchodilator therapy.
Make the distractors mutually exclusive.
Poor example:
How long does a biennial plant generally live?
a) It dies after the second year
b) It lives for many years
c) It lives for more than one year
d) It needs to be replanted every two years
Good example
How long does a biennial plant generally live?
a) One year
b) Two years
c) Several years
Make distractors approximately equal in length. Students often select the most extended
option as the correct answer.

b) True-false: True and False Questions consist of a question and two answer options. More
often than not, the answer options used are 'True and False'. You can however use other
options, such as 'Yes' and 'No', 'I Agree' and 'I Disagree'.
Also known as: TF, binary choice questions, objective
Use True and False Questions to Assess:
 Recognizing facts
 Reflection of materials learned
 Knowledge check
Question Usage Ideas:
 Statement Analysis
 Feedback
 Item Analysis
 Pre Tests
 Surveys
Advantages of True and False Questions:
 Can customize to use 'Yes' and 'No' or 'I Disagree' and 'I Agree'
 Easy to grade on paper
 Automatically graded online
 Can be answered quickly by Test takers

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  Large range of content can be tested
 Questions are easy to create
Disadvantages of True and False Questions:
 Takes time to create questions
 There's a 50% chance of candidates getting the question correct
 Hard to determine who knows the material and who doesn't
 Can be “too easy”
 Candidates can just check an answer without any comprehension of the question
Tips for developing true/false questions
 Keep question text to a minimum
 Add more 'false' questions than 'true'. Candidates tend to choose 'true' more than they
do 'false'.
 Use your own wording
 Avoid using double negatives
 Use only one fact/statement per each question
 Keep the statement either all true or all false - no in between
 Be clear with your wording
 Keep both true and false statements the same length

C) Matching: Developing matching questions

 Matching questions generally involve pairing a set of stems or premises (e.g., causes)
with a set of responses (e.g., effects).
 Matching questions consist of two columns, typically one column is on the left, and one
column is on the right. We will refer to the left side as ‘Clues’ and the right side as
‘Matches’.
 The objective is to pair the clues on the left side with their matches on the right.
 For example, students might be asked to match constructs with new examples or
principles with new applications.
Use Matching Questions to Assess:
 Comprehension
 Item association
 Knowledge Recall
 Organisation Skills
Advantages
 Great for candidates who have a lower reading level
 Less chance for guessing than other question types
 It can cover a large amount of content.
 Easy to read
 Easy to understand
 Easy to grade on the paper
 Graded automatically online
 More engaging for candidates
Disadvantages
 Can take time to create questions
 Disengaging for the user, if having to search through too many matches
 Time-consuming for the user taking Tests, especially if the test is timed
Tips for developing
 Keep clues (left side) short. This allows candidates to view all options quickly.
 Use more matches (right side) than there are clues for more of a challenge.
 Add clues (left side) in a logical order.

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  Don't use too many items per question. Again, you are testing the material, not
searchability.
 Add clear instructions
 Keep matches (right side) plausible
 Shuffle matches and clues
 Consider limiting the number of items to 10 or less.

d) Completion/Fill-in-the-blank: Completion questions require a student to complete a

statement that is missing one or more essential elements (words, phrases, numbers, etc.).
Similar to matching and true/false, completion questions are better for assessing lower levels
of cognition and are best to check whether crucial facts have been memorised.
Advantages
 high reliability,
 easier to write, and
 limits guessing.
Disadvantages
 they are harder to score
 numerous possible correct answers may exist
 takes more time for students to complete them
Tips for developing completion/fill-in-the-blank
 Ensure blank spaces are the same length. Test-designers may unintentionally provide
students with clues if blanks vary in length. Consider providing a uniform column to
the right of the question in which students can record answers.
 Structure fill-in-the-blank questions such that the blank comes at the end of the
statement. This enhances readability and can reduce confusion.
 Ensure that each blank corresponds to only one correct answer. This reduces marking
time.
 Avoid using more than two blanks per item to reduce ambiguity and confusion.
 Avoid copying text directly from a textbook to construct the question. This can lead to
an emphasis on trivia and encourage memorisation

2. Subjective Items – students present an original answer. These types of items are easier to
use for higher-order Bloom’s (apply, analyse, synthesise, create, evaluate). Subjective test
items are best used when essay questions assess:
 Comprehension of material learned
 Writing skills
 Evaluation
 Analysis
 User's ability to organise facts and ideas
 Vocabulary
 Problem Solving
Question Usage Ideas:
 Gain Feedback
 Gather information
 Comparison of two items
 Discussion

a) Essay There are two significant categories of essay items-short response (also referred to
as restricted or brief) and extended response.
i) Short Response

