WEBVTT 00:00:06.000 --> 00:00:06.970 position:50% align:middle - [Latrice] Hello. 00:00:06.970 --> 00:00:12.855 position:50% align:middle My name is Latrice Johnson, RN manager of content development here at NCSBN. 00:00:12.855 --> 00:00:17.950 position:50% align:middle During my 12 years of test development, I have been actively involved in numerous 00:00:17.950 --> 00:00:20.376 position:50% align:middle item development panels. 00:00:20.380 --> 00:00:26.520 position:50% align:middle Today, Dr. Hong and I will be talking about sensitivity review and differential item functioning, 00:00:26.520 --> 00:00:31.700 position:50% align:middle otherwise known as DIF, two procedures that include item review panels that we 00:00:31.700 --> 00:00:33.550 position:50% align:middle host to reduce bias. 00:00:33.550 --> 00:00:38.680 position:50% align:middle By the end of this presentation, you will be able to identify the purpose of conducting 00:00:38.680 --> 00:00:42.590 position:50% align:middle the sensitivity review panel and the DIF review panel. 00:00:42.590 --> 00:00:48.414 position:50% align:middle You will understand why these panels are necessary and what it means for an item to DIF. 00:00:48.530 --> 00:00:55.850 position:50% align:middle Finally, you will be able to describe how NCSBN conducts the sensitivity and DIF review panels. 00:00:55.850 --> 00:01:02.280 position:50% align:middle Before we discuss sensitivity and DIF, let's look at the REx-PN item development process. 00:01:02.280 --> 00:01:09.123 position:50% align:middle Review of this process will help you identify the many actions taken to develop the REx-PN items. 00:01:09.400 --> 00:01:15.286 position:50% align:middle This diagram illustrates the steps used in the development of the REx-PN exam. 00:01:15.530 --> 00:01:21.622 position:50% align:middle The REx-PN item development process is a multifaceted process adhering to the standards 00:01:21.622 --> 00:01:24.770 position:50% align:middle outlined in professional test development. 00:01:25.010 --> 00:01:28.874 position:50% align:middle The exam process starts at the top with nursing practice. 00:01:29.683 --> 00:01:35.557 position:50% align:middle Nursing practice provides the foundation for the REx-PN item development process by identifying 00:01:35.557 --> 00:01:39.609 position:50% align:middle activities that can be performed by an entry-level nurse. 00:01:40.860 --> 00:01:44.920 position:50% align:middle I'll briefly review each step within the item development process. 00:01:44.920 --> 00:01:51.283 position:50% align:middle To summarize, after the practice analysis and test plan development, items are developed by 00:01:51.283 --> 00:01:54.930 position:50% align:middle volunteer nurse educators at item writing panels. 00:01:54.930 --> 00:02:01.695 position:50% align:middle Then, items are revised by our content developers here at NCSBN to ensure that the items look as if 00:02:01.695 --> 00:02:07.572 position:50% align:middle one writer has written them since we do have many volunteers who attend our panels. 00:02:08.060 --> 00:02:13.080 position:50% align:middle Items are then submitted for additional editorial review, which ensures that items 00:02:13.080 --> 00:02:14.979 position:50% align:middle are grammatically correct. 00:02:14.979 --> 00:02:20.200 position:50% align:middle After editorial review, items are sent to the item review panel. 00:02:20.200 --> 00:02:25.654 position:50% align:middle Volunteer nurse clinicians who work directly with entry-level nurses attend item review panels 00:02:25.654 --> 00:02:31.390 position:50% align:middle to ensure that the items are accurate, entry-level, current practice, and linked appropriately 00:02:31.390 --> 00:02:33.250 position:50% align:middle to the test plan. 00:02:33.700 --> 00:02:36.880 position:50% align:middle Items are then sent to sensitivity review. 00:02:36.880 --> 00:02:40.390 position:50% align:middle I'll share more details about sensitivity review later. 00:02:40.390 --> 00:02:45.690 position:50% align:middle After sensitivity review, items then go on to the exam for pre-testing. 