continuing education Paper-and-pencil tests have be-

come the initial determinant of who is fit to enter school, leave school, teach, practice medicine, drive an automobile, fly an airplane, sell real estate, practice law, style hair, and audit accounts. Since in so many cases, the individual’s future depends on receiving at least a “pass- ing score,” The Test has become an anxiety-provoking stimulus, a fact which, in turn, tends to lower The Score. With each successive test- taking experience, anxiety grows and the score is more adversely affected. Research has shown that such a cycle in and of itself can cause failure; however, it has also shown that even in those whose anxiety has a defeating effect, the cycle can be reversed.

Anxiety per se is not necessarily

Examinee Strategies for Increasing Test Scores RUTH HUNT, PhD, and WlLLlAM A. GRANZIG, PhD

Test-taking is increasingly becoming a fact of life for nurses as they become involved in graduate courses, other continuing education programs, and certi- fication. Guidelines and helpful hints for preparing to take objective tests are given in this article. On& aim is to help the test taker remove anxieties that might interfere with hislher performance. The explanations should also be of help, incidentally, to those having to construct objective tests.

defeating in a testing situation. A little anxiety puts most people on their mettle. What makes the dif- ference is the degree of anxiety. A high degree of anxiety usually in- terferes with performance; a slight degree of anxiety can have the op- posite effect. The adult, however, is more likely to manifest intense anx- iety over test situations than the

child, since, as research suggests, the degree of test anxiety tends to in- crease with the level of education s

Not everyone has problems with test situations Those who seem to thrive on what to others is anxiety provoking, more likely than not, have learned how to approach and handle the test situation They have developed a strategy for taking tests which is known as “test-wiseness ”

Until recently very little has been written on thc subject of test- wiseness itself Much more has been written on how to develop tests so that test-wiseness will be a minimal factor in determining the final score for any examinee Now, however, writers have begun to suggest that teaching the student how to take a test should be part of the cur- riculum of every school.6-g

Test-wiseness has been defined by Millman, Bishop, and Ebel as “ a subject’s capacity to utilize the characteristics and formats of the test and/or the test-taking situation to receive a high score ”lo This classic definition will be used by the authors of this paper, with one addition-test-wiseness is a learned capacity That is not to say that test-wiseness is necessarily learned through formal instruction, but it is learned nevertheless-if not through formal instruction, then through ex- perience in taking tests

The fact that test-wiseness is learned may explain why younger persons (those who have more recently completed their formal education) seem to have less diffi- culty with objective tests than those whose formal schooling was com- pleted twenty or more years ago In the first instance, the students were treated to large helpings of objective tests In the second, students were more often tested by means of essay or oral examinations Thus, younger students have developed test-taking strategies, while older ones have not

Such test-taking strategies vary

September/October 1975 JOGN. Nursing 47

among the users. One of the most successful involves looking to three soiirces for help: first, the test situa- tion; second, the person who con- structed the test; and third, the in- strument. None of these sources are intended to help the examinee, but each does so inadvertently.

The Test Situation and How to Use I t

No test situation can be unique. It must conform to some aspects com- mon to all test situations. First, the examinee knows in advance that a test will be given; what attribute will be tested; the test site; the time al- lowance; and the general type of in- strument that will be used. Therefore, he can prepare for what is to come.

People who tend to become anx- iety stricken about tests use such in- formation to increase their anxiety. What they should do is use it for rehearsal purposes. They should im- agine themselves succeeding in the test situation instead of failing in it. They can fantasize the room, the test paper, the proctor, the others who will be taking the test, and most important of all, using test-taking strategies to succeed.

Anxiety-ridden persons automati- cally fantasize failure, not success. The more they think about failure, the more anxious they become. If they could fantasize success, they worild reduce much of the anxiety and perhaps even enjoy tak- ing the test. If they could see the test situation as a positive experience, they would do much to allay their fears and thus improve their perfor- mance.

This suggested fantasizing is ac- tually a planning stage, and by plan- ning how to take the test one can avoid many pitfalls. First, since the test will be objective, the examinee knows in advance that guessing the correct answer is both possible and permissible. But guessing is a science in itself.

