Formative online multiple-choice tests in nurse education: An integrative review

Richard Say; Denis Visentin; Elizabeth Cummings; Andrea Carr; Carolyn King

doi:10.1016/j.nepr.2021.103262

Formative online multiple-choice tests in nurse education: An integrative review

Nurse Educ Pract. 2022 Jan:58:103262. doi: 10.1016/j.nepr.2021.103262. Epub 2021 Nov 28.

Authors

Richard Say¹, Denis Visentin², Elizabeth Cummings³, Andrea Carr⁴, Carolyn King⁵

Affiliations

¹ College of Health and Medicine, University of Tasmania, Locked Bag 5052, Alexandria, 2015 NSW, Australia. Electronic address: richard.say@utas.edu.au.
² College of Health and Medicine, University of Tasmania, Locked Bag 5052, Alexandria, 2015 NSW, Australia. Electronic address: denis.visentin@utas.edu.au.
³ College of Health and Medicine, University of Tasmania, Locked Bag 5052, Alexandria, 2015 NSW, Australia. Electronic address: elizabeth.cummings@utas.edu.au.
⁴ University College, University of Tasmania, Private Bag 70, Hobart, 7001 Tasmania, Australia. Electronic address: a.r.carr@utas.edu.au.
⁵ University College, University of Tasmania, Private Bag 70, Hobart, 7001 Tasmania, Australia. Electronic address: carolyn.king@utas.edu.au.

PMID: 34902804
DOI: 10.1016/j.nepr.2021.103262

Abstract

Aim: The aim of this integrative review is to explore how formative online multiple-choice tests used in nurse education promote self-regulated learning and report on pedagogies that support their design.

Background: Online multiple-choice tests are widely used as learning and formative assessment tools in a range of educational contexts. However, little is known about how these tools are used to promote patterns of learner self-regulation. It is important that nurses and nursing students develop the capability to self-regulate learning to be effective lifelong learners and navigate complex and unfamiliar practice environments.

Design: A five-stage approach guided this integrative review: problem identification, literature search, data evaluation, data analysis and presentation.

Method: A systematic search of ERIC, Web of Science, Ovid Medline, Scopus, PubMed, Embase and CINAHL was conducted in February 2021. Seventeen peer-reviewed papers were identified that discussed formative online multiple-choice tests in nurse education. Purposive sampling and ancestry searching identified an additional paper. Articles were analysed and sorted into themes of outcomes (presented as components of self-regulated learning theory) and pedagogy.

Results: Formative online multiple-choice tests are used with good effect in nurse education as measured by knowledge gain and exam performance, increased confidence and learner satisfaction. There was no literature that explored metacognitive outcomes and minimal literature considered behavioural outcomes. Pedagogy supporting the implementation of multiple-choice tests was lacking in most articles.

Conclusions: Formative online multiple-choice tests are widely used with good effect in nurse education. However, opportunities for further research on how these tools can encourage metacognition and self-regulatory behaviours is warranted.

Keywords: Education; Formative assessment; Integrative review; Learning; Multiple-choice; Nursing; Online education; Quizzes; Self-regulated.

Publication types

Review

MeSH terms

Clinical Competence
Education, Nursing*
Educational Status
Humans
Learning
Students, Nursing*