00:02:45.690 --> 00:02:48.370 position:50% align:middle We use pre-testing for data collection. 00:02:48.370 --> 00:02:52.070 position:50% align:middle These items do not count towards the candidate score. 00:02:52.070 --> 00:02:57.983 position:50% align:middle Pre-test items and items that are operational or count towards the candidate score may undergo 00:02:57.983 --> 00:03:03.536 position:50% align:middle differential item functioning or DIF review, which Dr. Hong will discuss later. 00:03:04.170 --> 00:03:09.530 position:50% align:middle Items are also reviewed by nursing regulatory bodies to determine if the content is appropriate 00:03:09.530 --> 00:03:11.140 position:50% align:middle for their province. 00:03:11.140 --> 00:03:16.180 position:50% align:middle And the last step is exam administration, of which items are now operational and count 00:03:16.180 --> 00:03:17.940 position:50% align:middle towards the candidate score. 00:03:17.940 --> 00:03:22.490 position:50% align:middle As you can see here, the entire process is rigorous and requires a lot 00:03:22.490 --> 00:03:24.420 position:50% align:middle of nurse volunteers. 00:03:24.420 --> 00:03:29.652 position:50% align:middle It takes approximately 18 months to 2 years for an item to be developed and become 00:03:29.652 --> 00:03:31.565 position:50% align:middle operational on the exam. 00:03:31.565 --> 00:03:35.040 position:50% align:middle Now, let's go back to sensitivity and DIF review. 00:03:35.040 --> 00:03:38.480 position:50% align:middle What is the purpose of sensitivity and DIF reviews? 00:03:38.480 --> 00:03:43.492 position:50% align:middle Do you know that the REx-PN will be administered to candidates who plan to practice 00:03:43.492 --> 00:03:46.233 position:50% align:middle in British Columbia and Ontario? 00:03:46.233 --> 00:03:49.370 position:50% align:middle These candidates represent global diversity. 00:03:49.370 --> 00:03:53.430 position:50% align:middle We want to make sure that the exam is fair to all candidates. 00:03:53.430 --> 00:03:56.730 position:50% align:middle This is the purpose of sensitivity and DIF reviews. 00:03:56.730 --> 00:04:01.820 position:50% align:middle It is critical that every candidate has a fair opportunity to demonstrate their nursing knowledge, 00:04:01.820 --> 00:04:04.182 position:50% align:middle skills, and abilities. 00:04:05.510 --> 00:04:11.670 position:50% align:middle Fairness in an exam means that the exam provides an equal opportunity for all candidates. 00:04:11.670 --> 00:04:16.870 position:50% align:middle We want our examination to make distinctions between people based on their knowledge, skills, 00:04:16.870 --> 00:04:21.520 position:50% align:middle and abilities within the nursing profession alone and nothing else. 00:04:21.520 --> 00:04:24.580 position:50% align:middle So, how do we ensure fairness on REx-PN? 00:04:24.580 --> 00:04:28.470 position:50% align:middle As I mentioned before, there are two procedures during the item development 00:04:28.470 --> 00:04:31.144 position:50% align:middle process to ensure fairness. 00:04:31.510 --> 00:04:34.630 position:50% align:middle The first one is sensitivity review panel. 00:04:34.630 --> 00:04:39.800 position:50% align:middle This panel includes a diverse group of volunteer laypersons and two nurses. 00:04:39.800 --> 00:04:45.200 position:50% align:middle The panelists review newly written items before the items are used for pre-testing. 00:04:45.770 --> 00:04:50.240 position:50% align:middle The second procedure is DIF review, which Dr. Hong will discuss next. 00:04:50.240 --> 00:04:54.570 position:50% align:middle For now, I want you to notice that each panel includes volunteer 00:04:54.570 --> 00:04:57.228 position:50% align:middle laypersons from diverse backgrounds. 00:04:58.158 --> 00:05:01.618 position:50% align:middle Let's talk about the sensitivity review panel. 