Implications of multiple-choice testing in nursing education.

The evaluation of knowledge/competence is understood as an essential component of nursing education and practice. As such, nurse educators have a plethora of existing evaluation strategies from which to choose. A common written evaluative format used across all higher education settings is multiple-choice testing. This evaluation approach is accepted as a 'user-friendly' strategy to assess knowledge. Researchers from the disciplines of psychology and education have long been concerned with the consequences of multiple-choice testing on learning outcomes, a discussion that is essentially absent from the nursing literature. The purpose of this paper is to address the professional implications of multiple-choice testing in nursing. The potential knowledge consequences for nurse-learners, and by extension the provision of care to healthcare recipients, resultant from use of this testing modality are addressed within the context of the implementation of best practice guidelines in a long-term care home in a mid-sized rural and northern Canadian community with both regulated and non-regulated care providers.

Concept analysis: the importance of differentiating the ontological focus.

AIM: The aim of this paper is to clarify the philosophical underpinnings of concepts and concept analysis and the implications of their use through the lens of particular ontological perspectives. BACKGROUND: Information on the philosophical foundations of concepts from an ontological and epistemological perspective is not readily identifiable in the international literature. Although some authors have made reference to the ontological perspectives of specific concept analysis processes, none have addressed the implications of the realist or relativist perspective in relation either to the analysis process or the implications of a particular ontological perspective on the meaning and utility of a specific concept. METHOD: We describe the evolution of concept analysis and influence of ontological paradigms on specific analysis methods. Using an historical review of concept development within nursing thought, we decode the language of concepts and processes of concept analysis, outline the importance of the ontological foundation of concept development, and describe the impact of concept use. DISCUSSION: The nursing literature is dominated by concepts created from a realist perspective. Although recent nurse-authors have introduced evidence-based data to facilitate the development of a number of concepts, they have held fast to the perception that the 'best', most adequate or mature concepts transcend context. CONCLUSION: The theoretical shift from context-bound empirical analysis of concepts belies the complexity of nurses' work. Concepts are unapologetically context-bound. A concept that transcends context (based on realist ontology) will remain the same even when the context of praxis changes limiting its utility.