Earlier article have presented the importance of developing programs of assessment designed to measure knowledge and abilities basic to community-focused healthcare practice. In the field of assessment, considerable attention recently has been given to what has come to be called "alternative assessment" methods. Alternative assessment formats offer the possibility to more accurately assess a range of abilities, such as critical thinking, problem solving, and clinical decision making, that are fundamental to community-based nursing practice. The authors present one such alternative assessment method--portfolio assessment--and discuss its application to the measurement of student performance in a community-focused practice environment.

Assessing knowledge and performance on computer is rapidly becoming a common phenomenon in testing and measurement. Computer adaptive testing presents an individualized test format in accordance with the examinee's ability level. The efficiency of the testing process enables a more precise estimate of performance, often with fewer items than traditional paper-and-pencil testing methodologies. Computer simulation testing involves performance-based, or authentic, assessment of the examinee's clinical decision-making abilities. The authors discuss the trends in assessing performance through computerized means and the application of these methodologies to community-based nursing practice.

In the development and administration of a certification examination in holistic nursing, an important issue is to ensure adequate content validity. Thus, the American Holistic Nurses' Association (AHNA) and the American Holistic Nurses' Certification Corporation (AHNCC), with the assistance of the National League for Nursing, conducted a practice analysis study to generate empirical data on the professional activities and knowledge required to practice holistic nursing on a day-to-day basis.

What and how we teach, how we learn, and how we practice nursing are fundamentally changing. Perspectives on Assessment invites dialogue on assessment's central role in the paradigm shifts currently occurring in nursing education and nursing practice. Programs of assessment in educational and practice institutions offer the opportunity for continuous feedback on the quality and effectiveness of our efforts to prepare nurses who are competent to practice in a healthcare environment that is continuously changing and increasingly community based. The assessment process itself offers the opportunity for us to engage in an ongoing conversation about our progress with these two paradigm changes.

Considering the needs of the elderly long-term client in the context of the current healthcare environment adds urgency to the ongoing challenge of effective care planning for this population. Increasingly, home health agencies must demonstrate progress toward achievement of predicted care outcomes. With such emphasis on achieving positive outcomes, a well-designed plan of care for clients receiving long-term home health services becomes even more necessary. This article presents a strategy for creating individualized care plans for the homebound elderly based on a stepwise approach to goal development.