WEBVTT 00:00:06.120 --> 00:00:06.900 position:50% align:middle Hello. 00:00:06.900 --> 00:00:12.150 position:50% align:middle My name is Latrice Johnson, content manager here at NCSBN. 00:00:12.150 --> 00:00:16.730 position:50% align:middle During my 12 years in test development, I have gained a lot of experience 00:00:16.730 --> 00:00:18.750 position:50% align:middle with item development. 00:00:18.750 --> 00:00:24.220 position:50% align:middle By the end of this presentation, you will understand the REx-PN item development process 00:00:24.220 --> 00:00:28.020 position:50% align:middle and how we identify and correct outdated content. 00:00:28.020 --> 00:00:30.607 position:50% align:middle What is REx-PN? 00:00:30.690 --> 00:00:35.090 position:50% align:middle REx-PN is the Canadian practical nurse exam developed by the 00:00:35.090 --> 00:00:41.821 position:50% align:middle British Columbia College of Nurses and Midwives and the College of Nurses of Ontario. 00:00:42.130 --> 00:00:47.600 position:50% align:middle The purpose of the REx-PN is to ensure patient safety and public protection. 00:00:47.600 --> 00:00:52.369 position:50% align:middle The exam achieves this by adhering to three foundational principles. 00:00:52.369 --> 00:00:58.789 position:50% align:middle The exam is fair and comprehensive, entry-level, and current practice. 00:00:59.180 --> 00:01:01.139 position:50% align:middle Fair and comprehensive. 00:01:01.139 --> 00:01:07.710 position:50% align:middle To ensure fairness of the exam, content within the REx-PN exam is the direct result of 00:01:07.710 --> 00:01:15.240 position:50% align:middle gathering data from nurses in British Columbia and Ontario regarding activities of entry-level nurses. 00:01:15.240 --> 00:01:22.190 position:50% align:middle Additionally, volunteer panels perform ongoing item reviews to ensure elimination of bias, 00:01:22.190 --> 00:01:26.320 position:50% align:middle to provide a fair examination for all candidates. 00:01:26.320 --> 00:01:31.526 position:50% align:middle Our measurement and testing team will also diligently monitor all REx-PN items 00:01:31.526 --> 00:01:37.870 position:50% align:middle and perform statistical analysis to ensure that each item is devoid of potential bias. 00:01:37.870 --> 00:01:43.510 position:50% align:middle And that every exam administered falls within the examination specifications. 00:01:43.510 --> 00:01:50.048 position:50% align:middle These processes ensure that the REx-PN exam is testing nursing knowledge only. 00:01:50.350 --> 00:01:52.930 position:50% align:middle Entry-level and current practice. 00:01:52.930 --> 00:01:57.530 position:50% align:middle REx-PN items are developed to assess entry-level nursing knowledge. 00:01:57.530 --> 00:02:00.000 position:50% align:middle This characteristic is important. 00:02:00.000 --> 00:02:04.430 position:50% align:middle As we know, nursing knowledge evolves with time and experience. 00:02:04.430 --> 00:02:10.427 position:50% align:middle We define an entry-level nurse as one who has been practicing for 12 months or less. 00:02:11.170 --> 00:02:16.580 position:50% align:middle REx-PN content is referenced using textbooks, journals, and websites, 00:02:16.580 --> 00:02:19.828 position:50% align:middle commonly used in nursing curricula to ensure 00:02:19.828 --> 00:02:24.078 position:50% align:middle a content reflects what is taught within educational programs. 00:02:24.078 --> 00:02:30.197 position:50% align:middle In addition, REx-PN items are reviewed by practicing nurses to determine whether the content is 00:02:30.197 --> 00:02:31.910 position:50% align:middle current practice. 00:02:33.307 --> 00:02:39.948 position:50% align:middle The REx-PN process includes item development, pool maintenance, and measurement. 00:02:40.110 --> 00:02:45.266 position:50% align:middle During the next few slides, I will share details about each process. 