Section A: Formative Assessment Blueprint
Criteria Task
TASK A
A1. Assessment overview Assessment Type: Quiz
Purpose: The purpose of this quiz is to assess the student’s understanding of resources available to communities for accessing health care services as well as the role of the community health nurse.
Expected Outcome: Student will be able to accurately identify community resources available at the local, state and federal levels by obtaining a passing grade on the quiz. Students will demonstrate knowledge of the role of the community health nurse as well as how she prioritizes her responsibilities by answering quiz questions correctly.
A2. Module title Introduction to Community Health Nursing
Course objectives By the end of this course students will:
1) Assess community health needs to include access to health care providers, pharmacological interventions and referral services within the community
2) Differentiate the role of the community health nurse to the role of other nurses within local facilities
3) Prioritize responsibilities of the role of the community health nurse
Student learning outcomes 1) By the end of this module students will observe the role of the community health nurse for a minimum of eight hours to experience responsibilities of the community health nurse
2) By the end of this module students will be able to research health care resources available for communities at the local, state and federal levels to include at least five local resources to refer patients to
A2a. Assessment Activity Alignment

The quiz that is assigned for this module will assess the student’s ability to identify community health needs and services that allow members of a community to access health care providers which is one of the responsibilities of the community health nurse compared to other nurse roles. The assessment will also include questions that require students to refer individuals to health care resources. After the observation experience of the community health nurse’s role, the student will be able to transfer that knowledge in answering questions asked throughout the quiz and be knowledgeable of local, state and federal level resources. Question #1 – #5 aligns with course objective #2 and #3, which require students to know the roles and responsibilities of the community health nurse, as well as student learning outcome #1, which has the student observing the community health nurse’s role. Multiple-choice question #6 and #7 align with student learning outcome #2, which requires students to be able to research health care resources and refer individuals to the appropriate ones. Multiple-choice question #8 aligns with course objective #3, which identifies another responsibility of the community health nurse, communication and collaboration. Multiple-choice question #9 and #10 align with course objective #1 and #3, which requires students to be able to appropriately assess community health needs, one of the community health nurse’s roles. Community health nurses must be culturally competent to do this. Each of the items on the quiz align with one or more of the course objectives or student learning outcomes.
A3. Cognitive level Analyzing & Evaluation
A4. Item Types Multiple-choice items and sequence question
A5. Number of Items 10 (five multiple-choice and 5 sequence)

Section B: Formative Assessment Instructions

B1. Assessment Instructions
This 10-question quiz will assess your understanding of the role of the community health nurse, recognition of prioritizing responsibilities and community resources for accessing health care. The quiz consists of multiple-choice questions as well as sequence questions. After reading assigned material and completing your observation experience, you will complete this quiz, in the classroom, during week 4 to check your understanding of material. Once completed, please turn in to your instructor for grading.

B2. Formative Assessment Activity
This 10-question quiz will include five multiple-choice items about local, state and federal level resources available to communities in accessing health care services as well as roles and responsibilities of the community health nurse. The five sequence questions will require the student to prioritize the actions of the community health nurse.

Questions 1-5 Prioritize the following five items in terms of importance for the role of the community health nurse as discussed in your assigned readings.

1) ___________________ A. Organizing community health events to keep the public informed
2)____________________ B. Protecting the health of communities and preventing disease
3) ___________________ C. Maintaining a list of local resources for health care services
4) ___________________ D. Identifying risk factors in the community that can affect health
5) ___________________ negatively
E. Ensuring that brochures and other material are available in
multiple languages for public education
Multiple-Choice:

6) A client asks you which of the following websites they can access to find out information about health care related resources that are provided at the federal level. After evaluating the needs of this individual, which of the following resources do you provide to the client?
A. The website to the local health department
B. The website to Centers for Medicare and Medicaid Services
C. The website for the Virginia Community Healthcare Association
D. The website for the Department of Social Services

7) A young mother asks the community health nurse how she can get food locally for her family after finding out that her husband will be out of work for the next three months due to an injury. The community health nurse provides information on which of the following resources to the client to assist her in obtaining food for her family?
A. U.S. Department of Food and Administration
B. Food and Nutrition Service U.S. Department of Agriculture
C. Centers for Medicare and Medicaid Services
D. Local department of social services that offers Supplemental Nutritional Assistance
Programs (SNAP)

