Fluent Essays

please complete the following assignments attached to this post. all assignment must be submitted by 10/9 11:59 PM EST. no exceptions. Susan J. Beck, Ph.D., MLS(ASCP)CM and Vicky A. LeGrys, D.A., MT(ASCP) Division of Clinical Laboratory Science, The University of North Carolina at Chapel Hill Copyright 2014: The American Society for Clinical Laboratory Science Test Development and Analysis: Homework Assignment A. Given the following objectives, write 5 multiple choice questions covering all of the COGNITIVE taxonomic levels. Label the test item with its taxonomic level and correct answer. OBJECTIVES: At the end of the lecture, the student should be able to: 1. Explain the principle of the antiglobulin test. 2. List the steps in the DAT and the IAT tube agglutination procedures and describe the rationale for each step. 3. Discuss the applications of the direct and indirect antiglobulin tests. 4. Given an example of an antibody panel, identify the antibody. 5. Given an example of antigen identification using the indirect antiglobulin method, evaluate the results of the controls and patient’s tests. B. Find multiple choice questions in a textbook or review book. Find one example of a well written multiple choice question and one example of a poorly written multiple choice question. List the source of the items you select. Write out each question and explain why you think it is well written or poorly written. Susan J. Beck, Ph.D., MLS(ASCP) CM and Vicky A. LeGrys, D.A., MT(ASCP) Division of Clinical Laboratory Science, The University of North Carolina at Chapel Hill Copyright 2014: The American Society for Clinical Laboratory Science 1 Test Development and Analysis: Post Test Choose the one best answer. 1. Testing can be used to: A. assess learner competency B. design a CLS curriculum C. organize learning activities D. establish course goals 2. A comprehensive, final exam in a microbiology lecture course is considered a: A. placement test B. formative test C. summative test D. certification test 3. A test designed to assess necessary prerequisite skills for a course is: A. comprehensive B. formative C. placement D. summative 4. An instructor wants to assess a learner’s cognitive and psychomotor skills in a laboratory course. The best form of testing for this scenario would be: A. written test B. oral test C. online, computerized test D. practical test 5. A test in which learners are evaluated in comparison to one another is: A. criterion-referenced B. standardized C. norm-referenced D. competitive performance 6. “Grading on a curve” represents: A. norm-referenced test B. criterion-referenced test C. certification test D. competency test Susan J. Beck, Ph.D., MLS(ASCP) CM and Vicky A. LeGrys, D.A., MT(ASCP) Division of Clinical Laboratory Science, The University of North Carolina at Chapel Hill Copyright 2014: The American Society for Clinical Laboratory Science 2 7. What is the most significant problem associated with the following objective and corresponding test item: Objective: Analyze a case study for acid base status. Test item: What methodology is used for analyzing pCO2 in the clinical laboratory? This test item: A. is subject to interpretation B. does not match the objective C. evaluates a higher cognitive level D. does not evaluate current practice 8. An instructor gives a lecture on creatinine methodology. Which of the following represents a test item evaluating a higher cognitive level? A. What is the reagent used in measuring serum creatinine? B. What is the reference interval for serum creatinine? C. How is serum creatinine determined in the clinical laboratory? D. Analyze a case study involving a diabetic patient and discrepant creatinine results. 9. You are preparing a summative examination in hematology. The learners will have fifty minutes to complete the exam, and must score above 70\% in order to continue on to the clinical rotation. The exam contains 100 multiple choice questions and 3 case studies for analysis and evaluation. What is the most significant problem with this scenario? A. summative examinations should not contain multiple choice questions B. higher cognitive skills are not being assessed C. the test is norm referenced D. the test contains too many items for the time allowed 10. When designing a test, the first thing an instructor should do is: A. allocate the number of test items devoted to each topic B. choose the type of questions for the examination C. determine the number of items on the examination D. create the test items 11. Which of the following test items is considered subjective? A. multiple choice B. true/false C. matching D. essay Susan J. Beck, Ph.D., MLS(ASCP) CM and Vicky A. LeGrys, D.A., MT(ASCP) Division of Clinical Laboratory Science, The University of North Carolina at Chapel