Advantages and Disadvantages of Short Answer Question in Nursing Education - Research Paper Example

 Table of Contents I. Introduction ..................................................................................... 3 II. Literature Review ............................................................................ 4 a. Importance of Educational Assessment ........................... 4 b. Short Answer Questions ................................................... 5 b.1 Question ............................................................ 7 b.2 Fill-in-the-Blank Questions ................................ 8 c. Advantages and Disadvantages of Using Short Answer Question Technique in terms of assessing the Students’ Knowledge in Nursing and Medical Education ................. 10 c.1 Advantages ........................................................ 10 c.2 Disadvantages ................................................... 11 d. Comparison between Short Answer Questions and the Different Educational Assessment Techniques used in Nursing and Medicine Courses ......................................... 12 d.1 Multiple Choice Exams vs. Short Answer Questions .................................... 12 d.2 Essay Exam vs. Short Answer Questions ........... 13 e. Strategic Ways on How Assessment Using Short Answer Questions can be Measured ............................................. 14 III. Conclusion and Recommendations ................................................. 17 Appendix I – Summary of Cognitive, Affective, and Psycomotor Domain . 18 References ............................................................................................. 19 – 22 Chapter I – Introduction Educators are highly accountable for the quality of education they provide to the students (Oermann and Gaberson, 2009, p. 3). In measuring the learning outcome of the students, educators should carefully select the most appropriate and effective assessment technique to improve the teaching and learning process between the educators and the students. Based on the assessment results, educators will have a basis on how they can modify the course curriculum for nursing- and medicine-related subjects (Oermann and Gaberson, 2009, p. 4). For several years, I teach cardiopulmonary resuscitation (CPR), advanced life support (ALS), immunizations and vaccinations, and nurse prescribing in one of the local universities in UK. With regards to unfair student evaluation, educators should be aware that each type of assessment method has its limitations in terms of assessing the students’ overall learning outcome (McDonald, 2002, pp. 4 – 5). As part of teaching nursing- and medicine-related subjects, this study will briefly discuss the importance of educational assessment. After going through the different educational assessment techniques used in nursing and medicine courses, ways on how assessment can be measured will be tackled in details followed by determining whether or not the use of short answer questions is a suitable method to assess or examine the learning outcome of nursing and medical students. Aside from describing short answer questions and the assessment process of short answer questions from an objective point-of-view, the advantages and disadvantages of using short answer question technique in terms of assessing the students’ knowledge in nursing and medical education will be identified, analyzed and interpreted based on the past and current research studies that were conducted on this matter. Based on the secondary research findings, the final stage of this study will conclude whether the use of short answer questions is considered an effective tool in measuring the students’ knowledge. Chapter II – Literature Review Importance of Educational Assessment Educational assessment or diagnostic testing aims at gathering information concerning the learning outcomes of the students. In line with this, educational assessment is an important part of education since assessment exam given to the students after discussing a course material will serve as the learning feedback coming from each of the students. Assessment results or the students’ grades notifies the nurse educators whether or not the teaching techniques they use in teaching certain topic and skills is effective. In line with this, Oermann and Gaberson (2009, p. 4) explained that assessment results serves as a basis for nurse educators to improve the existing course curriculum, educational and clinical practices. Categorized using letters from A to F, the students’ grades makes the nurse educators realize and determine whether or not the students are able to meet the general study objectives. This is important in enabling the nurse educators develop strategies that can improve the students’ clinical competencies. Lombardi and Oblinger (2008) revealed that there are a lot of newly graduates who enters the workplace unprepared with necessary skills that will make them become competitive in their chosen career path. Educators can improve the educational standards in nursing- and medicine-related courses by improving the students’ learning assessment (Vleuten, 1996). By improving the competency of learning