An Evidence-Based Approach to Constructing Multiple-Choice Test Questions for Knowledge Assessment.

BACKGROUND: This article provides nursing educators practical tips and evidence-based strategies for effective construction of multiple-choice questions (MCQs). Well-designed MCQs that align with the intended learning objectives are critical for implementing sound assessment practices. METHOD: This article offers a step-by-step approach to test construction, starting with the assessment blueprint and followed by important considerations when writing the specific components of the MCQ. RESULTS: Appropriate inclusion of clinical context in the MCQ and a description of common flaws to avoid, with suggested remedies, are also addressed. CONCLUSION: Ultimately, the goal of this article is to equip nurse educators with the foundational tools to create high-quality MCQs that effectively assess knowledge acquisition by learners. [J Contin Educ Nurs. 2024;55(6):289-296.].

Evaluating the Quality of Multiple-Choice Test Questions in the Postlicensure Environment.

BACKGROUND: Multiple-choice test questions are among the main measures of knowledge used by educators in the postlicensure environment; however, these tests are often constructed in the absence of guidelines or the means to evaluate examination quality after administration. METHOD: Previously, guidance was provided on constructing quality test items. Here we present instruction for professional development specialists to use postadministration test data for an item analysis, providing insight on test flaws and opportunities for iterative examination improvement. RESULTS: The topics of item difficulty, index of discrimination, and distractor analysis are covered for independent analysis, and topics such as reliability are addressed for those who have access to a formal program. CONCLUSION: Three levels of strategies are described: using a learning management system for item analysis, using free open-source software, and using a minimal standards method of evaluating test items. [J Contin Educ Nurs. 202x;5x(x):xx-xx.].

Spanish Translation and Cultural Adaptation of the Intensive Care Unit Delirium Playbook.

Background: A lack of high-quality provider education hinders the delivery of standard-of-care delirium detection and prevention practices in the intensive care unit (ICU). To fill this gap, we developed and validated an e-learning ICU Delirium Playbook consisting of eight videos and a 44-question knowledge assessment quiz. Given the increasing Spanish-speaking population worldwide, we translated and cross-culturally adapted the playbook from English into Spanish. Objective: To translate and culturally adapt the ICU Delirium Playbook into Spanish, the second most common native language worldwide. Methods: The translation and cross-cultural adaptation process included double forward and back translations and harmonization by a 14-person interdisciplinary team of ICU nurses and physicians, delirium experts, methodologists, medical interpreters, and bilingual professionals representing many Spanish-speaking global regions. After a preeducation quiz, a nurse focus group completed the playbook videos and posteducation quiz, followed by a semistructured interview. Results: The ICU Delirium Playbook: Spanish Version maintained conceptual equivalence to the English version. Focus group participants posted mean (standard deviation) pre- and post-playbook scores of 63% (10%) and 78% (12%), with a 15% (11%) pre-post improvement (P = 0.01). Participants reported improved perceived competency in performing the Confusion Assessment Method for the ICU and provided positive feedback regarding the playbook. Conclusion: After translation and cultural adaptation, the ICU Delirium Playbook: Spanish Version yielded significant knowledge assessment improvements and positive feedback. The Spanish playbook is now available for public dissemination.