Hill Copyright 2014: The American Society for Clinical Laboratory Science 3 12. The primary disadvantage a multiple choice test items is : A. difficulty in grading B. samples a small amount of course materials C. tendency to test recall level D. learners with poor writing skills often perform poorly 13. The primary advantage of a multiple choice test is that it A. is easy to construct B. is easy to grade C. is useful for assessing affective skills D. stimulates learners creativity 14. The primary disadvantage of true/false test items is: A. difficulty in grading B. encourages guessing C. takes a long time to administer D. assesses higher level cognitive skills 15. Matching test items are most useful in: A. assessing problem solving skills B. assessing the affective domain C. correlating laboratory data D. evaluating communication skills 16. An advantage of essay tests is that they: A. are easy to construct B. are easy to objectively grade C. tend to test at the recall level D. are useful as standardized tests 17. To minimize subjectivity in grading essay questions, the instructor should: A. develop a grading rubric after reading all test papers B. grade all the answers from one learner before grading the next paper C. grade the test without knowing the learner’s identity D. grade the test papers from the higher achieving learners first Susan J. Beck, Ph.D., MLS(ASCP) CM and Vicky A. LeGrys, D.A., MT(ASCP) Division of Clinical Laboratory Science, The University of North Carolina at Chapel Hill Copyright 2014: The American Society for Clinical Laboratory Science 4 18. Given the following test item: Anti-A1 A. Is routinely detected in A1 individuals B. Reacts with A2 red cells C. Gives a mixed field reaction with A1 cells D. Is found in group B individuals This item could be improved by A. writing the stem in the form of a question or incomplete statement B. changing the length of the correct answer C. changing the alternatives to match the stem grammatically D. placing a or a(n) in the stem 19. Given the following test item: A patient with diabetes will have a: A. 2 hour post-prandial glucose greater than 50 mg/dL B. 2 hour post-prandial glucose greater than 70 mg/dL C. 2 hour post-prandial glucose greater than 100 mg/dL D. 2 hour post-prandial glucose greater than 140 mg/dL This item could be improved by A. removing unnecessary information from the stem B. including the phrase of the following in the stem C. removing repetitive information from the responses D. changing the length of the correct answer 20. Given the following test item: Which of the following statements is associated with Type I diabetes mellitus? A. The patients are always obese B. Patients are prone to ketoacidosis C. Patients can be treated by diet alone D. Onset occurs in early adulthood This item could be improved by: A. changing the length of the correct answer B. removing the word always from response A C. adding a or a(n) to the stem D. removing repetitive information from the alternatives Susan J. Beck, Ph.D., MLS(ASCP) CM and Vicky A. LeGrys, D.A., MT(ASCP) Division of Clinical Laboratory Science, The University of North Carolina at Chapel Hill Copyright 2014: The American Society for Clinical Laboratory Science 5 21-24. Given the following test scores, what are the mode, median and mean and range and standard deviation? 78 88 71 89 89 94 61 82 91 76 73 72 81 87 80 21. The median value is: A. 75 B. 81 C. 88 D. 89 22. The mean value is: A. 75.6 B. 79.5 C. 80.8 D. 89.6 23. The mode is: A. 75 B. 81 C. 88 D. 89 24. The standard deviation is: A. 1.2 B. 3.4 C. 8.7 D. 9.1 Susan J. Beck, Ph.D., MLS(ASCP) CM and Vicky A. LeGrys, D.A., MT(ASCP) Division of Clinical Laboratory Science, The University of North Carolina at Chapel Hill Copyright 2014: The American Society for Clinical Laboratory Science 6 25. If test scores are significantly skewed, which measurement of central tendency is best? A. mean B. median C. mode D. range 26. An item with a difficulty index of 0.05 (5\%) would be considered: A. a very easy item B. a moderately difficult item C. a very difficult item D. an item that discriminates well 27. The criterion validity of a test refers to the A. ability of the test scores to predict future performance on a related measure B. internal consistency of the test scores C. match between the test and a representative sample of objectives D. ability of the test items to meet the criteria for difficulty and discrimination 28. A discrimination index of 0.5 on a test item indicates the correct response was chosen: A. equally by the high and low achievers B. more often by the high achievers than the low achievers C. more often by the low achievers than the high achievers D. by 50 percent of the learners taking the test Susan J. Beck, Ph.D., MLS(ASCP) CM and Vicky