assessment, McDonald (2002, p. 5) revealed that the educators can develop effective solutions that will enable them improve the learning experience of the students. The nurse educators are directly accountable for the learning outcome of the students. For this reason, the nurse educators should carefully select the best and most appropriate assessment tool that could accurately examine whether or not the existing course curriculum is aligned with the faculty personnel’s learning expectations (Kent State Univesity, 2011; Oermann and Gaberson, 2009, p. 30). By doing so, the nurse educators could effectively mold the nursing students to become one of the most competitive nurses in the near future. Short Answer Questions The use of short answer questions is an example of a constructed-response type of exam questionnaires. This kind of assessment technique allows the students to answer a given question with a single- or two-words, phrase, or numbers (UW Teaching Academy, 2011). According to Oermann and Gaberson (2009, p. 117), the nature short-answers can either be a question wherein the students can provide their answers using a few words or phrases and/or the completion or fill-in-the-blank type of questions wherein the students will be instructed to write down the best word(s) that will complete the sentence. In some cases, Young and Paterson (2007, p. 236) revealed that the students can be asked to provide short description with regards to the patient’s health care situations. Oermann and Gaberson (2009, p. 118) emphasized the idea that short answer questions can be utilized by nurse educators in order to measure the students’ ability to interpret information and make use of correct formula in solving the required medicine dosage. Based on Bloom’s taxonomy of cognitive levels, nurse educators should be able to develop short answer questions that will assess the student’s improvements in “knowledge, comprehension, application, analysis, synthesis, and evaluation” (Oermann and Heinrich, 2007, p. 296). Within the knowledge level, Elder and Paul (2002) revealed that the students should be trained to improve their memory by going through the process of repitition. Aside from encouraging the students to recall what was tackled in class discussion, nurse educators should also encourage the student to explain or express their answers by requirng the students to demonstrate how they understand a given clinical process. Eventually, the students should be requested to analyze and apply what they have learned in a different case scenario. To make the teaching of basic and advance cardiopulmunary resuscitation effective, the students should be familiar wih the anatomical parts of the human body. In line with this, examples of short answer questions that can be given to nursing students includes requesting the students to: (1) label the different parts of the human anatomy; (2) identify basic instruments used in the provision of basic life support intervention to the victims; (3) recall abbreviations and acronyms of each medical and nursing terms based on a list of terms given to the students (Brookhart and Nitko, 2008, p. 130). For example: BLS stands for basic life support whereas EGTA stands for esophageal gastric tube airway. Despite the benefits associated with the use of short answer questions, there are also some limitations associated with the use of this particular assessment technique. Aside from increasing the diffuculty on the part of the nurse educators to assign grades in the students’ answer, this type of assessment technique is not always applicable in assessing the students’ clinical skills and knowledge in nursing theories (UW Teaching Academy, 2011). To improve the learning experience of the students, nurse educators should take it a challenge on how they can develop new strategies that will make it possible for nurse educators to use short answer questions to the advantage of the students. Question When designing a short answer question, Oermann and Gaberson (2009, p. 119) strongly suggest that nurse educators should avoid copying open-ended questions or statements that has already been asked in textbooks, lecture notes, and other reading materials because of the possibility that some of the students may have already memorized some information that can found in the textbooks or lecture notes. Instead of directly copying questions that are readily available in the textbooks or lecture notes, the nurse educators should only use these reading materials as a basis when designing unpublished short answer questions. By rephrasing the information found in the textbooks or lecture notes combined with the use of new words in the short answer questions, the nurse educators can effectively assess the students’ ability to analyze and comprehend with the questions asked (ibid). To assess the students’ knowledge with regards to immunization program, educators can instruct the students to give the correct time or sequence when administering tetanus toxoid (TT1 to TT5) vaccine dose to a pregnant woman. In response to the question, the students are expected to present their answers to the question using tables as shown below: Vaccine Dose Time of Vaccination TT1 5 – 6 months of pregnancy or at first prenatal care visit TT2 4 weeks after TT1 TT3 At least 6 months after TT2 TT4 At least 1 year after TT3 TT5 At least 1 year after TT4 Source: World Health Organization, 2003, p. F-2 There are many ways in which the nurse educators can ask the students with open-ended short answer questions. The following questions are good example of short answer questions: 1. What is the goal of CPR? 2. Describe the proper way of clearing the victim’s airway? 