Summative assessments provide essential information about overall student learning, as well as insights into the quality of classroom teaching. Oermann and Gaberson (2013) state that summative assessments provide a summary of student skills developed in clinical practice (para. p.239). Summative assessment is used by the student and instructors to provide improvement. The summative assessments began and ended at a certain time. Strategies used for summative assessments are short answer, multiple choice, nonfiction, and formal papers (Billings & Halstead, 2012). The assessment tool does not effectively evaluate the student's clinical performance according to the principle of formative and summative assessments. Provides the maximum amount of points students can earn. The tool does not evaluate student progress in producing positive patient outcomes in any targeted or systematic way. Nor does the evaluation tool evaluate the instructor's performance in providing effective learning activities that produce positive students