| Course | NURS 600 Evaluation Strategies for Nurse Educators (NURS600) |
|---|---|
| Module/Week | 4 |
| Assignment | Written Assignment 3 on Item Analysis, Reliability and Validity |
| Paper type | Written assignment (3+ pages, 3+ references plus textbook and Bible) |
| Length | about 875 words, 3 double-spaced pages plus title page and references. Course guide: at least three pages of text in APA format, plus three or more sources that are not the textbook or the Bible |
| Format | APA 7 student paper |
| Points | 75 |
| School | Liberty University Online |
| Program | MSN |
| Where it sits | Module/Week 4 in Liberty's published NURS 600 course guide; current sections can differ |
| Updated | October 2026 |
Free sample paper for NURS 600 Week 4
Written Assignment 3: Reading an Item Analysis for a 40-Item Exam, Four Items Kept, Revised or Discarded and What the Reliability Coefficient Says
[Student Name]
School of Nursing, Liberty University
NURS 600: Evaluation Strategies for Nurse Educators
Written Assignment 3
[Instructor Name]
[Date]
The exam, the 60 students and every item statistic are composites written for a model assignment; follow the prompt and data your course provides.
Written Assignment 3: Reading an Item Analysis for a 40-Item Exam, Four Items Kept, Revised or Discarded and What the Reliability Coefficient Says
The Exam and the Analysis
The exam was a 40-item multiple-choice and multiple-response test given to 60 students at the end of a respiratory unit in a junior medical-surgical course. After scoring, the testing software produced an item analysis. Oermann and Gaberson (2017) describe two classical indexes as the core of such an analysis. The difficulty index is the proportion of students who answered an item correctly, so a higher value means an easier item. The discrimination index compares how often high-scoring and low-scoring students answered correctly. For this analysis, the upper and lower groups were the top and bottom 27% of scores, 16 students each.
Item-by-Item Decisions
Item 19 asked students to choose the first action for a patient with chronic obstructive pulmonary disease whose oxygen saturation had fallen after a sedative. Overall, 33 of 60 students answered correctly, a difficulty index of 0.55. In the upper group, 12 of 16 were correct (0.75), and in the lower group, 5 of 16 (0.31), so the discrimination index was 0.75 minus 0.31, or 0.44. The item is of moderate difficulty and discriminates well. Decision: keep.
Item 24 asked about interpreting arterial blood gas values. Its difficulty index was 0.62 and its discrimination index 0.31, both acceptable, but the distractor table showed that option C was chosen by no students at all. Oermann and Gaberson (2017) note that distractors that attract no one add nothing to an item and make guessing easier. Decision: revise option C to reflect a common misinterpretation, such as mistaking compensated respiratory acidosis for metabolic alkalosis.
Item 12 asked about the expected effect of a leukotriene modifier. Only 23 of 60 students answered correctly (0.38), and the upper group did worse than the lower group, 5 of 16 (0.31) against 7 of 16 (0.44), giving a negative discrimination index of minus 0.13. A negative discrimination index is a signal to check the item, not a verdict on it, because the most common cause is a key or wording error rather than weak students. Review found that the keyed answer was defensible but a second option was also arguably correct after a recent guideline change. Decision: remove the item from scoring for this exam and rewrite it.
Item 7 asked which oxygen saturation should prompt immediate action in a postoperative patient. It was easy, with a difficulty index of 0.92, and discriminated weakly, with 16 of 16 correct in the upper group and 14 of 16 in the lower group, an index of 0.13. Many faculty would discard an item like this, but it tests a safety-critical threshold that every student must know. Decision: keep, because the content matters more than the statistic.
What the Reliability Coefficient Means
The software reported a KR-20 coefficient of 0.74 for the 40 items. Oermann and Gaberson (2017) explain that reliability refers to the consistency of scores, and KR-20 is the usual estimate of how consistently a set of right-or-wrong items measures the same thing. A value of 0.74 suggests reasonable consistency for a classroom test of this length, though not the higher values expected of high-stakes examinations. The coefficient matters most for students near the passing score of 77%. With moderate reliability, a student scoring 76% might score above the cut on another set of similar items, so faculty should be cautious about letting a single unit exam decide progression.
Published analyses offer useful comparisons. Guedjati et al. (2026) analyzed 150 multiple-choice items taken by 760 candidates on a medical residency entrance examination and found that 52% of items fell in an acceptable range of difficulty, 30% were too difficult, 64% discriminated acceptably or better, and 26% were rejected, with an overall reliability of 0.84. Damor et al. (2026) compared 30 faculty-written and 30 AI-generated items on a dental specialty exam taken by 100 interns and found internal consistency of 0.851 for the faculty items and 0.798 for the AI items. Our exam's 0.74, from fewer items and fewer students, is within a reasonable range, and removing or revising weak items like Items 12 and 24 should improve it.
Validity: Do the Scores Support the Decisions?
Reliability is necessary but not sufficient. Oermann and Gaberson (2017) treat validity as a question about the scores' meaning: how well the available evidence justifies the conclusions and decisions faculty draw from them. One form of evidence is whether scores predict later performance. Shah et al. (2026) examined 404 practical nursing students in nine programs and found that reaching benchmark scores of 850 or 900 on a standardized exit exam strongly predicted passing the Next Generation NCLEX-PN on the first attempt, at rates of 98.5% to 98.8%. Unit exams cannot claim that kind of evidence, but faculty can build validity by matching items to a blueprint, as this exam did, and by tracking whether students who struggle on unit exams also struggle in clinical practice and on later standardized tests.
