專科護理師筆試命審題暨衍生優質試題策略之探討

A Study on the Written Examination Questions of the Nurse PractitionerExamination and the Strategy of Derivating High-quality Examination Questions

從測驗屬性觀之，專科護理師考試屬於一種「能力測驗」，此類測驗通常包括筆試、口試，筆試部分評量的重點在於認知部分，以專業的知識與認知歷程評量為重點，專科護理師口試則採OSCE（客觀結構化臨床考試），技能部分的評量為其重點，兩階段的考試的及格標準均屬「效標參照」，顯示應考人對某些專業知識與技能熟悉的程度，這是將應考人在測驗的行為表現，與稱之為「效標」的熟練標準比較所得的結果。依據試題組卷難易度的預設標準，難中易比例最好接近25%、50%及25%，鑑別度屬於尚可及優良的總和比例也會愈高。107年與108年第1次的專科護理師通論試題實際考後結果難易度適中比例均超過5成，個別難易比例也與25%差距有限，鑑別度尚可與優良的比例總和均超過7成，顯見此兩年度的試題品質相當理想。爰此，試題的設計成為測驗成敗之關鍵，尤其試題可有效反映效標行為，亦即我們經常論及的試題效度。筆者參與專科護理師考試10多年，也長期觀察試題品質的變化，本文將著重在筆試部分，除選取最近年度的專科護理師筆試結果進行比較解讀外，另將歷年於筆試命題技術研習會講授之命審題技術加以說明，並探討如何利用過去的考畢試題品質分析指標重新命擬或衍生優質試題，並從專科護理試筆試各科試題中選取試題範例加以解析，俾利掌握具有信、效度的試題命題技巧。

 

From the perspective of test characteristics, the nurse practitioner exam is a kind of "ability test." Thistype of test usually includes a written test and an oral test. The assessment of the written test focus-es on the cognitive part, focusing on professional knowledge and cognitive process assessment. The nurse practitioner’s oral examination adopts OSCE (Objective Structured Clinical Examination), and the assessment of the skill part is the focus. The passing standards of the two-stage examinations are "reference to the performance criteria", showing the candidate’s familiarity with certain professional knowledge and skills. This is the result of comparing the test taker’s behavioral performance with the proficiency standard called "Criterion of Validity". According to the pre-set standard for the difficulty of the test question composition paper, the ratio of difficult to easy is preferably close to 25%, 50% and 25%, and the proportion of the sum of acceptable and excellent discrimination will be higher. The moderate difficulty of the general theory examination questions for nurse practitioner exam in 2018 and 2019Ⅰwere more than 50%, and the ratio of difficult and easy was also close to 25%, the proportion of the sum of acceptable and excellent discrimination was more higher than 70%, which shows that the quality of the test questions. In this regard, the design of test questions has become the key to the suc-cess or failure of the test, especially the test questions can effectively reflect the behavior of the bench-mark, that is, the validity of the test questions we often talk about. The paper author has participated in the examination of nurse practitioner for more than 10 years, and has been observing the quality of the test questions for a long time. This article will focus on the written examination. In addition to se-lecting the most recent year’s written examination results of nurse practitioner for comparison and in-terpretation, it will also be taught in the technical seminar of written examinations over the years. The proposition examination technique is explained, and how to use the past examination quality analysis indicators to re-design or derive high-quality examination questions, and select examples of examina-tion questions from the various subjects of the nurse practitioner written examination questions for analysis, so that the proposition experts can master written skills with reliability and validity.