3. Briefly descibe the differences between esophageal gastric tube airway (EGTA) and esophageal-tracheal combitube (ETC)? Fill-in-the-Blank Questions Specifically the NCLEX® computerized exam is using drag-and-drop fill-in-the-blank questions. With regards to this type of assessment method, students who are taking the NCLEX® exam are requrested to answer a given nursing-related question by “placing a list of responses in the proper order” (Oermann and Gaberson, 2009, p. 118). Without the use of computers, educators can still make use of fill-in-the blank questions to assess and evaluate the students’ knowledge with regards to nursing topics related to immunization programs, CPR, and ALS. To assess the students’ knowledge with regards to terminology associated with CPR, educators can ask fill-in-the-blank questions like the following: 1. _____ a supraglottic airway rescue device that enables the first-aid rescuers to facilitate ventilation by making the source of pressured gas closer to the glottic opening (Orebaugh, 2007, p. 139). Answer: Esophageal-Tracheal Combitube. 2. _____ unusual heart rhythm of up to 300 beats per minute can be present in children and infants who were diagnosed with congenital heart diseases (Seidel and Henderson, 1997, p. 43). Answer: Atrial Flutter 3. _____ consist of invasive life-saving procedures which aims to monitor the patient’s airway, breathing, and circulation (Brouhard, 2008). Answer: Advanced Cardiac Life Support. 4. _____ originating from the posterior fascile in the patient’s inferior left ventricle apex or midseptal region, this symptoms occur in patients with no structural heart disease (García-Civera, Barón-Esquivias, and Blanc, 2006, p. 219). Answer: Ventricular Tachycardia. 5. _____ aiming to force air into the trachea, this instrument is made out of a plastic hollow tube that contains an inflatable cuff at the end to ensure that the tube insterted into the esophagus will not be dislocated (Schilling et al., 2004. P. 534). Answer: Esophageal Gastric Tube Airway. Fill-in-the-blank questions can also be used when asking the students to solve or calculate provided that the students will be able to provide solutions for the answer. In line with this, the nurse educators can ask the students to convert pounds (lbs) to kilograms (kg) or convert kilograms (kg) to pounds (lbs). To solve this particular fill-in-the-blabk problem, the students should be aware that 1 lb is equivalent to 2.2 kg. It is also possible for nurse educators to provide a given case scenario wherein the students will be asked to compute for the right medicine dosage. For example: The physician orders the nurse to administer 0.25mg of oxycodone hydrochloride immediate-release oral capsule. Given that each of the medicine bottle is available at 0.5 mg, the nurse should give to the patient _____ tablet. Choices of answers: ½, 1, 1-1/2, 2, 2-1/2 tablets. Based on the solution provided below, the answer for this particular short answer question should be ½ tablet. (Solution: ¼ desired dosage ÷ ½ onhand doasage = ¼ × 2/1 = ½ tablet) Advantages and Disadvantages of Using Short Answer Question Technique in terms of assessing the Students’ Knowledge in Nursing and Medical Education Advantages Medical professionals such as in the case of registered nurses and doctors should have a strong ability to recall medical terms, concepts, theories, diagnostic test, treatment procedures, and other related health care information (Brookhart and Nitko, 2008, p. 130). To improve the students’ ability to recall these information, teachers can take advantage of short answer question exam since this method will encourage the students recall what they have learned during the class discussion. Likewise, this particular assessment technique enables the teachers to examine the students’ ability to spell the words correctly. As a learning assessment technique, the use of short answer questions allow the students to be able to construct their responses into words, phrases, or sentences to each question based on how they understand each nursing- or medicine-related topic (UW Teaching Academy, 2011). Likewise, short answer question does not require the students to write a very long essay just to respond to each question (Oermann and Gaberson, 2009, p. 117; Young and Paterson, 2007, p. 236). Disadvantages Similar to the use of other assessment technique, the use of short answer question also has its own limitations. First, not all nursing- and medicine-related questions can be answered in few words or at most two sentences (UW Teaching Academy, 2011). Even though short answer questions can offer the students the freedom to express and answer the questions based on how the