Cynthia M Clark1, Susan Luparell2. 1. ATI Nursing Education, Boise State University, 279 E. Danskin Drive, Boise, ID 83716, United States of America. Electronic address: cindy.clark@atitesting.com. 2. Montana State University, College of Nursing, PO Box 173560, Bozeman, MT 59717, United States of America. Electronic address: luparell@montana.edu.