8) Which of the following nurse roles is a primary role of the community health nurse?
A. Communicating with stakeholders, families and individuals to identify community
health care needs
B. Assessing community health needs every five years
C. Requiring all community members to be employed, in some capacity, to receive health
care referrals
D. Disregard policies as community health nursing is its own specialty of nursing

9) In order to provide education on health maintenance and disease prevention to communities, it is important that the community health nurse do which of the following?
A. Maintain cultural competence and cultural sensitivity
B. Ensure that members of the community are able to understand the primary language
that is spoken within that community
C. Assess community health needs once every ten years
D. Ensure that all educational brochures come in every language that is spoken within the
Community

10) Identifying health needs within a community is vital for the community health nurse to be able to promote health within the community for which of the following reasons?
A. Identifying community health needs will allow the community health nurse to single
out individuals and families who choose not to vaccinate
B. Identifying community health needs will allow the community health nurse to focus on
interventions that will create the most positive outcomes within the community and
prevent diseases
C. Identifying community health needs will preserve community resources just for those
individuals that can afford to pay for them
D. Identifying community health needs allows the community health nurse to change the
environment to improve health outcomes

Key
1) B
2) D
3) C
4) E
5) A
6) B
7) D
8) A
9) A
10) B

B2a. Feedback and Goal Setting Language
Graded quizzes will be returned to students and results will be discussed as a group. First, questions that were answered correctly by a majority of the students will be highlighted in the discussion and strengths of the group as a whole will be discussed. Students that missed questions that were answered correctly by a majority of the class, will be encouraged to seek clarification about why they got it wrong through class or small group discussion. Next, I will use data from the results of the quiz to identify and discuss areas of weakness. Questions missed by more than 25% of the class will be thoroughly discussed, along with rationales of why the correct answer is what it is. I will provide students with resources to remediate on questions that were missed and allow small group discussions to discuss incorrect answers and encourage students to share ideas about how to remember the content that was asked in the quiz. Students will be encouraged to set goals to identify their weaknesses with certain concepts. Students will be encouraged to set goals to master concepts such as reviewing remediation material provided to them. The goal of the quiz will be to score an 80% or higher, however, a score below 80% does not mean that the student failed. It would highlight the need for further remediation.

Section C: Formative Assessment Implementation and Evaluation Plan

C1. Assessment Administration Procedures
The faculty that taught the material for this quiz will administer this assessment. This assessment will be administered after the student completes the observation experience of the community health nurse, which will occur about halfway through the module (week 4 to week 5). There will be a 30-minute timeframe on the quiz and students will need pencils to fill in the scantron where the answers will be placed for this quiz. No additional resources will be needed.

C2. Communication of Assessment Results
With the utilization of scantrons for grading, grades will be returned to students the same day. The graded scantron will allow students to see which questions they missed and which ones they answered correctly. The scantron and quiz itself will be returned to the student for initial review then the quiz will be turned back in to be stored by the instructor. The scantron will also provide a percentage-based grade.

C2a. Pass/fail criteria
The pass/fail criteria will not apply to this assessment. A grade will be applied to this assessment, however, the grade will inform students of where their current knowledge of community resources and the role of the community health nurse in utilizing those resources stands. This grade will potentially be modifiable. Students will be required to remediate on the materials provided to develop the content of this quiz, such as assigned readings, to correct any quiz items that were answered incorrectly with a rationale. Points can be earned back with accurate completion of quiz questions with appropriate rationales to allow students to learn from their previous incorrect answers.

C3. Analytical Methods
The detailed scantron report of quiz grades will allow me to analyze the items that were answered correctly as well as the ones that were answered incorrectly. It will also allow me to analyze the number of students that answered each question correctly and incorrectly. With these scores, I will be able to determine the median score, standard deviation, item difficulty and item discrimination. The median score will provide me with a class average taking into account all grades within the class. The standard deviation will allow me to assess the variability of grades and how far away from the mean score that they are. The item difficulty will allow me to identify if there was a particularly difficulty question that was missed by the majority of the students that may need to be modified for future testing. The item discrimination will provide me with information on how students scored on a particular question compared to their overall score on the assessment. I can use this information to determine if the question may have been too difficult as well.

