CLUE TO THE RESOLUTION OF THE NURSING SCANDAL


IF CHEATING HAS BEEN GOING ON FOR YEARS, THEN IT IS BETTER TO BE A 2006 PASSER WHO HURDLED A 390-QUESTION EDITED EXAM CLEANSED OF DETECTED LEAKED QUESTIONS, THAN ONE OF PRIOR YEARS’ PASSERS WHO HURDLED A 500-QUESTION EXAM, ALL RIGHT—BUT INCLUSIVE OF UNDETECTED LEAKAGES!



HOW TO RESOLVE THE NURSING SCANDAL WITH THE LEAST DAMAGE TO FILIPINOS, WITH PROTECTION TO THE NURSING PROFESSION, AND WITHOUT GRAVE INJUSTICE TO INNOCENT PASSERS

POINTS TO CONSIDER

Following are important points to consider in addressing the 2006 nursing scandal:

• We have to realize that the problem has to be resolved expeditiously and decisively because the longer it remains pending, the more bad publicity it generates from damaging exposes by contending parties, the more full blown it becomes--especially if it reaches up to the Supreme Court--the more the nation as a whole will suffer. The net result will be diminished opportunities for our present and future nurses that translate to shattered dreams of many Filipinos.

• This is not to say that the scandal be suppressed. On the contrary, it should be addressed in the most constructive but least destructive way, under the humane but just fundamental philosophy of a democratic society: punish the guilty and spare the innocent. We cannot go wrong by following this dictum, the only question is how to do it.

• However, it is not enough that we punish the guilty and spare the innocent. We have to do something more. We have to prevent future cheating through streamlining the nursing licensure examination system and ridding it of vulnerabilities to corruption in future exams.

• How to punish the guilty and spare the innocent depends on the facts of the case. Based on media reports, the facts or allegations are as follows:

---The cheating consisted of some but not all test questions leaked by two examiners to specified review center officials, passed on in turn to their reviewees. Copies of the leaked questions are available with some complainants.

---The manner of disseminating the leakage through power point presentation in a public place was so blatant. The inference is that cheating has been goingon for years but not caught, which made the perpetrators too bold and careless.

---There are no other evidences presented that would implicate other review centers and examinees in the leakage. 

---Out of 500 total exam questions, 110 were object of leakage and were excluded by the Professional Regulation Commission (PRC) in the computation of grades. Thus, as reported by media, roughly 80% of total exam questions remained valid and were the ones used in testing the competence of 2006 examinees .

THE CRUCIAL QUESTION: DOES THE EDITED EXAM SERVE THE PURPOSE OF THE EXAMINATION? 

CAN’T WE SAY THAT PRIOR YEARS’ PASSERS---PROBABLY INCLUDING COMPLAINING DEANS---HURDLED UNEDITED BOARD EXAMS WITH HIDDEN REDUCED VALID QUESTIONS---BECAUSE THEIR EXAMS WERE SIMILARLY ATTENDED TO BY CHEATING EXCEPT THAT THE LEAKAGES HAVE REMAINED UNEXPOSED TO THIS DAY AS NOBODY SQUEALED? IF THEIR LEAKAGE-INCLUSIVE EXAMS WERE GOOD ENOUGH, THEN THE 2006 PASSERS’ LEAKAGE-FREE EDITED EXAM SHOULD BE MUCH BETTER!

After taking the 2006 exam, the examinees have a vested right in the examination. They are entitled to become nurses for as long as their answers to the test exams are correct to the extent needed, whether the result was released early or late. They are entitled to know the result whether there would be a retake or not, otherwise there would be a hanging question (whether they passed or not) for the rest of their lives—a totally underserved cruel punishment that would show insensitivity to the feelings of 42,000 exam takers. If the innocent passers do not want to give up what they earned through refusing a retake, that is their right. They worked hard to earn it. They have already shown that they deserve it through accomplishing what 25,000 others failed to do.