00:02:46.400 --> 00:02:51.740 position:50% align:middle This is an overview of the activities and tasks that are completed during development, 00:02:51.740 --> 00:02:54.506 position:50% align:middle pool maintenance, and measurement. 00:02:54.570 --> 00:02:58.290 position:50% align:middle This graphic depicts the item development cycle. 00:02:58.290 --> 00:03:04.026 position:50% align:middle Note that it takes approximately 18 months to two years from the time an item is written to the 00:03:04.026 --> 00:03:08.116 position:50% align:middle time it becomes operational on the REx-PN exam. 00:03:09.090 --> 00:03:14.950 position:50% align:middle Now let's take a closer look at each step included in the item development process. 00:03:14.950 --> 00:03:20.704 position:50% align:middle This diagram illustrates the steps you use in the development of the REx-PN exam. 00:03:20.800 --> 00:03:27.270 position:50% align:middle The REx-PN item development process is a multifaceted process adhering to standards outlined 00:03:27.270 --> 00:03:30.000 position:50% align:middle in professional test development. 00:03:30.000 --> 00:03:34.110 position:50% align:middle The exam process starts at the top with nursing practice. 00:03:34.110 --> 00:03:40.255 position:50% align:middle Nursing practice provides the foundation for the REx-PN item development process by identifying 00:03:40.255 --> 00:03:44.322 position:50% align:middle activities that can be performed by an entry-level nurse. 00:03:44.830 --> 00:03:49.960 position:50% align:middle I'll briefly review each step within the item development process. 00:03:49.960 --> 00:03:56.424 position:50% align:middle The next step in the item development process is the practice analysis, which is like a job analysis 00:03:56.424 --> 00:04:01.070 position:50% align:middle where certain functions or activities of a job are assessed. 00:04:01.837 --> 00:04:08.390 position:50% align:middle In this instance, the practice analysis is the study of the task performed in entry-level practical or 00:04:08.390 --> 00:04:10.964 position:50% align:middle vocational nursing practice. 00:04:11.240 --> 00:04:17.990 position:50% align:middle Ultimately, the practice analysis results guide the content distribution of the client needs categories 00:04:17.990 --> 00:04:21.120 position:50% align:middle noted in the REx-PN Test Plan. 00:04:21.120 --> 00:04:28.010 position:50% align:middle The test plan includes content distribution information, REx-PN integrated processes, 00:04:28.010 --> 00:04:34.328 position:50% align:middle administration information, nursing content, examples with sample test items after 00:04:34.328 --> 00:04:39.386 position:50% align:middle each category, and principles of computerized adaptive testing. 00:04:40.120 --> 00:04:46.940 position:50% align:middle The results of the practice analysis directly influence the development of the REx-PN test plan. 00:04:46.940 --> 00:04:54.200 position:50% align:middle The REx-PN Test Plan is updated every five years in conjunction with the practice analysis to reflect fair, 00:04:54.200 --> 00:04:58.933 position:50% align:middle comprehensive, current entry-level nursing competency. 00:04:59.170 --> 00:05:05.151 position:50% align:middle This ensures that the content on the exam is consistent with entry-level PN practice in 00:05:05.151 --> 00:05:07.981 position:50% align:middle British Columbia and Ontario. 00:05:08.070 --> 00:05:13.664 position:50% align:middle The content distribution within the test plan is used to guide REx-PN content delivery 00:05:13.664 --> 00:05:15.373 position:50% align:middle during each exam. 00:05:15.373 --> 00:05:20.820 position:50% align:middle Essentially, the test plan links the nursing activities outlined in the practice 00:05:20.820 --> 00:05:25.171 position:50% align:middle analysis to specific REx-PN exam content. 00:05:25.320 --> 00:05:31.030 position:50% align:middle The test plan also serves as an excellent source for candidates preparing for the exam. 00:05:31.030 --> 00:05:35.650 position:50% align:middle Now, let's discuss the item development process. 