I am a third-semester nursing student who has been using test banks since my first semester in the program. You could say that I discovered the existence of test banks by accident, but ever since I began using them, I have scored nearly 100 on every test I have taken. But here is the catch -- my teachers don't use questions from just one test bank. Instead, they pull questions from a database of test banks supplied by the publishing company. So for example, if my program assigns the textbook "Med-Surg Nursing XYZ," they have access to that book's test bank as well as the test bank to every other med-surg textbook from the same publisher. The company that publishes the med-surg textbook my school uses also publishes at least 6 or 7 other med-surg books, so for every chapter in the book we're supposed to read, there are at least 6 or 7 different test banks with questions on the same content supplied by the publisher. So in other words, that's 6 or 7 test banks with questions on preoperative nursing (or any other nursing concept area). And here's the thing.... I don't think it would make a difference if the teachers decided to start writing their own test questions, because what I've noticed is that, after reading questions based on the same chapter in 3 or 4 test banks, it becomes clear that there are certain types of questions that are going to be asked on a certain topic. Also, it becomes obvious that the primary differences that exist between different test banks is the wording of the questions. For example, consider the topic of blood pressure assessment. By the time I have read through the "Blood Pressure Assessment in Nursing" chapter in 3 or 4 test banks from the same publisher, I basically know everything that could possibly be asked on a nursing exam regarding that topic. So even if my professors decide to start writing their own questions, I know what they will most likely test on; the only thing that would be different would be that the wording of their questions would be different from the wording of the test banks' questions. I also like to supplement my test bank studying with prep book studying (Saunders, Kaplan, etc.). Between test bank studying and prep book studying, it gets to the point that there's no question I haven't seen already. So I think that's why it probably wouldn't make much of a difference if most nursing programs started requiring their faculty to write their own questions. I think it would throw off the students who only study 1 or 2 test banks, but for students who study lots of them like me, I don't think it would make much of a difference.