00:05:01.798 --> 00:05:06.880 position:50% align:middle During the sensitivity review panel, the participants are asked to review each item 00:05:06.880 --> 00:05:13.940 position:50% align:middle to identify inappropriate language, underlying assumptions and stereotyping, ethnocentrism, 00:05:13.940 --> 00:05:16.849 position:50% align:middle and inflammatory language or content. 00:05:16.910 --> 00:05:21.466 position:50% align:middle Now, let's take a closer look at our sensitivity review criteria. 00:05:21.750 --> 00:05:23.790 position:50% align:middle Inappropriate language. 00:05:23.790 --> 00:05:29.980 position:50% align:middle Our panelists are instructed to flag any item that classifies a client by their diagnosis, age, 00:05:29.980 --> 00:05:32.477 position:50% align:middle religion, or disability. 00:05:32.610 --> 00:05:38.100 position:50% align:middle They are also instructed to flag items that use expressions and slang that may not be known 00:05:38.100 --> 00:05:40.176 position:50% align:middle by all candidates. 00:05:41.050 --> 00:05:45.968 position:50% align:middle Here is an example of an item that contains inappropriate language. 00:05:46.170 --> 00:05:49.390 position:50% align:middle This item classifies a client by diagnosis. 00:05:49.390 --> 00:05:52.980 position:50% align:middle Note, "diabetic 50-year-old male client." 00:05:52.980 --> 00:05:56.530 position:50% align:middle Instead, we would use "client with diabetes." 00:05:56.530 --> 00:06:00.740 position:50% align:middle In addition, 50-year-old is not necessary in this case. 00:06:00.740 --> 00:06:02.460 position:50% align:middle Age is not relevant. 00:06:02.460 --> 00:06:06.923 position:50% align:middle As we know, clients can have diabetes at any age. 00:06:07.100 --> 00:06:10.450 position:50% align:middle Note here that "male" is not necessary. 00:06:10.450 --> 00:06:14.330 position:50% align:middle Diabetes is not a sex-specific diagnosis. 00:06:14.330 --> 00:06:19.870 position:50% align:middle We rely on the nurses in this panel to determine whether inclusion of a client's sex and age are 00:06:19.870 --> 00:06:22.158 position:50% align:middle necessary for the item. 00:06:22.690 --> 00:06:26.080 position:50% align:middle Note here the use of the term "flip-flops." 00:06:26.080 --> 00:06:31.030 position:50% align:middle Flip-flops is slang and would not be included on the REx-PN exam. 00:06:31.030 --> 00:06:37.710 position:50% align:middle "All things in moderation" is an idiomatic expression and would not be included on the REx-PN exam. 00:06:37.710 --> 00:06:42.120 position:50% align:middle Now, let's talk about underlying assumptions and stereotyping. 00:06:42.120 --> 00:06:48.090 position:50% align:middle Our panelists are instructed to flag any item that implies a generalized belief about a particular group 00:06:48.090 --> 00:06:55.260 position:50% align:middle of people that represents an oversimplified opinion, prejudice attitude, or uncritical judgment. 00:06:56.190 --> 00:07:02.447 position:50% align:middle This is an example of an item that contains an underlying assumption or stereotype. 00:07:02.610 --> 00:07:09.229 position:50% align:middle Here, use of the term "same-sex" is not necessary and reflects stereotyping. 00:07:09.870 --> 00:07:13.560 position:50% align:middle Next, let's discuss ethnocentrism. 00:07:13.560 --> 00:07:18.740 position:50% align:middle Our sensitivity panelists are instructed to flag any item that supports the attitude that a 00:07:18.740 --> 00:07:24.380 position:50% align:middle particular group, ethnicity, or nationality is superior to others. 00:07:24.380 --> 00:07:30.230 position:50% align:middle It cannot be assumed that all REx-PN candidates subscribe to Canadian norms. 00:07:30.230 --> 00:07:34.880 position:50% align:middle This is an example of an item that reflects ethnocentrism. 00:07:34.880 --> 00:07:41.150 position:50% align:middle Option number one implies that this is a cultural norm that is appropriate across all cultures. 00:07:41.150 --> 00:07:46.420 position:50% align:middle This item reflects content that would be flagged and removed from the REx-PN exam. 00:07:46.420 --> 00:07:50.040 position:50% align:middle Now, let's discuss inflammatory language or content. 