00:05:35.650 --> 00:05:42.337 position:50% align:middle The item development process includes item writing, item review, sensitivity review, 00:05:42.337 --> 00:05:48.156 position:50% align:middle differential item functioning review, and nursing regulatory body review. 00:05:49.330 --> 00:05:55.266 position:50% align:middle Our item development process includes item writers who write the test questions or items that are 00:05:55.266 --> 00:05:57.923 position:50% align:middle included on the REx-PN exam. 00:05:58.300 --> 00:06:02.847 position:50% align:middle Our item reviewers review every item created by the writers. 00:06:03.700 --> 00:06:10.193 position:50% align:middle All REx-PN item development volunteers must have a current unencumbered nursing license in order to 00:06:10.193 --> 00:06:13.597 position:50% align:middle be considered for panel participation. 00:06:14.570 --> 00:06:20.798 position:50% align:middle Panelists are recruited to represent various areas of expertise and practice settings in British Columbia 00:06:20.798 --> 00:06:25.300 position:50% align:middle and Ontario to provide diversity within each panel. 00:06:25.300 --> 00:06:31.210 position:50% align:middle Item writers are required to be currently employed in a faculty position teaching nursing students 00:06:31.210 --> 00:06:33.464 position:50% align:middle within the clinical setting. 00:06:33.870 --> 00:06:40.230 position:50% align:middle All REx-PN items must be linked to the test plan suitable for entry-level practice, 00:06:40.230 --> 00:06:44.840 position:50% align:middle accurate current practice, and have one correct answer unless it is 00:06:44.840 --> 00:06:46.849 position:50% align:middle a multiple-choice item. 00:06:48.410 --> 00:06:55.246 position:50% align:middle Item reviewers differ in that they are required to work with precept and/or supervise entry-level 00:06:55.246 --> 00:06:59.985 position:50% align:middle nurses in a clinical setting for greater than eight hours per week. 00:07:01.470 --> 00:07:07.190 position:50% align:middle During item review panels, reviewers check exam items for content accuracy, 00:07:07.190 --> 00:07:13.653 position:50% align:middle current practice, connection to the test plan, and appropriateness for entry-level practice. 00:07:14.450 --> 00:07:19.110 position:50% align:middle The review process also includes unintentional bias reviews. 00:07:19.110 --> 00:07:24.792 position:50% align:middle The sensitivity review panelists review the items that are used to collect statistical data, 00:07:24.792 --> 00:07:27.390 position:50% align:middle also called pre-test items. 00:07:27.680 --> 00:07:34.692 position:50% align:middle Differential item functioning, or diff panelists, review both pre-test items and operational items. 00:07:36.010 --> 00:07:41.091 position:50% align:middle The diff and sensitivity panelists are asked to flag items that reflect stereotypes, 00:07:41.091 --> 00:07:46.652 position:50% align:middle inflammatory material, inappropriate language, and assumptions. 00:07:46.750 --> 00:07:53.954 position:50% align:middle These reviews are essential to ensure that item content excludes unintentional bias language. 00:07:54.070 --> 00:07:59.059 position:50% align:middle These items flagged during these panels are reviewed by nursing regulators and revised 00:07:59.059 --> 00:08:04.390 position:50% align:middle to remove insensitive words or phrases that may affect the exam measurement. 00:08:04.860 --> 00:08:09.796 position:50% align:middle Each REx-PN item is reviewed during the editorial review process. 00:08:09.820 --> 00:08:15.550 position:50% align:middle The editor reviews the items for grammar, clarity, punctuation, and spelling. 00:08:15.550 --> 00:08:19.800 position:50% align:middle The editor also reviews the items for style consistency. 00:08:19.800 --> 00:08:22.606 position:50% align:middle This is an important step because we have many 00:08:22.606 --> 00:08:26.968 position:50% align:middle volunteers who volunteer to write the REx-PN items. 