The assessment of reasoning skills in nursing student selection – Test development and psychometric testing

The purpose of this three-phased study was I) to identify reasoning skills to be assessed in nursing student selection, II) to develop and psychometrically test a Reasoning Skills (ReSki) test for undergraduate nursing student selection, and III) to assess nursing applicants’ reasoning skills and factors related to them. The aim was to develop a valid and objective ReSki test for national use in nursing student selection. The ultimate goal was to develop the undergraduate nursing student selection and thus the selection of applicants who are in the future able to make sound decisions thus promoting good nursing care and patient safety. In phase I, a scoping review (24 original studies) and focus group interviews (16 nursing students and 9 experts) were conducted. Charting, collating, summarising, and inductive content analysis were used to analyse the review data. Deductive and inductive content analysis were used to analyse the focus group data. In phase II, an electronic ReSki test (version 2) was developed (including a pilot-study and expert panels) and psychometrically (including a usability evaluation) tested with a methodological cross-sectional study with 1,056 nursing applicants. The data were analysed using descriptive statistics, correlations, Item Response Theory (IRT) and usability analysis. In phase III, the data (n=1,056) from the psychometric testing (phase II) were used. Descriptive statistics, correlations, and analysis of covariance with Tukey’s test in post-hoc multiple group comparisons were used to analyse the data. The assessment of nursing applicants’ reasoning skills involved skills in collecting information, processing information, and identifying the problem and establishing goals. The ReSki test was a valid, usable, and objective assessment method, but the IRT-analysis indicated further improvement to the distractor items is needed for the desired adjustment of the difficulty level. Applicants succeeded best in collecting and processing the information and worst in identifying the problem and establishing goals. Age, gender, previous education, and work experience (only in identifying the problem and establishing goals) were statistically significantly related to the applicants’ reasoning skills. The results have implications especially for nursing education and its research.Päätöksentekotaitojen arviointi sairaanhoitajakoulutuksen opiskelijavalinnassa – Testin kehittäminen ja psykometrinen testaus Tämän kolmivaiheisen tutkimuksen tarkoituksena oli I) tunnistaa sairaanhoitajakoulutuksen opiskelijavalinnassa arvioitavat päätöksentekotaidot, II) kehittää sairaanhoitajakoulutuksen hakijoiden päätöksentekotaitoja arvioiva Reasoning Skills (ReSki)-testi ja arvioida sen psykometrisia ominaisuuksia, sekä III) arvioida hakijoiden päätöksentekotaitoja ja niihin yhteydessä olevia tekijöitä. Tavoitteena oli kehittää luotettava ja objektiivinen ReSki-testi kansalliseen käyttöön. Lopullinen päämäärä oli kehittää sairaanhoitajakoulutuksen opiskelijavalintaa, mikä edistäisi hyvää hoitoa ja potilasturvallisuutta. Vaiheessa I toteutettiin kartoittava katsaus (scoping review) (24 tutkimusta) ja fokusryhmähaastattelut (16 sairaanhoitajaopiskelijaa ja 9 asiantuntijaa). Katsausaineisto analysoitiin taulukoimalla, kokoamalla, tiivistämällä ja induktiivisella sisällönanalyysilla, ja fokusryhmäaineisto deduktiivisella ja induktiivisella sisällönanalyysilla. Vaiheessa II kehitettiin sähköinen ReSki-testi (versio 2) (vaihe sisälsi pilottitutkimuksen ja asiantuntijapaneelit). Psykometrinen testaus toteutettiin (sisältäen käytettävyysarvioinnin) poikkileikkaustutkimuksen avulla (1056 sairaanhoitajakoulutuksen hakijaa). Aineisto analysoitiin kuvailevin menetelmin, korrelaatioilla, osiovaste- ja käytettävyysanalyysilla. Vaiheessa III käytettiin samaa aineistoa kuin vaiheessa II (n=1056). Aineisto analysoitiin kuvailevin menetelmin, korrelaatioilla ja kovarianssianalyysilla (Tukeyn testi). Päätöksentekotaitojen arviointi koostui tiedon keräämisen, tiedon prosessoinnin sekä ongelman tunnistamisen ja tavoitteiden asettamisen taitojen arvioimisesta. ReSki-testi oli luotettava, käytettävä ja objektiivinen arviointimenetelmä, mutta osiovasteanalyysin perusteella harhauttajaväittämiä tulisi muokata testin vaikeustason optimoimiseksi. Parhaiten hakijat menestyivät tiedon keräämisessä ja prosessoinnissa, ja heikoiten ongelman tunnistamisessa ja tavoitteiden asettamisessa. Päätöksentekotaitoja selittivät pääosin ikä, sukupuoli ja koulutustausta sekä osittain työkokemus. Tuloksia voidaan hyödyntää erityisesti hoitotyön koulutuksessa ja sen tutkimuksessa