C3a. Assessment Improvement
Short-term goals would include thoroughly reviewing the results of the quiz and identifying potential knowledge gaps to be reviewed with the students. After doing this, the next step might be dropping items that the students did poorly on and re-grading the quiz to evaluate student improvement. The students will be able to correct any missed quiz items along with providing rationales to earn points back on their scores. A long-term goal would identifying items that were answered incorrectly by the majority of students and ensuring that they align with the student learning outcomes and course objectives. If they do not align with the student learning outcomes and course objectives then they need to me omitted from this assessment for future use or rewritten to ensure learning outcome alignment.

C4. Test Security Procedures
Procedures to ensure test security would be having the faculty store the quizzes in a locked environment such as an educator’s office or electronically so that they will only be printed when needed then shredded after the fact. Faculty must collect all quizzes, only returning the scantron to the student after completion. If remediating, students may hold on to the quiz questions, but only have possession of them in the classroom where they can be monitored by the educator. In the event that there is a breach in test security, any hard copy of the quizzes will be shredded and the electronic version will be discarded. A new quiz will be created ensuring that answers on the new quiz do not line up with answers on the scantron of the previous quiz. All new questions will be created.

Section A: Summative Performance Assessment Blueprint
Criteria Task
TASK A
A1. Assessment overview Assessment Type: Case Study
Purpose: The purpose of this case study is to identify methods of delivering education to members of a community in regards to disease transmission and pediatric immunizations as a preventative measure. Students will explain how diseases are tracked and monitored as well as how to deliver education to members of a community based off of their educational needs.
Expected Outcome: Student will appropriately identify and analyze knowledge gaps that exist in relation to disease transmission and preventative measures such as pediatric immunizations. Students will be able to identify such gaps and deliver education to communities that align with community learning needs. Students will correctly demonstrate methods of monitoring and tracking disease within a community.
A2. Module title Preventing Communicable Disease within the Community
Course objectives By the end of this course students will:
1) Analyze outcomes of pediatric immunization administration schedules
2) Establish methods to educate communities about preventing disease transmission through appropriate hygiene
3) Explain processes for reporting communicable disease cases within the community
Student learning outcomes 1) After reviewing pediatric immunization schedules during this module, students will teach a minimum of three parents and/or caregivers about the benefits of adhering to recommended immunization schedules.
2) By the end of this module, students will be able to compare and contrast different ways to deliver proper hygiene education to individuals and communities.
A2a. Assessment Activity Alignment
The case study assigned with this module will allow the students to gather data that supports pediatric immunizations and educate members of the community on the importance of those immunizations as well as when children should receive them. This case study will include a family that has several knowledge gaps when it comes to disease prevention and transmission that the student nurse must address. The case study will require students to analyze and establish ways that they can effectively educate community members on disease prevention, transmission and monitoring and tracking of diseases. During this case study, students will determine the best methods to educate parents and/or caregivers about immunizations and disease prevention strategies. Students will also demonstrate effective ways to deliver hygiene education to individuals and communities. Question #1 and #2 align with student learning outcome #1, which require students to establish methods of education and teach individuals. Students must understand how a lack of education or social contact can limit one’s ability to learn complex materials. Students must also know how to assess an individual’s understanding of material. Question #3 aligns with course objective #1 and student learning outcome #1, which requires students to analyze pediatric immunization schedules and provide education to individuals about immunization schedules. Question #4 aligns with student learning outcome #1, which requires the student to educate patients about pediatric immunization schedules. This can also include where to obtain such immunizations. Question #5 aligns with course objective #2 and student learning outcome #2, which requires the student to establish methods to educate about the transmission of communicable diseases and deliver this education to individuals. Question #6 aligns with course objective #2. When creating a method to educate someone, the student must also know how to assess if that method is working in helping the individual to learn. Question #7 aligns with course objective #2, which requires the student to educate communities on disease transmission. Question #8 aligns with course objective #3, which requires students to be knowledgeable of how diseases are tracked and monitored through reporting processes. Each of the short answer questions provided in this case study align with one or more course objectives or student learning outcomes.
A3. Cognitive level Analyzing & Applying
A4. Item Types Short answer responses
A5. Number of Items 8