00:08:27.097 --> 00:08:32.868 position:50% align:middle The editor ensures that the items look and read as though they were written by one writer. 00:08:34.200 --> 00:08:39.780 position:50% align:middle Every REx-PN item is pre-tested before being placed in the operational pool. 00:08:39.780 --> 00:08:44.570 position:50% align:middle We gather statistical data on each item before it is used to accurately measure a 00:08:44.570 --> 00:08:46.800 position:50% align:middle candidate's nursing knowledge. 00:08:46.800 --> 00:08:51.515 position:50% align:middle There are 30 pre-test items on every REx-PN exam. 00:08:52.000 --> 00:08:55.840 position:50% align:middle Pre-test items do not look any different from operational items. 00:08:55.840 --> 00:09:00.194 position:50% align:middle So their integration into the exam is seamless to a candidate. 00:09:01.290 --> 00:09:07.012 position:50% align:middle Pre-test items are not scored and do not affect the outcome of a candidate's examination. 00:09:07.180 --> 00:09:09.180 position:50% align:middle Regulatory body review. 00:09:09.180 --> 00:09:14.234 position:50% align:middle Nursing regulatory bodies may choose to review items and provide feedback on whether 00:09:14.234 --> 00:09:20.901 position:50% align:middle items reviewed reflect entry-level practice and adhere to laws and statutes in their province. 00:09:21.000 --> 00:09:25.800 position:50% align:middle If an item is determined to be inconsistent with nursing practice within their province, 00:09:25.800 --> 00:09:29.736 position:50% align:middle supporting documentation is submitted to NCSBN. 00:09:30.120 --> 00:09:35.358 position:50% align:middle The REx-PN Practical Nurse Examination Committee makes the final decision regarding 00:09:35.358 --> 00:09:37.562 position:50% align:middle the item disposition. 00:09:37.970 --> 00:09:45.100 position:50% align:middle The REx-PN Practical Nurse Examination Committee has the ultimate oversight responsibility 00:09:45.100 --> 00:09:47.870 position:50% align:middle for the REx-PN examination. 00:09:47.870 --> 00:09:53.548 position:50% align:middle The committee is composed of nursing regulators within British Columbia and Ontario. 00:09:54.310 --> 00:10:01.246 position:50% align:middle For additional information about item writing and item review, please visit the ncsbn.org website 00:10:01.246 --> 00:10:03.740 position:50% align:middle to access the webinars. 00:10:04.720 --> 00:10:08.930 position:50% align:middle During the next few slides, I will talk about how we maintain the REx-PN 00:10:08.930 --> 00:10:11.603 position:50% align:middle exam item development. 00:10:11.930 --> 00:10:18.715 position:50% align:middle REx-PN maintenance includes pool rotation, item reviews, and content currency. 00:10:18.740 --> 00:10:25.862 position:50% align:middle Pool rotation involves following an item pool delivery schedule to reduce the risk of overexposure. 00:10:26.960 --> 00:10:34.159 position:50% align:middle It also includes performing many internal reviews and quality control checks prior to pool deployment. 00:10:34.330 --> 00:10:37.599 position:50% align:middle Let's talk about item review and maintenance. 00:10:37.730 --> 00:10:42.260 position:50% align:middle Note that all items, both existing and newly developed items will go 00:10:42.260 --> 00:10:46.970 position:50% align:middle through the item review process to ensure currency of content. 00:10:47.210 --> 00:10:51.213 position:50% align:middle Items are reviewed at each segment of the item development process 00:10:51.213 --> 00:10:54.123 position:50% align:middle and prior to every pool deployment. 00:10:54.309 --> 00:10:58.790 position:50% align:middle Are you wondering how we identify practice changes and outdated content? 00:10:58.790 --> 00:11:02.930 position:50% align:middle Well, we have two ways in which we identify outdated content. 