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Team testing teaches collaboration

Crawford, Donna PhD, MSN, RN, CNE

doi: 10.1097/01.NURSE.0000531023.75781.d8

Team testing promotes collaboration

Donna Crawford is an assistant professor at the Indiana State University School of Nursing in Terre Haute, Ind.

The author has disclosed no financial relationships related to this article.

NURSE EDUCATORS collect information about student learning using various assessment methods. The decision to use a particular strategy depends on factors such as the objective being assessed, the setting in which learning occurs, the level and number of students, and time constraints. This article describes the use of collaborative testing, an assessment method in which pairs or small groups of students work together to develop answers on course exams.1 Collaborative testing may also be referred to as group testing, cooperative testing, double-testing, or dyad testing.2 This assessment method has been utilized for years by academic nurse educators, but it can also be an effective learning approach for clinical nurse educators.

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Team vs. individual testing

Collaboration is extremely important in nursing practice. Competencies identified by The National Academy of Medicine, formerly The Institute of Medicine, have been adopted by the nursing profession in the form of Quality and Safety Education for Nurses (QSEN) competencies, which are used throughout nurse education to guide preparation for basic practice as a skilled nurse.3 The QSEN guidelines consist of six competencies. One of the QSEN competencies, teamwork and collaboration, is defined as the skills required for a nurse to “function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care.”4 Collaborative testing is a learning strategy that encourages students to participate, negotiate, and work together as a team during testing.

Traditional testing requires learners to complete tests alone in order to assess what the individual learner knows about a given topic. While essential in many situations, traditional testing methods have some drawbacks. For example, students who complete traditional tests may receive only a final grade without specific feedback to guide future learning. A traditional test is often followed by a test review session, which can consume valuable class time and may become emotionally charged for both the learners and the instructor. Many students find that traditional tests increase feelings of isolation and anxiety.

Unlike traditional testing, in which sharing answers is considered cheating, collaborative testing encourages learners to share knowledge to improve performance.

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An educator interested in using this method needs to decide if the use of collaborative testing is appropriate and what type of collaborative testing best fits the content and the objectives of the class. For example, collaborative testing can't measure individual knowledge.

There are two methods of collaborative testing: students can simply take the exam once in pairs or small groups, or students can take the same test twice, which is often referred to as double-testing.2,5,6 A typical double-testing session starts with each student completing the test individually. Once all students have finished and the answers are submitted, students are assigned to groups where they're allowed to review the questions and answers together before completing and submitting a second set of answers to the same questions. The group testing session typically lasts 15 to 20 minutes, which provides time for debate and discussion.

Double-testing results in two sets of test scores. An educator using this method needs to decide on a plan for final grading. For example, students may be given the highest score as a final score, or the two scores may be averaged to make up the final score. Additional details about final scoring are discussed below.

Collaborative testing has been used most often with paper-and-pencil testing, but it's also possible to utilize this method with tests taken electronically. Digital platforms can be set up to calculate grades. Collaborative testing methods can also be adapted for use in distance education via a discussion board.

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Groups and consensus

Groups must be created before the use of collaborative testing. Educators may choose to randomly place students into groups, allow students to form groups on their own, or assign students to groups based on preestablished criteria, such as nurses who work together in the same clinical area or nursing students who belong to a clinical group.

While there is no ideal group size, some evidence suggests that small groups of about three students allow for the participation of all students and may encourage those who are typically quiet in the classroom to join the discussion.7,8

Educators also must decide about the requirement of consensus on the collaborative test. If the students are required to submit one answer sheet per group, they'll need to negotiate a consensus on each answer. Alternately, each student can complete an individual answer sheet following the group discussion. This method allows for more independent decision-making on the student's part.

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Scoring a collaborative test can take more time and be somewhat more challenging than scoring a traditional test. If consensus on test answers is required and students submit answers as a group, then each student will receive the group score. Grading is more complicated with double-testing because each student will receive two grades for the test. Refer to Grading methods in academic settings for various options.