Section B: Summative Performance Assessment Title

B1. Assessment Instructions
A case study involving patients and/or caregivers of small children and members of the community who require additional knowledge about pediatric immunizations, disease prevention and monitoring of diseases will be provided to students. Throughout the case study, short-answer questions will be need to be answered, in order, after reading each section of the case study. Once the case study is completed it is to be turned in to the instructor. At the end of the case study, small group discussion about your answers will occur with your peers. We will then discuss the case study as a group and review the correct short question answers. Rationales will be discussed, as well as student knowledge in identified areas such as pediatric immunization schedules and education delivery methods.

B3. Summative Performance Assessment Activity
Students will read through the following case study and answer each question as they arrive to it. All answers will be written directly on the case study and a pencil will be required. Student knowledge of material and transfer of knowledge will be evaluated within the rubric. The case study will be as follows:

Elizabeth is a 26-year-old mother of two small children that has contacted the local health department to gather information on pediatric immunizations for her children. Her children are ages three months and two years old. She has not had either of them vaccinated and is concerned about them acquiring mumps, which has been reported in her community recently. Elizabeth is a stay at home mother and has chosen to not vaccinate her children due to her plans of homeschooling them and not participating in public daycares or education. Elizabeth is a high-school graduate that has never been employed. Her husband is a factory worker that provides for her family financially.

1) Explain how Elizabeth’s level of education and current employment status affect her ability to make an informed decision about vaccinating her children.

2) Determine how you would ensure that Elizabeth understands the information that you are providing to her.

Elizabeth questions the community health nurse about pediatric immunization schedules. She wants to know if it is too late to start vaccinating her two year old. Elizabeth also wants to know what the potential complications with starting a vaccination schedule at two years old are.

3) Examine local resources that you could refer Elizabeth to as well as online resources.

4) Determine how you would go about referring Elizabeth to these local resources.

In addition to immunizations, Elizabeth asks the community health nurse about other measures to prevent her children from contracting communicable diseases. She asks, “What can I do when I am out in public to protect them?” Elizabeth also questions how she can educate herself on local outbreaks of communicable diseases and ways that she can educate her family members.

5) Prioritize hygiene methods that Elizabeth can utilize in public settings to help prevent the spread of communicable diseases.

6) Distinguish the best way to ensure that Elizabeth is able recall the hygiene methods that you discuss with her.

7) Develop a plan with Elizabeth on how to educate members of her family on disease prevention methods when it comes to transmission.

8) Explain ways that community health nurses track and monitor disease processes.

B3a. Summative Performance Assessment Rubric

Criteria Needs Work (0) Partially Correct (5) Full Credit (10)
Ability to identify knowledge gaps and factors affecting health care knowledge Student does not identify knowledge gaps or individual factors that affect health care knowledge based off the given scenario Student does not clearly understand how an individual’s level of education and employment status effects knowledge of preventative health or an in-depth explanation is not provided Student correctly states the effects that level of education and employment status has on an individual’s knowledge of preventative health
Develops an accurate method to evaluate an individual’s understanding of information Student does not state two reliable methods for assessing an individual’s understanding of information Student states two methods of assessing and individual’s understanding of information, but methods are not reliable or are unclear Student correctly states two reliable methods for assessing an individual’s understanding of information discussed with them
Identification of resources to refer community members to Student lists zero local resources or credible online resources that provide pediatric immunization schedules

Student lists local resources only or online resources only that can be used to gain information on pediatric immunization schedules Student lists local resources and credible online resources that can be used to obtain accurate information on pediatric immunization schedules
Ability to appropriately refer individuals to local health care resources Student does not provide appropriate referrals to individuals for needed health care resources Student provides referrals to individuals, however, referral information is too much or too little and how the individual should contact the resources is not clear Student explains the correct way to refer an individual to local resources by providing them with appropriate contact information and ensuring that such resources provide services needed by the individual

