Best Online Proctoring for Nursing Programs

Best online proctoring solution for online nursing program exams

It’s safe to say that nursing students take A LOT of exams throughout their educational journey, and for good reason–because nurses save lives.

Online nursing programs face challenges

While online education is flexible and convenient, it can be challenging to prevent cheating on exams – especially without the right online proctoring solution in place.

Without online proctoring, you may find your test questions leaked on the internet, students can use cell phones to look up answers, and they can take exams with other students.

The right proctoring solution does more than prevent cheating on exams

Online proctoring allows nursing programs to test students in more ways that show knowledge AND practical application without concerns of exam cheating.

What if you could use these exam activities in an online environment and still prevent cheating?

  • Math problems for dosing calculations using pen & paper
  • Virtual demonstrations of how to use medical equipment
  • Using real nursing charting software to document patient information
  • Open book & open notebook exams

What’s the best way to proctor online nursing exams?

The best proctoring solution for nursing exams combines AI monitoring software with human review. This type of solution is referred to as blended online proctoring or blended proctoring solution.

What’s a blended online proctoring solution?

A blended proctoring solution combines AI exam monitoring software and human proctors to monitor student behavior, prevent cheating, and support students during exams.

Why’s this the most effective way of proctoring online nursing exams?

Because AI is good, but it isn’t perfect and neither are humans. While both have strengths, they’re most effective when they’re combined.

Combining AI with human review creates a noninvasive test environment with fewer distractions, works for many different exam formats, and streamlines the review process.

What kinds of nursing exams can be proctored?

Pretty much any nursing exam can be proctored, such as: 

  • Entrance exams for nursing programs taken in person or online
  • Nursing certification exams for continuing education
  • Nontraditional online exam activities such as:
  • Completing math problems and essays by hand
    • e.g., students complete dosage calculations along with an essay about patient safety and protecting privacy
  • Virtual demonstrations and presentations
    • e.g., students identify the parts of a specific medical device and show how it works
  • Using a real nursing charting system used by hospitals and creating an explainer video
    • e.g., Students add mock patient information into the charting system and discuss each step
How does online proctoring work with a blended solution?
  • AI monitors student behavior during the exam
  • If the AI detects any potentially dishonest behavior, it alerts a live human proctor in real-time
  • After the proctor is alerted, they can intervene and address the situation
  • Some online proctoring companies even allow the proctor to review the behavior in an analysis window before deciding if they need to intervene or not. This helps create a less intimidating and noninvasive testing experience for the student.
  • After the proctored exam is complete, instructors can review detailed reports and timestamped exam recordings.

What other exam proctoring features are available?

These proctoring features are available in addition to the combination of AI and human review:

Software that automatically searches for leaked test content

Have you ever found your test question leaked on the internet?

It’s an unfortunate byproduct of homework help sites and internet forums. But online proctoring platforms have AI that can identify leaked test content.

Which option sounds the best to you?

Option 1: manually click each and every test question you want the proctoring platform to search for, wait for the results, and spend time sending takedown requests to each and every one.

Option 2: automatically search the internet for all of your test questions in a few minutes and send takedown requests in a single click

Unless you like time consuming, manual tasks, you probably picked Option 2. The best online proctoring platform provides features to protect your test content and save you time.

Video for monitoring behavior, ID verification, and room scans

The student’s webcam is used to: 

  • Verify their identity and complete a room scan prior to the exam
  • Monitor behavior during the exam
Direct LMS integration

A direct integration between your LMS and the proctoring platform is a game changer. This integration ultimately impacts the testing environment, ease of use, and data security.

The direct integration between Honorlock’s proctoring platform and the LMS creates a testing experience and environment that’s pretty much the same for educators and students with the exception of a few clicks. This integration also means no extra passwords or logins needed for students or educators.

Nursing educator proctoring experience
  • Nurse educators will create exams just like they already do. And they can customize exam settings with a couple clicks. After the proctored exams are done, educators can view reports and recordings without leaving the LMS.

