One Objective, Four Ways to Measure It: Matching Assessment Methods to the Cognitive Level of Each Objective in a Maternal-Newborn Course
[Student Name]
University of Phoenix
NSG/533: Educational Assessment and Evaluation
Week 2 Assignment
[Instructor Name]
[Date]
The school, the course and its assessments are a composite written for a model paper.
In Week 1, I found that the maternal-newborn course I lead in an accelerated BSN program sets five of its six objectives at the level of application or higher, while 65% of its exam items test remembering or understanding. This paper takes the next step: choosing, for each objective, the assessment method that can actually measure it.
The Methods Available
Four families of methods are practical in an eight-week course with 56 students.
Multiple-choice items are efficient, can be scored reliably and can sample a wide range of content. Well-written items built on clinical scenarios can measure application and analysis. They cannot measure performance, communication or the ability to generate an answer rather than recognize one (Oermann & Gaberson, 2021).
Written assignments, such as care plans, case analyses and reflective papers, can measure analysis, evaluation and creation and show how students reason. They take time to grade and are less reliable unless a clear rubric is used.
Simulation with a rubric lets students show clinical judgment and skills in a realistic but safe setting, with performance observed and scored. It is resource-intensive and depends on well-designed scenarios and trained raters.
Clinical observation measures performance with real patients and families, the ultimate goal. It is the least standardized, because every student sees different patients, and instructor judgments vary.
No single method measures everything the course promises, which is why the choice has to be made objective by objective.
Objective by Objective
Objective 1, the course's knowledge objective about the body's normal changes in pregnancy and after birth, sits at the two lowest levels of the taxonomy (Anderson & Krathwohl, 2001). Multiple-choice items are appropriate and efficient here, and a short formative quiz before the first clinical day would let students check their knowledge.
Objective 2, deciding which of several mothers and babies with complications needs care first, is at the analyze level. Scenario-based multiple-choice items asking students to choose which patient to see first can measure it on exams, and a simulation in which students manage two patients at once can measure it in action. I will use both.
Objective 3, interpret assessment findings to recognize deterioration, is at the apply and analyze levels. Unfolding case studies on exams, in which new data appear across several items, can measure it, and simulation of a postpartum hemorrhage can measure it in real time with a rubric based on clinical judgment. Lasater (2007) developed a rubric for clinical judgment in simulation, based on Tanner's model, that describes performance in noticing, interpreting, responding and reflecting; an adapted version will be used here.
Objective 4, apply evidence to teach families, combines cognitive and affective elements and communication. A written teaching plan, graded with a rubric, can measure the application of evidence; clinical observation of a teaching session measures the communication. I will use the teaching plan as a graded assignment and the observation as part of the clinical evaluation.
Objective 5, judge the effectiveness of nursing interventions, is at the evaluate level. A written case analysis in which students evaluate the care given to a patient in a case and recommend changes can measure it, graded with an analytic rubric. Post-conference discussion can serve as formative assessment of the same skill.
Objective 6, plan culturally responsive care, is at the create level and includes affective elements. A care plan for a family from the student's clinical experience, including cultural assessment and adaptations, graded by rubric, can measure it, supported by reflective journaling as formative assessment.
Formative Assessment Throughout
Week 1 found that almost all assessment in the course is summative. The revised plan adds weekly low-stakes practice: a short set of scenario questions each week with immediate feedback, a formative simulation debriefing before the graded simulation and instructor comments on a draft of the teaching plan. Formative assessment gives students the chance to learn from mistakes before they are graded, which is its main purpose (Oermann & Gaberson, 2021).
Psychomotor and Affective Outcomes
Two kinds of learning in the course fall outside the cognitive taxonomy. Psychomotor skills, such as a newborn physical assessment or fundal assessment, will be checked in the skills lab with a performance checklist before students perform them in clinical, and again by clinical instructors. Affective outcomes, such as respect for families' choices and cultural practices, will be assessed through reflective journals and instructor observation of interactions, with feedback rather than grades, because attitudes are best developed through reflection and modeling rather than scored.