A. LeGrys, D.A., MT(ASCP) Division of Clinical Laboratory Science, The University of North Carolina at Chapel Hill Copyright 2014: The American Society for Clinical Laboratory Science 7 29 and 30. Refer to the following item analysis: Item 1: Responses A B* C D Difficulty Index Discrimination Index Number of learners 0 12 13 0 0.52 - 0.20 * indicates the correct answer 29. The discrimination index is unacceptable because: A. it does not correlate with the difficulty index B. the correct answer was selected more often by learners who performed poorly on the examination than by the learners who performed well C. the correct answer was selected more often by learners who performed well on the examination than by the learners who performed poorly D. only half of the learners selected the correct answer. 30. Responses A and D should be revised because they are: A. causing the difficulty index to be too high B. causing the discrimination index to be a negative number C. distracting the good learners D. implausible and contain clues Question 2: Off Question 3: Off Question 4: Off Question 5: Off Question 6: Off Question 7: Off Question 8: Off Question 9: Off Question 10: Off Question 21: Off Question 11: Off Question 12: Off Question 13: Off Question 14: Off Question 15: Off Question 16: Off Question 17: Off Question 18: Off Question 19: Off Question 20: Off Question 1: Off Question 22: Off Question 23: Off Question 24: Off Question 27: Off Question 28: Off Question 26: Off Question 25: Off Question 29: Off Question 30: Off Susan J. Beck, Ph.D., MLS(ASCP)CM and Vicky A. LeGrys, D.A., MT(ASCP) Division of Clinical Laboratory Science, The University of North Carolina at Chapel Hill Copyright 2014: The American Society for Clinical Laboratory Science 1 Test Development and Analysis The material presented in this chapter should enable the learner to: 1. Describe the sequence of steps involved in planning an instructional activity. 2. List the purposes of testing. 3. Describe placement, formative, and summative testing. 4. Discuss the uses of various testing platforms. 5. Compare norm referenced and criterion referenced exam with regard to function, analysis, and evaluation criteria. 6. State the limitations of testing and suggest ways of improvement. 7. Describe the development of a grading rubric to decrease subjectivity. 8. Outline the steps involved in designing a test. 9. Discuss the advantages and disadvantages of the various types of test items. 10. Given an example of a multiple choice test item, analyze the item and suggest ways to improve it using the stated criteria. 11. Given an instructional unit, develop and analyze a test using the guidelines presented in this unit. 12. Discuss the statistics used to describe the central tendency and dispersion of test scores. 13. Evaluate the performance of a test item based on the item’s difficulty index and the discrimination index. 14. Define reliability and validity. 15. Discuss the ways that an instructor can improve the reliability of test scores. 16. Given a set of objectives and an examination for a course, evaluate the content validity of the examination. 17. Given an instructional unit, develop and analyze a test using the guidelines stated in this unit. THE INSTRUCTIONAL SEQUENCE Goals: The first step in planning an instructional activity is to identify goals. Goals are statements that describe the general knowledge skills or attitudes that the learner will possess after the instructional activity. Objectives: The next step in instructional planning is writing objectives. Objectives are statements that describe the specific learning outcomes of an instructional activity and they are written in greater detail than goals. Objectives specify the observable knowledge, skills or attitudes that the learner is expected to exhibit after completing an instructional activity. Objectives serve to communicate the instructors intent for a particular learning experience. 4 Susan J. Beck, Ph.D., MLS(ASCP)CM and Vicky A. LeGrys, D.A., MT(ASCP) Division of Clinical Laboratory Science, The University of North Carolina at Chapel Hill Copyright 2014: The American Society for Clinical Laboratory Science 2 Learning Activities: Instructional activities or learning activities are chosen to help the learner master the objectives. They include such things as lectures, laboratory exercises, demonstrations, and online instruction. Evaluation: An evaluation process should be planned to tell the instructor whether or not the learners were able to master the objectives and whether or not the instructors approach was effective in assisting learners. PURPOSES OF TESTING Testing is an integral part of any clinical laboratory educational experience. It is used as an evaluation tool in CLS/CLT programs, in continuing education programs and in competency testing for laboratory personnel. From the instructor’s perspective, testing is useful for:  Making objective decisions concerning the competency of a learner or practitioner in the clinical laboratory. In competency assessment for laboratory personnel, testing is one mechanism to document that the individual possesses the necessary knowledge, skills and attitudes required to perform laboratory procedures.  