Knowledge of disease transmission Student does not demonstrate knowledge of disease transmission or appropriate hygiene methods Student does not demonstrate knowledge on both disease transmission and appropriate hygiene methods or does not prioritize these methods appropriately
Student demonstrates an in-depth understanding of disease transmission and appropriately prioritizes hygiene methods that are used to prevent disease transmission
Assesses teaching outcomes Student does not identify an accurate way to assess an individual’s understanding of information or how to perform any skills associated with the information
Student identifies a way that an individual can recall information, but the method is not reliable or is not specific enough to determine understanding of any skills required Student identifies the best way to assess an individual’s ability to recall information provided to them with specific information on any skills involved in the teaching
Delivers education to individuals that does not have a health care background Student does not identify an individual’s understanding of information provided and does not develop a plan that the individual can use to educate others Student demonstrates the ability to recognize how an individual best receives information, but fails to develop a method of teaching others that is easy to use by non-health care individuals

Students demonstrate the ability to recognize how an individual best retains information and successfully develops a method of teaching that can be easily used to teach others
Knowledge of disease tracking methods Student does not list any credible websites for finding disease statistics and/or does not correctly identify how diseases are reported and tracked by community health nurses Student lists 1 credible website for finding disease statistics and/or correctly identifies 1 way that diseases are reported and tracked by community health nurses Student lists 2 credible websites for finding disease statistics and correctly identifies 2 different ways that diseases are reported and tracked by community health nurses
Points
Total points /100

Section C: Summative Performance Assessment Implementation and Evaluation Plan

C1. Assessment Administration Procedures
The case study will be administered at the beginning of class in week four, as we are completing our first half of the course. This case study is independent work and your instructor will be present during completion of this assignment. You will have one hour to complete this case study. That will allow time for you to use your learning resources to provide accurate and thorough answers to the questions asked throughout your case study. You will need a pencil, your laptop and the assigned textbook for this course to successfully complete the case study. These resources will be used to gather information such as local resources for community referrals and accurate pediatric immunization schedules.

C2. Communication of Assessment Results
The rubric will provide each student with their score. The rubric will help the student to identify areas of the assignment that did not meet expectation by providing detailed feedback. Seeking 1:1 feedback from the instructor during office hours will be offered in order to assist students in understanding their feedback provided on the rubric.

C2a. Pass/fail criteria
A numerical grade will be assigned to this assessment based off the rubric provided. That numerical grade will be aligned with a letter grade to provide students with a pass/fail status. Students must obtain a C or greater to pass. The letter grades will be as follows:

A – 90-100
B – 80-89
C – 70-79
D – 61-69
F – 60 and below

C3. Analytical Methods
I will analyze the distribution of grades to determine how the class did as a whole on this assessment. I will then review each student assessment grade to try and identify areas of content that need improvement and areas that met competency for full credit. This will assist me in determining the reliability of the assessment. By identifying areas were students performed poorly, I can identify knowledge gaps and areas of the assessment that may have potentially had a high difficulty level. This will allow me to analyze any potential changes that need to occur in the delivery of content to help the students better learn that information and align the content with student learning outcomes. Item discrimination results will also help me to determine the level of difficulty in a particular question or area of content.

C3a. Assessment Improvement
After thoroughly reviewing assessment results I will determine if the student learning outcomes and course objectives were met. If there appears to be an area of weakness in a particular course objective or student learning outcome then I will try and identify which area of the course could benefit from change to better assist learners in reaching these goals. My short-term improvement goal would include reviewing the rubric to ensure that it accurately reflects the content being delivered in the case study. I would also evaluate the information provided in the case study to ensure that it is detailed enough to provide the student with the information they need to correctly respond to the questions. Since this assessment is administered at the halfway point of the course, there is still time to assist the students in understanding certain concepts that they may be struggling with prior to taking the final assessment. My long-term improvement plan would consist of making improvements within the course to ensure that learners obtain the knowledge that is required to meet the stated goals. This could be adding on additional assignments or modifying assignments that already exist. I may also need to modify my rubric to ensure that the criteria is weighted fairly to provide the student with a clearer picture of expectations.