Advanced mathematical skills and relating factors of engineering applicants: a cross-sectional study

Higher education institutions assess applicants with entrance examinations as a way to identify and rank those applicants with adequate ability to proceed in their studies. Engineering students form a significant group of higher education students, both in Europe and Finland. Finnish universities of applied sciences (UASs) developed and harmonised their student selection in the Development Project in 2017–2020. In the Development Project, a new national digital universities of applied sciences entrance examination (UAS Exam) was developed. In the current study, a cross-sectional design was used to assess advanced mathematical skills and related factors of the bachelor-level engineering applicants performing the newly developed UAS Exam. The advanced mathematical skills exam section contains mathematics and physics problems. The data were collected via the digital exam system. Altogether, 1205 engineering applicants consented to the study and performed the exam section. The data were statistically analysed. The applicants’ mean scores were 4.8 (SD 5.2, median 3.9, range -4.9–20 pts) out of 20 maximum points. Over 20% of the applicants failed. Some of the background variables explain the applicants’ exam results, indicating that older applicants scored better than younger ones, males better than females, and high school graduates and applicants with previous higher education degrees better than those with vocational diplomas. The results indicate that engineering applicants’ advanced mathematical skills were rather poor, indicating that it may be possible that engineering applicants lack the basic skills in mathematics and physics, but this may vary between applicants

Identifying reasoning skills for the selection of undergraduate nursing students: a focus group study

Background: Reasoning is a cognitive skill crucial to making solid decisions. The assessment of reasoning skills in nursing student selection is studied scarcely. Aim: To identify which reasoning skills should be assessed when selecting undergraduate nursing applicants. Design: A qualitative descriptive design. Methods: Four focus group interviews (n = 25) were undertaken with nursing students (n = 16) and experts (n = 9). The Clinical Reasoning Model was used as a deductive framework for the main categories. Subcategories were formed inductively. Results: All eight steps of the clinical reasoning process were deductively identified including 15 subcategories and representing reasoning skills in the selection phase: Consider the situation, Collect cues and information, Process information, Identify the problem, Establish goals, Take action, Evaluate outcomes and Reflect on the process of action and new learning. The beginning of the clinical reasoning process was emphasised most. Conclusion: The assessment of applicants' reasoning skills should focus on the information processing skills. Impact statement: This study identifies reasoning skills which should be considered in the assessment of nursing applicants.</p

The assessment of learning skills in nursing student selection: A scoping review

Higher education student selection has significant societal, institutional and individual impacts. Thousands of applicants apply only for nursing, one of the major higher education disciplines. As the nursing profession is characterised by cognitive requirements, higher education institutions assess the learning skills of nursing applicants. However, there has been no comprehensive analysis of learning skills assessment for nursing student selection. The purpose of this scoping review was to describe the assessment of learning skills in undergraduate nursing student selection. Five databases were systematically searched, and 24 studies published between 2006 and 2016 were included. Learning skills were most commonly assessed using standardised tests in the areas of language and communication, reasoning, mathematics and natural sciences. Overall scores of onsite selection methods were found to best predict future academic performance. The results indicate that higher education institutions may benefit from comprehensive assessment of learning skills in their selection processes. This assessment should focus on a wider range of cognitive aptitudes, including reasoning skills. This review focussed on nursing education, but the results may benefit other higher education disciplines due to the generic nature of learning skills and similar cognitive requirements of higher education studies. The results support the development of more comprehensive and valid methods for assessing learning skills