Evaluating the effectiveness of instruction and curriculum. Identifying subject areas in which the majority of the learners performed poorly provides instructors with the opportunity to alter the presentation of the material to make it more effective. From the learner’s perspective, testing is a useful tool for:  Assessing strengths and weaknesses and improving problem areas as the course progresses.  Motivating the learner to study the material and challenging the competitive learner. TYPES OF TESTS Placement tests are used to assess the prerequisite skills needed for a course of study or the knowledge, skills and attitudes prior to instruction. Formative tests are used to assess knowledge during a course. These test grades are often averaged into the final grade and cover a limited portion of material. Susan J. Beck, Ph.D., MLS(ASCP)CM and Vicky A. LeGrys, D.A., MT(ASCP) Division of Clinical Laboratory Science, The University of North Carolina at Chapel Hill Copyright 2014: The American Society for Clinical Laboratory Science 3 Summative tests are used to assess the mastery of material and learners’ readiness to progress in a program or into the profession. Examples of summative testing include  comprehensive final examinations for a course.  comprehensive examination evaluating all areas of the curriculum given at the end of the program.  certification examinations to assess the competency of individuals to work in the clinical laboratory.  competency testing for laboratory personnel to assess the practitioner’s mastery of laboratory procedures. TESTING PLATFORMS Tests can be given in a variety of platforms such as 1. Written 2. Oral: Used in the laboratory to question individual learners in order to develop their problem solving abilities 3. Online: Used in standardized achievement tests, certification examinations, distance education, and in course management systems. The advantages of online testing compared to written examinations is that the testing is arranged individually, the individual answers fewer questions, testing takes less time, it is easier to enter the answers using a computer versus on an answer sheet and the results of the test are often available sooner.1 4. Practical examinations: Developed by combining the performance of a laboratory procedure with the response to written questions. Practical examinations are able to assess both psychomotor and cognitive skills. This type of test format is very useful in evaluating learner performance and is more accurate than using written tests alone to assess the learner’s ability to function effectively in the clinical laboratory. NORM-REFERENCED AND CRITERION-REFERENCED TESTS Characteristics of norm-referenced tests: Susan J. Beck, Ph.D., MLS(ASCP)CM and Vicky A. LeGrys, D.A., MT(ASCP) Division of Clinical Laboratory Science, The University of North Carolina at Chapel Hill Copyright 2014: The American Society for Clinical Laboratory Science 4  They represent the traditional achievement tests in which learners are evaluated against one another on test performance.  They are often graded on a curve establishing a set number of As, Bs, and so on. An 80\% score on a norm-referenced test may be an A if everyone in the class performed at a level below 80\% or an 80\% may be a C if the mean for the test was 85\%.  The group of test takers determines the standards of acceptability. These tests may be useful in selection of learners for advancement but are limited in their ability to assess competency. Characteristics of criterion-referenced tests:  They assess mastery by achieving predetermined minimal competencies. Minimal competency is defined as the knowledge, skills and attitudes necessary to perform an activity according to prevailing standards of adequacy.2  The criteria for mastery are developed prior to test administration.  It is possible for all learners to do well on the criterion-referenced test items if they have achieved minimal competency.  