Item Writing Resource Page

Exam creation begins and ends with the planning, development, and refinement of the individual assessment items. Using best practices, this item writing training provides the foundation for reliable, valid and fair exam items, helping to ensure the legal defensibility of the CRNA credential. The NBCRNA’s item-writing process uses subject matter experts, job analyses, and stringent practices and guidelines to develop content for item banks for NBCRNA’s credentialing programs.

The Item-Writing Course series was developed by the NBCRNA to offer a foundation for potential item writers.  All courses are online and eligible for Class A credit, up to 3.75 credits total.

Course 1: Item-Writing Theory and Practice: Foundation, is eligible for 2.00 Class A credits and is being offered for $50. The Foundation course serves as a prerequisite to Course 2: Alternative Question Formats (0.5 Class A credits). Earn up to 3.75 Class A credits for completing both courses. 

To register for the Foundation course, click the register button below and follow the bulleted instructions. Find out more in the FAQs below.

Registration Instructions

  • Click the register button and select create account.
  • Enter your information and be sure to select the Item-Writing Theory and Practice dropdown
  • After saving your account information, select Catalog from the upper-right corner of your dashboard.
  • Add the course to your cart and press the green cart button in the top right corner to checkout.
  • Once purchased, the course will show in the current courses tab of your dashboard.

Upon passing the Foundation course, you will be automatically registered for Course 2.

Interested in becoming an NBCRNA item writer?

Email learning@nbcrna.com of your interest and review the resources listed on this page. In addition, please complete Course 1: Item-Writing Theory and Practice: Foundation (3rd ed.). 

Item Writing Courses

  • Course 1: Item-Writing Theory and Practice: Foundation (3rd ed.)

    2.00 Class A credits

    This course covers fundamental concepts of test development, including professional practice analysis, standard setting, and the life cycle of an item. Users learn to write multiple choice questions that minimize testing error and construct-irrelevant variance. The course serves as a prerequisite to Item-Writing Theory and Practice--Alternative Question Formats and Item-Writing Theory and Practice--Writing Clinical Scenario Item Series.

    This program has been prior approved by the American Association of Nurse Anesthetists for 2.00 Class A CE credits; Code Number 1040362; Expiration Date 5/31/2024.

  • Course 2: Item-Writing Theory and Practice: Alternative Question Formats (4th ed.)

    1.75 Class A credit

    This course offers insight into the advantages and disadvantages of multiple choice questions. It provides examples and best practices for authoring alternative question formats such as multiple correct response, short answer, drag-and-drop, hotspots, and care scenario sets.

    This program has been prior approved by the American Association of Nurse Anesthesiology for 1.75 Class A CE credits; Code Number 1042129; Expiration Date 5/31/2025.

Resources

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Online Item-Writing Courses FAQ

  • Q How many item-writing courses are there?

    There are two courses: Item-Writing Theory and Practice: Foundation, Item-Writing Theory and Practice: Alternative Question Formats

  • Q What are the courses about?

    Item-Writing Theory and Practice: Foundation covers fundamental concepts of test development, including professional practice analysis, standard setting, and the life cycle of an item. It lays out best practices for authoring psychometrically sound multiple-choice question stems and options, and techniques for maximizing coverage of higher-order thinking. The course uses video, readings, and an interactive tutorial.

    • Item-Writing Theory and Practice: Foundation is a prerequisite for Item-Writing Theory and Practice: Alternative Question Formats. If you pass the Foundation course, you will be automatically registered for Alternative Question Formats.

     

    Item-Writing Theory and Practice: Alternative Question Formats picks up from the Foundation course to offer insight into advantages and disadvantages of multiple-choice questions. It provides examples and best practices for authoring alternative question formats such as multiple correct response, short answer, drag-and-drop, hotspots, and case scenario sets.

  • Q What is there to know about question writing? It seems simple.

    Although almost everyone has taken standardized exams, most are unaware of the extent of the knowledge and effort involved in creating and maintaining useful, defensible exams. In terms of certification exams, there are procedures beyond just the correct writing and review of items that maximize the validity of an exam for determining whether professionals meet an acceptable level of ability. These courses cover item-writing best practices in some depth and also give an overview of certification test development procedures.
  • Q What kinds of materials are included in the courses?

    The courses include video lecture with accompanying slides, published articles on testing, item-writing development guidelines, an alternative item tutorial, and alternative item samples.

  • Q Who developed these courses?

    The courses were developed by the NBCRNA.

  • Q How long do the courses take?

    The Foundation course includes video material that is approximately 2 hours in length.

    In addition to video, the accompanying reading material could take some additional time to read in depth, although only the video lecture material is directly tested. The posttest is 25 questions and can be completed in 30 minutes. The program evaluation takes 10 minutes to complete.