C4. Test Security Procedures
To ensure test security I will provide the students with the rubric at the beginning of the course to allow them to adequately prepare for the timed assessment and review all content that will be required to be successful on the assessment. With the case study being administered in the classroom in the presence of faculty, independent work can be monitored. This would require that students not access means of communication while on their laptops that could potentially lead to cheating. This would need to be monitored by faculty as well and any available software to assist with such monitoring. All case studies will be submitted at the end of the hour in which testing will occur. Students will not be allowed to keep the case studies after they have reviewed their grades. In the event of a test security breach, the case study will either be destroyed or all questions will be discarded and new questions will be created. If the case study itself can be preserved and only the questions recreated, it would be a less time consuming solution. However, in the event that a breach is suspected, it may be best to disregard the entire case study along with questions. When the new case study is created information should be very different then the information provided in the previous case study.
Section A: Summative Objective Assessment Blueprint
Criteria Task
TASK A
A1. Assessment overview Assessment Type: Exam
Purpose: The purpose of this assessment is to evaluate the students’ ability to appropriately identify and classify barriers to accessing health care as they relate to communities and individuals residing in communities. This assessment will allow the instructor to analyze if course outcomes and student learning objectives were met by the end of this course.
Expected Outcome: Student will appropriately identify and categorize modifiable and non-modifiable social determinants that affect a community member’s ability to access health care resources. Through appropriate identification of such barriers, students will be able to educate community members and assist them in accessing health care resources.
A2. Module title Social Determinants of Accessing Community Health Care Resources
Course objectives By the end of this course students will:
1) Evaluate the different types of health care resources available within communities
2) Classify modifiable versus non-modifiable social determinants present within communities
3) Develop methods to evaluate the presence of social determinants
Student learning outcomes 1) By the end of this module, students will identify three modifiable and three non-modifiable social determinants that affect access to health care.
2) By the end of this module, students will summarize five social determinants that affect access to health care resources within the community.
A2a. Assessment Activity Alignment

This assessment will require students to transfer knowledge into decision making as they choose the correct answers on their exam. Students will be expected to provide correct responses on how to identify the presence of social determinants as well as how to educate individuals on identifying social determinants in their environments. This assessment will evaluate student knowledge of the types of social determinants, factors affecting access to health care and environmental factors that can affect health. Exam question #1 aligns with student learning outcome #2, which requires the student to be able to identify social determinants. Question #2 aligns with course objective #1 in which the student must be knowledgeable of health care resources within the community and how to access them. Question #3 aligns with course objective #2 and student learning outcome #1, which requires the student to know that both modifiable and non-modifiable social determinants exist as well as how the affect health and the access to health care. Question #4 aligns with course objectives #1 and #2 by requiring the student to identify that transportation is a modifiable social determinant that can affect access to health care. Question #5 aligns with course objective #3, which requires the student to evaluate the presence of social determinants. Question #6 aligns with course objective #1, #2 and #3 as well as student learning outcome #1 and #2 as recognizing and addressing social determinants are important in health promotion and disease prevention. Question #7 aligns with course objective #3, which requires the student to be able to identify social determinants. Question #8 and #9 align with course objective #3, which requires students to explain methods to help evaluate the presence of social determinants. Question #10 align with course objective #2 and #3 which require students to have an understanding of what social determinants are and how to analyze them.
A3. Cognitive level
Analyzing & Applying
A4. Item Types
Multiple-choice and select all that apply
A5. Number of Items 75 (10 examples provided below)

Summative Objective Assessment

B1. Assessment Instructions
This assessment will be administered in an online format. You will be required to use a lockdown browser on your device that prevents you from viewing anything but the test during testing. You will need to download this application prior to testing if testing from a home computer. You will sign up for a test time if testing on campus. If testing from home, you will need to let your instructor know of your test date and time so that the assessment is made accessible at that specified time. You will be allowed 1.5 hours for completion of 75 multiple-choice and select all that apply questions. This is independent work and you may not use any resources during the test. Please allow 24 hours for test results to be posted.

