Instructions

Benchmark-Summative Assessment

Formative and summative assessments should align with instructional objectives and provide instructors with a variety of ways to measure learning. Instructors have the responsibility to create a test blueprint before creating the assessment to guide them in item writing.

The purpose of this assignment is to create NCLEX style questions and a test blueprint based on the QSEN competency you selected and the course objectives you created in the Topic 3 assignment. Create a summative assessment that consists of five NCLEX-style questions. All questions should be leveled based on Bloom’s taxonomy assigned appropriately to where your course fits in the curriculum.

Complete the “Test Blueprint” template to guide your distribution of 100 questions across all Bloom’s levels for the four objectives you created in Topic 3. These questions should be distributed according to the semester your course will occur. Use the “Test Blueprint” template to complete the following:

1. Create five NCLEX-style questions based on your QSEN competency.
2. Identify Bloom’s level and rationale for including each of the five NCLEX-style questions.
3. Complete the “Test Blueprint” template of 100 hypothetical questions (you do not have to create 100 questions, just designate how many questions per Bloom’s level and how many of the 100 questions would be select-all-that-apply).
4. Provide a rationale that explains why you assigned questions to each of Bloom’s levels within the test blueprint.

Incorporate the “Test Blueprint” template, five NCLEX-style questions, and associated narratives into one Word document.

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Solution

Introduction

The creation of a test blueprint is a significant step in the preparation of assessment for any course. Instructors in nursing education utilize testing devices to measure specified student achievement in different course outcomes (Javaeed, 2018). The educational objectives are significant in guiding educators in setting the assessment by informing them on the number of questions or emphasis for each objective. This paper presents the preparation of a summative assessment for the Psychiatric Nursing in Underserved Populations Champion Course. The author describes examples of NCLEX-type questions, related professional standards, and test blueprint for the assessment.

                Alignment to Professional Standards and Nurse Educator Competencies

The RN-BSN program equips students with more leadership proficiency, advanced career skills, and more knowledge of the nursing practice (Altmiller and Hopkins-Pepe, 2019). The RN-BSN program is significant in imparting students with skills needed in quality improvement and patient-centered care. The quality and safety education for nurses’ competencies helps students acknowledge their weaknesses and strengths before qualification and identify ways to improve. This summative assessment considers the QSEN competencies, which the student should acquire after the course. The course outline and objectives incorporate learning experiences, which will help the student attain the competencies. The assessment will involve testing students to achieve the following QSEN competencies required of them upon licensure.

• Improvement of quality – knowledge, and skills in quality improvement are integral in graduate nurses (Altmiller and Hopkins-Pepe, 2019)
• Patient-centered care – treating clients with dignity is a significant virtue in nursing practice
• EBP- utilization of best evidence from research is integral in psychiatric nursing
• Informatics – the comprehension of the role of informatics in increasing efficiency in the management of information is also significant for the students
• Healthcare providers’ collaboration – students will demonstrate their competencies in teamwork and collaboration in psychiatric nursing services to underserved populations.

NCLEX Style Questions

1. While caring for patients with psychiatric disorders in the community, the nurse understands that such populations face additional barriers to access preventive practices, health promotion services, and healthcare. As a nurse working among underserved populations, what other facts about psychiatric nursing among the populations should you consider? Select all that apply.
2. Most ethnic or racial minority populations have similar cases as the whites
3. The rates of psychiatric conditions in marginalized populations of African Americans are similar to those of the general population
4. The history of American Indians, Alaska Natives reveals intergenerational trauma imparted to these populations and has an insignificant effect on the rate of health problems than the general population.
5. Cultural and structural barriers among millions of Asian Americans and Pacific Islanders are insignificant in influencing their access to mental health care.
6. The Appalachian people are over-represented in the U.S.A’s worst quintile of social determinants of health.
7. The Lesbian, Gay, Bisexual, Transgender, Queer/Questioning (LGBTQ) population faces a similar risk of mental illness as heterosexual men.
8. The bisexual population has characteristic confidence that increases their uptake of mental health services while the homosexual individuals face more adverse health outcomes distress related to stigma.

QSEN Competency: Evidence-based practice

Objective: Determinants of health and their relation to psychiatric health (objectives one and two)

Concept: Social determinants of health and health-related disparities in psychiatric nursing

Bloom Level: knowledge

Rationale: The teacher decided to test learner recall of content learned in the classroom and various learning experiences. In the knowledge-levels question, the learner should demonstrate that they could identify the course concepts learned, which is crucial in utilizing the content to higher levels of thought (Scully, 2017). The question requires students to allude to the content on determinants of health and consider the racial, ethnic, gender, developmental, social contexts, and economic aspects of underserved populations in the U.S. healthcare disparities among marginalized communities in the U.S.A such as the Appalachian people are significant causes of poor outcomes of mental illnesses (Snell-Hood et al., 2017). Specifically, the learner will respond by recalling the different demographic facts about various marginalized.