They are used in a pass/fail situation such as certification examinations Both criterion-referenced and norm-referenced tests are used in clinical laboratory educational programs. Many programs establish minimum scores in both the didactic/lecture and laboratory courses which must be achieved by the student in order to remain in the program. In a profession such as clinical laboratory science, all individuals must be able to master certain skills such as typing blood, identifying abnormal cells, and recognizing panic values. These skills must be achieved by all individuals, regardless of peer performance. The thought of an individual who did not achieve minimal competency but passed on a curve and graduated from a program is contrary to ethical standards of practice. After establishing minimum competency standards, represented by course or curriculum objectives, many clinical laboratory education programs use norm referencing to assign learners a grade relative to the performance of others. Norm-Referenced Tests Criterion-Referenced Tests Function Ranks the learner’s performance relative to the group’s performance Compares the learner’s performance with predetermined standards Analysis Occurs after the test administration Occurs before and after test administration Pass/Fail criteria Determined by the test group’s performance Pre-determined, independent of the test group’s performance PITFALLS OF TESTS Problem areas include: 1. Limited assessment of cognitive skills 2. Assessing irrelevant material Susan J. Beck, Ph.D., MLS(ASCP)CM and Vicky A. LeGrys, D.A., MT(ASCP) Division of Clinical Laboratory Science, The University of North Carolina at Chapel Hill Copyright 2014: The American Society for Clinical Laboratory Science 5 3. Assessing material not covered in the objectives 4. Subjective grading 5. Poorly designed tests 1. Limited assessment of cognitive skills The most critical shortcoming of tests for clinical laboratory science learners is that they contain too many items at the recall level. While it is important that all learners know certain basic facts, it is essential that clinical laboratory science learners be able to analyze, interpret, and evaluate data. Often the higher level cognitive skills are included in the course objectives, yet when the test is constructed, only the lower skills are tested. Learners soon discover that the majority of the questions are at the recall level and, therefore, study by memorizing the facts. In an effort to make the test more difficult, many instructors include trivial or esoteric facts in their test items, ignoring fundamental principles. Learners who perform well on these tests may be good at memorization but may not be competent to practice. Suggestions for improvement: To ensure that higher cognitive level items are included in the test, the instructor should present novel situations requiring application, analysis, interpretation, and evaluation. A key point in designing higher level test items is to present data the requiring the learner to interpret unfamiliar examples. Test items can ask the learner to: 2,3  Perform calculations  Identify unfamiliar examples of peripheral blood smears  Interpret unfamiliar examples of QC  Recognize and correct discrepant results  Evaluate the reportability of test results  Judge appropriate troubleshooting action  Interpret test results in a case study  Resolve a quality control problem  Determine appropriate further testing or follow up action  Predict results and outcomes 2. Assessing irrelevant material Another problem can occur with tests when the content of the tests is not relevant to current practice in the clinical laboratory. In this case, the test cannot assess competency for entry level practitioners. Suggestions for improvement: Instructors should continually evaluate and update their objectives and tests to ensure that the objectives and the tests reflect current practice.4,5 Susan J. Beck, Ph.D., MLS(ASCP)CM and Vicky A. LeGrys, D.A., MT(ASCP) Division of Clinical Laboratory Science, The University of North Carolina at Chapel Hill Copyright 2014: The American Society for Clinical Laboratory Science 6 3. Assessing material not covered in the objectives A common and often valid complaint from learners concerning testing is that they studied the wrong material or did not know what to expect on the test. Suggestions for improvement: This situation can be rectified by designing the test material based on the course objectives. The instructor should avoid stating the objectives in one manner and testing in another. For example: Objective: Discuss common interferences in creatinine assays. Which of the following test questions best matches this objective? 