00:07:50.040 --> 00:07:56.320 position:50% align:middle Finally, our sensitivity panelists are instructed to flag any item that is patronizing, 00:07:56.320 --> 00:08:02.110 position:50% align:middle displaying or indicative of an offensively condescending manner such as calling a person 00:08:02.110 --> 00:08:04.144 position:50% align:middle honey or sweetie. 00:08:04.460 --> 00:08:08.914 position:50% align:middle Condescending language is language that implies that one is conscious of descending from a 00:08:08.914 --> 00:08:12.313 position:50% align:middle superior position, rank, or dignity. 00:08:12.690 --> 00:08:18.810 position:50% align:middle Offensive language is language that is disapproving to the moral sense, good taste, or is insulting, 00:08:18.810 --> 00:08:20.498 position:50% align:middle such as a cruel joke. 00:08:21.130 --> 00:08:27.120 position:50% align:middle Finally, we ask our panelists to flag any item that contains inflammatory content. 00:08:27.120 --> 00:08:31.829 position:50% align:middle For example, statements that support or refute one's political opinion. 00:08:32.502 --> 00:08:37.340 position:50% align:middle This is an example of an item that contains inflammatory language or content. 00:08:37.340 --> 00:08:44.228 position:50% align:middle The statement, "Don't worry sweetie," is patronizing and could be considered condescending. 00:08:44.950 --> 00:08:49.267 position:50% align:middle Now, let's talk about how the sensitivity panel works. 00:08:49.349 --> 00:08:53.270 position:50% align:middle Panelists are asked to individually review a group of items. 00:08:53.270 --> 00:08:59.200 position:50% align:middle The panelist reviews one item at a time and decides if the item is approved or not approved based on 00:08:59.200 --> 00:09:01.609 position:50% align:middle the four criteria just reviewed. 00:09:01.821 --> 00:09:05.232 position:50% align:middle If approved, the panelist will move to the next item. 00:09:05.370 --> 00:09:11.660 position:50% align:middle If not approved, the panelist is asked to provide a comment specifying which sensitivity review criteria 00:09:11.660 --> 00:09:13.070 position:50% align:middle has been breached. 00:09:13.070 --> 00:09:18.230 position:50% align:middle After all panelists have reviewed the items, the items that are not approved, the flagged items, 00:09:18.230 --> 00:09:20.250 position:50% align:middle are reviewed by the group. 00:09:20.250 --> 00:09:25.279 position:50% align:middle The group will discuss each flagged item, and the group will reach consensus about whether 00:09:25.279 --> 00:09:28.113 position:50% align:middle the item is approved or not approved. 00:09:28.240 --> 00:09:31.459 position:50% align:middle The approved items are used for pre-testing. 00:09:31.650 --> 00:09:37.303 position:50% align:middle The flagged items are returned to the beginning of the item development process for revision. 00:09:37.480 --> 00:09:43.453 position:50% align:middle Now, I would like to introduce Dr. Hong, who will talk about differential item functioning. 00:09:47.840 --> 00:09:49.618 position:50% align:middle - [Dr. Hong] Thank you, Latrice. 00:09:49.618 --> 00:09:50.948 position:50% align:middle I'm Dr. Hong. 00:09:50.948 --> 00:09:55.340 position:50% align:middle I will talk about differential item functioning, DIF. 00:09:55.340 --> 00:09:56.940 position:50% align:middle Sounds very psychometric. 00:09:56.940 --> 00:10:00.337 position:50% align:middle Make sure you have enough coffee around you. 00:10:01.090 --> 00:10:03.184 position:50% align:middle What does DIF mean? 00:10:03.270 --> 00:10:09.504 position:50% align:middle We know each item should measure only the knowledge, ability, or skills in nursing. 00:10:09.710 --> 00:10:14.890 position:50% align:middle If this is the case, then candidates with comparable nursing knowledge will 00:10:14.890 --> 00:10:21.170 position:50% align:middle perform similarly on exam items, regardless of their gender, ethnicity, 00:10:21.170 --> 00:10:24.033 position:50% align:middle or other irrelevant factors. 