Nursing student proctored exam experience

  • It’s just as simple for students taking the nursing exam. They log into the LMS they’re already comfortable with, verify ID, and launch the exam. Students can also get support during the exam without leaving the LMS.
Voice detection, not sound detection

Most proctoring platforms use sound detection instead of voice detection. The terms are used interchangeably but they’re not the same.

  • Sound detection can trigger false flags for basically any noise, like coughing or a dog barking. That means irrelevant flags for instructors to review.
  • Voice detection listens for specific keywords and phrases, like “OK Google,” to detect potential cheating and alerts a human proctor in real-time.

The best online proctoring software takes this a step further by providing a transcript of what the student said.

Browser lockdown software

Nursing educators can enable a browser lock to prevent students from accessing other browsers and applications, restrict some keyboard functions, and record the student’s desktop.

Note: browser lockdown software is an entry-level tool that really shouldn’t be used as your only proctoring solution for exams in your nursing program. They only cover a small portion of exam cheating and students can easily work around them.

Timestamped recordings and reports

The best remote proctoring software collects extensive data during the exam and provides actionable reports and time-stamped recordings within the LMS.

The proctored exam reports are in a simple format that’s easy to read and includes relevant information about student activity, like suspicious behavior and potential violations.

No scheduling required to take proctored nursing exams

On-demand proctoring services like Honorlock provide nursing students with the flexibility and convenience of taking exams and getting support 24/7/365 without leaving the LMS.

What company has the best proctoring software and services for online nursing exams?

Honorlock’s blended solution is the best online proctoring software to protect online nursing exams. It’s also the highest-rated proctoring software on peer-to-peer review site, G2.

“Through the use of Honorlock, we have been able to maintain the integrity of our classes, many of which are precursors to entry into our nursing program. It is an easy-to-use, comprehensive system that will not be intrusive to students.” – Jill M.

Why aren’t other proctoring solutions as effective?

Some proctoring solutions do very little, but some do a lot more. So, it depends on your definition of “effective” and what your goals are.

If you’re only looking for an inexpensive proctoring solution that checks the box, like browser lockdown software, just remember that you get what you pay for.

You can use AI or live proctors to monitor exams, but they both have limitations. AI covers some things, but like any technology, it needs human oversight to truly harness its effectiveness. And only using live proctors can lead to scheduling issues, test anxiety, and unexpected testing costs.

Read part 2

Read part 2 of this series to see how it’s actually applied.

We’ll show you real examples of how to proctor nursing exam activities like:

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Tyler Stike

Tyler is Honorlock's Director of Content and a doctoral student at the University of Florida focused on educational technology.

How to Proctor Real-World Nursing Exams

Examples of how to proctor exams with real nursing job tasks

Hybrid proctoring: Combines AI and live proctors. The AI monitors behavior during the exam & alerts a live proctor if it detects potential issues.

Test content protection: automatically searches the internet for leaked test questions & gives the ability to send takedown requests with one click.

Cell phone detection: AI detects when students attempt to use their cell phones during exams.

Video monitoring: uses the students’ webcam to monitor student behavior during the exam, scan the room, and verify ID.

ID verification: the webcam captures a picture of the student along with their photo ID.

Voice detection: listens for specific keywords & phrases such as, “OK Google” or “Hey Siri” & provides a transcript of what a student says. Much more effective than sound detection, which can trigger because of a sneeze or a dog barking.

Browser lockdown: primarily prevents students from accessing other browsers & applications. Some allow instructors to give students access to specific sites & applications while still restricting others.

Entrance exams (online or at a testing center)

Whether nursing entrance exams taken in-person at a testing center, for example, you can use a mix of proctoring software and human review to prevent cheating.

Protecting written components (handwritten or typed)

If the nursing entrance exam has a written component, a hybrid proctoring solution can help secure them regardless of whether they’re handwritten or typed. The section immediately after this covers how to proctor essays and math problems, but here’s a quick summary of how it works:

  • Handwritten essays and math: Choose the setting within the proctoring platform that allows students to look down at their papers without being flagged and include exam instructions that require them to only use blank sheets of paper and to show their work before and after they complete each question.
  • Typed essays: The AI and browser guard block access to other websites and applications (except the specified word processor, such as Microsoft Word or Google Docs), while also disabling copy-and-paste keyboard functions and recording the test taker’s desktop activity.