students understand each given question, there is a high risk wherein the students’ understanding or ability to express what they mean into words may not satisfy the nurse educator’s expected answers based on how they understood the topic (Freel, Holmes, and Struder, 2004, p. 218; Mertler, 2003). Specifically in the case wherein the students are expected to write their answers in more than a couple of sentences, the inability of the students to spell the words correctly, use proper punctuation marks or express their answers in correct sentences and paragraph format may also affect the students’ grades (Freel, Holmes, and Struder, 2004, p. 218). The use of short answer question can make it difficult on the part of the nurse educators to measure the students’ existing knowledge or critical thinking. For this reason, there is a higher risk wherein the students will not be able to receive grades they deserve (UW Teaching Academy, 2011; Miller, Linn, and Gronlund, 2009, p. 242). To prepare the students to become competitive nurses, nurse educators should continuously assess the students’ cognitive, affective, or psychomotor domain (Oermann and Gaberson, 2009, pp. 17 – 18). The problem with the use of short answer questions is that this type of assessment method is limited in terms of assessing and measuring the affective and psychomotor domains of the students. Comparison between Short Answer Questions and the Different Educational Assessment Techniques used in Nursing and Medicine Courses Multiple Choice Exams vs. Short Answer Questions There is quite a lot of educational assessment techniques used in nursing and medicine-related courses. One of the most commonly used assessment technique is the multiple-choice type of exam (McDonald, 2002, p. 4). Although it is easier on the part of the nurse educators to assess and measure the results of multiple choice exams, the problem with excessive use of multiple choice questions is that this type of assessment technique does not give the educators the opportunity to express in words what they understood about the nursing related topics. As compared to the use of short answer questions, the use of multiple choice exam increases the chance wherein the students will be guessing the correct answer (Oermann and Gaberson, 2009, p. 117). In other words, the use of multiple choice exams will not provide the educators an accurate measurement of the students’ actual learning outcome. Essay Exam vs. Short Answer Questions In an essay type of questions, the students are instructed to develop a more extended or lengthy response to each question or statement given to them by the teachers (Oermann and Gaberson, 2009, p. 117). Using sentences that are carefully structured in each paragraph, the students are expected to describe, differentiate, and explain a given nursing research topic followed by analyzing and interpreting the gathered information before drawing into conclusions. With this in mind, the students are expected to be able to summarize and defend their arguments based on facts and figured gathered from a list of reliable academic resources. In cases wherein the students are expected to memorize and recall facts, the best way to assess and measure the students’ full understanding of the study lesson is to ask them to write an essay about the subject matter. In line with this, Miller, Linn, and Gronlund (2009, p. 239) explained that requiring the students to write an essay on a particular subject matter will enable the nurse educators test how well the students understood the topic. In line with this, the students’ knowledge will be assess and measured based on how well they can write an essay that integrates the nursing theories and medical terms. The problem with long essays lies behind the nurse educator’s criteria in giving grades to the students. It is a fact that not all students who are native English speakers are able to express their thoughts and ideas into words. Because of language barriers, there are some students who are unable to spell the English words correctly or even express their answers in a universally accepted sentences and paragraph format (Freel, Holmes, and Struder, 2004, p. 218; Mertler, 2003). In other words, the ability of the students to write legibly in lengthy essays could significantly affect the nurse educators’ first impression about each student (Oermann and Gaberson, 2009, pp. 124 – 125). Often times, the ability of the students to present papers that were written legibly are not a good basis on evaluating the knowledge of the students. Therefore, this type of assessment practices can be bias to some students in terms of receiving a fair grade. As compared to lengthy essay exam, the use of short answer question is more practical on the part of the students in the sense that they can easily write their answer in a few words or a couple of sentences (UW Teaching Academy, 2011). However, the students are expected to provide their responses to each question in a precise manner because of the limited time given to provide their answers in a few words or at most two sentences (Oermann and Gaberson, 2009, p. 121). Strategic Ways on How Assessment Using Short Answer