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 Usually require students to respond to an open-ended prompt using a few words to a
few sentences.
 Short Response items are more focused and constrained than extended response
questions. For example, a short response might ask a student to “write an example”,
“list three reasons”, or “compare and compare two techniques”.
Advantages
 Quick and easy to grade
 Quick and easy to write
Disadvantages
 Encourage students to memorise terms and details so that their understanding of
the content remains superficial
 It can be challenging to develop a key that can accommodate a variety of responses.

ii) Extended Response Essay

 Some questions require more than a one-word answer. "Extended response items"
have traditionally been called "essay questions.
 An extended response item is an open-ended question that begins with some type of
prompt.
Advantages
 Offer students an opportunity to demonstrate knowledge, skills, and abilities
in a variety of ways
 It can be used to develop student writing skills, particularly the ability to
formulate arguments supported with reasoning and evidence
Disadvantages
 Require extensive time to grade
 Encourage use of subjective criteria when assessing answers
 If used in class, it necessitates quick composition without time for planning or
revision, which can result in poor-quality writing
Tips for developing essay questions
 Only add a few essay questions per test
 Keep essay questions per Test specific to one or two topics
 Ask the question in your own words
 Leave opinions at home when grading
 Inform candidates ahead of time of how grading will be completed
 Provide customised feedback per student
 Make the question clear
 Use directives such as “Compare”, “Identify”, “Explain”, “Describe”, “Define.”
 Show the points an essay question is worth.
 Provide instructions on how in-depth and detailed you want in an answer.
Example: What is the best season of the year? Give details and explain your response.
Poor Answer: summer
Good Answer: The best season of the year is summer. Summer has the most opportunity to
do fun things. You can go swimming and go on hikes. It is sunny and bright, and the days are
long. Summer is the best time to see outdoor concerts. Summer is the only season in which
you can be outside all day.

b) Performance Testing
 An assessment of individual performance in a systematic way.
 It requires an examinee to perform a task or activity rather than simply answering questions
referring to specific parts.

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 The purpose is to ensure greater  fidelity  to what is being tested. It can be individual or
group. Some performance tests are simulations.
 An example is OSCE questions
Advantages
 It can be used to assess from multiple perspectives
 Direct observation of student ability
 Can be scored holistically or analytically
 Active student engagement
 Authentic assessment of ability
 Assess transfer of skills and integration of content
 Encourages time on academics outside of class
 Provide a dimension of depth not available in the classroom
 Promote student creativity
 Can be summative or formative
 Place faculty more in a mentor role than as a judge
 Provide an avenue for student self-assessment and reflection
 Can be embedded within courses
 Most valid way of assessing skill development

Disadvantages
 It can be very time consuming
 It can be costly
 Relies heavily on student initiative and drive
 It relies heavily on specific skill sets of students
 Ratings and Results can be subjective
 It can be intimidating to students
 Requires careful design and training of ratter’s
 Sample of behaviour or performance may not be typical, especially if observers are
present

In summary, Objective and subjective test items are both suitable for measuring most
learning outcomes and are often used in combination. Both types can be used to test
comprehension, application of concepts, problem-solving, and ability to think critically.
However, ertain types of test items are better suited than others to measure learning
outcomes. Learning outcomes that require a student to ‘demonstrate’ may be better measured
by a performance test item. In contrast, work requiring the student to ‘evaluate’ may be better
measured by an essay or short answer test item.

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 TEST ADMINISTRATION
(I) Introduction: Test administration procedures are developed for an exam program to help
reduce measurement error and increase the likelihood of fair, valid, and reliable assessment.
Consistent, standardised administration of the exam allows you to compare examinees'
scores directly. However, the examinees may have taken their tests on different dates, at
various sites, and with different proctors.

(II) Learning Objectives

At the end of this session, you should be able to :
• Define the concept of test administration
• Highlights the principles of test administration
• Compare the different types of methods of test administration
(III) Principles of Test Administration
• All examinees should be given a fair chance to demonstrate their achievement of the
learning outcomes intended or planned.
• Students having positive attitudes towards a test.
• Cover all learning tasks.
• Use appropriate test items.
• Make test valid and reliable.
• Use the test to improve learning.
Guidelines to consider to ensure that the actual administration of the test accomplishes
everything you want to:
• when and where the test will be administered?
• How will it be administered?
• Who will administer the test?
• What facilities/apparatus would be necessary for the successful administration of the
test?

