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.

Supporting Canadian Nursing Students to Write the NCLEX-RN Exam: A Three-Phased Mixed Methods Descriptive Design

BACKGROUND

In 2015, the College of Nurses of Ontario, replaced the Canadian Registered Nurse Examination with the NCLEX-RN exam as entry-to-practice. Faculty in a college-university partnership searched for products to provide nursing students with focused practice in writing exams modelled on the Canadian NCLEX-RN test plan.

PURPOSE

The aim of this three-phased evaluation study was to test and validate NCLEX-RN exam preparation materials newly developed for the Canadian context.

METHODS

A mixed methods descriptive design was used to capture subjective perspectives and objective measures. After ethical approval was obtained, 13 students assessed the e-learning platform's usability. Eight faculty/clinical experts assessed the content validity of materials using a content validity index (CVI) at both item (I-CVI), and scale (S-CVI) levels. Lastly, 72 completed tests served as the basis for assessing psychometric properties of selected test items.

RESULTS

Materials were assessed as useful and easy to use and navigate. I-CVIs ranged between 0.5 to 1.0 with none falling below 0.5 while S-CVIs were above the standard for acceptability of greater than 0.8 with none falling below 0.9. Overall test reliability measured by the Kuder-Richardson formula was 0.73. Many items assessed for difficulty (64%) showed a proportion of correct responses within desired ranges, and most point-biserial indices ranged from fair to very good.

CONCLUSION

Strong evidence supported the usability and content validity of the materials assessed. Item difficulty and discrimination analyses were within acceptable ranges. Suggestions for improvements were offered. Predictive analysis should form the basis of future research in this area.

Let's Talk About Racism: Strategies for Building Structural Competency in Nursing

A major goal of Healthy People 2020 is healthy equity, or the attainment of the highest level of health for all groups of people. Yet, disparities based on race remain the most persistent and difficult to address. Getting at the root causes of disparities, inequities, and injustices is essential for health equity to become a reality. The authors elucidate the urgent need for the nursing profession (and all health care professions) to push beyond cultural humility to structural competency and shift the focus from individuals to institutions, systems, practices, and policies to address racism, bias, and discrimination as root causes of disparities and inequities in health, health care delivery, and health care outcomes.Through a case study approach, the authors demonstrate the need for faculty to contextualize learning to help integrate the necessary historic and contemporary drivers of racism, bias, and discrimination into health care. They discuss strategies for faculty to develop the knowledge, skills, and attitudes to teach about the importance of addressing structural racism and discrimination in health care. Through a "no shame, no blame" approach, the authors encourage faculty to develop the courage to engage with students, colleagues, other health care professionals, and communities in conversations about racism, bias, and discrimination.