00:10:24.033 --> 00:10:27.217 position:50% align:middle But that is not always the case. 00:10:28.270 --> 00:10:37.166 position:50% align:middle DIF means that an item behaves differently for various examinee groups of equivalent ability. 00:10:37.166 --> 00:10:41.140 position:50% align:middle The keyword here is equivalent ability. 00:10:41.140 --> 00:10:48.411 position:50% align:middle If nursing abilities of two groups are not the same, of course, they will perform differently on items. 00:10:48.411 --> 00:10:55.480 position:50% align:middle But the problem here is two groups with similar nursing ability from other items, 00:10:55.480 --> 00:11:00.176 position:50% align:middle but they perform differently on this one particular item. 00:11:00.176 --> 00:11:04.352 position:50% align:middle Then we need to investigate this item. 00:11:05.190 --> 00:11:13.346 position:50% align:middle When talking about DIF, we always compare two groups, reference group versus focal group. 00:11:13.420 --> 00:11:20.617 position:50% align:middle Reference group is usually traditional demographic group such as females or white. 00:11:20.617 --> 00:11:24.961 position:50% align:middle Reference group needs to compare to the focal group. 00:11:24.961 --> 00:11:29.070 position:50% align:middle Focal group can be males or non-white. 00:11:29.070 --> 00:11:36.728 position:50% align:middle Remember, DIF is always comparing two groups, reference group versus focal group. 00:11:37.962 --> 00:11:41.828 position:50% align:middle Here is a graphic representation of DIF. 00:11:42.170 --> 00:11:45.831 position:50% align:middle DIF is always comparing two groups of people. 00:11:46.080 --> 00:11:51.068 position:50% align:middle In this example, we compare females and males. 00:11:51.068 --> 00:11:55.781 position:50% align:middle Female is reference group, and male is focal group. 00:11:56.270 --> 00:12:01.000 position:50% align:middle On the horizontal axis, we have item difficulty for female candidates 00:12:01.000 --> 00:12:07.306 position:50% align:middle from -4 to +4, the easiest to the hardest. 00:12:07.306 --> 00:12:11.960 position:50% align:middle On the vertical axis, we have item difficulty for male. 00:12:11.960 --> 00:12:15.608 position:50% align:middle The same scale, from the easiest to the hardest. 00:12:15.945 --> 00:12:17.422 position:50% align:middle Think about it. 00:12:17.422 --> 00:12:24.970 position:50% align:middle If an item is the same difficulty level for both men and women, then the blue dots, which are items, 00:12:24.970 --> 00:12:31.530 position:50% align:middle should all fall on a diagonal line, which means the item men find equally easy or equally 00:12:31.530 --> 00:12:33.526 position:50% align:middle hard as women. 00:12:34.200 --> 00:12:41.470 position:50% align:middle From this graph, you can see most items fall on the diagonal line, which means they are equal difficulty 00:12:41.470 --> 00:12:43.312 position:50% align:middle for both groups. 00:12:43.740 --> 00:12:49.345 position:50% align:middle But every once in a while, you will see items not on the diagonal line, 00:12:49.345 --> 00:12:53.743 position:50% align:middle item easier for one group than another group. 00:12:54.010 --> 00:12:58.150 position:50% align:middle For example, the items on the top left. 00:12:58.150 --> 00:13:06.333 position:50% align:middle If you draw a line vertically down, you will see, for women, this item difficulty is about -1.5, 00:13:06.333 --> 00:13:08.210 position:50% align:middle which is pretty easy. 00:13:08.560 --> 00:13:17.491 position:50% align:middle If you draw a line horizontally left, you will see, for men, the item difficulty is about 2.5. 00:13:17.491 --> 00:13:21.716 position:50% align:middle That is a lot harder than -1.5. 00:13:21.716 --> 00:13:25.188 position:50% align:middle So you know this item is favoring women. 