Questions can be Measured There are many ways on how the students’ knowledge can be assessed and measured (Oermann et al., 2009; Wang, 2008). In line with this, periodical exams can be given to the students by instructing them to answer a set of multiple choice questionnaires, short answer questions, or an essay type of written exam after each nursing topic has been discussed inside a classroom. According to Brookhart and Nitko (2008), the scores each student will receive after taking an exam will indicate the degree wherein the students were able to learn and understand the subject matter. It means that the educators can measure and evaluate the students’ knowledge by assigning numbers that will represent the students’ academic achievements based on certain rules. As part of measuring and interpreting the students’ scores, Oermann and Gaberson (2009, p. 6) explained that educators can based the score interpretations either from norm-referencing or criterion-referencing. Within a clinical setting, the use of norm-referencing interpretation will require the educators to compare the students’ test scores and learning assessment with a norm group. It means that the students’ test scores can be classified by ranking such as “below the average grade” or “above the average grade” (Oermann and Gaberson, 2009, p. 7). In general, a preset criteria is similar to the study objectives in the sense that both clearly states what each of the nursing students are expected to learn and be able to perform within the clinical area (Gronlund and Brookhart, 2009, p. 4). Instead of comparing the learning outcome of each learner with a group of students, the use of criterion-referenced interpretation requires the educators to interpret the students’ scores individually depending on the specified preset criteria (Oermann and Gaberson, 2009, p. 7). Given that each of the registered nurses are required to practice discipline, Gaberson and Oermann (2007, p. 5) revealed that the learning experiences that each student will receive from a clinical practice is far more important as compared to what they will learn inside the classroom. For this reason, a competitive preset criteria for nursing students should focus on assessing the cognitive, affective, or psychomotor domain of the students (Oermann and Gaberson, 2009, pp. 17 – 18). A preset criteria that focuses on assessing the students’ cognitive domain would mean that the educators are focused on measuring the students’ comprehension, application, and analysis ability (Oermann and Gaberson, 2009, p. 17). For example: Nursing students can be asked to define nursing- and medical-related terminology or compare and contrast the purpose and usage of different immunization drugs. Doing so will enable the nurse educator measure and keep track of the students’ cognitive development. A preset criteria that focuses on assessing the students’ affective and psychomotor domain would mean measuring the students’ ability to work in harmonious with other nursing students and their ability to carry out a nursing procedure respectively (Oermann and Gaberson, 2009, pp. 17 – 18). To measure the psychomotor abilities of the students, it is possible on the part of the nurse educators to request each students to perform an actual CPR on a dummy. However, this type of asseessment method is no longer related to the use of short answer question. (See Appendix I – Summary of Cognitive, Affective, and Psycomotor Domain on page ) As compared to norm-referencing interpretation, the use of criterion-referenced interpretation method is more applicable when assessing the knowledge and learning experience of the nursing students. Since excessive use of norm-referencing does not give the educators a slight idea on what the students can or cannot do, Miller, Linn, and Gronlund (2009, pp. 88 – 91) explained that criterion-referenced interpretation is applicable in the study of nursing- and medicine-related subjects since this type of assessment measurement technique can be used in describing the specific and individual learning that each students can perform. Chapter III – Conclusion and Recommendations Nursing as a profession is very complex in the sense that a registered nurse should not only obtain and develop a strong cognitive abilities from the educational institutions but also strengthen their social interaction skills and ability to perform a prescribed clinical tasks. Given that the use of short answer questions could only assess and measure the cognitive domain of the students, nurse educators should consider integrating the use of this type of assessment technique with other methods that can be used in assessing and measuring the affective and psychomotor domains of the students. According to Ross and Strenfors-Hayes (2008, p. 159), “there is no comprehensive evidence-based model of medical teaching has yet been developed”. To enable the nurse educators to effectively assess the students’ affective behavior, critical thinking abilities, and psychomotor skills, McDonald (2002, p. 7) explained that the use of a multidimensional assessment approach is necessary. For instance: On top of the actual performance assessments that will be conducted