Best Practices for Writing Test Items

This article enhances the current literature’s guidance for those interested in developing, assessing, or utilizing items to test competency in nursing. It does so by underlining the purpose of a test item and deriving four item-writing principles from that central purpose. The article then relates these four principles to the task of developing multiple-choice nursing test items. These principles include the strong alignment of a test item with the measurement of the examinee’s grasp of knowledge, the inclusion of important rather than nonessential concepts, the differentiation of competent from incompetent examinees by items of appropriate difficulty, and the creation of a fair examination consisting of appropriate and applicable items. Within the framework provided by these four principles, this article suggests some effective methods for devising nursing test items that remain faithful to the central purpose of assessing proficiency.