Summative assessments provide essential information about overall student learning as well as insights into the quality of classroom instruction. Oermann and Gaberson (2013) assert 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 make improvements. Summative assessments began and ended at a certain time period. Strategies used for summative assessments include: short answer, multiple choice, essays, and formal documents (Billings & Halstead, 2012). The assessment tool does not effectively assess the student's clinical performance based on the principle of formative and summative assessments. It provides the maximum number of points that students can accumulate. The tool does not assess student progress in producing positive patient outcomes in a targeted and systematic manner. The assessment tool also does not evaluate the instructor's performance in providing effective learning activities that produce positive student outcomes..