NET tests are developed through an eight-step process:
1. The examination committee discusses the need for an updated NET test.
2. The committee reviews current literature, including journal articles, textbooks, state and professional guidelines, clinical activities, and curricula data from various national programs.
3. They develop an outline from information gathered during the review of the literature.
4. Experts from the discipline review the outline for effectiveness.
5. Writers with expertise in the specific area submit items, which are reviewed for cognitive level, formatting, and grammar.
6. NET test writers develop an exam, incorporating items approved during the outline process.
7. The committee sets up alpha testing using students from particular medical areas. They then adjust the test accordingly and move into beta testing. They performance-test each item, as well as the test as a whole, and make changes to the test based on their analysis of the data.
8. An annual review of the exam’s effectiveness is conducted.
NET tests are rated on seven criteria: reliability, statistical review procedures, validity, content validity, question clarity, constructs validity, and predictive validity.
1. Reliability: Reliability is defined as accuracy, consistency, dependability, and stability of responses. NET tests must be reliable generating data and identifying random errors.
2. Statistical Review Procedures: A statistical review is done each year on all items. The review considers accuracy, clarity, content, appropriateness, and response rates. About ten percent of the items on a NET test are replaced every year.
3. Validity: Validity is defined as the degree to which the test measures what it was designed to measure and is criterion-based. Exit assessments are compared to the NCLEX exam results.
4. Content Validity: Content validity is vetted by nursing experts and current textbooks, and articles related to the content are reviewed along with the curricula of various nursing schools. The items in NET tests are not created to be tricky or confusing.
5. Question Clarity: The goal is to write the items in clear English in such a way as to determine who understands the subject and who does not. The continuing review of the items strives to eliminate confusion and bias and evaluate critical thinking skills and the ability to make clinical decisions.
6. Constructs Validity: Content experts review each item in the NET tests to ensure the content meets the requirements of the professional licensure exams.
7. Predictive Validity: The review process also assesses the predictive value of the NET tests in accurately determining which students will most likely be successful in a nursing career or other healthcare profession.