Development and psychometric evaluation of the Emotional Intelligence Test (EMI-T) for social care and healthcare student selection

Aim: To develop an emotional intelligence (EI) test and evaluate its psychometrics for social and healthcare student selection. Design: A cross-sectional methodological design. Methods: The test was developed based on a systematic review and focus group interviews. Content validity was evaluated with expert panels, and preliminary psychometrics with two pilot studies. Descriptive statistics, correlations and item response theory were used. Data Sources: Search was conducted in six databases 2018. Focus group interviews were conducted with educators and professionals in 2019. Expert panels with doctoral students, researchers and educators were conducted in 2020. Pilot tests with students were conducted 2020–2021. The developed test was administered to 4808 applicants 2021. Results: The test included four subscales. Correlations support the test's theoretical structure. The items were mainly easy. Conclusion: The test assesses EI objectively and comprehensively. The item-level distractor analysis can be used for further test development. Impacts: Social care and healthcare students engage in clinical practice early in their studies, and these environments can be emotionally challenging. Assessing EI in student selection with adequate test can help the institutions of higher education to select the students with required abilities to succeed in the studies. The assessment of EI during student selection also provides information higher education institutions could use to develop and provide support interventions. The results may also encourage practice placements to include EI elements as learning objective. The results of this study and especially the use of IRT and detailed distractor analysis to evaluate the psychometric properties of EMI-T can benefit researchers and educators that develop or evaluate objective assessment tools with multiple choice questions. Implications for the profession and/or patient care: Emotional intelligence is important for students to enable professional interaction.publishedVersionPeer reviewe

Nursing applicants' reasoning skills and factors related to them: A cross-sectional study

The assessment of reasoning skills is recommended in undergraduate nursing student selection. Reasoning skills are crucial for sound decision-making, improving patient safety and are necessary from the very beginning of studies. Nursing applicants' reasoning skills based on the reasoning process have not been previously measured.To assess undergraduate nursing applicants' reasoning skills and factors related to them.A cross-sectional study.Undergraduate nursing applicants (n = 1056, response rate 55.4%), who consented to the study and performed a joint electronic entrance examination to six Finnish Universities of Applied Sciences in spring 2019, participated in the study.The Reasoning Skills (ReSki) test, based on the steps of the reasoning process, was used, comprising three question sections (collecting information, processing information, and identifying the problem and establishing goals). Background variables were collected through a questionnaire and the Positive System Usability Scale (P-SUS). The data were analysed with descriptive statistics, Pearson correlation coefficients and analysis of covariance with Tukey's test in post-hoc multiple group comparisons.Applicants' total reasoning skills mean scores were above the centre of the range of possible scores (2.72/4.5, SD = 0.80). The applicants scored higher in collecting and processing information than in identifying the problem and establishing goals. Standard deviations demonstrated variance between the applicants' ability. Age, gender, and previous education were statistically significantly related to applicants' reasoning skills. Previous work experience was statistically significantly related to success only in the step of identifying the problem and establishing goals.Nursing applicants' reasoning skills vary in the student selection phase. Applicants are less able to identify the problem and establish goals than to collect and process information. Vocational education does not necessarily develop adequate reasoning skills and thus prepare students for higher education studies. The results have implications for educational institutions and further research.</div

Development and psychometric testing of Reasoning Skills test for nursing student selection: An item response theory approach

Aims To develop and psychometrically test the Reasoning Skills (ReSki) test assessing undergraduate nursing applicants' reasoning skills for student selection purposes.Design A methodological cross-sectional design was applied for the psychometric testing.Methods The ReSki test was developed as part of a wider electronic entrance examination. The ReSki test included a case followed by three question sections assessing nursing applicants' reasoning skills according to the reasoning process. Item response theory was used for psychometric testing to assess item discrimination, difficulty and pseudoguessing parameters. The ReSki test was taken by 1056 nursing applicants in six Finnish Universities of Applied Sciences (28 May 2019).Results In the development process, the expert evaluations indicated acceptable content validity. In the psychometric testing, the test reliability was supported by item variance, the theoretical structure was supported by the correlation coefficients and the applicant mean performance supported an acceptable overall test difficulty. The item response theory indicated variance between the items' difficulty and discrimination ranges. However, most of the wrong items failed at being functional distractors.Conclusion The ReSki test is a new and valid objective assessment of undergraduate nursing applicants' reasoning skills. The item response theory provided item-level information that can be used for further development of the test, especially related to the revisions needed for the distractor items to achieve the desired level of difficulty.Impact What problem did the study address? The assessment of nursing applicants' reasoning skills is suggested, but there is a lack of admission tools. What were the main findings? The results provided support for the reliability and validity of the ReSki test. Item response theory indicated the need for further item-level improvement. Where and on whom will the research have an impact? The results may benefit higher education institutions and researchers when developing a test and/or student selection processes.</div