00:13:25.188 --> 00:13:29.976 position:50% align:middle Women find this item easier, and men find this item difficult, 00:13:29.976 --> 00:13:34.375 position:50% align:middle even though these two groups have a similar nursing ability. 00:13:34.375 --> 00:13:35.990 position:50% align:middle What do we do? 00:13:35.990 --> 00:13:40.445 position:50% align:middle We pull out this item, send this item to DIF panel for review. 00:13:40.445 --> 00:13:48.010 position:50% align:middle If there is something about the content that makes the item behave this way, sometimes it is, 00:13:48.010 --> 00:13:50.012 position:50% align:middle sometimes it isn't. 00:13:50.620 --> 00:13:58.525 position:50% align:middle If an item shows a statistically significant amount of DIF, then it is reviewed by a DIF panel to determine 00:13:58.525 --> 00:14:04.800 position:50% align:middle if there is an identifiable problem with the content, or the fancy statistics, 00:14:04.800 --> 00:14:12.380 position:50% align:middle it's just a mathematical way to do what I just told you in previous slide, picking out all the items that favor 00:14:12.380 --> 00:14:15.330 position:50% align:middle one group significantly. 00:14:16.010 --> 00:14:22.390 position:50% align:middle If a panel determines that there is bias, the item is reviewed by Practical Nurse 00:14:22.390 --> 00:14:25.250 position:50% align:middle Exam Committee, PNEC. 00:14:25.250 --> 00:14:28.440 position:50% align:middle PNEC is REx-PN oversight group. 00:14:28.440 --> 00:14:33.790 position:50% align:middle They make all the decisions about whether an item go or stay. 00:14:34.435 --> 00:14:36.431 position:50% align:middle Bias is bad. 00:14:36.431 --> 00:14:38.434 position:50% align:middle Difference may not be bad. 00:14:38.434 --> 00:14:42.272 position:50% align:middle Difference can be biased, but it may not be. 00:14:42.510 --> 00:14:46.842 position:50% align:middle If an item shows DIF, it could mean three things. 00:14:47.110 --> 00:14:54.611 position:50% align:middle First, although the statistics were positive for DIF, there's no evidence from reading the item itself 00:14:54.611 --> 00:14:57.086 position:50% align:middle that DIF exists. 00:14:57.320 --> 00:15:02.876 position:50% align:middle When the DIF panel reviewed the item that, identified by statistical methods that it has DIF, 00:15:03.090 --> 00:15:07.845 position:50% align:middle the panel thinks, "There is nothing wrong with the item after reviewing it." 00:15:07.910 --> 00:15:10.428 position:50% align:middle And this is pretty common. 00:15:10.606 --> 00:15:14.667 position:50% align:middle Second, there is a genuine group difference, 00:15:14.667 --> 00:15:19.533 position:50% align:middle but nursing content requires that concept to be tested. 00:15:19.773 --> 00:15:27.559 position:50% align:middle For example, for items about pregnancy or child care, women routinely do better than men, 00:15:27.559 --> 00:15:29.621 position:50% align:middle which makes sense. 00:15:29.621 --> 00:15:36.270 position:50% align:middle But as an entry-level male nurse, you still need to know how to deal with that. 00:15:36.270 --> 00:15:38.373 position:50% align:middle So we keep this item. 00:15:38.730 --> 00:15:44.180 position:50% align:middle Conversely, there are some items men routinely do better than women. 00:15:44.180 --> 00:15:50.660 position:50% align:middle For example, items talking about medical equipment, how to use technology. 00:15:50.660 --> 00:15:57.070 position:50% align:middle We keep those items too because it is important for entry-level nurses to know. 00:15:57.070 --> 00:16:05.185 position:50% align:middle Whether you are men or women, which ethnicity, you still need to do the job, and it is the same job. 00:16:05.600 --> 00:16:12.800 position:50% align:middle Therefore, even though we find a DIF item, as long as nursing content requires this concept, 00:16:12.800 --> 00:16:18.408 position:50% align:middle we still keep this item, and this item is not biased. 00:16:19.110 --> 00:16:25.270 position:50% align:middle Third, there is an extraneous feature, which is irrelevant to nursing, 00:16:25.270 --> 00:16:28.210 position:50% align:middle within the item causing the problem. 