Nursing Education - Passing National Boards

The following information is from the Oklahomaspend less time studying.
Board of Nursing Task Force, that investigatedNo single faculty/program issue was identified by
the pass and fail rate of nursing students thatthe majority of programs as having a negative
have taken the NCLEX. The scores for the stateimpact on the pass rate. Increased faculty
of Oklahoma were lower than most of the statesturnover was selected most often as a negative
in the Union, prompting the formation of a taskfactor. Respondents with an NCLEX pass rate
force and investigation of possible reasons for thebelow the national average were more likely to
low scores. What all perspective nursing studentsidentify that administration has pressured the
can gain from this report is how crucial it is to sitprogram to maintain capacity enrollment and that
for the boards as soon as possible afterfaculty spend inadequate time evaluating NCLEX
graduation and to take advantage of all the helpresult data and planning program changes based
available in preparing for the NCLEX. The nurseson the data.
efforts in putting this wealth of knowledgeThe majority of respondents believe that their
together has been a monumental task and alladministrations have been supportive of
nursing schools across the country are gratefulmaintaining high academic standards.
for the information that they have been able to- Most respondents report that faculty have
provide after many long hours of research.received training on test development and
*Summary of Information from Pass Rateinstructional techniques.
Reports **_Recommendations _*
In reports submitted by nursing education*Recommendations for the Oklahoma Board of
programs with NCLEX pass rates ten percentageNursing *
points or more below the national average, the1. Clearly articulate and enforce regulations
following commonalities were noted:requiring programs to use a systematic program
Â- Some programs do not regularly useevaluation process to analyze student outcomes
accessible sources of data to evaluate theon the NCLEX examination and develop
correlation between admission scores, grade pointappropriate actions based on the analysis.
average, NCLEX predictor examination scores,2. Continue to evaluate full-time faculty to student
and NCLEX pass rate. This impacts the ability ofratios in the classroom and clinical area to
the program to make informed decisions aboutdetermine the relationship between such ratios
changes likely to result in an improvement of theirand student outcomes.
NCLEX pass rate.3. Ensure that pass rate reports include a
Â- Many programs have only recentlythorough analysis of student and program factors
begun the use of NCLEX predictor examinationsimpacting success on the NCLEX exam.
as a requirement of the program. Data on the4. Hold nursing education programs accountable
efficacy of these examinations and on appropriatefor their NCLEX pass rates. Utilize focus survey
follow-up plans is limited.visits, warnings and conditional approval status
Â- Grade inflation is a factor leading to awhen there is evidence of continued low pass
low NCLEX pass rate in some nursing educationrate and failure to meet educational standards.
programs, particularly in programs that allow5. Develop a mechanism to communicate and
significant point credit in theory courses forencourage the use of best practices that
attendance, participation, and completion ofpromote NCLEX success.
assignments.6. Utilize the annual report for ongoing evaluation
Â- Some programs do not identifyof factors influencing each program's NCLEX
minimum academic requirements for admission toresults.
the program. Instead, a point system may be7. Provide opportunities for faculty development
used to select those who are deemed to berelated to the NCLEX examination and curricular
better qualified. While the use of point systems inresource sharing.
admission decisions may be appropriate, point8. Require that every program whose pass rate is
systems fail when applicant numbers drop. Inbelow the standard provide a pass rate report to
cases in which there is a small applicant pool,the Board, regardless of its size.
identifying minimum academic requirements (such9. Institute regulations requiring the NCLEX
as minimumscores on standardized pre-entrancecandidate (excluding foreign-educated and other
examinations) may be necessary to ensure thatendorsement candidates required to take the
students admitted have a reasonable chance ofexam) to pass the examination within one year of
success in the program and on the NCLEXgraduation from the program. If the candidate
examination.does not take the exam or pass within this time
Â- Student characteristics identified byperiod, the candidate would be required to
programs as leading to NCLEX failure include acomplete additional education prior to re-testing.
high number of work hours, family commitments,*Recommendations for Nursing Education
English as a second language, and low admissionPrograms *
points.1. Identify requirements for English language
Â- In some cases, problems within theproficiency and develop a plan for continued
program, such as resignation of the programsupport of students for whom English is a second
director, faculty turnover, inexperienced faculty,language.
lack of knowledge regarding the NCLEX2. Consider providing part-time program options to
examination and/or test development, andallow students to complete their nursing education
increased use of adjunct faculty were noted asat a slower pace.
