| Course | NR 536 Teaching Core Nursing Concepts: Strategies for Nurse Educators |
|---|---|
| Week | 7 |
| Paper type | Transfer assessment design |
| Length | About 1,110 words, 2 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN, Nurse Educator |
| Updated | September 2026 |
Free sample paper for NR 536 Week 7
Transfer Assessment Design: Six Perfusion Items, Five Built From Patients No Student Has Met in Class, Each Asking for a Classification and the Attribute That Decided It
Student Name
College of Nursing, Chamberlain University
NR 536: Teaching Core Nursing Concepts: Strategies for Nurse Educators
Instructor Name
Month Day, Year
Transfer Assessment Design: Six Perfusion Items, Five Built From Patients No Student Has Met in Class, Each Asking for a Classification and the Attribute That Decided It
Purpose
This design sets out the perfusion section of the unit examination in our third-semester concepts course. Its purpose is to measure whether students can recognize and reason about impaired perfusion in patients they have not met before. An item built from a case the class already studied measures memory of that case and will produce a comfortable score. Last year's examination did exactly that: an item about a septic patient, close to the case taught in class, was answered correctly by 29 of 32 students, while an item about a cold, pulseless foot with a normal blood pressure was answered correctly by only 13. The first item flattered the teaching; the second measured it.
Transfer to situations that differ from the learning context is the goal of concept-based teaching and also the hardest thing to achieve. Barnett and Ceci (2002) described transfer as varying along several dimensions of distance, including the knowledge domain, physical setting, time and the kind of task. This design deliberately places most items at a distance from the classroom exemplars on several of those dimensions at once.
The Blueprint
Table 1 lists the six items, how far each sits from the exemplars taught in class and what it measures.
Table 1
Perfusion Item Blueprint
| Item | Patient | Distance from class exemplars | What it measures |
|---|---|---|---|
| 1 | Septic shock from pneumonia in the emergency department | Near: same condition as a class exemplar, different source of infection | Baseline recognition; anchors the scale |
| 2 | Frostbite of three fingers after a night outdoors | Far: new cause, new setting, local, cold exposure | Recognition of reduced flow from vessel constraint in an unfamiliar cause |
| 3 | Older adult with abdominal pain out of proportion to a soft abdomen and atrial fibrillation | Far: organ not studied, pain as the main sign | Reasoning from mechanism when classic limb signs are absent |
| 4 | Person on hemodialysis with a cold, painful hand on the fistula side during treatment | Far: new setting, flow diverted rather than blocked | Recognition that reduced flow can come from diversion |
| 5 | Person after a house fire with a normal oxygen saturation, pink skin and headache | Boundary: looks well perfused, is not a perfusion problem | Discrimination at the edge: oxygen carrying, not flow |
| 6 | Postpartum patient with heavy bleeding, falling pressure and cool hands | Moderate: shock state not taught in this unit | Recognition across a concept boundary with fluid loss |
Item Format
Each item has two parts. Part A is a classification: is this primarily a perfusion problem, a gas exchange problem, an oxygen-carrying problem or none of these? Part B asks which of the three defining attributes of impaired perfusion, flow, tissue consequence or mechanism, decided the answer, and requires a one-sentence justification from the stem. Part A is scored right or wrong. Part B is scored on a three-point scale: the correct attribute with a justification drawn from the stem, the correct attribute with no usable justification, or an incorrect attribute.
The two-part format addresses a weakness of single-answer items: a student can choose the right classification for the wrong reason, particularly on a boundary item. Requiring the deciding attribute exposes the reasoning. Guidance on writing multiple-choice items recommends that items test important content, avoid clues in the stem and use plausible distractors (Haladyna et al., 2002). Part A follows that guidance. Part B goes beyond it, because recognition of a concept is the outcome being measured and a correct letter alone is weak evidence of recognition.
Writing the Unfamiliar Items
Items 2 through 6 were written under three rules. First, the condition must not have been named in class, in the reading or in the case studies. Second, the stem must contain enough assessment findings for the attributes to be applied without knowing the diagnosis. Item 3, for example, does not name mesenteric ischemia; it describes an older adult with atrial fibrillation, severe abdominal pain, a soft abdomen that is not very tender and a rising lactate. A student who knows perfusion can reason that a clot may have blocked flow to the bowel without ever having heard of the condition. Third, the surface of each item must differ from every class exemplar on at least two dimensions, such as site and setting.
Item 5 is the boundary item. Carbon monoxide poisoning produces tissue hypoxia with normal flow and a misleadingly normal pulse oximetry reading, because the oximeter cannot distinguish carbon monoxide from oxygen on hemoglobin. Students who equate pink skin with good perfusion and low oxygen with poor perfusion will be misled in both directions. The item tests whether they can place the problem in oxygen-carrying capacity, as the unit's concept brief did with anemia.
Why Item 1 Stays
Item 1 is close to the class case, and a design focused only on transfer might drop it. It stays for two reasons. It gives students an early item they are likely to answer correctly, which settles the examination. More importantly, it provides a comparison: the difference between item 1 and the far items shows how much of the class's understanding travels. If students score well on item 1 and poorly on items 2 to 4, the teaching produced near transfer only, and the unit needs more comparison of varied exemplars, as research on analogical encoding suggests (Gentner et al., 2003).