Sometimes a correction-for-guess- ing formula is applied to the score, i.e., there is a penalty for wrong answers. When such is the case, jiidgment must be used concerning

when and when not to guess. It is always wise to ask beforehand whether such a formula will be used. Even if it will be, then guessing may still be wise but only under certain circumstances.

Most formulas that correct for guessing follow this pattern:

w Score = R - - N - 1

where R = the number of correct responses, W = the number of incor- rect responses, N = the number of options for each question. In other words, for a 4-option, multiple- choice test, the corrected score worild be

W Score = R - - 3 or

R - 1/3 W

The “system” is beatable whenever the respondent who guesses has been able to narrow the possible correct answers down to two of the options. He has a one-in-two chance of guess- ing correctly in such a situation and only a one-in-three chance of being penalized for being wrong.

People who are risk-takers will guess under even less favorable cir- cumstances if, at the same time, they are able to use the general principles of test-wiseness well, but such “guesses” are usually based on cer- tain clues that the items give through faulty construction.

When no correction for guessing is to be made, the examinee should always guess rather than leave an item unanswered.

Since there is usually a time limit for taking tests, the rate of answering items becomes crucial. The usual rate at which adults are expected to respond to objective items that have four options is two per m‘inute. Thus the adult examinee would have about one hour in which to complete a 120- item test in which each item is a 4-option, multiple-choice item. The examinee, therefore, should con- struct a time schedule for his work that will permit him to progress quickly. The order in which he re- sponds to the items is important in helping to meet the time schedule and should be as follows:

1. Respond first to all items that pose no problems, making check- marks by the side of those skipped.

2. Respond next to those skipped items that require the least amount of effort.

3. Respond last to the items that remain because they are difficult to read, concern material un- familiar to the examinee, or necessitate some type of time- consuming problem solving.

It is with this last group of items that guessing may be relied on most heavily. Since these items, like the others, have been read at least cur- sorily, informed guessing will be done and the suggestions given will apply. Should it happen that there remains any group of items that has not yet been read, and time is very short, then if no correction for guess- ing is to be used, it is best to blind guess, which means guessing with- out reading any part of the items. If a correction for guessing will be used, it is wise not to blind guess at all, but to leave the items unanswered.

If time still remains after all items have been responded to, check the answers to be sure that no error in marking was made due to haste. One note of caution must be given relative to such checking, however. The examinee should not change an answer rinless he is sure that he has made a mistake. Second thoughts about what the answer should be are more likely to be wrong than right. The examinee’s first judgment is usually the best.

Throrighorit the procedure, the ex- aminee must be alert to word mean- ing. Before answering any of the questions, he must be sure that he understands the instructions. Two readings of directions, therefore, are advisable. He must also read the items carefully. If he has a question, he should ask it of the proctor, un- less it has been stated that no clarifi- cation will be given (which is always the case for a standardized test).

In any event, the most effective

48 September/October 1975 JOGN Nursing

way to approach any item is as follows:

1.

2 .

3.

4.

5.

6.

Carefully read the stem (question or statement to which the options refer) Try to ,determine what informa- tion the test-writer is attempting to elicit On the basis of judgment of the above, determine what the re- sponse should be Read the options for under- standing Eliminate those options that are known to be wrong Choose the correct option

It is not always easy to eliminate as incorrect all but one option. Some ptrategy may be required to make a final determination among even more than two. In such cases, the op- tions themselves may provide clues, or the content of the other items may provide assistance. More often than one may think, previous or following items provide the correct response for an item in question. For example, consider these:

1. Which of the following is a male hormone? a. estrogen b. progesterone c. FSH d. testosterone

a. female hormone

c. pancreatic secretion d. adrenal secretion

2. Testosterone is best described as a

’ b. male hormone

One can often eliminate as wrong an option that does not fulfill the conditions of the stem. Consider the following item:

3. Which one of the following white blood cells would normally be found in the largest number? a. leukocytes b. erythrocytes

’ c. neutrophils d. phagocytes

The “b” response can be eliminated because an erythrocyte is a red blood cell, not a white blood

cell, which the stem calls for. Thus, that option does not fulfill the condi- tions of the stem.