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(IV) Methods of Test Administration
(i) Paper-and-Pencil Tests (PPT)
• PPT refer to a general group of assessment tools in which candidates read questions
and respond in writing.
• One of the most common and systematic ways of gathering information about the
learners’ behaviour and performance.
• Assess the level of knowledge and ability or skill qualifications.
• Because many candidates can be assessed simultaneously with a paper-and-pencil
test, such tests are an efficient method of assessment.
Advantages
• Economical in terms of time and money
• Provides an opportunity to obtain detailed feedback for both the teachers and learners
because the responses are being recorded.
• A large number can be tested at the same time
• Allows one to test the students under uniform conditions because examination time can
be strictly controlled.
• Cover a wide area of syllabus than performance and oral tests.
• All students answer the same question paper; hence comparison of the results can be
made effectively.
Disadvantages
• The results may be influenced by external factors like sickness, stress etc.
•  High cost associated with the process. 
•  Non-eco-friendly- a lot of paper is needlessly wasted in the traditional evaluation
process. 

(ii) Computer-Based Testing (CBT). This includes:

• Computerised fixed-form testing (CFT)
• Linear–on-The Fly Testing (LOFT)
• Computerised Classification Testing (CCT)

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 • Computerised Adaptive Testing (CAT)
• Computerised Simulations and Multimedia

a) CBT: Computerized fixed-form testing (CFT)/Preassembled Parallel:

 Preconstructed, intact test forms that are administered by computer to large numbers of
students.
 CFT has fixed time and test length for all candidates & one is [randomly] selected for
each examinee.
Advantage of CFT
• The presentation sequence for the items may be scrambled (i.e., randomly ordered).
• Allows for standard content and technical reviews of test forms before test
administration.
• It is simple to implement because it does not require real-time or online test-delivery
software to perform any particular item selections.
Disadvantage of CFT
• Scrambling creates minor data management challenges
• A practical limitation on the number of test forms may be imposed by the size of the
active item bank

b) CBT: Linear–on-The Fly Testing (LOFT)

 Full-length exam in which the computer selects different questions for you without
consideration of your performance level.
 It consists of a full range of test questions – from easiest to most complex – but not
always in order.
 A bank of approved questions is set up at the start of the process. Then, every time a
candidate sits the exam, the computer-based assessment system generates a new exam
paper in real-time specifically for them.
 This is based on the question of “picking” rules defined within the system—scored in the
same way as a paper-based test.
Advantage of LOFT
• Produces unique (or nearly unique) forms, which can address specific security
concerns because candidates see different sets of items.
• LOFT is used in a computer-based delivery setting, candidate thus response times can
be captured, which is extremely useful when analysing test sessions for irregularities
Disadvantage of LOFT
• Not as well-suited for high-volume programs.
• It is primarily attributed to complex assembly techniques needed due to pressure
placed on the item pool and the need to control item exposure rates.

c) Computerized Classification Testing (CCT)/ Computerized Mastery Testing (CMT)

 Appropriate when only a pass/fail decision is needed. Tests parallel in content and
difficulty are administered successively until an adequate degree of precision or certainty
has been achieved to determine the pass/fail status (mastery model).

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 The number of tests administered will differ with more tests administered to
candidates whose knowledge or ability is close to the passing point and fewer tests
that pass or fail.
A CCT requires several components:
• An item bank calibrated with a psychometric model selected by the test designer
• A starting point
• An item selection algorithm
• A termination criterion and scoring procedure
Advantages of T/CMT: Promote retentiveness and mastery skills
Disadvantage of CCT/CMT: Not suitable for a large number of students

d) Computerised Adaptive Testing (CAT)

An adaptive computer test is one in which the computer selects a range of questions based on
candidates’ performance levels. These questions are taken from a huge pool of possible
questions categorised by content and difficulty. The computer re-estimates its ability and
chooses the one suitable until the measurement accuracy reaches a predefined level. CAT is
performance or individual based testing. The more a candidate answers questions correctly,
the more challenging questions appear on the screen, and vice versa.
Advantages of using CAT
• Decreases the amount of time needed for test preparation and marking, increasing
consistency of the results.
• Greater precision of measurement
• Increased motivation: Because of the better experience, there is likely an increase in
examinee motivation. Low examinees feel better, and high examinees feel challenged.
Both will try harder than with a conventional test.
Disadvantages or challenges to using CAT
• A large, calibrated item pool is needed to support the item selection algorithm.
• The size of a CAT pool usually needs to be eight times the length of the test. So, if a
fixed-length CAT is 100 items long, then the pool should have around 800 calibrated,
active items.
• Building and maintaining large item banks can be expensive and require well-
thought-out pilot plans so that the pool stays fresh.