Some retake advocates pointed out that the edited or reduced exam no longer serves the purpose of the exam. They said that the deleted questions were on very important subjects. Mr. Dante Ang, head of the Task Force created to look into the anomaly, opined that passing only the edited exam—some 80% of original total—has lowered the bar of competence. In reaction,to begin with, the matter is subjective, it is a matter of individual perception, and those who have the burden of proof, those for retake, cannot conclusively prove that they are right, based on the following points:

• If the deleted questions are indeed that important, the passers can very well know the answers to them through going back to their books and, voila, now they know what needed to be known—so onward to oath taking!

• It maybe interposed then that knowing the answers to the deleted questions on a post-facto basis is not the point. What is meant is that the measure of competence has been lessened with the reduction of the exam to 80%, as alleged by Mr. Dante Ang.

The total number of questions set at 500 is arbitrary. It is not cast in stone. Why not 100, or 200, or 1,000, or 10,000? I suppose the 500 total was arrived at because it is the estimated number of questions that can be answered within the test-hours of a two-day board exam. But why two days, why not one, or three? In other words, there is subjectivity, and we should not be straight-jacketed to or imprisoned in the 500-question two-day exam. We should deviate if dictated by compelling reasons because we are not robots who cannot think beyond what is programmed in them.

If what is measured is competence and not the knowledge per se of the excluded leaked questions, then answering 80% of 500 questions should be enough. This means 390 questions successfully answered to the extent needed by 17,000 passing examinees, but not by 25,000 others who did not make it. That 390 total, which represented a cross-section of nursing subjects, is formidable enough. 

Consider NCLEX, for example. There are only 265 exam questions, but even that is not always totally considered. If the examinee answers correctly 60 of the first 75 questions, the computer does not go any further. It automatically declares the examinee as passing. It will only go to the extent of 265 questions if the examinee did not hurdle the first minimum number of questions. If NCLEX can entrust the lives of foreign patients to nurses who passed a much lesser number of test-questions, why can’t we do so on examinees who passed an array of 390 questions? In the first place, complainants simply assume that the passers failed in the excluded 20%, but that may be true for those who did not pass the 390 questions, but not for the passers. For them, it is more the other way around—they could have also passed it. We cannot close our eyes to their hurdling 390 numerous questions. They should be given the benefit of the doubt. Undetermined result—either passed or failed—on 20% of the exam should not prevail over the conclusive favorable result on 80% of it. 

Even the Supreme Court, when the bar exam was rocked by scandal, deviated from standard practice by excluding from the year’s bar exam the particular subject tainted by cheating—Mercantile Law.

• Moreover, even in past exams, there was no equal distribution of questions to subjects. Some subjects have more questions than others—causing many examinees to gripe--and yet there was no accusation then that the passers were not fully tested by the exams.

• We have to accept a hard-to-prove reality—but reality just the same—which has to be considered in decision-making, otherwise the decision-makers will become na├»ve doers of injustice to victimized innocent passers. The injustice can destroy a great part of the victims’ lives. It can cause them hatred and distrust of others, to be manifested in unconscious aggression against society and the government itself for as long as they have not come to terms with the injustice suffered. 

The alleged culprits in the 2006 exam—two examiners and some review center officials—have become so blatant and bold in their modus operandi, like making a power point presentation of the leaked questions in a public place, because of one inescapable reason: cheating has been going on for years without being caught!

The implication then is that in prior years, the true test of the passers’ competence was also not the total 500 exam questions but a much smaller number—only those not subject of leakage. For example, if 200 questions were leaked, only the remaining 300 are valid questions that really tested the examinees’ capability. Worse, unlike in 2006 where the exam was subsequently exorcised of detected leaked questions, thereby producing honorable result, in prior years the undetected leaked questions were not purged, thus producing dishonorable results! Can’t we safely assume then that prior years’ passers, including complaining deans, were products of vitiated licensure exams with questionable and intolerable results? 