1. Serum creatinine is used to assess the function of the: A. liver B. kidney C. bone D. CNS 2. Which of the following situations will result in an increase in serum creatinine values? A. hepatitis B. diabetic ketoacidosis C. myocardial infarction D. metastic bone disease Question 2 matches the objective 4. Subjective grading Another frequent learner complaint is that the grading on a test or assignment was too subjective or vague. If a learner does not understand what constitutes acceptable and unacceptable performance, it is difficult for the instructor and the learner to assess performance. Suggestions for improvement: Criteria for acceptable performance should be established in the objectives at the beginning of the course and should be given to the learner. For assignments with evaluations that are subjective e.g. research papers, oral presentations, discussion forums, a grading rubric can be useful. A grading rubric consists of a grid, linking scaled scores to descriptive criteria. See an example of a rubric below. The use of a rubric is beneficial to both learners and instructors as a mechanism for clarifying expectations and decreasing subjectivity in evaluation. To develop a rubric, the instructor should begin by developing a list of qualities that compromise proficiency in the desired learning Susan J. Beck, Ph.D., MLS(ASCP)CM and Vicky A. LeGrys, D.A., MT(ASCP) Division of Clinical Laboratory Science, The University of North Carolina at Chapel Hill Copyright 2014: The American Society for Clinical Laboratory Science 7 outcomes. Generally a numerical score is associated with the level of quality for a quantitative evaluation and can be weighed differently for the various criteria. Once a draft rubric is developed, the instructor should ask colleagues to review it and provide feedback. The instructor may find that after use, revisions are needed for future use. While developing a grading rubric can initially be time consuming for the instructor to develop, eventually it saves time by standardizing evaluation and decreasing grading ambiguity. 6-8 Susan J. Beck, Ph.D., MLS(ASCP)CM and Vicky A. LeGrys, D.A., MT(ASCP) Division of Clinical Laboratory Science, The University of North Carolina at Chapel Hill Copyright 2014: The American Society for Clinical Laboratory Science 8 Example of a Rubric for Evaluating an Oral Presentation Student: Jane Doe Topic: Evaluation of a Novel PCR Mastermix Overall Score: 84 Criteria Evaluation and Comment Organization: 30 points-each criteria worth 6 points  Logical progression of ideas 6  Focused 6  Easy to follow 6  Contained introduction 4  Contained valid conclusion 6 28 points. The presentation was well organized, logical, focused and easy to follow. The conclusion was supported by the information presented. The introduction could be improved by providing more detail concerning the justification for the project. Delivery: 30 points-each criteria worth 6 points The presenter:  Spoke at an appropriate pace 4  Spoke at an appropriate volume 6  Established eye contact 4  Spoke enthusiastically 6  Spoke clearly 4 24 points. Jane was an enthusiastic speaker with appropriate volume. However, she seemed very nervous which caused her to rush her presentation and, at times, mumble her words. She should practice looking at the audience more than looking at her notes in future presentations Content: 40 points-each criteria worth 8 points  Well researched 6  Comprehensive 5  Accurate 8  Current and appropriate references 5  Presenter used the material on the slides for illustration and organization but orally expanded on the printed text 8 32 points. The presentation was well prepared and an accurate description of the project. However, it failed to address all of the components of a validation study in that there was no discussion of precision. The references should have included the current CAP requirement for method validation. Jane did elaborate on the materials on the slides and did more than simply read them to the audience. Susan J. Beck, Ph.D., MLS(ASCP)CM and Vicky A. LeGrys, D.A., MT(ASCP) Division of Clinical Laboratory Science, The University of North Carolina at Chapel Hill Copyright 2014: The American Society for Clinical Laboratory Science 9 5. Poorly designed tests Due to time constraints, test construction is often postponed until the last minute. In a panic, the instructor may retrieve the test from last year, change the date, and use it again or may quickly create a new test without taking the time needed to revise or edit the items. When an old test is reused, some items may be irrelevant and the test may be incomplete. A hastily prepared new test may be given only to discover that some items have no one best answer. In these situations it is difficult to arrive at any useful assessment of learner performance. Suggestions for improvement: The ideal method of test construction is to create several test items after each lecture. It is easier to create plausible distracters (incorrect answers) when learners’ perceptions are fresh in the instructors mind. The following section on designing test material will describe a systematic approach to creating an effective test. DESIGNING TEST MATERIAL Tests should always be based on objectives and should cover all taxonomic levels. It has been suggested that for an examination for laboratory professionals, 50\% of the items should be at the recall level, 30\% application and 20\% analysis.2 1. Choose the type of questions for the examination. Decide whether the test will include multiple choice, matching, short answer, or essay questions. The choice will depend on the purpose of the examination. Each type of question has its characteristic strengths and weaknesses which are described later in this unit. No one testing form is perfect in assessing competency; therefore, other forms of evaluation should be included in the overall assessment of a learner’s knowledge, skills and attitudes. 