Nuoruusiän seksuaaliterveys vanhemmuuden näkökulmasta

Opinnäytetyö on toimeksianto Vaasan kaupungilta, ja osa Vaasassa tapahtuvaa seksuaaliterveyden edistämistä. Opinnäytetyön tarkoituksena on toimia kattavana teoriapakettina, jonka pohjalta toteutetaan jatkotyönä keväällä 2010 seksuaalikasvatusmateriaali Vaasan vanhempainyhdistysten käyttöön. Lisäksi opinnäytetyö on ajankohtainen katsaus yläkouluikäisten nuorten seksuaaliterveyden tämänhetkiseen tilaan ja sen haasteisiin. Opinnäytetyön punaisena lankana kulkee vanhemmuus osana nuoruusiän seksuaaliterveyttä ja seksuaalikasvatusta. Opinnäytetyön menetelmänä käytettiin perinteistä kirjallisuuskatsausta. Siinä hyödynnettiin monipuolisesti aineistoa liittyen nuoruusiän seksuaaliterveyteen sekä kodin ja koulun seksuaalikasvatukseen. Käytettyä aineistoa voidaan pitää luotettavana, sillä se on pääasiassa alan asiantuntijoiden kirjoittamaa ja näyttöön perustuvaa. Lisäksi aineistossa esiintyvät tutkimustulokset ovat yleistettävissä. Aineistoa hakiessa karsittiin pois lähteet, joiden asia ei perustunut tutkittuun tie-toon, jäi aiherajauksen ulkopuolelle tai sisälsi vanhaa tietoa. Nuorten seksuaaliterveyden tila on kohenemassa, vaikka 1990-luvun alun lamanaikaisten säästötoimien vaikutukset näkyvät yhä edelleen. Seksuaaliterveyteen liittyvät tiedot, taidot ja motivaatio näyttävät parantuneen. Seksuaalikasvatustavoitteita muokataan nykypäivän seksuaalikasvatushaasteita vastaaviksi asenteiden ja seksuaalikäyttäytymisen muuttuessa. Hyvä seksuaalikasvatus perustuu kodin, koulun ja terveydenhuollon väliselle saumattomalle yhteistyölle. Vanhemmuudella on kokonaisvaltainen merkitys nuoruusiän seksuaaliterveyden edistämisessä. Seksuaalisuuden muuttuessa omakohtaiseksi vanhempien suhtautuminen vaikuttaa nuoruusiän kehitystehtävien saavuttamiseen, erityisesti seksuaalisen identiteetin jäsentymiseen. Vahva vanhemmuus edistää parhaimmillaan seksuaaliterveyttä ja seksuaalista itsemääräämisoikeutta nuoren sisäisiä voimavaroja vahvistamalla. Nuoruusikä on herkistymisen aikaa, ja vanhemmista irtautumiseen tähtäävä itsenäistymistaistelu voi olla kivinen tie. Silti nuori tarvitsee vanhempien huolenpitoa ja läsnäoloa, rajoja ja rakkautta.This bachelor`s thesis is an assignment given by the city of Vaasa, and a part of the sexual health promotion strategy. The purpose of this bachelor´ s thesis is to give a comprehensive theoretical frame for a future project where the purpose is to produce sexuality education material in spring 2010 to be used by the parents´ association in Vaasa. A further purpose is to present the current state and challenges of sexual health among adolescents in the upper level of comprehensive school. The focus is on the role of the parents and parenthood as a part of adolescent sexual health and sexuality education. The method is a traditional literature review. The material used in this study gave information about adolescent sexual health and the sexuality education given at home and at school. The data of the study is reliable and valid, as it is mainly written by persons that are experts in this particular field and based on empirical research. In addition the results can be generalised. When searching for material and processing the data, all outdated sources, not based on empirical research, were left out. As a conclusion it can be said that the sexual health among adolescents is improving in spite of the poor level of sexual health during the 1990`s. However, the level of knowledge, skills and motivation in sexual health is better than ever. Nowadays, the goals of sexuality education correspond to the present challenges while the sexual behaviour and attitudes are changing. Sexuality education of high quality is based on the continuous co-operation between the home, the school and the health care providers. During adolescence sexuality becomes personal for the first time. With the supportive attitude of parents, an adolescent has the possibility of reaching the goals of their age level, such as finding their sexual identity and autonomy. Strong parenthood promotes the best sexual health and increases the self-determination of an adolescent by making their inner resources stronger. Adolescence is a sensitive phase in life and finding the autonomy can be challenging. Nevertheless, an adolescent needs parental care and presence of the family, as much as boundaries and most importantly, love