Shouldn’t all of prior years’ passers do a retake to purge from their ranks those who passed simply through the benefit of leakage? 

Horror of horrors! If we go by the accusation to 2006 passers whose competence is put in doubt owing to passing an edited exam, that meant many Filipino nurses out there could kill patients! They are those who passed prior years’ leakage-vitiated exams, some of whom are already spread in the four corners of the world. 

However, in actuality, what is the score? Have we been deluged by cases upon cases of malpractice suit against Filipino nurses? Have they turned out as killing machines in hospitals all over the world? No! One reason is, from my own experience as a professional, once one passed the more difficult board exam without books, it is easier in actual practice with open books. Meaning, if in some cases in actual practice one has doubts, he can always refer to his books during off hours, refresh his memory, and find out what to do. 

Under the situation, there is simply no reason to deny the 2006 passers the benefit of the doubt. They passed an edited exam cleansed of leakage, a condition much more honorable than those in the years of the complaining deans where the exams were not purged of leakage. 

WHY EXAM RETAKE IS UNJUST AND WILL DO MORE HARM THAN GOOD

Having a retake, whether full or partial, is grossly unjust to innocent passers. It will create traumatized haters of society long after this scandal is over. This is against the law of probability, under which every year thousands of examinees pass. Declaring zero passer in 2006 by way of retake is simply absurd and insulting to honor graduates and many other deserving members of this batch—and will simply serve as damaging admission to the international community of the stark reality of cheating not only in 2006 but also in prior years’ board exams, with possible irreversible fallout to us. The potential injustice to innocent passers will likewise be hard to bear—because it will be inflicted by their government that will harm them instead of protecting them against the evil impact of the culprits’ wrongdoing. Just remember how the furious passers appeared and talked in TV when they went to PRC on their originally scheduled oath-taking last August 22nd. Please note that one single individual is important. Israel went to war provoked by the kidnapping of just three soldiers—incredibly, even at the cost of more lives! In our case, we are talking of 17,000 innocent passers over whose lives some of us want to play God.

As previously explained, the innocent passers, cleansed of the benefit of leakage, have to be given the benefit of the doubt. They are looked down upon because of what is being said against them, which is unfair. We have to put ourselves into their place to understand them. A retake is tantamount to taking from them what is due them, earned by them through years of diligent effort. Those sworn to do justice to every one have to live by their oath.

As for the exceptional passers who want to retake, fine, let them. But their will should not be imposed on others because we should not make rules on the basis of exception. 

RECOMMENDED WAYS OF RESOLVING THE NURSING SCANDAL WITH THE LEAST DAMAGE TO FILIPINOS, WITH PROTECTION TO THE NURSING PROFESSION, AND WITHOUT GRAVE INJUSTICE TO THOUSANDS OF INNOCENT SUCCESSFUL EXAMINEES
Based on the foregoing considerations, the following line of action is hereby recommended: 

• Suspected culprits—examiners and review center officials involved--should be fully investigated, prosecuted, and punished if found guilty.

• Exam passers without leakage should be allowed to take their oath because they passed an edited exam that has been cleansed of leakage. They studied hard in college, they reviewed hard for the exam, they played by the rules, and their parents who sacrificed for their studies are eagerly awaiting their financial independence. Their passing 80% of 500 questions is no mean feat and ably showed their competence, as shown by 25,000 others who could not do it. Even NCLEX passers hurdle a much lower number of questions. Moreover, there is no proof that under honest circumstances, they would fail the remaining 20%. It can very well be the other way around, that they would pass it but, as in NCLEX, there is no point in going further and having them undergo the same ordeal and trouble and sacrifice of taking another exam. The 80% passed questions, not the much smaller 20% (which is not necessarily failed at that) should be the basis of a decision favorable to the potential mass victims of injustice. Moreover, as declared by a foreigner in TV on August 22, 2006 who showed at PRC and spoke to some dejected passers, he welcomes the 2006 passers because, in the first place, they will be screened individually before they are hired. 