    The Alternative Question Formats course videos total about 80 minutes. In addition to video, the accompanying reading material could take some additional time to read in depth, although only the video lecture material is directly tested. The posttest is 20 questions and could be completed in under 30 minutes. The program evaluation takes 10 minutes to complete.

  • Q How much time will I have to complete the courses once I register?

    You can work through the courses at whatever pace suits you. For the Foundation and Alternative Question Formats courses, prior-approved Class A CE credit for the courses is available until June 2025.

  • Q Do the courses include questions from NBCRNA exams?

    To maintain the integrity of NBCRNA exams, we cannot include any live test materials in the course. However, the types of items in the examples are representative of items on NBCRNA exams, and most do concern nurse anesthesia.

  • Q Do I have to take the courses at a specific time?

    The courses can be completed any time of day or night, any day of the week.
  • Q Do I have to take the courses in a specific order?

    Yes. The Foundation course is a prerequisite for the Alternative Question Formats course.

    Within each course, there is also an order of required course elements that participants have to follow. Videos have to be watched in order, and all requirements have to be completed before taking the posttests. But participants can go back to already completed elements as needed.

  • Q How much Class A CE credit can I get?

    The Foundation course is prior-approved by the AANA for 2.00 Class A CE credits. The Alternative Question Formats course is prior-approved for 1.75 Class A credits.

  • Q What are the course objectives?

    Foundation:

    • Identify some important statistical terms in testing.
    • Detail the process that results in an exam content outline.
    • Outline the steps in the life cycle of an item.
    • Summarize 2 methods for standard setting.
    • Explain the test theory behind item-writing best practices.
    • Name the key elements of a multiple-choice question.
    • Identify common psychometric flaws in multiple-choice item stems.
    • Select appropriate methods of revision for sample flawed item options.
    • Apply important terms used to describe common item flaws.
    • Distinguish different levels of skill and knowledge tested by multiple-choice items.
    • Construct items to reach higher levels of Bloom's taxonomy.

    Alternative Question Formats:

    • Identify advantages and disadvantages of multiple-choice questions.
    • Distinguish more effective revision choices from less effective ones.
    • Contrast alternative question formats with multiple-choice items.
    • Appropriately convert multiple-choice items into alternative question formats.
    • Write clinical case scenario items that apply clinical knowledge in a real-life context.
    • Distinguish questions that are related to an initial clinical case from standalone questions.
    • Identify some of the challenges of writing scenario-based question sets and how to address them.
    • Q Who can take the courses?

      The courses are aimed at nurse anesthesia program administrators and faculty, but anyone can register for them. However, only nurse anesthetists can receive Class A CE credit approved by the AANA.

    • Q How do I register?

      To register for the courses, please click here. Follow the instructions listed in bullet points at the top of this page.



    • Q How do I get my Class A CE credit?

      When you pass the posttest for a course and complete the online course evaluation, you will be able to print out a certificate. NBCRNA will report completed Class A CE credits to the AANA at the end of the month. It will not be possible to obtain immediate credit for completing the courses.
    • Q Is there a posttest?

      Per AANA requirements for this type of Class A CE program, there is a posttest for each course that requires a passing score of 80%. There are no time limits on the posttests. There are no practice questions for them either, although checkpoint questions during the videos touch on some of the same content.

      After you finish a test, you will immediately know whether you passed or failed. You will be able to see your entire test performance after you fill out the course evaluation.

      If you do not pass the posttest, you will not receive Class A CE credit for the course, nor will you be able to retake the course or the test per AANA requirements. Reviewing course materials before the test is strongly encouraged.

    • Q How much do the courses cost?

      Course 1: Item-Writing Theory and Practice: Foundation (3rd ed.) can be purchased for $50. Upon completion of the Foundation course, you will be automatically registered for Course 2 at no additional cost. 
    • Q What equipment do I need?

      It is better to take the courses on a PC rather than a tablet or mobile phone, as some course elements may not present as well on a smaller screen. You will also need a good broadband connection, preferably at least 2.5 Mbps, to view the video elements. Chrome is the recommended browser; we have seen some issues reported using Firefox, so that browser is not recommended at this time. 

      Other important parameters include:
      CPU: 2 GHz
      Memory: 2 GB RAM (32-bit) or 4 GB RAM (64-bit)
      Operating System (at least): Windows 7, Mac OS X 10.7, iOS 6, Android 4
      Screen Resolution: 1024 × 768
      Browser Plugins: Flash Version 10.1

    • Q Whom do I contact about technical issues?

      Please contact learning@nbcrna.com