00:16:28.210 --> 00:16:33.811 position:50% align:middle Sometimes, it is a wording issue or an unusual terminology that is 00:16:33.811 --> 00:16:36.201 position:50% align:middle not necessary for nursing practice, 00:16:36.201 --> 00:16:38.112 position:50% align:middle which causes DIF. 00:16:38.300 --> 00:16:44.265 position:50% align:middle In this case, the item is biased and needs to be revised. 00:16:45.375 --> 00:16:50.380 position:50% align:middle Here are previous findings on nursing content that has shown DIF in the past. 00:16:51.047 --> 00:16:54.330 position:50% align:middle If you look at the list, it makes sense, right? 00:16:54.330 --> 00:16:58.695 position:50% align:middle For these concepts, you are expecting DIF items. 00:16:58.695 --> 00:17:03.970 position:50% align:middle But again, these concepts are required by nursing practice. 00:17:03.970 --> 00:17:09.940 position:50% align:middle Even though they have DIF, they are not biased and we still keep these items. 00:17:09.940 --> 00:17:12.900 position:50% align:middle Let's summarize DIF review process. 00:17:12.900 --> 00:17:21.710 position:50% align:middle First, DIF panel will read the item and indicate the groups showing DIF such as female versus male. 00:17:21.710 --> 00:17:27.752 position:50% align:middle The second step is to form hypotheses about why the item may have shown DIF 00:17:27.752 --> 00:17:30.632 position:50% align:middle for or against a group. 00:17:30.856 --> 00:17:35.394 position:50% align:middle The panel needs to find out why this item is showing DIF. 00:17:35.394 --> 00:17:41.939 position:50% align:middle If the reason belongs to one of the first two situations, that's fine. 00:17:42.230 --> 00:17:50.430 position:50% align:middle If there is a bias, they need to do the third step, vote to refer the item to the PNEC. 00:17:50.430 --> 00:17:56.039 position:50% align:middle Again, PNEC will make a decision to keep the item or kill the item. 00:17:57.350 --> 00:17:59.942 position:50% align:middle Now, let's review the objectives. 00:17:59.942 --> 00:18:08.886 position:50% align:middle By the end of this presentation, you will be able to, first, identify the purpose of conducting sensitivity 00:18:08.886 --> 00:18:12.034 position:50% align:middle panel review and a DIF panel review. 00:18:12.034 --> 00:18:18.082 position:50% align:middle Now you know the reason is to make sure that exam is fair to everybody. 00:18:18.334 --> 00:18:23.420 position:50% align:middle Second, understand what it means for an item with DIF. 00:18:23.420 --> 00:18:30.670 position:50% align:middle Now you know that DIF means two groups with similar nursing knowledge but perform differently 00:18:30.670 --> 00:18:32.103 position:50% align:middle on the item. 00:18:32.750 --> 00:18:35.300 position:50% align:middle Does it necessarily mean bias? 00:18:35.300 --> 00:18:36.200 position:50% align:middle No. 00:18:36.200 --> 00:18:43.050 position:50% align:middle Because sometimes there is a genuine group difference on an item, but the item is required 00:18:43.050 --> 00:18:46.613 position:50% align:middle by nursing practice and we keep this item. 00:18:46.720 --> 00:18:51.270 position:50% align:middle No matter which gender you are or which ethnic group you are from, 00:18:51.270 --> 00:18:53.879 position:50% align:middle you still need to do the same job. 00:18:55.122 --> 00:19:02.560 position:50% align:middle Third, describe how NCSBN conduct sensitivity panel review and DIF panel review. 00:19:02.560 --> 00:19:05.650 position:50% align:middle Now you know these two processes. 00:19:05.900 --> 00:19:09.030 position:50% align:middle Thank you very much for joining us in this session. 00:19:09.030 --> 00:19:11.057 position:50% align:middle I hope you didn't fall asleep. 00:19:11.057 --> 00:19:15.450 position:50% align:middle You can enter any questions you have in the Q&A box. 00:19:15.450 --> 00:19:19.506 position:50% align:middle We will have a live Q&A session coming up next.