Designing theoretical assessments at nursing higher education institutions: A scoping review

Keywords: assessment design, assessment practices, nurse educator, theoretical assessment


Assessment in higher education remains one of the most reliable forms of assessing the effectiveness of the learning and teaching (L&T) process. Excellence in theory assessment design is, therefore, a pivotal element of the success of many Higher Education Institutions (HEIs) around the world. This scoping review aimed to establish current assessment best practices in nursing at HEIs. The five steps of Arksey and O’Malley’s framework guided this scoping review. Following a systematic search of various databases, including Academic Search Complete, CINAHL, ERIC, MEDLINE, PubMed, Sage Online Journals, SCOPUS, and Wiley Online Library for the period from 2010 to 2020, a rigorous screening process was undertaken by three independent reviewers. The search terms included assessment best practice and nursing education institution. Of the 652 articles screened, 12 studies met the inclusion criteria. Four quantitative, four qualitative, one mixed-method, and three studies that did not specify their design were included. The findings revealed that various factors influence how educators design assessments. Theoretical assessment design is a vital activity and requires collaboration between policymakers and HEIs to enhance the quality designing of assessments by educators through professional development.

Author Biography

G. Donough, University of the Western Cape, Cape Town

School of Nursing, Community Health and Sciences


Abdalla, Mohamed Elhassan. 2013. “Multiple Choice Questions Revisited: Improvement of Validity for Fair Tests.” Gezira Journal of Health Sciences 9(1): 1.

Ahmed, Ekhlas Mohammed Ali. 2012. The use of Multiple choice questions in assessing nursing students. Faculty of Applied Medical Sciences, University of Gezira, Department of nursing. University of Gezira.

Arksey, Hilary and Lisa O’Malley. 2005. “Scoping studies: Towards a methodological framework.” International Journal of Social Research Methodology 8(1): 19‒32.

Ashford-Rowe, Kevin, Janice Herrington, and Christine Brown. 2014. “Establishing the critical elements that determine authentic assessment.” Assessment & Evaluation in Higher Education 39(2): 205‒222.

Bearman, Margaret, Phillip Dawson, Sue Bennett, Matt Hall, Elizabeth Molloy, David Boud, and Gordon Joughin. 2017. “How university teachers design assessments: A cross-disciplinary study.” Higher Education 74(1): 49‒64. 10.1007/s10734-016-0027-7.

Bearman, Margaret, Phillip Dawson, David Boud, Sue Bennett, Matt Hall, and Elizabeth Molloy. 2016. “Support for assessment practice: Developing the Assessment Design Decisions Framework.” Teaching in Higher Education 21(5): 545‒556.

Bennett, Sue, Phillip Dawson, Margaret Bearman, Elizabeth Molloy, and David Boud. 2017. “How technology shapes assessment design: Findings from a study of university teachers.” British Journal of Educational Technology 48(2): 672‒682. 10.1111/bjet.12439.

Biggs, John. 1996. “Enhancing teaching through constructive alignment.” Higher Education 32(3): 347‒364.

Biggs, John. 2003. “Aligning teaching for constructing learning.” Higher Education Academy 1(4).

Billings, Diane M., Edd R. N. Faan, and Judith A. Halstead. 2019. Teaching in Nursing e-Book: A Guide for Faculty. Elsevier Health Sciences.

Blaauw, Duane, Prudence Ditlopo, and Laetitia C Rispel. 2014a. “Nursing education reform in South Africa–lessons from a policy analysis study.” Global Health Action 7(1): 26401.

Blaauw, Duane, Prudence Ditlopo, and Laetitia C. Rispel. 2014b. “Nursing education reform in South Africa – lessons from a policy analysis study.” Global Health Action 7(1). 10.3402/gha.v7.26401.

Chinembiri, France. 2017. “Evaluation Methods Used during the Assessment of an Academic Program at Micro-Level.” Online Submission.

Davids, Nuraan and Yusef Waghid. 2018. Teaching and learning as a pedagogic pilgrimage: Cultivating faith, hope and imagination. Routledge.

Duque, Lola C. and John R. Weeks. 2010. “Towards a model and methodology for assessing student learning outcomes and satisfaction.” Quality assurance in education.

Elahi, Nasrin, Mohamad Adineh, and Zahra Rasooli. 2016. “How to Make Clinical and Classroom Evaluation in Nursing Effective: Content Analysis.” African Educational Research Journal 4(2): 69‒75.

Fayilane, Nontlantla Isabella. 2017. “Analysing cognitive levels of final examination questions for the Diploma Nursing programme using the revised bloom’s taxonomy at a selected nursing college in Eastern Cape.” Doctoral dissertation.

Fives, Helenrose and Nicole Barnes. 2017. “Informed and uninformed naive assessment constructors’ strategies for item selection.” Journal of Teacher Education 68(1): 85‒101.

Flores, María Assuncão, Ana Margarida Veiga Simão, Alexandra Barros, and Diana Pereira. 2015. “Perceptions of effectiveness, fairness and feedback of assessment methods: A study in higher education.” Studies in Higher Education 40(9): 1523‒1534. 10.1080/03075079.2014.881348.

Fogliano, Fernando, Fernando Fabbrini, André Souza, Guilherme Fidélio, Juliana Machado, and Rachel Sarra. 2019. “Edgard, the Chatbot: Questioning Ethics in the Usage of Artificial Intelligence Through Interaction Design and Electronic Literature.” International Conference on Human-Computer Interaction.