00:11:02.930 --> 00:11:10.220 position:50% align:middle First, our internal staff use textbooks, journals, and websites to reference every REx-PN item. 00:11:10.220 --> 00:11:14.275 position:50% align:middle Second, the item reviewers and the nursing regulators will also 00:11:14.275 --> 00:11:17.731 position:50% align:middle alert us to any changes in nursing practice. 00:11:18.001 --> 00:11:22.640 position:50% align:middle During this validation process, we can identify a change in practice 00:11:22.640 --> 00:11:24.666 position:50% align:middle or outdated content. 00:11:24.710 --> 00:11:28.790 position:50% align:middle Here are some common changes that can result in pool reviews. 00:11:28.790 --> 00:11:34.980 position:50% align:middle Change within healthcare guidelines and medication recall, device discontinuation, 00:11:34.980 --> 00:11:37.521 position:50% align:middle or change in public policy. 00:11:38.340 --> 00:11:43.898 position:50% align:middle Here are a few examples of changes that have occurred during my 12 years in test development 00:11:43.898 --> 00:11:46.406 position:50% align:middle that required a pool review. 00:11:46.500 --> 00:11:53.419 position:50% align:middle Remember when CPR guidelines changed from ABC airway, breathing, and circulation to CAB 00:11:53.500 --> 00:11:57.380 position:50% align:middle circulation, airway, and breathing, that was a fun one. 00:11:57.380 --> 00:12:01.440 position:50% align:middle We reviewed and modified several items to ensure accuracy. 00:12:02.457 --> 00:12:09.880 position:50% align:middle If an item is not consistent with current practice, or if clinical practice update is needed and identify, 00:12:09.880 --> 00:12:12.430 position:50% align:middle we take immediate corrective action. 00:12:12.430 --> 00:12:17.980 position:50% align:middle We mass-live [SP] items in the field to ensure that no candidate receives the item that contains 00:12:17.980 --> 00:12:20.130 position:50% align:middle the outdated content. 00:12:20.130 --> 00:12:26.280 position:50% align:middle We perform a database search to ensure that items that contain the outdated content is not deployed 00:12:26.280 --> 00:12:28.039 position:50% align:middle on an exam. 00:12:28.230 --> 00:12:34.340 position:50% align:middle We revise the item and the item is returned to the beginning of the item development process. 00:12:34.340 --> 00:12:37.556 position:50% align:middle Then the item is included in pre-testing. 00:12:38.080 --> 00:12:45.890 position:50% align:middle In summary, the REx-PN item development process is a multi-step rigorous thorough process that relies 00:12:45.890 --> 00:12:48.130 position:50% align:middle heavily on volunteers. 00:12:48.130 --> 00:12:52.580 position:50% align:middle This process is essential to the development of a psychometrically sound and 00:12:52.700 --> 00:12:55.233 position:50% align:middle legally defensible examination. 00:12:56.100 --> 00:13:02.330 position:50% align:middle The item validation process includes both internal referencing and item reviews by nurses who work 00:13:02.330 --> 00:13:05.160 position:50% align:middle directly with entry-level nurses. 00:13:05.160 --> 00:13:08.850 position:50% align:middle The accuracy of the exam is very important. 00:13:08.850 --> 00:13:15.050 position:50% align:middle We have immediate actions that we can take to maintain the accuracy of the exam. 00:13:15.130 --> 00:13:20.640 position:50% align:middle Now that you have learned about the development of the REx-PN exam, we hope that you are inspired 00:13:20.640 --> 00:13:22.750 position:50% align:middle to join us as a volunteer. 00:13:22.750 --> 00:13:28.320 position:50% align:middle If you enjoy discussions about the nursing practice, want to contribute to the nursing profession, 00:13:28.320 --> 00:13:34.840 position:50% align:middle or would like to learn more about nursing from other nurses, then volunteer to develop REx-PN. 00:13:34.840 --> 00:13:36.747 position:50% align:middle Come on, we make it fun. 00:13:36.747 --> 00:13:39.783 position:50% align:middle Thank you for your time and attention today.