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Guidelines for Identifying and Revising Culturally Biased Multiple-Choice Nursing Examination Items

Hicks, Nikole Anderson MSN, RNC-OB, CNE

doi: 10.1097/NNE.0b013e3182333fd2
Feature Articles

To increase the diversity of the RN workforce, programs of nursing need to recruit, retain, and graduate a multicultural student body. One reason attributed to high attrition rates for minority students is bias in nursing examinations. Ensuring that nursing assessments are valid and reliable measures of student learning will improve outcomes for diverse students. The author explores the issue of bias in multiple-choice nursing examinations. Bias is defined, and its prevalence in nursing examinations is discussed. Guidelines are provided to assist evaluating and revising test items that are fair for students of all cultural groups.

Author Affiliation: Assistant Professor of Clinical Nursing, College of Nursing, University of Cincinnati, Ohio; PhD Student, University of Northern Colorado, Greeley.

The author declares no conflict of interest.

Correspondence: Ms Hicks, University of Cincinnati, Academic Health Center, Cincinnati, OH 45221 (

© 2011 Lippincott Williams & Wilkins, Inc.