Ammattikorkeakoulujen uuden digitaalisen valintakokeen kehittäminen – toteuttamisvaiheen tulokset

Ammattikorkeakoulujen uusi digitaalinen valintakoe (AMK-valintakoe) otettiin käyttöön syksyllä 2019 korkeakoulujen yhteishaussa. Koe kehitettiin osana hankkeen Ammattikorkeakoulujen opiskelijavalintojen kehittäminen (AMK-opiskelijavalinnat) 2017–2020 toteuttamisvaihetta. Toteuttamisvaiheen (syksy 2019) tarkoituksena oli AMK-valintakokeen käyttöönotto. Lisäksi AMK-valintakokeesta kerättiin laaja tutkimusaineisto poikkileikkausasetelmalla. Tutkimuksen tarkoituksena oli analysoida hakijoiden valintakoemenestystä sekä valintakokeen luotettavuutta ja käytettävyyttä. Tämä raportti esittelee toteuttamisvaiheen tulokset. AMK-valintakoe oli ensimmäinen Suomessa korkeakoulusektorilla käyttöön otettu valtakunnallinen digitaalisesti toteutettava valintakoe. Kokeen sisältö ja rakenne perustuivat AMK-opiskelijavalinnat-hankkeen määrittely- ja kehittämisvaiheen tuloksiin. Koe ei edellyttänyt hakijoilta pitkää valmentautumista

Instruments used in graduating nursing students’ exit exams : an integrative review

Background: Worldwide, nursing students comprise a large portion of students in higher education institutions (HEIs). The expectation that HEIs will educate professionally competent nurses is high. To ensure adequate competence, exit examinations play a significant role in evaluation in many countries. However, there has been no comprehensive analysis of the instruments used and the content evaluated in exit examinations globally. Purposes: The aim of this study was to identify and describe the instruments used in undergraduate nursing students’ exit examinations. Methods: Five databases were systematically searched, and eleven studies were included. The data of content used in exit exams were analysed using inductive content analysis. The instruments used in exit exams were tabulated and described. The systematic process was followed to identify included papers. Results: Eleven different instruments were identified, including nine theoretical instruments and two clinical instruments. The exit examinations of undergraduate nursing students varied considerably depending on the country and educational organisation. The content evaluated in the exit examinations covered the holistic nursing perspective. Conclusions: The findings of this review suggest that HEIs should develop and implement more comprehensive evaluation methods and instruments to ensure students’ competence upon graduation. The results are important for developing exit examinations in nursing education because they indicate that summative evaluation is needed. Clinical examinations have been used marginally in HEIs, which should be considered when implementing new examinations. Digitalisation (e.g. virtual environments) could be one solution for offering objective assessment, validity and cost-effectiveness. Impact statement: This review provides a comprehensive analysis of undergraduate nursing students’ exit examinations and indicates that more clinical evaluation methods should be developed to ensure adequate competence.publishedVersionPeer reviewe