Fairness in Using Item Analysis
Item analysis protects students as well as tests. When Item 12 was found to have two defensible answers, removing it from scoring corrected an injustice that would otherwise have cost every student a point. Deuteronomy 25:15 calls for "a full and fair weight" (English Standard Version Bible, 2001/2016), and an exam reviewed in this way comes closer to that standard. Faculty who explain such decisions openly to students also model the integrity they hope students will bring to practice.
References
Damor, P., Gill, S., Wani, W., Arora, G., & Charan, M. (2026). A psychometric comparison of faculty-authored and large language model-generated multiple-choice questions in endodontics. Cureus, 18(8), Article e114830. https://doi.org/10.7759/cureus.114830
English Standard Version Bible. (2016). Crossway. (Original work published 2001)
Guedjati, M. R., Benaldjia, H., Bouhidel, J. O., Taibi, A. D., & Hamizi, A. (2026). Qualité psychométrique des QCM du concours de résidanat à la Faculté de médecine de Batna: Un outil d'amélioration des pratiques docimologiques [Psychometric quality of multiple-choice questions in the residency entrance examination at the Faculty of Medicine in Batna: A tool for improving assessment practices]. La Tunisie Médicale, 104(5), 627-633. https://doi.org/10.62438/tunismed.v104i05.6612
Oermann, M. H., & Gaberson, K. B. (2017). Evaluation and testing in nursing education (5th ed.). Springer Publishing Company.
Shah, M., Baker, R., Bussard, M. S., Butts, S., & Lander, L. (2026). Predictive validity of standardized exit exams for Next Generation NCLEX-PN outcomes: A multiprogram analysis of exam scores and institutional policies. Nurse Educator, 51(4), e265-e270. https://doi.org/10.1097/NNE.0000000000002176
What the NURS 600 Week 4 instructions ask
Written Assignment 3 follows the shared rules for the course's written assignments: at least three pages of body text, current APA, and three or more references that are not the Oermann and Gaberson textbook or the Bible. Students turn it in during Module/Week 4, with the second discussion forum, while the reading covers the textbook's chapter on the validity and reliability of assessments and its chapter on assessing higher-level learning. Assignments this week therefore often ask students to analyze test results, interpret indexes of difficulty, discrimination and reliability, and make decisions about items, or to explain how an assessment supports valid conclusions. The specific data come from the course shell.
How this NURS 600 Week 4 example is built
The paper opens with the exam's context and the method of the item analysis, including how the upper and lower groups were formed. Four items are then analyzed in turn, each with its difficulty index, discrimination index and a short decision: one item kept, one revised because a distractor did no work, one discarded for negative discrimination after a key check, and one kept despite being easy because it tests a safety-critical fact. A section on reliability explains what a KR-20 of 0.74 means for a classroom exam. A validity section connects unit exams to licensure prediction. Two 2026 psychometric studies supply comparison values, and a closing paragraph reflects on fairness.
NURS 600 Week 4 grading rubric: where the points go
Item analysis assignments are usually graded on correct calculation and interpretation of the indexes, sound decisions about items with reasons, accurate explanation of reliability and validity, the strength of the outside sources, and APA style. Calculations should show the numbers used, such as the proportion correct in the upper and lower groups, so the grader can follow them. Decisions earn credit when they consider more than one statistic, for instance keeping an easy item because its content is essential. Explanations of reliability should avoid treating the coefficient as a grade for the test and should say what it implies for decisions based on scores.
NURS 600 Week 4 help: mistakes that cost points
Students commonly lose points by computing the discrimination index from the wrong groups, by deleting every item with a low discrimination index without checking the key or the content, and by describing reliability and validity as the same thing. Some interpret a difficulty index of 0.90 as a hard item, reversing its meaning. Others report statistics without decisions, or decisions without statistics. Show each calculation, remember that a higher difficulty index means an easier item, check for a miskeyed answer before discarding an item with negative discrimination, and explain how reliability affects the confidence faculty can place in scores near a passing cut. A short table of the indexes for each analyzed item makes the paper easier to grade.
Related NURS 600 sample papers
Other NURS 600 weeks
- NURS 600 Week 1: Reflection Paper 1
- NURS 600 Week 2: Written Assignment 1
- NURS 600 Week 3: Written Assignment 2
- NURS 600 Week 5: Written Assignment 4
- NURS 600 Week 6: Philosophy of Clinical Evaluation
- NURS 600 Week 7: Written Assignment 5
- NURS 600 Week 8: Reflection Paper 2
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NURS 600 Week 4 questions, answered
What is NURS 600 Written Assignment 3?
Worth 75 points and due in Module/Week 4, it is the third written assignment, usually on interpreting item analysis, reliability and validity, written in APA across at least three pages and backed by a minimum of three outside studies.
Where can I find a free NURS 600 Week 4 sample paper?
The worked NURS 600 Week 4 item analysis, with four items analyzed, a reliability discussion and references, has been posted on this page for open reading.
How do you calculate an item discrimination index?
Subtract the proportion of the lower-scoring group who answered correctly from the proportion of the upper-scoring group who did; values near 0.30 or higher usually indicate an item that separates stronger from weaker students.
What does a difficulty index of 0.90 mean?
It means 90% of students answered the item correctly, so the item is easy; the difficulty index is the proportion correct, so higher values mean easier items.
What is a good KR-20 reliability for a nursing exam?
Many faculty aim for about 0.70 or higher on classroom exams; higher values give more confidence in decisions, especially for students whose scores fall near the passing cut.
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