Date of Paper/Work


Type of Paper/Work

Scholarly project

Degree Name

Master of Arts in Nursing




Roberta J. Hunt


Evidence based guidelines for the development and assessment of multiple choice test item quality and validity are well documented in the literature, however contemporary evidence indicates that multiple choice exams used to assess student competency in undergraduate nursing education are heavily flawed. These exams subject students to invalid, low quality measures of their academic performance. The results from the literature review are significant because multiple choice exams serve as a primary assessment of student success. Failure to adequately assess student performance can have dire consequences on student grades, career opportunities, and future scholarship. Inaccurately assessing student competency dramatically affects the reliability and legitimacy of academic institutions and can adversely impact the integrity of the nursing profession itself. The literature recommends recognizing the prevalence of flaws in multiple choice exams, increasing faculty education regarding multiple choice exam development and assessment, and developing peer review teams to assess the exams and offer recommendations prior to the exam’s administration.