Technical Documentation 

Employment Test for Nursing Assistants, Nursing Aides, and Home Health Workers

Overview

This technical documentation is designed to meet various professional and legal guidelines. As such it contains language unfamiliar to many human resource and other professionals. We would be happy to answer any questions you have concerning this documentation. Questions on this report may be directed to Technical@workskillsfirst.com  or by calling 804.301.3036.

Test Content

The Nursing Assistant Test contains four sections, two of which are designed to predict attendance and turnover and two of which are designed to predict job performance.

Attendance/Turnover

The first part of the attendance/turnover test provides examinees with various possible reasons for not going to work and are asked if they would skip work or go to work.  An example is provided below.

Sample Item to predict Attendance/Turnover

The circle above Skip Work has been marked because it is OK to skip work for this reason.

The second part of the attendance/turnover test asks a series of questions about work habits and the examinee is asked if the statements are true or false. 

Job Performance

There are two parts to the section of the test designed to predict job performance.  First, examinees read a set of instructions and are asked questions about the instructions.  Second, examinees are asked to solve simple math problems involving addition and subtraction.  All items are provided in the context real issues that are likely to be encountered by a nursing assistant.

Employers seeking to determine the usefulness of the test for a specific job may review the test content to determine the appropriateness of the test for the job. Employers may also consider the reliability and validity evidence presented in this report.

Criterion‑related validity evidence describes the extent to which the test predicts important job criteria. This test yields two scores:

     • Attendance/Longevity

     • Job performance.

The attendance/longevity score predicts both attendance and longevity. Attendance was assessed by a supervisor's rating. Longevity was defined as the length of time one stays in a job. The job performance score predicts job performance as rated by supervisors.

Criterion‑related validity evidence was collected by administering the test to 119 incumbents and by collecting job criteria data. Table 1 presents validity coefficients (Pearson correlation coefficients) between the test scores and their intended criteria. Our data were collected from one hospital, one home care service, and several nursing homes.

Figure 1 shows the probability of excellent attendance as a function of the applicant's score on the attendance and longevity score. Figure 2 shows the probability of staying on the job 5 or more years as a function of the attendance and longevity score. Figure 3 shows the probability of having excellent job performance as a function of the job performance test score.

Table 1. Validity of Test Scores for Predicting Job‑Related Criteria

Note: Sample Size 118‑119.

Figure 1. Probability of Excellent Attendance

Figure 2. Probability of Staying 5 Years or More On the Job

Figure 3. Probability of Excellent Job Performance

This test, although very useful in applicant screening, is far from a perfect screening tool. There will be some applicants who are selected on the basis of this test who will be undesirable employees. Likewise, this test will reject some applicants who would have been acceptable employees. This happens in all selection systems. The incorporation of this test into employers’ current selection systems is intended to reduce such errors.

Applicants can be deceptive when taking the test. Applicants can improve their scores by lying or by enhancing their desirable qualities.  The ODD score described below is our attempt to identify such individuals.

If the test suggests that the applicant will have excellent attendance and stay on the job a long time, but the references and background checks reveal that the candidate has recently had poor attendance and changed jobs frequently, we suggest that more credence be given to the background check and reference information because the best predictor of future behavior is past behavior.

An applicant may obtain a high ODD score by having an unusually large number of desirable qualities. Such applicants may make good employees. However, one may also obtain a high ODD score by exaggerating one’s positive qualities. Such applicants may make less than desirable employees. The dilemma is that it is not readily apparent whether the applicant will be a good or poor employee.  

To assist in making a decision about an applicant with a high ODD score, additional time should be spent with the applicant in interviews and available background and reference information on the applicant should be carefully reviewed.

Norms

The meaning of an applicant’s test score is increased when it can be compared with a reference group. We suggest that the most meaningful norms are those based on your current incumbents and industrial psychologists of Work Skills First can assist you in preparing a norm table for your organization. However, such local norms are not always feasible to collect due to a limited number of incumbents or insufficient resources to test the incumbents.

For those facilities without local norms, we provide norms for the two primary test scales in Tables 2 and 3. These norms were obtained by administering the test to 142 nursing assistants and home health aides in one hospital, two home health care facilities, and several nursing homes. We provide norms for the full sample of 142 incumbents and broken down by hospitals, nursing homes, and home health care organizations. The norms are provided separately by type of organization because the test scores varied meaningfully across the three types of employer. On average, scores are highest for the hospital employees and lowest for the home health care employees. The nursing homes employees tended to score lower than the hospital employees but higher than the home health care employees.

The percentile scores associated with a given test score is the percentage of the employees in the norm group who scored lower than the test score. For example, for the job performance scale for the full sample norm group, a test score of 32 places you at the 55‑56th percentile. This means that 55 to 56% of the norm group scored lower than this score.

Table 2. Test Norms for the Attendance and Turnover Test Score