Effect of Audiovisual Enhancement on Problem-Solving and Decision-Making Activities During a Computerized Clinical Simulation Test (CSTtm) of Nursing Competence

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Abstract
The purpose of this study was to explore the effects of interactive audiovisual (AV) enhancement on examinee problem-solving and decision-making activities during a Computerized Clinical Simulation Test (CST) of nursing competence and to determine which activities were most affected by AV inclusion. Two forms of CST and a questionnaire requesting examinee opinions about CST were administered to two different groups. Findings suggest that no reliability was lost by a change in format. An analysis of the item difficulty calibrations under the different administration conditions revealed that some items (particularly data-gathering items) functioned differently when cases were presented in an AV format. Those exposed to an AVformat presentation took significantly longer to complete the AV-enhanced cases but committed significantly fewer risky and inappropriate actions. Examinees exposed to AV format reported feeling more involved with the patients and better able to identify patient problems.