Detecting phones, smartwatches, and other devices

Cell phones, smartwatches, and other secondary devices are easy to conceal during exams taken remotely or in a testing center, but some forms of proctoring software can detect when test takers try to use them.

Verifying identity before exams

Confirms that the person taking the entrance exam is the same one getting credit; typically involves using the webcam to take a clear photo of the test taker along with a valid form of identification, such as a driver’s license, passport, or student ID.

Scanning the room and monitoring behavior

Scans the room for unauthorized items like phones or notes, but follows the exam administrator’s instructions to allow specific items, such as scratch paper, a pen or pencil, or a glass of water. Test takers are recorded and monitored by AI throughout their exam session, with a human proctor reviewing potential academic misconduct flagged by the AI and stepping in only after confirming it needs to be addressed.

Locking the browser

Blocks access to websites and applications during exams, but allows exam administrators to permit specific ones, like a link to a nursing case study or a desktop calculator, while keeping all others restricted.

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Essays & math problems

Example: nursing students use pen and paper to complete:

  • 3 dosage calculation math problems
  • 1 handwritten essay about patient dosage safety

Handwritten essays and math problems

Turn on “Scratch Paper Allowed”

The nursing instructor simply enables a setting called “Scratch Paper Allowed” which allows students to look down at their paper without the AI flagging them.

Block or allow specific resources

Provide the proctor with instructions that allow students to use a calculator, whether it’s a physical calculator or one on their desktop. You can also specify certain websites students can visit during the exam, such as research articles, links within your online course, videos on YouTube, etc. while blocking everything else.

Provide clear exam rules and instructions, such as:

  • Only use a black or dark blue pen and blank white sheets of paper.
  • You may use the calculator function on your desktop computer.
  • Hold the blank paper up to the camera and show each side before starting and after completing each question.
  • Upload the written responses into the LMS after showing your work.

Typed nursing essays

Allow access to a word processor

Provide proctor instructions that allow students to access word processors like Microsoft Word and Google Docs while blocking any other applications and websites.

Prevent copying and pasting

If remote proctoring technology isn’t used, a student could copy text before the exam, whether notes and definitions or text from an AI chatbot, and paste it into the document. Some proctoring solutions prevent this by blocking keyboard shortcuts entirely.

Block the use of AI tools during essays

Some proctor systems combine a slew of features that work together to prevent the use of AI such as ChatGPT and Microsoft Copilot. This includes detecting cell phones, listening for commands that activate AI voice assistants, securing the browser, and monitoring desktop activity.

Virtual demonstrations & presentations

Example: nursing students identify the parts of a Sphygmomanometer and show how it works.

How to proctoring nursing exam virtual demonstrations & presentations

Detect voices and get a complete transcript of what the student said

The proctoring software can detect voices and provide the instructor with a full transcript of what’s said during the exam activity. It listens for things like, “Hey Siri” and “OK Google” as well as custom lists from the instructor that include phrases like, “help me,” or “what’s the answer?”

If the AI detects any potential issues, it alerts a live proctor who can review the situation and decide to enter the session to intervene and redirect the student. A transcript allows instructors to key in on specific subjects, like the student naming the parts of a Sphygmomanometer, which can speed up the review process.

The transcript is also particularly helpful for instructors who may be deaf or hard of hearing, but still want to provide students with the ability to virtually present.

Record the presentation or demonstration

The proctoring platform records the entire virtual presentation and demo for the instructor to watch. Instructors will also have reports and recordings with timestamps of potentially suspicious behavior to review.

Scan the room and monitor student behavior

The webcam can be used to complete a room scan to make sure the student doesn’t have any notes taped on the wall in front of them or resources on their desk.

What if a student has a speech disorder?