This item shows other clues to elimination as well. Option a” can be eliminated, because the word “leukocyte” is another word for “white blood cell” and, therefore, includes all such cells. Option “d” can also be eliminated, since more than one type of leukocyte is clas- sified as a phagocyte and the stem suggests that the correct response is only one type of white blood cell. Only one option remains and that is “c. neutrophils,” the correct re- sponse.

The item in question thus points out several techniques for respond- ing. Not only can one eliminate false responses by noting any that do not fulfill the main proposition of the stem, but also those that imply a general when a specific is required (“phagocyte” and “leukocyte”) or those that are merely substitutes for words in the stem (“leukocyte”).

“

What the Test Constructor Does to Help

The test constructor does much to help the respondent, although usual- ly not intentionally. Test construc- tors are merely people. They are not superior beings in any way. They are fallible, and the tests they create are imperfect.

Every objective test item consists of two parts: the stem and the op- tions. Take for example the 4-option, multiple-choice item. The stem pre- sents the statement or question. The options are the choices one has as answers. One option is the correct answer while the other three options are the wrong answers, or distractors.

There are many problems inherent in writing an appropriate item of this kind. The language must be ap- propriate to those taking the test. Spelling, punctuation, and diction must be correct. In addition, three responses must be plausible but wrong, a condition that causes the greatest problem to the test construc- tor. The test constructor can usually think of one plausible but wrong

answer. He may, in some cases, rather quickly think of two plausible but wrong answers. The third plausi- ble but wrong answer will take more time; a fourth would take even more time than that; a fifth, even more time; and so on. That is why in a 4- option, multiple-choice item at least one distractor is often a foolish answer. Every time the test construc- tor has included such a distractor, he has unwittingly aided the test taker who knows how to read test items.

Test constructors who include foolish options often do so, however, for another reason. They mistakenly believe that it is necessary to con- found the test taker as much as possi- ble. Item 3, concerning the white blood cells is a case in point. If such an item were written seriously, it would most likely be the work of such a person.

The examinee can benefit from the test constructor’s foibles by quickly scanning items at random to note any peculiarities that might ap- pear in the manner in which the stems are phrased or the options are written. Here are some of the peculiarities that test constructors may have:

1 Make correct answer longer or shorter than other options for the item

2. Tend to qualify correct response much more than the distractors

3. Tend to position correct answers so that they are either “b” or “c” options

4. Where the options themselves form a logical sequence, tend to place correct response in center of that sequence

5. Tend to make the correct re- sponse a word or statement that is opposite in meaning to the other options

6. Tend to include “none of the above” as an option when they cannot think of suitable final distractor

7. Tend to make “all of the above” the correct response when the other options consist of a list of characteristics.

In terms of positioning correct responses, test constructors tend to

September/October 1975 JOCN Nursing 49

use the second or “b” position of a 4- option, multiple choice item as the location of the correct response more often than any other. The second favorite position of many test con- structors is the third or “c” position.

When the correct option is longer than the distractors, it is usually because it is qualified more, as shown in the following:

4. Insulin is produced by the a. adrenals ’ b,’ beta cells of islands of Langer-

hans of the pancreas c. thyroid d. pituitary

When the correct option is shorter than the distractor, it is usually be- cause the stem is so general that distractors must be created from sev- eral pieces of information.

5. A person is called a neonate a. from the beginning of the

third trimester until the end of the first 24 hours of life

b. only if he has been born through the vagina rather than by a C-section

Oc. for the first 28 days of life d . until the neonatologist or

other pediatrician determines that the baby is capable of breathing on his own

Using the same subject, a test con- structor might fall into the trap of placing the correct response within a logical sequence of time as follows: 6. For how many days following

birth will the baby be considered a neonate? a. 14

“b. 28 c. 42 d. 56

This ordering is not in itself always a clue, If only one such item is in- cluded in the test, then no pattern of test-constructor behavior shows. If, on the other hand, several items with sequential options occur, and if several of them have the correct response so ordered, the others will probably be ordered in a like man- ner.

