Review of nursing exams with students

meanmaryjean, DNP, RN · Oct 1, 2016

Are you talking about exams these students have already taken? Because I can see if the same exam is used in subsequent semesters- that would pose a HUGE exam security problem. But I feel discussing, in a general manner, topics the students as a group did poorly on to be beneficial as a learning tool.

BeenThereDoneThat74, MSN, RN · Oct 1, 2016

Hi. Not sure if I am talking to a student or a current faculty member (but my answer really shouldn't change), so here goes!

I have seen it done three ways: No review at all, a group review immediately after the exam (under the same strict testing conditions- no writing, no getting up to get your phone/notes, not even a bathroom break before the review begins) and a one-on-one review by appointment (again, no pencils, phones, notes).

The common denominator in all situations is security. Schools and faculty are paranoid about the exams leaking. When the school I taught in did not review at all, students complained that they didn't really know what the answer was (and no rationale for their wrong answers). So we went back to a very strict review. Bottom line; no difference in overall outcomes (statistics of how man passed/failed, did better on the final, etc).

As an educator, I will say this: I hate reviews. They are incredibly stressful, emotional, students are scared, stressed, angry and some are downright nasty. While I understand the importance of the review (for the sake of the students' understanding of the questions/answers), I wish there was a way to make it for that, and not a fight for points.

random_nurse12 · Oct 6, 2016

Exams need to be reviewed. If you allow students to write things down I hope you are writing completely unique exams every semester. Which is very tough to do because you are not able to validate your questions.

I personally review every exam. There is no recording, no writing anything down. Correct answers are given. I will do a brief explanation of high missed questions. There is no arguing with me or I will immediately end the review.

Students can meet with me individually if they would like to take more time. Still, no writing anything down.

Harveyslake · Oct 8, 2016

Here was my experience. We reviewed the exams after the tests were graded. We were not allowed to take notes nor were we allowed to keep the tests. The review consisted of an hour long "witch" and moan session where students tried to "defend" their thinking and get the instructor to accept their answer as "more correct" it was horrible! The instructors immediately got defensive. The major problem was the questions were poorly written and the faculty didn't even know the correct answers to their own questions! I quickly learned that the open review was pointless and always made an appointment with my instructor in their office to review my exams. On more than one occasion I had to prove my instructors wrong,.....they love that by the way. I actually had an instructor tell me my answer was wrong because she had "made up" the term I had chosen for the correct answer. I opened the text book and word for word out of the textbook was "her" question and quess what,....my answer was the correct one. She did NOT make up the term. SHEESH!!! Her only reply was, "I guess I have to give you those points" double SHEESH!!! If you don't know the answers to your own questions you shouldn't be asking your students!!! I had a previous degree and had taken courses from astronomy to zoology and everything in between. NEVER where exams so poorly written in any other subject. We always got to keep our exams to boot. Nursing education needs to be burned to the ground, the earth salted and should be rebuilt in a logical fashion. Not the way it is done now.

historyfan · Oct 12, 2016

Hi: We adopted Collaborative Test Review several years ago and it has been very successful. Rather than having the "b*tch and moan" sessions, the students have started to take ownership. We place students into small groups (4-5) and return their test booklets to them (no scantrons are returned at this time). Everything must be cleared from the room (books, jackets, phones, pens/pencils, backpacks) and so all they have in front of them is their test booklets. We (the faculty) strategically organize the students so that there is a mixture of students with high marks and with lower marks in each group. Then we give the students anywhere from 30-45 minutes to go thru each question and discuss how and why they answered the questions the way they did. At this point, students still do not know if they answered the question correctly or not. Stronger students might have a way of thinking about answering a question that weaker students can learn from. There always is a lot of energetic discussion during this time.

Once the students have gone thru the exam, we return the scantrons so they can see the correct answers. As faculty, there is very little for us to "defend" by this time because students have usually figured it out through their discussion.

We've found that students really learn from this experience!

historyfan · Oct 12, 2016

I just posted a separate entry about collaborative test review. We (nursing faculty) also felt the same way (defensive, etc) but collaborative test review has really minimized these stressful situations.

Whispera, MSN, RN · Oct 15, 2016

My students write their answers to their multiple choice questions on the text booklet as well as the scantron. I return the booklet to them for review, with a copy of their scantron. I keep the original in case they would be tempted to change answers. They have 15 minutes to look over their test. If they question the scoring, they can write, on their booket, their defenses of their answers. I review them and make changes in grades if they convince me that I was wrong. Then I email each with my thoughts.

I also am available for individual review of tests, if the 15 minutes isn't enough.

I don't discuss tests with the group.

This has worked very well for me, for lots of years.

BeenThereDoneThat74, MSN, RN · Oct 22, 2016

Hi: We adopted Collaborative Test Review several years ago and it has been very successful. Rather than having the "b*tch and moan" sessions, the students have started to take ownership. We place students into small groups (4-5) and return their test booklets to them (no scantrons are returned at this time). Everything must be cleared from the room (books, jackets, phones, pens/pencils, backpacks) and so all they have in front of them is their test booklets. We (the faculty) strategically organize the students so that there is a mixture of students with high marks and with lower marks in each group. Then we give the students anywhere from 30-45 minutes to go thru each question and discuss how and why they answered the questions the way they did. At this point, students still do not know if they answered the question correctly or not. Stronger students might have a way of thinking about answering a question that weaker students can learn from. There always is a lot of energetic discussion during this time.
Once the students have gone thru the exam, we return the scantrons so they can see the correct answers. As faculty, there is very little for us to "defend" by this time because students have usually figured it out through their discussion.
We've found that students really learn from this experience!

I like this idea!! I can see how there is a lot less moaning afterwards, as their peers have helped them to understand why the right answer was right!

You said you give them back their scantrons? I am assuming no pencils and strict oversight?

Natasha A., CNA, LVN · Oct 26, 2016

As a student i struggled with exams and yes office hours are better when you really do not understand. I was wondering how about going over a test question from a different angle with a similar concept for students to write down instead of reviewing with the exact test question because it may be that students may not understand the concept. Plus, it may be better to see the concept being presented in different angles for critical thinking purposes.

If we are taught how to read a nursing textbook to think like a nurse and exams it will help exam grades. sometimes is the basics that we all forget to understand material. PP are okay but the nursing textbooks helps to see the big picture.

nursej22, MSN, RN · Oct 27, 2016

We do collaborative exams as well, with higher scoring students matched with lower scorers. If they are still not satisfied, they can meet one on one with the instructor. Sometimes some items are miss-keyed. We use the same exams from session to session, so security is important. We also compile test statistics including item analysis to track validity of our questions.

historyfan · Oct 27, 2016

Yes, indeed. We do not return the scantrons until the students have looked over the test booklets together in their small groups (our exams have 25-30 questions, the review takes about 30-40 minutes). After that, we return the scantrons so they can see the correct answers. No writing utensils, nothing of the kind is allowed during the exam review. The faculty does ask if there are any lingering questions but this usually goes fast since the students have already figured out the correct answers and have a pretty good understanding of why the answer is correct. We've been doing this for about four years now and we swear by it. There is research and articles out there on this topic but we heard about it at a conference.