title: Measuring grade inflation: a clinical grade discrepancy score.
abstract: Grade inflation presents pedagogical and safety concerns for nursing educators and is defined as a "greater percentage of excellent scores than student performances warrant" (Speer et al., 2000, p. 112). This descriptive correlational study evaluated the relationship of licensure exam-style final written exams and faculty assigned clinical grades from undergraduate students (N = 281) for evidence of grade inflation at a private undergraduate nursing program in the Northeast of the United States and developed a new measurement of grade inflation, the clinical grade discrepancy score. This measurement can be used in programs where clinical competency is graded on a numeric scale. Evidence suggested grade inflation was present and the clinical grade discrepancy score was an indicator of the severity of grade inflation. The correlation between licensure-style final written exams and faculty assigned clinical grades was moderate to low at 0.357. The clinical grade discrepancy scores were 98% positive indicating likely grade inflation. Some 70% of clinical grade discrepancy scores indicated a difference of student licensure-style final written exams and faculty assigned clinical grades of at least one full letter grade (10 points out of 100). Use of this new measure as a tool in exploring the prevalence of grade inflation and implications for patient safety are discussed.
authors.affiliation: William F. Connell School of Nursing, Boston College, 140 Commonwealth Ave., Chesnut Hill, MA, USA; Pioneer Valley Family Medicine, Baystate Health, USA. Electronic address: paskausa@bc.edu.
authors.forename: Anna L
authors.initials: AL
authors.lastname: Paskausky
authors.affiliation: William F. Connell School of Nursing, Boston College, 140 Commonwealth Ave., Chesnut Hill, MA, USA. Electronic address: colleen.simonelli@bc.edu.
authors.forename: M Colleen
authors.initials: MC
authors.lastname: Simonelli
mesh_terms: D000124:Achievement; D000293:Adolescent; D002983:Clinical Competence / Q000592:standards*; D004508:Education, Nursing, Baccalaureate / Q000458:organization & administration*; D004521:Educational Measurement / Q000592:standards*; D005181:Faculty, Nursing; D005260:Female; D006801:Humans; D008004:Licensure / Q000592:standards*; D008297:Male; D009511:New England; D012016:Reference Values; D013223:Statistics as Topic; D013338:Students, Nursing; D055815:Young Adult
keywords: Clinical competence; Grade inflation; Grading; Nursing education