B4. Summative Objective Assessment

1)Which of the following is considered to be a physical determinant of health?
A. Public safety
B. Built environment such as building and sidewalks
C. Quality of education
D. Social norms and attitudes

2) Which statement by a client, in regards to accessing health care resources within the community, would require additional education by the nurse?
A. “Since I do not have health insurance, I am unable to have access to a primary care
physician.”
B. “There are resources available to me within the community to obtain medical
assistance when I need it even though I am unemployed.”
C. “The local health department can provide me with guidance as I am searching for a
primary care provider for me and my family.”
D. “Everyone, including myself, has access to health care. I just need to know which
resources will offer me services based upon my income and health insurance status.”

3) Which of the following statements should the nurse include in client teaching when discussing effects of social determinants on health?
A. “Social determinants are non-modifiable health care barriers that exist within one’s
community.”
B. “Every community experiences the same social determinants, therefore, every
community should address these determinants in the same manner.”
C. “Social determinants usually have positive effects on health and individuals do not
need to stress over.”
D. “Some social determinants are modifiable and modifying them once they are
identified can improve health outcomes and decrease disease occurrences.”

4) Which of these instructions should the nurse include when talking with the client who is concerned about not having transportation to medical appointments?
A. “Unfortunately you may have to miss or reschedule your appointments if you know
ahead of time that you will not have transportation.”
B. “It is most reliable to assume that a friend or family member can take you to your
appointments.”
C. “Taxi cabs are always available in the event that you do not have finances for reliable
transportation.”
D. “You may want to speak with your physician about telehealth and scheduling your
appointments when you know you will be coming to town.”
5) Which of the following factors can affect health outcomes? (Select all that apply)
A. Quality of schooling
B. Cleanliness of water, food and air
C. Access to social and economic opportunities
D. Size of our homes
E. Safety of our workplaces
6) The community health nurse is explaining the goal of public health nursing to a nursing
student. Which statement best identifies the main goal of public health nursing?
A. Public health nursing ensures that people stay organized with their health efforts and
attend all recommended physician appointments.
B. Public health nursing strives to promote health and prevention of disease.
C. Public health nursing ensures that all people can pay for their health care services.
D. Public health nursing focuses on curative services in attempt to keep disease processes
from advancing.
7) Which of the following statements by a client requires further education by the nurse?
A. “Since I live in a rural area, I do not have to worry about factors such as pollution
and unhealthy chemicals, that exist in cities that may negatively affect my health.”
B. “The location of my home and the environment around it may be exposing me to
factors that could have a negative impact on my health.”
C. “Since I do not have reliable transportation, I should reach out to resources available
within my community that could assist me with transportation to ensure that I am able
to keep my doctor appointments.”
D. “It is important for me to be knowledgeable of potential occupational exposures that
could negatively affect my health so I can protect myself while on the job.”
8) Which of the following are ways that the community health nurse can assess for the presence of social determinants within a community? (Select all that apply)
A. Ask social questions when talking to individuals to include employment, social
support and transportation reliability
B. Visit the homes of all community members to gain a better understanding of their
surroundings
C. Stay informed about location of health care resources and services they offer within
the local community
D. Mail out questionnaires to see if any community members have concerns about their
community
E. Be knowledgeable about water and food supplies as well as urban/rural conditions
around the community
9) When assessing health needs of a community, the nurse knows that assessing social
determinants is included in which type of health assessment?
A. Physical assessment
B. Primary assessment
C. Secondary assessment
D. Comprehensive assessment

10) After speaking with a client, the nurse correctly identifies that which statement made by the
client indicates the presence of a social determinant that may affect health outcomes?
A. “I am currently in my fourth year of college and plan on graduating this spring!”
B. “There seems to be a lot of community-based resources in my area to assist with
community living.”
C. “I live next to farmland and they are frequently spraying stuff on their fields to help
their crops grow.”
D. “I have a cell phone and internet connection that allows me to communicate with my
friends and family.”