2. Determine the number of items on the examination and the time limitations for the examination. The test should be as long as possible, given the time constraints, to ensure reliability.  Multiple choice questions take approximately 1 minute to answer,  Completion or short answer items take 1 to 3 minutes to answer  Essay questions vary widely in their response time. 3. Allocate the number of test items devoted to each topic. In order for the test to be valid, the test should reflect the amount of time spent on each subject category and should include a representative sampling of the material covered in the course. In choosing items for inclusion, the instructor should decide on the importance of the material to the learners future needs. 4. Create the test items. Clearly written course objectives are used to guide the instructor in item construction. 5. Group the test items according to the type of question. Group all the multiple choice questions together and all the matching or short answer items together. Susan J. Beck, Ph.D., MLS(ASCP)CM and Vicky A. LeGrys, D.A., MT(ASCP) Division of Clinical Laboratory Science, The University of North Carolina at Chapel Hill Copyright 2014: The American Society for Clinical Laboratory Science 10 6. Organize the test items according to the topic and begin the test with the easiest items in order to build the learners confidence. 7. Develop the test directions. Directions should state where to record the answers, the time limit, the maximum points assigned to the items, and the number of test items. The directions should also state whether or not there is only one answer per item or if some items may have multiple answers. Directions should state what, if any resources the student may use while taking the exam such as the textbook, an atlas or calculator. The Honor Code for the institution should be stated and the student should sign, acknowledging their acceptance. 8. Review the test for ambiguity and typographical errors. If possible, have a colleague review the test for clarity. ITEM CONSTRUCTION Test items can be divided into two main groups: Objective items that include multiple choice, true/false, and matching Subjective items that include short answer and essay questions Each type of item has advantages, disadvantages, and guidelines for construction. 8-10 Item Type Advantages Disadvantages Multiple Choice Easy to grade; Samples a large amount of material Difficult to construct; May test at a lower cognitive level True/False Easy to grade; Samples a large amount of material Difficult to construct; Encourages guessing; Tests at the lower cognitive level Matching Easy to construct; Useful for testing specific facts Encourages memorization; Tests at the lower cognitive level Essay/Short Answer Easy to construct; Useful for testing higher cognitive levels; Stimulates creativity, communication and organization skills; Minimizes guessing Time-consuming to grade; Lack of objectivity in grading; Limited sampling ability Susan J. Beck, Ph.D., MLS(ASCP)CM and Vicky A. LeGrys, D.A., MT(ASCP) Division of Clinical Laboratory Science, The University of North Carolina at Chapel Hill Copyright 2014: The American Society for Clinical Laboratory Science 11 Multiple Choice Items Multiple choice items consist of a stem which poses the question or problem, and several responses which include the correct answer and distracters: Which of the following represents a 1:10 dilution? (Stem) A. 0.5 mL of serum plus 9.5 mL of diluent (Distracter) B. 0.1 mL of serum plus 0.9 mL of diluent (Correct answer) C. 1 mL of serum plus 10 mL of diluent (Distracter) D. 1.5 mL of serum plus 9.5 mL of diluent (Distracter) Multiple choice items:  are the most popular type of test items  are found in certification examinations.  are useful to test the recall of facts  can be designed to measure higher cognitive skills such as analysis and evaluation 2,3 Advantages of multiple choice items for the instructor:  Easier to evaluate and analyze than subjective test items because scoring is highly objective and lends itself to automated grading systems.  