2. Consider the following scenario. A psychiatric client on treatment for twelve years marries in a formal wedding, includes her husband’s name in the medical records, and introduces him to the psychiatric nurse after marriage. Two months after the introduction, the husband visits the nurse at a primary health facility and requests to know the treatment or plan of care, the need for safety interventions for his wife, and prognosis. The psychiatric nurse discusses the diagnosis to the husband and a detailed history of the client. Considering your understanding of psychiatric nursing, what action(s) should the nurse have taken? Select all that apply.
3. Confirm that the husband is rightfully married to the client and discuss the diagnosis with him if medical records confirm the relationship.
4. Inquire about their marriage to determine whether they divorced.
5. Call the psychiatric client and request her consent.
6. Conceal the information.
7. Caution the husband not to share the information with other people, such as the client’s friends.

QSEN Competency: Patient-centered care

Objective: Discuss the ethical principles in nursing, patient rights, and responsibilities (objectives three and four)

Concept: Ethics, legal issues, and nursing principles relevant in the service provision of underserved groups

Bloom Level: Application

Rationale: Respect for patient preferences, values, and rights are integral in nursing practice. This question encourages the student to transfer knowledge learned in the classroom or other learning strategies into their practice as nurses. The psychiatric nursing practice also requires nurses to respect patient rights and adhere to ethical-legal issues related to patient care (Baciu et al., 2017). Therefore, patients with psychiatric disorders are not exceptional in receiving patient-centered care that respects their preferences and rights. The teacher included this question in the assessment to challenge the learner to apply knowledge learned in class to solve a problem or dilemma. During the teacher helps the learner build knowledge by building lower levels of through to higher orders. The student should therefore demonstrate that they grasped content and can use it to clove problems.

3. Social circumstances and individual characteristics are significant influencers of mental health. Depending on the context, some groups of people in the community have specific susceptibility to the development of psychiatric conditions. Which set of factors below represent the individual attributes, which influence mental health?
4. Emotional immaturity, communication difficulties
5. Family conflict, poverty
6. Poor access to essential services, discrimination
7. Gender inequalities, exposure to violence

QSEN Competency: Patient-centered care

Objective: State the risk factors of mental health conditions across the lifespan (objective one)

Concept: Mental health vulnerabilities across the lifespan

Bloom Level: Comprehension

Rationale: The teacher included this question in the assessment to test whether the learner grasped the meaning of different vulnerabilities and risk factors, which predispose people to mental health disorders. According to Adler et al. (2016), individual attributes are innate and learned behaviors of a person, which they use to manage those and feelings in daily life. Social factors differ with individual attributes involving other families, peers, work environment, and law that guides human behavior. Therefore, this question assessed whether the learner could identify the correct set of individual attributes to demonstrate their ability to summarize the content.

4. While working in the community, nurses need to implement evidence-based practice. In psychiatry nursing, nurses should understand that their interventions involve the best evidence from research and reliable studies related to the area. A psychiatric nurse championing for better services among the underserved populations understands that they can intervene by
5. Implementing telepsychiatry to diverse settings
6. Replacing human interactions with tele-mental health
7. Training nurses to work in underserved populations upon graduation and licensure.
8. Improving housing and eliminating disparities by instituting policies, which promote equal opportunities in child development

QSEN Competency: Evidence-based practice

Objective: Nurse practitioners will appreciate the significance of evidence-based practice in psychiatric interventions in underserved groups.

Concept: Evidence-based practices in addressing the health-related disparities in underserved populations about mental health

Bloom Level: Analysis

Rationale: The teacher included the question in the assessment to test their ability to find trends or patterns in course content and predict what would happen. Analysis questions challenge learners to move beyond sampling, recalling, comprehending, and analyzing content learned in class (Diab and Sartawi, 2017). The teacher tests the student’s analysis of the actions, which a psychiatric nurse can perform at their capacity to promote better services. Therefore, nurses can implement telepsychiatry at their capacity to deliver race to people in diverse locations.  

5. The translation of knowledge on the diagnosis of common mental health issues in underserved groups is integral in promoting the best patient care outcomes. for a patient with alcoholic hallucinosis, the nurse understands that the following symptoms confirm that the patient is experiencing the syndrome
6. Tactile hallucinations and extremes of anger
7. Fear, anxiety, and extreme anger
8. Visual hallucinations and clear sensorium,
9. Delirium and auditory hallucinations

QSEN Competency: Patient-centered care

Objective: Discuss the ethical principles in nursing, patient rights, and responsibilities (objectives three and four)

Concept: Ethics, legal issues, and nursing principles relevant in the service provision of underserved groups

Bloom Level: Knowledge

Rationale: The teacher decided to test learners’ recall of information and learn specific knowledge from classroom teaching. The question requires the learner to identify the characteristic presentation of a client with alcoholic hallucinosis. The syndrome can develop among people with prolonged alcohol abuse. The alcoholic syndrome can occur after 24 hours of the last alcohol intake. In this question, the students should demonstrate their remembrance that the syndrome presents with visual, auditory, and tactile hallucinations, clear sensorium, anxiety, and fear in extreme cases.