B4a. Summative Objective Assessment Answer Key

1) B
2) A
3) D
4) D
5) A, B, C, E
6) B
7) A
8) A, C, E
9) D
10) C

Section C: Summative Performance Assessment Implementation and Evaluation Plan

C1. Assessment Administration Procedures
The exam will be administered on-site by faculty at the educational institution. The assessment will be given during week eight of the module, which is the last week. The assessment will include a variety of material covered in the course. There will be a one and a half hour timeframe to complete this test given that the test is 75 questions. Students will only need access to their computers here on campus for this exam as it is a closed-book, closed-note exam in which resources are not allowed. Students will shut down their computers and exit quietly upon completion.

C2. Communication of Assessment Results
Students will receive test results within 24 hours. This allows time for the instructor to review the results and pull data to analyze the results prior to having students ask questions about their grades. The results will be automatically entered into the gradebook and the instructor will have the capability of printing off individual test reports for each student in the event that they have question about their grades or which specific question they have missed. During the testing process, each question will notify the student if they answered it correctly or incorrectly, as they proceed through the exam as well.

C2a. Pass/fail criteria
The following is the grading scale used for this assessment and a student must score a 70% or greater to successfully pass.
A – 90 – 100
B – 80 – 89
C – 70 – 79
D – 60 – 69
F – 59 and below

C3. Analytical Methods
I will initially review the overall scores focusing on the highest score and the lowest score as well as the median score. I will analyze if the median score is where I anticipated it should be. The median scores will allow me to analyze how the class did as a whole on the assessment. Next, I will evaluate the reliability of the scores. I will use the Kuder-Richardson Formula 20 to determine if the test was reliable and if I could expect similar results if I were to give this test to a similar group of students. Since this is a teacher-made test, I would anticipate a value of 0.6-0.85 to reflect that the questions and content included in the exam were well-written. I would also further assess questions that a majority of students seemed to answer incorrectly. Determining the item difficulty (p-value) of a question can help me to determine if the question was potentially too difficult or did not align with student learning objectives. I will also review item discrimination. On exams where students scored high, I can identify if they also answered certain items correctly that correlate with their overall score. This process will allow me to determine if distractors were well-written within my multiple-choice questions. I will expect that questions that are well-written will have a point biserial index of 0.3 – 0.7.

C3a. Assessment Improvement
In order to determine potential improvements for this assessment I will look at where the class, as a whole, scored on this exam as well as each individual student. My short-term goal would consist of performing an item analysis to see if any items should be dropped from the exam. I would then rescore the exam and evaluate improvements in student grades. If there seems to be a question that the majority of students missed, then I will review that content with the students and attempt to clarify any misunderstandings that they have. I will also provide them with the appropriate resources so that they may review the information on their own as well. For my long-term goals, I will ensure that frequently missed questions align with student learning objectives and that the content specific to that question is indeed covered within the course materials. I may also need to rewrite that specific question or eliminate it altogether based off the data that I collect.
C4. Test Security Procedures
To ensure test security there are multiple things that I can do. I can rotate a certain percentage of questions on the test every time that I give the test. I will also have the students utilize computers that are on campus when they come to test. This will prevent them from saving any information or resources on their personal computers that may be easily accessible during the test. A test ID will be given to the students once they are ready to start the test. This will prevent students from potentially having access to the test prior to when they are scheduled to take it. Providing more than one version of the test will also decrease the chances of students being able to copy one another’s answers. Students will only be allowed to have their computers on their desktops and no other items. In the event of a test security breach, access to the test, since it is electronic, will need to be evaluated. A software breach may exist that requires collaboration with information technology to fix. The test identification access code should be changed. If multiple versions of the test are administered then it will have to be determined which version was involved and if it were more than one version. All versions of the test may have to be recreated.

References
Centers for Medicare and Medicaid Services. (n.d.). Federal resources. Retrieved from https://www.cms.gov/About-CMS/Agency-Information/Emergency/EPRO/Resources/Federal-resources
Nurses for a Healthier Tomorrow. (n.d.). Public health nurse. Retrieved from nursesource.org/publichealth.html
Office of Disease Prevention and Health Promotion. (2014). Social determinants of health. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health
Virginia Department of Social Services. (2017). Supplemental nutrition assistance program. Retrieved from dss.virginia.gov/benefit/snap.cgi