The Assessment Blueprint
The blueprint records the plan. Unit exams and the final, redesigned so that at least 60% of items are at the apply level or higher, carry 50% of the grade and cover objectives 1, 2 and 3. The graded simulation, scored with the clinical judgment rubric, carries 15% and covers objectives 2 and 3. The teaching plan carries 10% and covers objective 4. The case analysis carries 15% and covers objective 5. The culturally responsive care plan carries 10% and covers objective 6. The clinical evaluation is pass or fail and must be passed separately, covering objectives 2 through 6 in real care. Weekly practice questions, the formative debriefing and the draft review are ungraded.
Balancing Workload and Reliability
The new plan asks more of faculty, since written assignments and simulation take longer to grade than multiple-choice exams. To keep it manageable, each written assignment is limited to a set length, rubrics are shared with students in advance and two faculty grade a sample of papers together each cohort to keep scoring consistent. Simulation is scored by two raters for a sample of students to check agreement, a step Week 4 will examine.
Sequencing Assessments Across the Eight Weeks
The order of assessments also matters. Weekly practice questions begin in week 1. The first unit exam in week 3 covers normal changes and early complications. The formative simulation debriefing in week 4 precedes the graded simulation in week 5, so students experience the rubric before being scored on it. The teaching plan draft is reviewed in week 4 and submitted in week 6, the case analysis is due in week 7 and the final exam is in week 8. Spacing the major graded work avoids three large assessments landing in the same week, which accelerated students named as a source of stress in past course evaluations.
Limits
Even a well-matched plan has limits. Exam items at higher levels are harder to write and must be checked for flaws. Simulation performance may not fully predict performance with real patients. Clinical observation remains variable across instructors. These limits argue for using several methods for the most important objectives, which the blueprint does.
Conclusion
Matching assessment methods to objectives showed that multiple-choice items can measure the course's knowledge objective and, when built on scenarios, much of its prioritization and interpretation objectives, while its objectives at the evaluate and create levels need written work and its performance goals need simulation and clinical observation. The blueprint puts the course's grades in proportion to what it promises students will be able to do. Week 3 will write the items and rubrics.
References
Anderson, L. W., & Krathwohl, D. R. (Eds.). (2001). A taxonomy for learning, teaching, and assessing: A revision of Bloom's taxonomy of educational objectives. Longman.
Lasater, K. (2007). Clinical judgment development: Using simulation to create an assessment rubric. Journal of Nursing Education, 46(11), 496-503. https://doi.org/10.3928/01484834-20071101-04
Oermann, M. H., & Gaberson, K. B. (2021). Evaluation and testing in nursing education (6th ed.). Springer Publishing.
How this NSG 533 Week 2 example is structured
The NSG/533 description calls for evaluating assessment methods used to measure performance and aligning tools to a taxonomy. This paper evaluates methods against each objective's level and domain, explains the strengths and limits of each method, chooses a mix and records it in an assessment blueprint so the alignment can be checked. Students search this week as NSG 533 Week 2, NSG533 Wk 2 or NSG/533 Wk 2; all three are the same assignment.
NSG/533 Week 2 questions, answered
What does NSG/533 Week 2 usually ask for?
The course description includes evaluating assessment methods and aligning them with an educational taxonomy. Many sections ask students to match assessment methods to course objectives at different cognitive levels.
What is an assessment blueprint?
A table that lists each objective, its cognitive level, the assessment methods used and the weight of each in the course grade, so faculty can see that assessments cover the objectives in proportion to their importance.
Can multiple-choice questions measure higher-level thinking?
Yes, when they present a clinical scenario and ask students to prioritize, interpret or decide, rather than recall a fact. They cannot measure skills such as communication or psychomotor performance.
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