If a student has a speech disorder, you can provide proctor instructions that provide the student with other ways to complete the virtual presentation, such as allowing text-to-speech assistive technology.

Can you remotely proctor virtual group presentations?

Example: two students in separate locations record a presentation using a common video conferencing tool, such as Zoom.

It’s basically the same process as proctoring an individual presentation, except the instructor only reviews the audio and video from one student instead of both. The proctoring platform verifies the identity of both students, scans the room, records the presentation, and provides a transcript.

Using real industry software to complete a task

Example: nursing students add mock patient information to an EMR/EHR charting system commonly used by hospitals.

How to remote proctor nursing exams that require the use of real software

Allow the charting system and prevent access to other software and sites

A browser lock can be used to only allow nursing students to access a specific EMR/EHR charting system during the exam without being flagged. While you can specify which charting system can be used,  you can still prevent students from accessing other systems and browser tabs during the nursing exam.

Record students’ screens during the nursing exam task

The students’ screens can be recorded throughout the nursing exam task. The instructor can watch each exam recording to see how students completed specific portions of the tasks within the software.

Want to make it an explainer video?

In addition to recording nursing students’ screens during the exam charting task, instructors can also record audio. This allows the instructor to watch the student complete the task within the charting system while listening to the student explain what they’re doing during the charting task activity and why.

Smart Voice Detection technology provides a transcript of what the student says during the recording. Similar to the other examples in this article, instructors can also verify ID, detect cell phone use, and complete a room scan.

Open book online nursing exams

Example: nursing students can use specific textbooks or notes during the exam.

How to conduct proctored open book nursing exams

Provide instructions that allow specific books and/or notes during the exam

Here’s an example of what an exam admin would provide to the proctor: Students may only use this text book: Evidence-based Practice in Nursing & Healthcare: A Guide to Best Practice (fifth edition) by Bernadette Mazurek Melnyk PhD, RN, CPNP/PMHNP, FNAP, Ellen Fineout-Overholt PhD, RN, FNAP, FAAN

Before the proctored exam starts, students planning to use the textbook will need to show it to the webcam during the room scan. The proctor will check to make sure it’s the right one.

Scan the room to make sure no other books and resources are in the exam room

During the room scan, students can have instructor-permitted books in the testing area that they can use during the proctored authentic assessment.

Want students to have access to digital notes and resources?

Instructors can allow students to access specific digital resources during the proctored exam. The instructor simply adds the exact URLs of the permitted sites in the exam setup.

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Honorlock online proctoring allows nursing programs to do more with exams

While many other proctoring companies struggle to protect exams that involve more than standard test question formats, Honorlock allows your nursing program to offer test questions and activities that truly test knowledge and application.

Honorlock is the best online proctoring for nursing programs, but don’t just take our word for it.

We encourage you to read verified Honorlock reviews on peer-to-peer software review site, G2, and our customer testimonials.

“Through the use of Honorlock, we have been able to maintain the integrity of our classes, many of which are precursors to entry into our nursing program. It is an easy-to-use, comprehensive system that will not be intrusive to students like live proctoring systems.” – Review by Jill M.

“The 24-7 availability to students is a real plus. I have been using Honorlock for 5 years and have never had a complaint from a student about their experience. Proctors are courteous and helpful to students.” – Review by Michael A.

“I think the best thing about Honorlock is the ease of use for our faculty and students. Getting them trained and ready was easy with the support and guidance from the team.” – Review by Amy S., Director of Instructional Technology

“Before Honorlock, our campus relied on in-person proctoring. Honorlock allowed us to move past this archaic practice and permit students to take tests honestly from their homes. Honorlock’s team reviews students’ test-taking environments.” – Review by an Administrator in Higher Education

“Honorlock, because of its ease of use, was widely adopted by our faculty and has been very effective. It is an elegant solution to a complex problem.” – Review by Tom M., Director of Learning Resources

“Honorlock is very easy for students to set up and start using. Setup for instructors is also pretty simple, they can easily pick which settings/features to turn on for their exams.” – Review by an Administrator in Higher Education.

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