Instituting Evidence-Based Changes to Improve First-Time NCLEX-RN® Pass Rates

Academic program enhancement supporting the success of undergraduate nursing students and graduates

Nursing program administrators, faculty, academic success coaches, and remediation specialists have implemented many interventions in support of baccalaureate nursing students' retention and graduates' NCLEX-RN® first-time pass rates. A private university's undergraduate nursing program's team incorporated additional evidence-based interventions aimed improving students' achievement of benchmarks following a 3-year decline in NCLEX-RN pass rates. Interventions expanded the prelicensure academic program's activities using a continuous quality improvement approach. A simulation center was constructed and a director was hired. A consultant also facilitated faculty engagement in curricular revisions. A new position, coordinator tutor/remediation specialist, was filled and the academic success coach launched interventions that complemented an initial and subsequent strategies for success initiative. New interventions were trialed and evaluated and became integral to students' and graduates' success. The academic success coach's commitment to students' achievements promoted their engagement in interventions. Pass rates increased and were sustained. Examples of interventions, supported by evidence, are presented in tables for review. A logic model depicts components of the program plan and its interventions as augmented by prospective strategies and remediation interventions. Continuous quality improvement processes will continue. Students and graduates have commented positively on the benefits of the assorted, success-promoting interventions.

Comprehensive licensure review and adaptive quizzing assignments for enhancement of end-of-programme exit examination scores in Saudi Arabia: a quasi-experimental study

OBJECTIVE

This study explores the effectiveness of a comprehensive licensure review and adaptive quizzing assignments intervention in improving the performance of undergraduate senior nursing students on the end-of-programme exit exam.

DESIGN

A quasi-experimental single-group design was used to compare pretest and post-test scores through computerised adaptive tests.

SETTING

The setting was a nursing college in Saudi Arabia.

PARTICIPANTS

The study included 292 senior nursing students enrolled in the Bachelor of Science in Nursing programme.

INTERVENTION

A comprehensive licensure review bundled with adaptive quizzing assignments was delivered over 15 weeks in the academic year 2021-2022. The bundle was guided by the elaboration theory, and it included 3-hour synchronous lectures every week and 23 adaptive quizzing assignments that covered weekly content.

PRIMARY AND SECONDARY OUTCOME MEASURES

Students' mastery scores and the percentage of correct answers were the primary and secondary measures, respectively. Both measures were collected in the pretest and post-test (exit examination). Additionally, demographic characteristics were collected in the pre-test using an online survey.

RESULTS

The overall mean of the mastery score was statistically significantly higher in the exit exam (M=2.51, SD=1.70) than in the pretest (M=1.45, SD=0.44; p<0.001). Although the overall mean of the mastery score in the exit exam did not reach the cut-off score, students who demonstrated the required knowledge and satisfactory performance in the pretest achieved a mastery score above the cut-off. The percentage of correct answers was statistically significantly higher in the exit exam (M=58.59%, SD=9.50) than in the pretest (M=49.32%, SD=9.78; p<0.001). A statistically significant difference in students' performance based on gender, age and grade point average was observed.

CONCLUSIONS

A comprehensive licensure review and adaptive quizzing assignments intervention bundle fostered the performance of undergraduate nursing students in the end-of-programme exit exam.

Strategies Used in Canadian Nursing Programs to Prepare Students for NCLEX-RN® Licensure Exam

Nursing educators need strategies for preparing students to be successful in the National Council Licensure Examination (NCLEX-RN^®). Understanding the educational practices used is an important step in informing curricular decisions and helping regulatory agencies evaluate nursing programs' efforts to prepare students for practice. This study described strategies used in Canadian nursing programs to prepare students for the NCLEX-RN^®. A cross-sectional descriptive national survey was completed by the program's director, chair, dean, or another faculty member involved in the program's NCLEX-RN^® preparatory strategies using the LimeSurvey platform. Most participating programs (n = 24; 85.7%) use one to three strategies to prepare students for the NCLEX-RN^®. Strategies include the requirement to purchase a commercial product, the administration of computer-based exams, NCLEX-RN^® preparation courses or workshops, and time dedicated to NCLEX-RN^® preparation in one or more courses. There is variation among Canadian nursing programs in how students are prepared for the NCLEX-RN^®. Some programs invest considerable effort in preparation activities, while others have limited ones.

Effect of a Commercial NCLEX-RN Preparation Product on First Time Pass Rates

Introduction

Passing the National Council Licensure Exam-Registered Nurse (NCLEX-RN) is the entry into the profession for nurses, and rates of passing the exam on the first attempt are used as an important outcome measure for schools, students, and accrediting agencies.

Objective

This study was conducted in order to investigate if a commercial NCLEX-RN test preparation product impacted first time pass rates.

Methods

Data were collected from 688 students from six institutions who were taking the NCLEX-RN for the first time. The intervention group (n = 396) received a 6-month subscription to a commercial product with which to prepare for the NCLEX-RN, and was compared to the control group (n = 292) to test for differences in demographics and test pass rates.

Results

The intervention group was more likely to be younger than 25 years of age (n = 160, 55.8% vs. n = 76, 34.6%; p < .001) when compared with the control group. No other significant differences in demographics or NCLEX-RN pass rates were observed between the groups.

Conclusion and Recommendations

This study failed to demonstrate a change in the likelihood of passing NCLEX-RN on the first attempt in a group of students who used a commercial test preparation product. We recommend that instructor-guided use of a test-preparation product, along with other interventions to support test success, be considered in creating an individualized plan for nursing students preparing for NCLEX-RN.

Standardized testing in nursing education: Preparing students for NCLEX-RN® and practice

Standardized testing that predicts nursing student success accurately and identifies weak content areas has played a critical role in nursing education. Critics of such testing lament the harm of this type of testing, often misinterpreting common practices as well as overlooking all value. The goal of nursing school is to graduate competent professionals with adequate knowledge to practice safely, who can pass the NCLEX-RN® and gain employment. The use of standardized exit exams or comprehensive exams that are valid and reliable should be embraced as evidence-based, academically rigorous evaluation tools, much like the discipline of education has embraced the Praxis Exam. This paper will present evidence supporting the value of "program exit standardized testing" and address the importance of assessing students and focusing on minimum competency. As a profession that prides itself on the use of evidence to guide practice, we need to use evidence to guide policy development with respect to the use of standardized testing in nursing education.