In June, we wrote to our membership about our work to identify and take action to promote inclusion, equity, justice, and peace in school health and society at-large.
We would like to share some of our accomplishments and works in progress in this area:
Exam Bias Review
The NBCSN noticed a trend in our exam data that demonstrated a disparity in passing rate among candidates with certain personal characteristics. While we realize many factors contribute to a candidate’s readiness or success on the certification exam, the board identified amelioration of language and cultural bias in our exam items as an initial key area to address. Language, or linguistic, bias occurs on exams when items are worded in a way that impacts the interpretation of the item by exam candidates who are not native speakers of, in our case, American English. Similarly, cultural bias is present on exams when knowledge of specific cultural experiences is required to correctly answer an exam question.
The purpose of the NCSN exam is not to test the linguistic abilities or cultural relevance of exam candidates, therefore we aim to review our exam items to ensure we are testing candidates on what they know and not who they are. The board is greatly looking forward to partnering with Lois S. Marshall PhD, MN, RN, Latoya Lewis EdD-CI, MSN, RN and Yania Ortega BSN, RN to conduct a review of exam items (questions) for possible language and cultural bias. Our review team has expertise in nursing, education, testing, as well as lived experience taking standardized exams as nurses for whom English is an additional language.
If you have interest in reading more about bias in nursing exams, please click HERE for free access to an article by Dr. Susan Bosher published in Nursing Education Perspectives with descriptions and examples of biased items.
Exam Candidate Eligibility
Determining a school nurse’s eligibility to take the NCSN exam requires careful consideration of many factors, including inclusivity and ensuring we are setting candidates up for success. The board determined in early 2020 that an unintended consequence of requiring a BSN to sit for the test may be exclusion of candidates who have not, thus far in their career, had access or opportunity to attend a BSN program. We convened a special committee of five NCSNS with varied educational entries to practice (e.g. BSN, ADRN, RN-BSN) to review our eligibility criteria, determine appropriateness, and suggest criteria revisions or methods for expanding access to school nurses without a BSN. The special committee held meetings, conducted a focus group of school nurse experts, reviewed current literature as well as our exam domains. Following their thorough efforts, the group advised the BSN remain a requirement at this time. Key content areas of the NCSN exam such population health, health policy, epidemiology, leadership, pediatric assessment, and nursing research are central to the curricula in BSN programs, but are not always included in diploma or ADRN programs. In order to foster success for exam candidates, a strong foundation in these areas is needed.
Our board is now exploring how we may offer or connect exam candidates with training modules that may be used as eligibility criteria fulfilment as well as study aids in these specific domains.
Finally, I am honored to share our revised Non-Discrimination and Anti-Hate policy linked HERE. Our board revised and expanded the language in our previous non-discrimination policy to make clear where our board stands in relation to this topic.
I also invite engagement from NCSNs and others interested in promoting excellence in school health to make us aware of other areas of opportunity, or places where you would like to see NBCSN contributing.
NCSNs who would like to contribute to these actions as well as the overall mission of the NBCSN are invited to apply for a board member position. The NBCSN will have one open board seat to be filled in January 2022, and two open seats in January 2023. Please CLICK HERE to learn more about board membership and HERE to apply for a position.