Can be quickly answered by the learners, so the tests can contain numerous items. This permits a greater sampling of the course material. Advantages of multiple choice items for the learner:  Individual items are not heavily weighted and the possibility of guessing the correct answer exists.  The right answer is present, requiring recognition of the correct response instead of creating the appropriate response, as would be the case with a short answer or essay test item. Disadvantages of multiple choice items for the instructor:  They are more time-consuming to develop than other test formats.  Can measure only recall and promote memorization. Instructors may think that they are testing analysis, only to discover upon closer inspection that the situation in the item was discussed in class. When this occurs, recall is measured, not analysis. Disadvantages of multiple choice items for the learner Susan J. Beck, Ph.D., MLS(ASCP)CM and Vicky A. LeGrys, D.A., MT(ASCP) Division of Clinical Laboratory Science, The University of North Carolina at Chapel Hill Copyright 2014: The American Society for Clinical Laboratory Science 12  The instructors, in an attempt to increase the item difficulty, may base the item on a trivial fact, instead of focusing on current, relevant knowledge required for entry level competency. Suggestions for Improvement: To improve the quality of multiple choice items the following guidelines should be followed: 8-10 1. The directions for the multiple choice items should state that the learner is to select the one best answer. 2. The item should measure significant facts, not trivia. Poor: Sanger sequencing is also called: A. Pyrosequencing B. PCR C. Q PCR * D. Direct sequence analysis Better: In Sanger sequencing, incorporation of which of the following reagents stops elongation? * A. ddNTP B. dNTP C. Taq Pol D. quencher probe Note: *The asterisk indicates the correct answer 3. The stem should present the problem clearly and specifically either in the form of a question or an incomplete statement. Poor: Hemoglobin AlC * A. Is measured by immunoassay B. Reflects diabetic control over several hours C. Is a new thalassemia variant D. Has decreased affinity for oxygen Better: Hemoglobin AlC can be measured in the clinical laboratory by A. Titration * B. Immunoassay C. ELISA D. Nephelometry 4. The stem should be clearly worded and concise. Avoid any unnecessary information in the stem unless it is important for the learner to be able to recognize irrelevant data. Susan J. Beck, Ph.D., MLS(ASCP)CM and Vicky A. LeGrys, D.A., MT(ASCP) Division of Clinical Laboratory Science, The University of North Carolina at Chapel Hill Copyright 2014: The American Society for Clinical Laboratory Science 13 Poor: A Group O Rh positive patient was admitted to the hospital for elective surgery. He had been blood donor for 5 years and had never experienced any adverse reactions to blood donation. Four units of blood were crossmatched for this patient; however, only two units were used during the surgery. Two days after his surgery his white cell count was elevated and he developed a fever. A culture of the surgical wound was obtained and he was given antibiotic therapy. On the fifth day after his surgery his white count and his temperature were normal but it was noted that his hemoglobin level was falling and his serum bilirubin was slightly elevated. There were no signs of active bleeding. Most probably, this patient A. Received ABO incompatible blood B. Has post-transfusion hepatitis C. Had an allergic reaction to the transfused blood * D. Had a delayed hemolytic transfusion reaction Better: A patient received two units of red blood cells with no complications. Five days later his hemoglobin had not risen above the pre-transfusion level. The patient had no signs of active bleeding and it was noted on his chart that his serum bilirubin was slightly elevated. Most probably, this patient A. Received ABO incompatible blood B. Has post-transfusion hepatitis C. Had an allergic reaction to the transfused blood * D. Had a delayed hemolytic transfusion reaction 5. The stem should be stated in a positive tone since the purpose of learning is to know the correct information, not the incorrect information. The instructor cannot assume that if learners know what does not apply that they will also know what does apply. If, however, it is necessary to state the stem in a negative form, underline the negative word and avoid double negatives between the stem and the alternatives. Poor: Which of the following descriptions does not apply to DNA structure? A. It does not contain uracil B. It is a double-stranded helix C. It is stabilized by hydrogen bonding * D. It is composed of ribose molecules Better: Which of the following describes the structure of DNA? A. It is composed of uracil bases * B. It is …