Using the Results
Results will be analyzed by item and by part. A low Part A score on a far item means students did not recognize the concept. A good Part A score with a low Part B score means they chose correctly without being able to say why, which suggests pattern matching. Results will be compared with last year's two items, recognizing that the items differ and the comparison is rough. Part B errors will also be sorted by type. Their distribution, whether students cite the wrong attribute or give no justification, will tell me which part of the concept to reteach in the next unit's opening class. Items that most students miss will be reviewed with a colleague before they are reused, to separate a weak item from a weak area of teaching. An item that fails because its stem is ambiguous tells me nothing about perfusion.
References
Barnett, S. M., & Ceci, S. J. (2002). When and where do we apply what we learn? A taxonomy for far transfer. Psychological Bulletin, 128(4), 612-637. https://doi.org/10.1037/0033-2909.128.4.612
Gentner, D., Loewenstein, J., & Thompson, L. (2003). Learning and transfer: A general role for analogical encoding. Journal of Educational Psychology, 95(2), 393-408. https://doi.org/10.1037/0022-0663.95.2.393
Haladyna, T. M., Downing, S. M., & Rodriguez, M. C. (2002). A review of multiple-choice item-writing guidelines for classroom assessment. Applied Measurement in Education, 15(3), 309-333. https://doi.org/10.1207/S15324818AME1503_5
The Chamberlain NR 536 Week 7 instructions
The Week 7 assignment usually asks you to design an assessment that measures students' ability to apply a concept in new situations. Prompts ask for the assessment items or tasks, how they measure transfer, scoring methods and how results will inform teaching. Build most items from patients or situations students have not met, varied on setting, site and cause. Write stems with enough findings for the concept to be applied without knowing the diagnosis. Include at least one boundary item. Require students to justify their answer by naming the deciding attribute, so correct choices made for wrong reasons can be seen. Plan how you will analyze results. Cite transfer and item-writing sources in APA 7.
How this NR 536 Week 7 example is built
The design opens with last year's two items, one close to the class case and answered well and one far from it and answered poorly. A blueprint table lists six items with their patients, distance from class exemplars and what each measures. A section describes the two-part format and its scoring, supported by item-writing guidelines. Another sets out three rules for writing unfamiliar items and explains the bowel ischemia stem and the carbon monoxide boundary item. A section explains why the near item stays, as an anchor and a comparison. The final section describes analysis by item and by part, the sorting of justification errors and a colleague's review of items most students miss.
Where the points sit in the NR 536 Week 7 rubric
Assessment design rubrics generally reward items aligned with the concept, a clear rationale for how they measure transfer, sound item construction, an appropriate scoring method and a plan for using results. Graders favor designs in which most items are genuinely unfamiliar, with distance from class material stated. Requiring a justification that names the deciding attribute strengthens validity and usually earns credit. A boundary item shows attention to the concept's edges. Keeping a near item for comparison shows measurement insight. A plan to analyze results by part and to review weak items demonstrates assessment literacy. A blueprint table and citations to transfer and item-writing sources support the evaluation.
Common NR 536 Week 7 mistakes, and how to avoid them
The most common weakness is items built from the cases taught in class, which measure memory and produce reassuring scores. Use unfamiliar patients. Another is stems that name the diagnosis, which lets students answer from recall rather than reasoning. Describe findings instead. Students also rely on single-answer items that cannot show why a student chose correctly. Add a justification. Avoid distractors that are obviously wrong. Do not drop all near items, since they give a baseline. Check items with a colleague before use. Finally, decide how you will use the results before the exam, so that analysis leads to teaching changes rather than a grade alone.
Get a NR 536 Week 7 example written to your instructions
Send the Week 7 instructions along with the concept, the item count and any blueprint or table your classroom requires, and tell us which cases were taught so nothing gets reused. A custom example is written to those requirements with the distractor rationales included, and it comes back inside 24 to 48 hours, the first one free.
More NR 536 papers and MSN samples
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NR 536 Week 7 questions, answered
Do the items have to be multiple choice?
No, and mixed formats often serve this design better. A short unfolding case with two open prompts can force reasoning that options would give away, while selected response items make misconception analysis easier to write down. What no format changes is the requirement that the patient in the item be unfamiliar, since a known case turns any format into recall.
How unfamiliar does a far transfer case have to be?
Different on every surface the class might have latched onto, and identical underneath. If the taught cases were adult and hospital based, a far item might sit in a clinic with an infant. What must not change is the concept itself. Once the underlying structure differs, a wrong answer no longer distinguishes a learner who failed to transfer from one who met new content.
Should the design include a rubric for the open items?
If your section asks for one, yes, and even where it does not a short criterion list strengthens the paper. Two or three levels are enough, written around whether the response names the concept's attributes in an unfamiliar patient. A rubric scoring writing quality or completeness instead measures something real but different, and will not detect the failure this design was built to catch.
Where can I find a free NR 536 Week 7 sample paper?
The six-item perfusion transfer design above is the entire NR 536 Week 7 sample, and it may be read without cost. If you need items for another concept, tell us what was taught in class and a design built on unfamiliar patients can be drafted.
Why should NR 536 items use unfamiliar patients?
Because items built from class cases measure memory of those cases. The sample uses five patients no student has met, varied by setting and cause, to test whether the concept itself was learned.