having an impact on the NCLEX pass rate.3. Use the systematic program evaluation plan to
Nursing education programs tend to take similartrack the correlation of such factors as admission
actions to address NCLEX pass rate concerns.ACT scores, high school or college GPA, nursing
Actions commonly taken by programs include:ocourse GPA, other selected student
Initiating the use of an NCLEX predictorcharacteristics, repeats of coursework, scores on
examination as a requirement in the programoNCLEX predictor examinations, with results on
Requiring students to complete NCLEX review,NCLEX examination.
tutoring, or other actions if the predictor4. Perform a cross-analysis of the curriculum with
examination score is lowo Increasing the minimumthe detailed NCLEX test plan, in order to ensure
passing gradeo Providing faculty education in theessential elements are covered adequately.
areas of the NCLEX examination and test5. Utilize consultants, including Board staff
development skillso Changing or increasingconsultants, as needed in program evaluation and
admission requirementscurriculum development.
*Results of Survey of Nursing Education6. Provide continuing education for faculty
Programs *members on test development and analysis skills.
In December 2002, a survey was sent to all7. Assess students for at-risk status upon
state nursing education programs to identify theadmission or early in the program. Implement a
directors' perceptions of factors impacting theplan to assist at-risk students with success in the
NCLEX pass rate and the actions taken byprogram and on the NCLEX.
programs to address pass rate. Based on the8. Develop and publicize scholarship programs in
data obtained from 50 respondents (an 86.2%order to facilitate minimal employment during the
return rate), the task force noted the following:time the student is in the nursing education
The majority of programs have minimumprogram
academic requirements for admission; generally*Recommendations for Students and NCLEX
based on minimum scores on standardizedCandidates *
assessment tests and/or a minimum required1. Accept responsibility for own success in the
grade point average on high school or collegeprogram and on the NCLEX examination and
courses.become an active participant in the learning
The minimum grade average to earn a "C" inprocess.
nursing courses tends to be higher than the2. Participate in study and test-taking skill
parent institution's requirement. The majority ofworkshops early in the program to facilitate the
respondents require at least a 75% average todevelopment of such skills.
pass nursing courses.3. Seek out all available resources to ensure
Most respondents allow students who fail aminimum work hours while attending the nursing
course to repeat the course one time, and almosteducation program.
half only allow students to repeat one course in4. Join a study group early in the program and
the program. Respondents with a pass rate at orensure that the study group time is used
above the national average were slightly moreeffectively.
likely to allow students to repeat a course only5. Use NCLEX review material and study questions
once and to repeat only one course in thethroughout the program to increase own
program. A higher number of respondents with afamiliarity with the NCLEX examination.
pass rate below the national average had no limit6. After graduation, develop a study plan for
on the number of courses that could be repeated.NCLEX preparation. Use computerized NCLEX
Most respondents have established a writtenpractice exams on a regular basis. Practice taking
policy to identify students at risk for failure in thethese exams in a campus computer lab to
program or on the NCLEX. The indicators mostsimulate NCLEX testing conditions.
commonly used are scores earned on7. Take the NCLEX examination as soon as
nationally-normed examinations designed to predictpossible after graduation, as studies show that
NCLEX success, grades earned in nursing courses,early completion of the NCLEX increases chances
and repeats of nursing courses. Once the studentof success.
has been identified as at-risk, the majority of*Recommendations for Employers *
respondents will notify the student and require the1. Establish programs that foster success for
student to meet with a faculty advisor at leastemployees attending nursing education programs.
once.Consider options such as providing full-time
Nearly all respondents report using a standardizedbenefits for part-time status during the school
NCLEX predictor examination, but only 34.8%year, full-time salary for reduced hours, and tuition
require students to earn a certain score on thereimbursement.
exam as a requirement for course completion or2. Encourage new graduates employed as nurse
graduation.technicians/nursing assistants to adequately
Student and graduate issues most often identifiedprepare for the NCLEX exam, through options
as negatively impacting pass rate are the numbersuch as allowing specified work hours for planned
of hours of employment, a limited number ofstudy sessions, reimbursement for review
hours spent studying, more family responsibilities,courses, and reimbursement for the examination.
being less academically qualified, and an inadequate3. Provide special recognition for employees who
amount of time spent preparing for the NCLEX.pass the NCLEX examination, such as restaurant
Respondents with a pass rate below the nationaland movie coupons, employee newsletter notice,
average were more likely to note that studentsor other options.