e) Computerised Simulations and Modelling

 A simulation is an imitation of a real-world process in a controlled environment.
 An interactive multimedia application device intended to imitate a real-life situation and
permit candidates to partake and experience in a risk-free environment.
 Item exposure rates must be carefully controlled to protect the integrity of the pool.
Advantages of Simulations and Modelling
• Can be safer and cheaper than the real world.
• Can use it to find unexpected problems.
• Able to explore ‘what if…’ questions.
• Can speed things up or slow them down to see changes over long or short periods of
time.

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 Limitations of Simulation or Modelling
• Mistakes may be made in the programming or rules of the simulation or model.
• The cost of a simulation model can be high.
• The cost of running several different simulations may be high.
• Time may be needed to make sense of the results.
• People’s reactions to the model or simulation might not be realistic or reliable

Advantages of using CBT

• Flexibility in test delivery
• Improved candidate reach
• Enriched results analysis
• Streamlined process    
• Quick delivery of results
• Test integrity: Remote proctoring and other security features make computer-based
testing extremely secure, maintaining the test integrity.
• Helpful for candidates with a disability

Drawbacks of using CBT

• It is an expensive option, and this factor can deter many government organisations
from opting for it.
• There is a possibility of a technical glitch, power outage or system failure.
• There is an uneven distribution of internet networks as the internet network in some
areas can be poor.

(ii) Oral Testing: An oral test is a test that is answered orally (verbally). The teacher or oral
test assessor will verbally ask a student, who will then answer it using words.
Advantages
 The oral test provides direct contact between the examiner and the examinee.
 More than one examiner can assess more than one candidate simultaneously
 Provides an opportunity to evaluate the strong and weak areas of each learner.
 Provides an opportunity to question the candidate about how she arrived at the
answer.
 Provides the examiner with an opportunity to clarify the question in case the
candidate has not understood.
Disadvantages
 It depends heavily on the examiner's experience and their ability to retain in their
minds an accurate impression of the standard required.
 Lacks standardisation; hence the results of the test cannot compare across candidates
 Expensive because an examiner cannot examine more than fifteen students in a day.
 Lacks objectivity because it is very subjective; examiner can be affected by other
factors external to the test.
 Lacks a precise definition of the criteria for the award of a satisfactory rate

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In conclusion, test construction and administration are critical components of effective
testing/assessment to evaluate and improve learning performance and quality educational
outcomes.
.
Group Activity
Participants (in groups) will be asked to discuss with group members the type of CBT that
can be adopted for the NMCN Professional examination
• Strategies of implementation
• Perceived challenges and
• Suggestions on the way forward
Then, a group report should be submitted, or group presentations can be conducted.

References
1. S.M. Downing, in International Encyclopedia of Education (Third Edition), 2010
2. Reference: McAllister, D., and Guidice, R.M. (2012). This is only a test: A
machine-graded improvement to the multiple-choice and true-false
examination. Teaching in Higher Education, 17 (2), 193-207.
3. Ahmad RG, Hamed O Impact of adopting a newly developed blueprinting method and
relating it to item analysis on students' performance. Med Teach. 2014 Apr; 36 Suppl
1():S55-61
4. Clark, D. (2010). Bloom’s taxonomy of learning domains. The three types of
learning.
5. Anderson, L., & Krathwohl, D. A. (2001). Taxonomy for learning, teaching and
assessing: A revision of Bloom's Taxonomy of Educational Objectives. New York:
Longman. 
6. Armstrong, P. (n.d.). Bloom’s Taxonomy. Center for Teaching, Vanderbilt University. 
7. Bloom, B. S.; Engelhart, M. D.; Furst, E. J.; Hill, W. H.; Krathwohl, D. R.
(1956). Taxonomy of educational objectives: The classification of educational goals.
Handbook I: Cognitive domain. New York: David McKay Company.
8. Harrow, A.J. (1972). A taxonomy of the psychomotor domain. New York: David McKay
Co.

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