The assessment will be a summative test for semester three, according to Table 1; the number of questions will be distributed to four levels of Bloom’s taxonomy- knowledge, comprehension, application, and analysis. After determining the semester, the teacher assigned the number of question or test items to the four levels

Table 1

COGNITIVE LEVEL	First Semester	Second Semester	Third Semester	Fourth Semester
Knowledge	40%	25%	15%	0%
Comprehension	35%	40%	25%	0%
Application	20%	30%	30%	15%
Analysis	5%	5%	30%	25%
Synthesis	0%	0%	0%	30%
Evaluation	0%	0%	0%	30%

Table 2

Test Blueprint

COURSE: _PSYCHIATRIC NURSING IN UNDERSERVED POPULATIONS CHAMPION COURSE_

TEST:  _THIRD SEMESTER SUMMATIVE TEST_

COGNITIVE LEVEL	Objective 1	Objective 2	Objective 3	Objective 4
Knowledge	4	4	5	2
Comprehension	6	10	4	5
Application	10	4	6	10
Analysis	4	6	12	8
Synthesis	0	0	0	0
Evaluation	0	0	0	0

The rationale for Bloom’s Level of Test Blueprint Questions

The third semester focuses on guiding the learner into lower to middle-order levels of Bloom’s Taxonomy. The choice of the question depended on the module objectives or content that was satisfactorily covered. According to Diab and Sartawi (2017), both classroom teaching and summative assessment should encourage the student to build cognitive skills from lower knowledge, comprehension, and application levels to higher analysis levels. The assessment for the third semester does not test the synthesis and evaluation of cognitive skills. The teacher included each question to the different levels of Bloom’s taxonomy to encourage the learner to build through from lower to higher levels of cognitive skills.

The number of questions for each objective depended on the teacher’s amount of significance of the specific objective. Out of the hundred questions, 45 questions belonged to the select-all-that apply (SATA) test items. The classroom teaching will also involve challenging the student to apply comprehended knowledge to new situations or solve problems. The teacher-included questions, which test students’ knowledge or recall of the content to encourage them, think from lower levels of cognitive skills. Out of the hundred questions, 15 assess the knowledge level of Bloom’s taxonomy. The four objectives were assigned different numbers of questions for the knowledge level depending on the amount of time spent teaching the content area and the importance assigned by the teacher.

Bloom identified that the comprehension level involves encouraging a learner to grasp the meaning of content and demonstrating the ability to explain the meaning of the material (Diab and Sartawi, 2017). Application-level questions focus on assessing how a learner can use the information to solve a problem or create a project. The analysis level focuses on challenging the learner to identify patterns in content material, break it down into parts and find the relation or trend among the parts. Questions assessing learners’ cognitive skills in analysis help them subdivide information, put it into a whole, and identify the relationship.

Conclusion 

Nursing educators utilize Bloom’s taxonomy domain to guide learners in instruction and assess them (Diab and Sartawi, 2017). The educators also use the learning objective to plan, implement and evaluate learning outcomes. Using Bloom’s taxonomy domains, educators guide the learner to build thought and knowledge from lower to higher levels of cognitive skills. The selection of questions into the test blueprint in this assessment depended on the objectives and specific cognitive skills among the learners expected.

References

Adler, N. E., Glymour, M. M., & Fielding, J. (2016). Addressing social determinants of health and health inequalities. Jama, 316(16), 1641-1642.

Altmiller, G., & Hopkins-Pepe, L. (2019). Why Quality and Safety Education for Nurses (QSEN) matters in practice.

Baciu, A., Negussie, Y., Geller, A., Weinstein, J. N., & National Academies of Sciences, Engineering, and Medicine. (2017). The state of health disparities in the United States. In Communities in action: Pathways to health equity. National Academies Press (US).

Diab, S., & Sartawi, B. (2017). Classification of questions and learning outcome statements (Los) into blooms taxonomy (bt) by similarity measurements towards extracting of learning outcome from the learning material. arXiv preprint arXiv:1706.03191.

Javaeed, A. (2018). Assessment of higher-ordered thinking in medical education: multiple choice questions and modified essay questions. MedEdPublish, 7(2), 60.

Scully, D. (2017). Constructing multiple-choice items to measure higher-order thinking. Practical Assessment, Research, and Evaluation, 22(1), 4.

Snell-Rood, C., Hauenstein, E., Leukefeld, C., Feltner, F., Marcum, A., & Schoenberg, N. (2017). Mental health treatment seeking patterns and preferences of Appalachian women with depression. American Journal of Orthopsychiatry, 87(3), 233.