Abstract
National Council Licensure Examination-Registered Nurse (NCLEX-RN) outcomes are extremely important to nursing institutions and students for myriad reasons. For students, the NCLEX-RN represents one of the final milestones to conquer before entering a nursing career. Nursing programs monitor NCLEX-RN pass rates as an important gauge of program quality and minimum levels frequently must be met. This study explored the implementation of an adaptive quizzing and learning system as part of an NCLEX-RN preparation strategy designed to increase student engagement and subsequent success on the NCLEX-RN. The adaptive quizzing system was used as part of an ongoing, proactive strategy to student preparation. This strategy is in contrast to the practice of using high-stakes exams scores to try and predict student NCLEX-RN outcomes. In the latter case there is mixed evidence on how scores relate to remediation and moving students toward success based on evidence of need. The study school required students (N = 54) to take regular, adaptive practice quizzes throughout their final year in the nursing program. Students were also given the HESI E2 in their final semester and all but one student achieved the target threshold with a range of scores (772 to 1028). Despite this variability, 90.7% of the students in the study group passed the NCLEX-RN on their first attempt, with a pass rate of 98% when considering those who passed on the second attempt. NCLEX-RN pass rates at the study school increased by 11.55% following the implementation of the system and in the second year of implementation (the data analyzed for this study) increased an additional 3.95% from the previous year. With many factors to consider, we cannot say, unequivocally, that using the AQS resulted in an increase in NCLEX-RN pass rates at the study school. Findings from this retrospective study do, however, support the use of an adaptive quizzing system as a component of the NCLEX-RN preparation strategy. Implications of these findings are discussed.
Highlights
Upon graduation from nursing school, graduates must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN®) before becoming a licensed nurse
NCLEX-RN pass rates at the study school increased by 11.55% following the implementation of the system and in the second year of implementation increased an additional 3.95% from the previous year
With many factors to consider, we cannot say, unequivocally, that using the adaptive quizzing system (AQS) resulted in an increase in NCLEX-RN pass rates at the study school
Summary
Upon graduation from nursing school, graduates must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN®) before becoming a licensed nurse. Faculty were aware that success on NCLEX-RN was dependent on this practice and had decided to require students complete a designated number of questions per each clinical course during the senior year of the program This policy, was difficult to implement as there was no way to track and monitor the number of questions students were answering and so was not instituted in a systematic way at the time. As part of a multi-pronged strategy, the adaptive quizzing and learning system, PassPoint (Wolters Kluwer) was adopted as a method to administer and monitor student completion of practice NCLEX-RN-style questions It was implemented at the beginning of the senior year in an effort to identify weaker students during the first semester to allow for earlier intervention and more remediation prior to the NCLEX-RN
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