Garekwe, Masaitsiweng. 2010. “Analysis of cognitive levels of examination questions set in the Bachelor of Nursing programme at the University of KwaZulu-Natal.” Doctoral dissertation.

Johannesen, Monica and Laurence Habib. 2010. “The role of professional identity in patterns of use of multiple‐choice assessment tools.” Technology, Pedagogy and Education 19(1): 93‒109.

Killingsworth, Erin, Laura P. Kimble, and Tanya Sudia. 2015. “What goes into a decision? How nursing faculty decide which best practices to use for classroom testing.” Nursing Education Perspectives 36(4): 220‒225.

Kinash, Shelley, Diana Knight, and Ron Kordyban. 2013. “First Steps Towards Blended Learning@ Bond.”

Meyer, Luanna H., Susan Davidson, Lynanne McKenzie, Malcolm Rees, Helen Anderson, Richard Fletcher, and Patricia M. Johnston. 2010. “An investigation of tertiary assessment policy and practice: Alignment and contradictions.” Higher Education Quarterly 64(3): 331‒350.

Moher, David, Alessandro Liberati, Jennifer Tetzlaff, Douglas G Altman, and Prisma Group. 2009. “Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement.” PLoS med 6(7): e1000097.

Mulaudzi, Fhumulani Mavis, Felicity M. Daniels, Kgomotso K. Direko, and Leana Uys. 2012. “The current status of the education and training of nurse educators in South Africa.” Trends in Nursing 1(1): 79‒90.

Nayer, Marla, Susan Glover Takahashi, and Patricia Hrynchak. 2018. “Twelve tips for developing key-feature questions (KFQ) for effective assessment of clinical reasoning.” Médical teacher 40(11): 1116‒1122.

Norton, Lin, Bill Norton, and Lee Shannon. 2013. “Revitalising assessment design: What is holding new lecturers back?” Higher Education 66(2): 233‒251. 10.1007/s10734-012-9601-9.

O’Flaherty, Jacqueline and Craig Phillips. 2015. “The use of flipped classrooms in higher education: A scoping review.” The Internet and Higher Education 25: 85‒95. j.iheduc.2015.02.002.

Oermann, Marilyn H., Jennie C. De Gagne, and Beth Cusatis Phillips. 2017. Teaching in nursing and role of the educator: The complete guide to best practice in teaching, evaluation, and curriculum development. Springer Publishing Company.

Oermann, Marilyn H. and Kathleen B. Gaberson. 2016. Evaluation and testing in nursing education. Springer Publishing Company.

Peters, Micah D. J., Christina Godfrey, Patricia McInerney, C. Baldini Soares, H. Khalil, and D. Parker. 2017. “Chapter 11: Scoping reviews.” Joanna Briggs Institute Reviewer’s Manual. The Joanna Briggs Institute.

Pijl-Zieber, Em M., Sylvia Barton, Jill Konkin, Olu Awosoga, and Vera Caine. 2014. Competence and competency-based nursing education: Finding our way through the issues. Elsevier.

Quesada-Serra, Victoria, Gregorio Rodríguez-Gómez, and Maria Soledad Ibarra-Sáiz. 2016. “What are we missing? Spanish lecturers’ perceptions of their assessment practices.” Innovations in Education and Teaching International 53(1): 48‒59. 10.1080/14703297.2014.930353.

Salminen, Leena, Minna Stolt, Mikko Saarikoski, Arja Suikkala, Heli Vaartio, and Helena Leino-Kilpi. 2010. “Future challenges for nursing education–A European perspective.” Nurse Education Today 30(3): 233‒238.

SAQA see SAQA South African Qualifications Authority.

South African Qualifications Authority. 2005. Guidelines for integrated assessment. Pretoria: SAQA.

Talman, Kirsi, Jonna Vierula, Anne-Maria Kanerva, Outi Virkki, Jaana-Maija Koivisto, and Elina Haavisto. 2020. “Instruments for assessing reasoning skills in higher education: A scoping review.” Assessment & Evaluation in Higher Education: 1‒17.

Uys, Leana R. and Hester C. Klopper. 2013. “What is the ideal ratio of categories of nurses for the South African public health system?” South African Journal of Science 109(5‒6): 01‒04.

Vierula, Jonna, Elina Haavisto, Maija Hupli, and Kirsi Talman. 2020. “The assessment of learning skills in nursing student selection: A scoping review.” Assessment & Evaluation in Higher Education 45(4): 496‒512.

Villarroel, Verónica, Susan Bloxham, Daniela Bruna, Carola Bruna, and Constanza Herrera-Seda. 2018. “Authentic assessment: Creating a blueprint for course design.” Assessment & Evaluation in Higher Education 43(5): 840‒854. 2017.1412396.

Voogt, Joke, Ola Erstad, Chris Dede, and Punya Mishra. 2013. “Challenges to learning and schooling in the digital networked world of the 21st century.” Journal of Computer Assisted Learning 29(5): 403‒413.

WHO see World Health Organization.

Wiliam, Dylan. 2013. “Assessment: The bridge between teaching and learning.” Voices from the Middle 21(2): 15. 4f8c3/1?pq-origsite=gscholar&cbl=33274.

World Health Organization. 2016. “Nurse educator core competencies.”

How to Cite
Donough, G., F.M. Daniels, and K.D.T. Mthimunye. 2022. “Designing Theoretical Assessments at Nursing Higher Education Institutions: A Scoping Review ”. South African Journal of Higher Education 36 (2), 79-98.
General Articles