the same time adopting admission practices that more accurately reflect the desired skills and attributes needed by future health professionals? In other words, how can diversity and quality goals coexist in admissions practices?

The chapter will begin with a brief description of the history, intent, and purposes of standardized tests used in higher education admissions. Though the discussion in this chapter is intended to provide general recommendations applicable to admissions policies for all health professions, it must be noted that admissions policies and practices vary considerably among the health profession disciplines studied here. Nursing education, for example, operates in a very different context for admissions decisions, with varying levels of “selectivity” depending on the type of degree program. Admission to many masters degree and doctoral level nursing programs is highly competitive, but admission to registered nurse (RN) education at the college or vocational institutional level is far less competitive than the post-graduate, doctoral educational settings of nursing, medicine, dentistry, and psychology. Many community college nursing education applicants are accepted if they meet minimum criteria for completing required courses, and in many states, community colleges are oversubscribed, and eligible applicants are put on a waiting list or go through a lottery process to matriculate. Even for baccalaureate-level nursing programs, the process is less competitive than for the doctoral health professions programs in other fields. Most of the baccalaureate nursing programs, for example, are at state colleges and not at “elite” universities.

STANDARDIZED TESTS AND HIGHER EDUCATION ADMISSIONS

A Brief Background on Standardized Tests

Historically, standardized admissions tests emerged from the early work of psychometric psychologists who attempted to quantify human intelligence through a variety of testing and assessment tools. In the late nineteenth and early twentieth centuries, these efforts were driven in large part by Darwinian theories of individual variation and natural selection (McGaghie, 2002) but were often accompanied by explicitly racist and eugenicist ideology regarding the racial superiority of European descendants and inferiority of non-Europeans. Many of the leading test developers, such as Alfred Binet, E.L. Thorndike, and others, saw the broad use of intelligence tests as not only an efficient means of distinguishing between individuals of differing intellectual ability, but also as a scientific means of verifying the intellectual superiority of Caucasians and inferiority of non-Caucasian racial groups, in accordance with laws of natural selection (Gould, 1996).

Early efforts to develop achievement tests that could be administered in



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