Test constructors often follow a

true-false point of view even in writing multiple-choice items, and in this case, the correct option may be a “true” statement while the distrac- tors are “false” statements or vice versa.

7. Which of the following state-

‘a. Astigmatism is caused by an atypical shape of the cornea.

b. In myopia, light rays from dis- tant objects focus behind the retina.

c. Hyperopia is more commonly called “near-sightedness.”

d. Emmetropia is a type of cataract.

ments is most defensible?

Once the test-taker eliminates .false statements (knows that em- metropia refers to the normal eye; hyperopia is called “ far-sightedness; and that in myopia the light rays focus in front of the retina), he can choose “a” as the only true state- ment.

As in the case where a pattern of position emerges for sequential op- tions, patterns can emerge for op- tions that include “none of the above” or “all of the above.” Again, it is not the single case that provides the clue but a pattern common to several cases.

Most important of all, read the statements and options as written. Do not look for fine degrees of sub- tlety or cleverness. Use whatever degree of sophistication in respond- ing that is called for by the items themselves. Consider the following example:

8. When confronted by an emergency delivery in which the head is presenting, and when no other medical personnel are near at hand, the first thing the nurse should do is a. wash her hands b. run for help c. get the emergency delivery

pack “d. assist the delivery

Little sophistication is required to answer this item correctly. The item is as simple as its language implies,

and so the correct answer is “d.” Ex- aminees often choose the wrong response to such items because they read into them something that is not there or decide that the test con- structor is being enormously clever, trying to determine whether the examinee appreciates, in this case, the importance of cleanliness, the medical team concept, or being pre- pared for emergency deliveries.

A few other hints may also have been given by the test constructor such as the fact that only the correct answer employs the same type of language that the stem uses; only the correct answer includes specific details that are relevant; and only the correct answer actually com- pletes the statement of the stem grammatically. All of these un- intended hints become examinee strategy.

The Test Itself and How to Use It

The test itself, primarily the pur- pose of it, is another area from which to draw clues for correct responses. Always determine what the test is ac- tually attempting to elicit. The ex- aminee knows in advance whether the test is intended to assess his achievement, intelligence, aptitude, interest, or personality. Whatever the purpose of the test, each item in it will be constructed to determine some facet of that attribute and that attribute only. Any option that fails to meet this criterion must neces- sarily be false.

One may actually practice taking any particular type of test. Books of sample items have been published on virtually every type of objective test for virtually every type of at- tribute. In preparation, the examinee can review such works. Books of test items may be purchased for a nominal fee, and the libraries of many colleges and universities, par- ticularly those that have a school or department of education, keep a file of actual standardized tests. Such tests are usually not in actual use any longer, but the same types of items are still employed. Intelligence tests, for example, still use the same type

5Q SeDtember/October iwr; lOGN Nursing

of items whether they are designed for children or adults. Items con- cerned with the meaning of words, mathematical problem-solving, in- cluding the determination of the next number in a sequence, are still favorite items in such tests. The ex- aminee would do well to note in ad- vance what type of problems and what types of sequences are used. For example, in this sequence of prime numbers,

13, 17, 19, 23, 29, . . . the next number would be 31.

If they are valid, achievement tests cover only a specified cur- riculum and so the content as well as the types of questions can be ascer- tained in advance. Outdated achievement tests dealing with the same curriculum can give the ex- aminee not only an idea of the kind of items he will be faced with but some of the content as well, since teachers more often than not develop different items for the same content areas. Even standardized tests repeat the same content to a large extent.

Once the examinee has developed his strategy for taking tests in general, he need only then deter- mine the fine points of difference among the tests for various attributes and govern himself accordingly. Having done these things, he is well on his way toward “beating the system” and leaving anxiety behind. He is also well on his way to receiv- ing not only a passing score but one that is high as well.

Conclusion Skill at test-taking, known as test-

wiseness, can materially increase test scores. Since such skill is learned, anyone can develop it. Knowing what such skill consists of and how to plan strategies around it, however, can speed the learning process.