If concerned about grade inflation, educators may decide to add double-testing points only after a student passes the exam independently.6,9 Although most students receive a higher score on the group test than on the individual test, occasionally a student will receive a higher grade on the solo attempt. To avoid punishing a student for collaboration, the final grade will be the higher score received on the individual test. Clearly communicate the testing method and scoring rules to students before testing.



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Collaborative testing usually results in an increase in test scores, although only a modest gain has been noted in some studies.5,9-11 When educators choose to award collaborative testing points, the grade increase received by students serves as a reward for their collaborative efforts. In one study, students' grades increased by an average of 3% with the use of double-testing.9

Student perceptions of collaborative testing have been consistently positive.12 Nursing students report less anxiety, increased learning, improved relationships and thinking skills, and increased motivation to study because they were responsible for knowing course content within their groups.1,5,6,10,11 Additionally, students were able to hear their classmates provide rationales for answers to test questions, which lead to improved test-taking skills and enhanced clinical reasoning.10 Of course, students also appreciate the opportunity for a grade increase, even if they gain only a few points.

The use of double-testing allows students to conduct their own posttest review. Through group discussion, students use their knowledge of the subject to clarify and explain questions and answers.

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As with any teaching method, an educator needs to balance the advantages with the disadvantages. Nursing students who've participated in collaborative testing express concerns about those students who contribute little to collaborative efforts while reaping the benefits of the group interaction. This behavior has been referred to as social loafing, free-riding, or freeloading.1 Assigning students into small random groups helps to discourage this behavior. Group assignments can be changed for every test. Educators may also wish to avoid announcing group assignments ahead of time.

Although collaborative testing has been shown to consistently increase scores on individual exams, it hasn't consistently shown an increase in long-term knowledge retention.1 This raises concerns that grade inflation will produce test scores that don't reflect students' true capabilities. To prevent excess grade inflation, educators may consider limiting the number of points that can be gained from collaborative testing. For instance, an educator may decide in advance that no more than three points will be added to the final exam score regardless of the result when the two exam scores are averaged.

Collaborative testing takes more class time than traditional testing and exams may need to be shortened to allow time for double-testing. One disadvantage of double-testing is that students who are rapid test-takers must wait for others to finish the test. Students who finish early should be asked to sit quietly in the classroom to discourage a group discussion of the exam outside the classroom, which would compromise the effect of group testing. Educators may wish to consider allowing students to bring reading material not related to the exam or provide stacks of nursing journals for students to read while waiting for other students to finish. If nursing journals are provided, the educator should review them to make sure they don't contain content relevant to the exam.

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Educator perceptions

Educators who've used collaborative testing report satisfaction with this strategy and feel that it improves student communication skills. Educators have observed that students generally remain engaged during the group discussion and can provide rationales to support their answers to test questions.6

During the group testing period, the educator should take advantage of the opportunity to observe group interactions. By listening, an educator can receive valuable feedback on exam questions, answers, and distractors, and identify concepts that students don't understand.

With double-testing, students tend to become less argumentative about test questions following group discussions. Whereas traditional educator-led exam review sessions have the potential to become tense and unpleasant when students argue to add a point or two to a test score, double-testing allows students to determine among themselves that questions are valid and fair. While test review sessions may still be necessary, they tend to be shorter and more pleasant.

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Clinical nurse educators should consider collaborative testing in settings where individual testing isn't required. The use of collaborative testing during agency orientation sessions, for example, would encourage newly hired nurses to get acquainted and practice working together. Collaborative testing may also be used as evaluation method during unit-specific instruction classes as a method for promoting teamwork among nurses who already work together. Collaborative testing methods could additionally be incorporated into interdisciplinary learning activities to encourage a spirit of collaboration between nurses and allied healthcare professionals. For example, using collaborative testing with a mix of nurses and respiratory therapists or physical therapists could promote more interdisciplinary respect and cooperation.

Collaborative testing is one method of learning that gives students or professionals the opportunity to develop essential communication and collaboration skills that will support their success within the demanding profession of nursing. Both students and educators report high levels of satisfaction with this method. Although collaborative testing shouldn't be used for all testing sessions, it appears to benefit both nursing students and educators when used in appropriate situations.

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