The teaching modalities utilized by nursing faculty have the potential to greatly influence students' success on the National Council Licensure Examination (NCLEX(R)) as well as their performance in the clinical setting as professional nurses. In nursing education, traditional classroom assessments often serve as the most significant component of course grades (Killingsworth, Kimble, & Sudia, 2015). Nursing faculty have a responsibility to their students to continually evaluate the teaching methods they utilize in order to ensure that students are receiving the highest quality educational experience possible. Active learning strategies, such as collaborative testing, promote problem solving, critical thinking, and peer interaction, all of which are essential for the transfer and application of testing is a nontraditional method of testing, that has been implemented in undergraduate nursing courses in recent years (Eastridge, 2014). In collaborative testing, students work together to complete exams, quizzes, or tests and have the opportunity to collaborate with their peers to analyze exam questions before collectively selecting their final answer choice (Heglund & Wink, 2011).

BACKGROUND

Collaborative testing can be implemented in a variety of ways, leaving faculty to determine which format may work best for their class. In the literature, the size of testing groups varies, ranging from groups of two to six students (Heglund & Wink, 2011). Centrella-Nigro (2012) utilized collaborative testing as a posttest review, and students took their exams independently. The author reported that when used this way, students were more interactive during the review and stated that their understanding of test content improved greatly. Wiggs (2011) utilized collaborative testing differently, allowing students to collaborate and discuss test questions. However, Wiggs did not require students to reach group consensus on a single answer and allowed the submission of individual exam answer sheets.

A major component of collaborative testing is the peer interaction, education, and collaboration that takes places while discussing each test question. Collaborative testing allows students to learn cooperatively from their peers and hear how and why other students reached a particular answer. Students reported that they gained a better understanding of course content, had improved problem-solving and critical thinking skills, had positive peer interactions and garnered improved communication skills (Centrella-Nigro, 2012; Eastridge, 2014; Heglund & Wink, 2011; Sandahl, 2010; Wiggs, 2011). Students reported that the collaborative testing experience better equipped them for the collaboration necessary when in clinical practice and helped hone their ability to communicate and critically think when discussing problems as a group. This collaborative process allows for immediate feedback, gives students the opportunity to discuss key concepts, and may foster understanding of differing perspectives.

It is important to remember that, as with any group interaction, there may be challenges. Research on collaborative testing revealed that when working in a group, some students attempted to dominate discussions and were not open to the ideas of their peers. Others did not participate or contribute to the collaborative efforts, leading to arguments when selecting a final answer for each exam question (Eastridge, 2014). Faculty should be mindful of these challenges and encourage students to work through these difficulties as a group, further fostering the concept of collaboration.

Collaborative testing has been shown to improve retention of course content as demonstrated by improved overall scores on both unit exams and final exams (Heglund & Wink, 2011; Sandahl, 2010; Wiggs, 2011). Centrella-Nigro (2012) reported an increase in NCLEX passing rates the year following the implementation of collaborative testing in an undergraduate baccalaureate nursing program. The increase in overall exam scores and NCLEX passing rates is consistent with the findings reported by students who stated they had a deeper understanding of course content and improved long-term retention of information.

A major criticism of collaborative testing is the potential for grade inflation by awarding extra points to students who did not earn the higher grade on their own merit (Duane & Satre, 2014). Faculty can determine how collaborative points are awarded. Often when grading a collaborative test, faculty will take the score of the individual exam and average it with the score obtained from the collaborative effort. This process may allow for a significant improvement in a student's overall test grade. Heglund and Wink (2011) required students to successfully pass their independent exam prior to receiving collaborative points. To safe guard against grade inflation when choosing to utilize collaborative testing, it is important for faculty to carefully consider their grading strategy, as it is possible that a poorly conceived grading strategy could decrease the perceived value of this educational intervention.

IMPLEMENTATION

To improve student engagement with course materials as well as their interaction with classmates, the authors implemented collaborative testing using quizzes in a seven-week maternal infant course in an accelerated second-degree baccalaureate nursing program. The following outlines specifics on how this innovative teaching strategy was implemented.

Four 20-question multiple-choice quizzes were electronically administered throughout the seven-week course. Each quiz included material taught in the previous week's class. To begin, each student had 30 minutes to complete the quiz individually. Then students were randomly assigned to groups of four using a computerized random assignment generator, with groups changing weekly. Primarily, this was done to address any concerns about stronger students repeatedly being in the same group, subsequently resulting in unfair advantages and overall higher collaborative scores compared to the rest of the class. By changing groups weekly, students had the opportunity to work within groups with varying dynamics and collaboration styles.

Groups were given one paper copy of the quiz as well as a group answer sheet. They were then given 20-30 minutes to discuss the questions collaboratively before collectively submitting one completed group answer sheet for scoring. No textbooks or Internet resources were allowed, nor was any discussion between groups permitted. Groups were monitored and reminded that the group discussion must stay on task. After all answer sheets were collected, the quiz was reviewed with the class as a whole to provide immediate feedback and answer questions about the quiz content.

Overall, collaborative testing accounted for 30 percent of the student's total course grade, with each quiz worth 7.5 percent. To address the possibility of grade inflation, students were required to achieve a score of 75 percent or better on the individual quiz in order to benefit from their group's collaborative score 75 percent was the minimum passing grade according to school policy. Students were unaware of their individual scores when collaborating as a group; all class members benefitted from the group learning and collaboration.

Evaluation

During the first class, collaborative testing was described to students as outlined in the course syllabus. Students were then asked to take an anonymous survey to gauge their perception and understanding of collaborative testing and determine their understanding and attitude toward this educational strategy. Only 3 of the 28 students had previously experienced collaborative testing. However, most (75 percent) were positive about trying this type of testing. Students believed weekly collaborative quizzes would help them study as they went along, in preference to waiting for larger exams to catch up on reading and review course materials. Students were also excited about the opportunity to improve their individual quiz grades when working together as a group. One student responded negatively, reporting she did not like group work. Another was fearful about receiving immediate feedback in case of failure, while another was concerned about not being a valued or contributing member of the collaborative group. Two other students felt they should receive all collaborative points regardless of their individual score. Understanding students' feelings about this new teaching strategy allowed faculty to better explain the intervention and address concerns.

At the end of the course, students were asked to complete another anonymous survey to evaluate their experience. This survey was used to determine if this educational strategy should be continued in the future. Seventy-eight percent of the 18 students who responded reported that the collaborative quizzes were helpful in supporting their learning of the course material. Students enjoyed the immediate feedback, and one student stated it helped to reinforce learning. All students stated that they studied for each of the weekly quizzes, and the collaborative testing helped them better prepare for course exams. Overwhelmingly, all respondents recommended this collaborative testing for use with future classes.

CONCLUSION

Nurse faculty strive to help students develop into skilled practitioners who are able to think critically, solve problems, understand complex concepts, and work collaboratively on interdisciplinary health care teams. Collaborative testing has been shown to enhance student learning, improve retention of course content, promote positive peer interactions and collaboration, promote problem-solving ability and critical thinking skills, and serve as an effective evaluation tool for educators (Wiggs, 2011). In this course, there were two independent course exams each worth 30 percent of the total course grade in addition to the collaborative quizzes. Because some faculty may be hesitant to implement a collaborative testing policy on all tests and exams, collaborative testing using quizzes may be a lower stakes method by which to begin to implement collaborative testing. This active learning strategy may be an effective, nontraditional approach to assessing students' knowledge and understanding of course content and could be a beneficial addition to any course within an undergraduate nursing curriculum.

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