• Exam passers with leakage during the exam shouldlikewise be allowed to take their oath—because that benefit was already taken away from them after the exam when it was purged of leakage prior to calculation of grades. They reviewed in good faith in the review centers involved. They did not initiate the leakage, they were just passive beneficiaries of it. As generally first-time examinees who did not know how it is in taking board exams, they were not even sure prior to the exam that the questions would really appear in the exam. With or without leakage, it is also quite probable that they will pass the entire exam, as shown by their passing 80% of it fair and square.

• The government should properly address the nursing exam cheating and not tolerate it. This should be done as a matter of self-respect and necessity, not just for the impression of the international community. This can be achieved through vigorously pursuing to the very end the punitive action against the suspected culprits, accompanied by an streamlining of the nursing licensure examination system that will minimize to insignificance, if not totally eliminate, cheating in annual exams. Toward this end, hereunder is the recommended strengthening of control over the examination system. It is based on raw information and can be fine-tuned depending on the needs of actual situation. 

MINIMIZING BOARD EXAM LEAKAGES

On minimizing leakages in licensure examinations as an offshoot of the past nursing exam leakage, PRC Commissioner Ms. Avelina dela Rea (I understand a CPA and former COA auditor) is on the right track in one of her or PRC’s proposals to hire test-item writers on a part-time or full-time basis. The proposal conforms to one of the fraud-prevention elements of internal control that CPA’s learned while in college, that is, no one person should be in complete control of transactions. That situation is vulnerable to corruption because under it, one single person can commit fraud and conceal it without the need of connivance with others, who, if approached, may even squeal on the anomaly. 

At present, a board examiner prepares test questions for her assigned subject. Thus, she knows all the questions from which actual exam questions will be selected. If she maintained notes of her potential exam questions, which can be done even before she submits her list of test-questions to PRC, she still has means of relaying to select review centers the possible questions before the exam takes place. So, the present system is weak.

PRC’s proposal can be fine-tuned or refined to minimize the number of questions that any one examiner can leak to outsiders. It will entail more work by a few examiners but the dividend is protection of the integrity of licensure examinations and the nursing profession itself. What can be done is for all nursing examiners to prepare the test questions for each of all subjects. This way, if there are five of them, the rough probability of an examiner’s test questions being selected is one-fifth or 20 percent. If there are ten of them including additional test writers, the probability is down to 10 percent. Thus, the probable share of each examiner or test-item writer in the actual exam questions is greatly minimized, with the impact of leakage from any one of them made insignificant.

Thereafter, the step-by-step process until exam questions reach examinees nationwide should be thoroughly reviewed and rid of vulnerabilities. This scheme, which may also apply to licensure exams for other professions, may be polished as desired by PRC to make it more practicable and effective. 

THE NEED OF THE HOUR: A REVOLT AGAINST TRADITION 

Less adventurous clerks treat what they are routinely doing with reverence. They do not deviate from it. They do not initiate changes. They easily reach their level of incompetence because they cannot adjust to the varying and unstructured demands from management by a dynamic environment in a rapidly changing world. Administrators are something else. They are a different breed. They are champion achievers who innovate and adapt to exigencies. Progress emanates from them because they are not contented with the present, they question age-old tradition, they introduce needed reforms. In the nursing scandal, we need administrators like them who can release the 2006 passers from the clutches of the 500 traditional total exam questions. We need champions who can free 17,000 successful examinees from the prejudices of prior years’ passers who hurdled 500-question exams, all right—but inclusive of leakages! 

Let’s have a revolt against tradition so that the 2006 passers can take their rightful place in the nursing profession and finally move on. 




MARCELO L. TECSON
San Miguel, Bulacan
August 24, 2006


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