Development of a three-tier diagnostic test for diagnose misconceptions in nursing education
Keywords:
A three-tier diagnostic test, Misconceptions in nursing education, Cognitive diagnosticAbstract
To comprehensively diagnose student cognition, a three-tier multiple-choice diagnostic test is highly recommended. A three-tier multiple-choice diagnostic test comprises three tiers of diagnostic questions. The first tier is in the form of ordinary multiple choice aiming to show the correct answer. The second tier is in the form of reasoning of the correct answer while the third tier is a question to the test for confirmation of their confidence on the answers has been chosen at the first and the second tier. The third tier was added to differentiate between the students’ lack of knowledge and their misconception. There are 5 steps in developing this three-tier diagnostic test as follow; 1) state the content of knowledge, 2) search the related literature to identify the possible misconception and the genuine conception, 3) construct the three-tier diagnostic test, 4) conduct a pilot study and 5) test its content validity, indexes of Item-objective congruence, item difficulty, reliability, internal consistency and a power of discriminant using Classical test theory and item response theory. The final three-tier diagnostic test is constructed after the item improvement. If the test response is designed into dichotomous scale, there will be 8 possible patterns of answer and the students who response the test can be classified into 5 groups. The first group refers to the ones with knowledge and genuine conception. The pattern of test response will be [1,1,1]. The second group refers to the ones with misconception. The pattern of test responses will be [0,0,1], [1,0,1] or [0,1,1]. The third group refers to the ones without knowledge. The pattern of response will be [0,0,0]. The fourth group refers to the ones without confidence. The pattern of response will be [1,1,0]. The fifth group refers to the ones who guess the answer. The pattern of response will be [1,0,0] and [0,1,0]. It is recommended that a three-tier multiple-choice diagnostic test should be employed in constructing the examination items in nursing discipline. This test will lead to accurate cognitive evaluation. A misconception of nursing knowledge can be corrected and the expected learning outcomes will be effectively achieved.
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