by the nursing educators within the clinical areas, it is advisable on the part of the nurse educators to give short answer questions and oral communication exams combined with actual return demonstration exam in order to assess and measure the students’ ability to perform actual CPR procedures, critical thinking and reasoning abilities. *** End *** Appendix I – Summary of Cognitive, Affective, and Psycomotor Domain Cognitive Domain Affective Domain Psychomotor Domain Knowledge Define Identify Label List Name Recall State Comprehension Defend Describe Differentiate Draw conclusions Explain Give examples Interpret Select Summarize Application Apply Demonstrate the use of Modify Operate Predict Relate Solve Use Analysis Analyze Compare & Contrast Detect Differentiate Identify Relate Select Synthesis Compile Construct Design Develop Devise Generate Plan Produce Revise Synthesize Write Evaluation Appraise Assess Critique Discriminate Evaluate Judge Justify Support Receiving Acknowledge Ask Reply Show awareness of Responding Act willingly Assist Is willing to Support Respond Seek opportunities Valuing Accept Assume responsibility Participate in Respect Support Value Organization of Values Argue Debate Declare Defend Take a stand Characterized by Value Act consistently Stand for Imitation Follow example of Imitate Manipulation Assemble Carry out Follow procedure Precision Demonstrate skill Is accurate in Articulation Carry out (accurately and in reasonable time frame) Is skilful Naturalization Is competent Carry out competently Integrate skill within care Source: Oermann & Gaberson, 2009, pp. 17 – 18 References Brookhart, S., and Nitko, A., 2008. Assessment and grading in classroom. Upper Saddle River, NJ: Pearson Education. Brookhart, S., and Nitko, A., 2008. Assessment and grading in classrooms. Upper Saddle River, NJ: Pearson Education. Brouhard, R., 2008, August 28. About.com. Advanced Life Support. [Online] Available at: [Accessed 10th February 2011]. Business-Higher Education Forum, 1997. Spanning the Chasm: A Blueprint for Action. Washington, DC: BHEF. Elder, L., and Paul, R., 2002. The miniature guide to the art of asking essential questions. Santa Rosa, CA: Foundation for Critical Thinking. Elder, L., and Paul, R., 2002. The miniature guide to the art of asking essential questions. Santa Rosa, CA: Foundation for Critical Thinking. Freel, B., Holmes, H., and Struder, M., 2004. Mastering the Alabama Direct Assessment of Writing: Grade 10. American Book Company. Gaberson, K., and Oermann, M., 2007. Clinical teaching strategies in nursing. 2nd Edition. New York: Springer Publishing Company. García-Civera, R., Barón-Esquivias, G., and Blanc, J.-J., 2006. Syncope Cases. 1st Edition. Blackwell Publishing. Gronlund, N., and Brookhart, S., 2009. Gronlund's writing instructional objectives. 8th Edition. Upper Saddle River, NJ: Merrill. Kent State Univesity, 2011. Why is assessment of student learning important? [Online] Available at: [Accessed 10th February 2011]. Lombardi, M., and Oblinger, D., 2008, January. Educause Learning Initiative. Making the Grade: The Role of Assessment in Authentic Learning. [Online] Available at: [Accessed 10th February 2011]. McDonald, M., 2002. Systematic assessment of learning outcomes: developing multiple-choice exams. Jones and Bartlett Publishers Inc. Mertler, C., 2003. Classroom assessment. LA: Pyrczak. Miller, M., Linn, R., and Gronlund, N., 2009. Measurement and assessment in teaching. 10th Edition. Upper Saddle River, NJ: Prentice Hall. Oermann, M., and Gaberson, K., 2009. Evaluation and Testing in Nursing Education. Springer Publishing Company, LLC. Oermann, M., and Heinrich, K., 2007. Annual review of nursing education: Innovations in curriculum . Springer Publishing Company, Inc. Oermann, M., Saewert, K., Charasika, M., and Yarbrough, S., 2009. Assessment and grading practices in schools of nursing: Findings of the evaluation of learning advisory council survey. Nursing Education Perspectives , 30(4). Orebaugh, S., 2007. Atlas of airway management: techniques and tools. Lippincott Williams & Wilkins. Ross, M., and Strenfors-Hayes, T., 2008. What do medical teachers do? . The Clinical Teacher , 5(3), pp. 159-162. Schilling, J., Holmes, H., Robinson, J., Kasmer, E., and Meyering, J., 2004. Lippincott's Nursing Procedures. 5th Edition. Lippincott Williams & Wilkins. Seidel, J., and Henderson, D., 1997. Prehospital care of pediatric emergencies. 2nd Edition. Jones and Bartlett Publishers Inc. UW Teaching Academy, 2011. Short Answer Questions. [Online] Available at: [Accessed 10th February 2011]. Vleuten, C., 1996. The assessment of professional competence: Developments, research and practical implications . Advances in Health Sciences Education , 1(1), pp. 41-67. Wang, T., 2008. Web-based quiz-game-like formative assessment: Development and evaluation. Computers & Education , 51, pp. 1247-1263. World Health Organization, 2003. Pregnancy, childbirth, postpartum, and newborn care: a guide for essential practice. Geneva: World Health Organization. Young, L., and Paterson, B., 2007. Teaching nursing: developing a student-centered learning environment. Lippincott Williams & Wilkins. References Read More