One way in which to discover both sriccessfril strategies and basic ele- ments of the skill itself is to read not only about test-wiseness but also about how to construct tests, since the directions given for writing test items are intended to inhibit the in-

fluence of test-wiseness on the exam- inee’s score. In other words, by re- versing the point of view, the exam- inee can use such rules as a basis for skill in handling individual items.

Above all, test anxiety is to be avoided, since it interferes with test performance. And the best way to deal with test anxiety is to know that one’s skill as an examinee includes ability not only in terms of the at- tribute to be tested but also in terms of attacking the items.

References 1 . Hansen, R . : “The Influence of

Variables Other than Knowledge on Probabalistic Tests.” J Educ Mea- sure 8:9-14, Spring 1971

2. Hall, B. W., et al.: “The Effect of Stress and Relax Instructions on the Predictive Validity of a Test De- vice.’’ Measure Eva1 Guidance 7:46- 50, April 1974

3. Katahn, M.: “Alleviating the Col- lege Strident’s Anxiety: Systematic Desensitization.” Natl Educ Assoc J 57:17-18, January 1968

4. Osterhorise, R. A.: “Desensitization and Stndy-Skills Training as Treat- ment for Two Types of Test-Anxious Students.” J Counsel Psychol

5. Kirkland, M. C.: “The Effects of Tests on Students and School.” Rev Educ Res 41:303-350, October 1971

6 Bariernfeind, R. H.: School Testing Programs. Boston, Horighton Mifflin Co., 1968

7. Collenbach, C.: “The Effects of Independent Test-Taking Tech- niques upon Standardized Reading Test Scores of Selected Second Grade Students.” J Educ Measure 10:25-29, Spring 1973

8. Aiken, L. R.: Psychological and Educational Testing. Boston, Allyn and Bacon, 1971

9. Barclay, J. R. : Controversial Issues in Testing. Boston, Horighton Mifflin Co., 1968

10. Millman, J., C. H. Bishop, and R. Ebel: “An Analysis of Test-Wise- ness.” Educ Psychol Measure 25:707- 726. March 1965

19~301-307, J d y 1972

Bibliography Blood, D. F., and W. C. Budd: Educa-

tional Measurement and Evaluation.

New York, Harper & Row, Pub- lishers, 1972

Ebel, R. L.: Measuring Educational Achievement. Englewood Cliffs, N. J. , Prentice-Hall, 1965

Green, J . A , : Introductfon to Measure- ment and Evaluation. New York, Dodd, Mead, 1970

Green, J. A, : Teacher-Made Tests. Sec- ond edition. New York, Harper & Row, Publishers, 1975

Gronlrind, N. E.: Measurement and Evaluation in Teaching, Second edi- tion. New York, The Macmillan Co., 1971

Remmers, H. H., N. L. Gage and J. F. Rrimmel: A Practical Introduction to Measurement and Evaluation. New York, Harper & Row, Publishers, 1960

Sax, G. : Principles of Educational Measurement and Evaluation. Bel- mont, Calif., Wadsworth Publishing Co., 1974

Thorndike, R. L . , and E. Hagen: Measurement and Evaluation in Psychology and Education. Third edition. New York, John Wiley, 1969

Dr. Hunt is currently the Administrator of Evaluation and Research, Department of Continu- ing Education, The American Col- lege of Obstetricians and Gyne- cologists, having previously served the College as a consultant on education and psychometrics. Her interesting career has also included such assignments as HEW Evaluator on the Medical Evaluation Team for Grady Hospital (Atlanta), Editor-in- Chief of the American Peoples En- cyclopedia and Yearbook, and Research Associate at the University of Illinois Medical Center.

Dr. Granzig i s the Administrator of ACOG’s Department of Continuing Education and Assistant Professor of Obstetrics and Gynecology at the University of Illinois Medical School. He coauthored another JOGN arti- cle, “The New Morality, Ethics, and Nursing,” which appeared in the SeptemberlOctober 1973 issue.

September/October 1975 JOGN Nursing 51