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Context-Dependent Item Sets In Nursing Education

Updated: Mar 6, 2020

Context-dependent item sets assess cognitive understanding by requiring the student to analyze the given information, involving a scenario description, to answer the question. A series of questions/items designed around a shared scenario/context provide the foundation for this evaluation strategy. Tests constructed using this evaluative method introduce NEW information, not previously encountered by the learners during former instruction or testing. It also provides data on the thought processes used by the learners in order to arrive to their selected response, rather than solely revealing their final answer. It is important to continuously introduce new material, not otherwise reviewed, in order to promote critical thinking and evaluate for deeper knowing, while building upon previously covered content.


Student nurses at various stages of learning are able to successfully implement appropriate degrees of critical thinking. As such, faculty must ensure the use of context-dependent item sets is relevant to the level of student nurse. For example, first-semester nursing students may take written tests with context-dependent item sets that require lower level critical thinking skills, and so on, with increasing complexity, as they progress through their program. In addition to the use of context-dependent item sets for individual test taking, this method can also be used during group discussion as well. To facilitate this, the course educator can instruct the students to disperse into groups of 3-4 to work together on a few questions of a test. The students can then discuss aloud with the class what answers they chose for their questions and why they feel that the correct options are correct and the incorrect options are incorrect. This team engagement offers assistance in building critical thinking skills during interactive collaborative development.


Tests utilizing context-dependent item sets for evaluating classroom learning can be integrated at regular intervals, such as weekly, to provide formative feedback. As competency in the course objectives must be thoroughly developed and evaluated, this method is a quality addition to other implemented evaluation strategies, as critical thinking is essential to functioning as an effective novice nurse. This form of testing also develops the student nurse’s ability to be successful on the N-CLEX examination, where scenario-type items can be found.


Pause, Reflect, and Plan:

Consider an intended learning outcome, then develop a scenario that directly relates to the outcome. Create novel items (two or more) that promote critical thinking and clinical reasoning skills. A variety of question types can be used. Define criteria for evaluation. Ask a faculty peer to review and provide feedback. Explore creative ways for students to work together to learn, brainstorm, and grow!

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