Testing Online in the Era of Social Distancing

By Susan Sportsman, PhD, RN, ANEF, FAAN

Most of us have been coping, both personally and professionally, with the results of social distancing as a result of the COVID-19 pandemic. While we would like life to return to “normal,” we also worry about the health impact of returning to our “face-to-face” lives.  Equally important, when this crisis passes, what will the new normal look like?

As we live through these uncertain times, I think it is instructive to think about what we have learned during this time of online teaching and learning, and what steps we should take moving forward. In general, I believe nursing faculty have learned that teaching-learning from afar is possible. I have been impressed with the stories from nursing faculty around the country about creative approaches they have used to supplement or replace clinical experiences and ways they have engaged students in online classroom activities, even in these stressful times. Despite these potentially positive results in teaching-learning, we must also be concerned about the effectiveness of our evaluation of student competencies. Has this online environment been sufficient to prepare students for the NCLEX examination and future practice?

Our obligations to evaluate our students’ performance requires us to consider how valid our online evaluation methods are. Realistically, even when colleges and universities open their doors to on-ground classes, social distancing will likely require students to remain six feet apart, even in a classroom.  In addition, many programs at all levels will continue to be primarily or completely online. Online instruction—and evaluation—is not going away. In fact, it may well become important in all our lives.

Online Testing

Throughout the country, nursing faculty (as well as other disciplines) express concern about the validity of online evaluation. Repeatedly, we hear faculty say, “How can we prevent (or reduce) cheating?  Can we keep our tests safe when they are online?”  Examples of best practices to reduce the potential for cheating on online tests include:

    • Establish a culture of academic honesty within your program. This includes developing and emphasizing an academic honesty policy through frequent discussions about its importance throughout the course.
    • Design test questions that require students to use application or analysis to address a relevant problem.
    • Change exam questions regularly.

If your testing software allows:

    • Randomize questions and answer to questions.
    • Allow only one question on the screen at one time. This makes it more difficult for students to take screen shots to share with their classmates.
    • Limit the types of feedback that are given to students after completing the test. Providing test scores is an important learning experience for students and should be made available at the completion of students’ test experience. However, through a process of elimination, students may be able to determine the correct answer for each test question if their submitted answers are identified as incorrect, or if the correct answer is provided. A George Washington School of Medicine and Health Sciences online document suggests that test-takers typically take approximately 45 seconds per question to answer the question if they know the material. While nursing questions are likely to require more time (historically, the NCLEX exam estimates that each question should take 1 minute to answer), the point remains the same. Students should not be given enough time to be searching for answers in other venues if they don’t know the answer(s) to the question.

Plan for the Future

Nursing faculty have some special challenges during this time of change. The Next Generation NCLEX initiative, designed to more specifically measure the clinical judgment of the graduating nurse by using case studies to mimic the kinds of critical decisions nurses make in a variety of health care settings, is scheduled to be completely implemented before 2023. In this new approach, test items require the test-taker to identify and analyze important cues, prioritize hypotheses, generate solutions, take actions, and evaluate those actions, all in the context of a particular clinical scenario. These questions focus on interactions between nurse and client, client’s needs and expected outcomes. Nursing faculty must prepare for these changes while they are also dealing with the results of online evaluation.

Test development and analysis of student results has always been challenging for educators. The current era of social distancing makes this faculty competency even more difficult. We will continue to focus on these concerns as we all move toward whatever the future brings.

In the meantime, stay safe.


Currier, J. (2019) NGN Talks:  Clinical Judgment Model Video Transcript.  National Council of State Board of Nursing.  https://www.ncsbn.org/Transcript_NGNTalk_Episode06.pdf.  Accessed, May, 2020.

________ (2020) Guidelines to reduce the risk of Cheating in Online Examinations.  George Washington University School of Medicine and Health Sciences. (https://smhs.gwu.edu/impact/sites/impact/files/Firmani_OCEPs.pdf)  Accessed, May, 2020.

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