Assessment Technologies Institute Research Articles

Use of standardized testing to predict NCLEX-RN success for associate degree nursing students in a concept-based curriculum

The study objective was to evaluate scores on the ATI Level 4 Concept-Based Assessment and demographic variables to predict NCLEX-RN pass rates in Associate Degree nursing students completing a Concept-Based Curriculum. BackgroundIn response to first time NCLEX-RN failures, a community college in Texas reviewed its current curriculum and identified the need to educate more contextually versus the traditional medical model. The nursing program adopted the Texas Concept-Based Curriculum. Assessment Technologies Institute (also known as ATI) developed the RN Concept-Based level Assessments. The Level 4 assessment is appropriate for assessing RN nursing students at the end of their concept-based curriculum. MethodThe study design was a secondary analysis. In the data analysis, descriptive statistics, bivariate analysis utilizing a t-test and Chi-square, and logistic regression were used. ResultsATI CBAL4 scores were a significant predictor, recording an odds ratio of 1.063. This indicated that students who scored higher on the ATI CBAL4 were more likely to pass the NCLEX. Additionally, Student Type was a significant predictor, odds ratio = 3.93. This indicates that transition students are 3.93 times more likely to pass the NCLEX than traditional students. ConclusionInstructors and associate degree nursing students completing a concept-based curriculum should be aware of the predictive power of the CBAL4.

Impact of Simulation on Undergraduate Student Outcomes.

Clinical reasoning is a cognitive and metacognitive process that is essential for positive patient outcomes. Simulation experiences provide situations and reflection where students can build clinical reasoning. This study examined the impact of a higher number of simulation experiences on undergraduate student outcomes. A retrospective comparison study examined differences between group grade point average, Assessment Technologies Institute (ATI) predictor, and National Council Licensure Examination (NCLEX) scores ( P < .05). A sample of 395 students was included in data analysis. No differences were noted in grade point average or NCLEX pass rates. However, students who completed a simulation elective had significantly higher ATI predictor scores. Cohen's d (0.39) approached a medium effect size. Incorporating higher levels of in-person simulation through creative delivery models can improve student outcomes. Simulations may enhance students' clinical reasoning skills.

Application of the Flipped Classroom Approach in an Undergraduate Maternal–Newborn Nursing Course to Improve Clinical Reasoning

Application of knowledge is shown to improve student comprehension, but with dwindling hands-on clinical opportunities in nursing programs, active learning strategies need to be incorporated into classroom learning. Nursing faculty in an undergraduate nursing program transitioned from a lecture format to a flipped classroom format, thereby incorporating active learning. Quantitative and qualitative data on student performance were collected over three semesters. The Assessment Technologies Institute (ATI) maternal-newborn content mastery exam, used as the final examination for the course, was used to assess student academic performance. End-of-course student feedback was collected from the Campuslabs IDEA Student Rating of Instruction (SRI) evaluation to assess students' perceptions of their ability to understand and apply knowledge, as well as perceptions of the flipped classroom format in general. The ATI exam scores for the course did not change significantly, but the SRI showed a statistically significant increase in the percentage of students who felt they gained a "deeper understanding" and could "apply the knowledge and skills." Although students resisted the flipped classroom format change initially, subsequent cohorts came to accept the change. Implications for educators are that although student dissatisfaction increased initially, the inclusion of the flipped classroom format within a course improved students' confidence in their ability to perform.

Comparison of Virtual Simulation to Clinical Practice for Prelicensure Nursing Students in Pediatrics.

BackgroundThe COVID-19 (coronavirus disease) pandemic has required a transition from in-person clinical practice to virtual learning.PurposeThis study compares the standardized assessment test scores of prelicensure nursing students who completed their pediatric clinical practicum in person for both the clinical and simulation practice settings versus virtually.MethodsThis study included 186 students in a pediatric clinical course. Half the students completed in-person pediatric clinical practice and simulation, and half the students used i-Human to complete their pediatric clinical practicum virtually. Scores on the Assessment Technologies Institute (ATI) Nursing Care of Children examination were compared using independent-samples t tests.ResultsThere were no significant differences in ATI scores between students who completed their pediatric clinical practicum in the clinical setting compared with virtually (P = .485; 95% confidence interval, −2.24 to 4.71).ConclusionsUsing the i-Human platform, along with prebriefing and debriefing, is an effective pedagogical approach to simulating a pediatric clinical practicum.

The Use of Collaborative Testing with Baccalaureate Nursing Students

The overall purpose of the study was to compare the mean Assessment Technologies Institute Comprehensive Assessment test scores between students taught using collaborative testing (CT) versus those using traditional pedagogy. A descriptive, comparative, and nonequivalent study design of 35 baccalaureate nursing students enrolled in the last nursing essential course. The finding showed that CT has short-term benefit on retention; however, it does not improve long-term retention among nursing students.

More than a cultural experience: Assessing the impact of a medical-surgical international clinical on nursing students' academic performance

A review of the extant literature suggests that there remains a dearth of evidence regarding the evaluation of well-defined outcomes related to international nursing clinical experiences. The purpose of this study was to explore the relationship between students' clinical experience (traditional versus international) and a number of academic outcomes including final medical-surgical course grades, performance on relevant Assessment Technologies Institute (ATI) proctored exams, and National Council Licensure Examination (NCLEX) pass rates. A non-experimental design was implemented using retrospective data obtained from a small university in the Midwest. Students complete a medical-surgical clinical in India during the interim of their third semester in the nursing program. Results of the t-tests show a statistically significant difference in final grades for Adult Health II theory when comparing students who completed a traditional clinical (M = 83.1, SD = 3.8) with those who completed an international clinical (M = 81.6, SD = 5.2); t(100) = 2.0, p = .043. The difference in mean scores for traditional clinical students (M = 70.3, SD = 6.6) versus international clinical students (M = 66.2, SD = 7.2) for the Adult Medical-Surgical proctored exam reached statistical significance, t(119) = 4.5, p ≤ .001. In contrast, there was no significant difference in means scores between the two groups with regard to scores on the Comprehensive Predictor proctored exam (traditional clinical, M = 76.1, SD = 5.9; international clinical, M = 75.2, SD = 6.4); t(121) = 1.0, p = .316. Finally, a chi square test of independence found that the relationship between clinical status and performance on NCLEX was not statistically significant, χ2 (1, N = 197) = 0.132, p = .716. Further research is needed to examine the impact of international clinicals on a broader range of outcomes including academic, cultural competency, and clinical performance measures.

The impact of instituting Process-Oriented Guided-Inquiry Learning (POGIL) in a fundamental nursing course

BackgroundPOGIL, using small groups of students, who assume the roles of leader, manager, recorder, and reflector to complete problem based activities in science courses, has demonstrated significant improvement in students' grades and course satisfaction in science courses and a nursing Fundamentals course. Using POGIL with nursing students in fundamentals nursing courses could help to improve final grades and course satisfaction while promoting active learning, critical thinking, and teamwork. ObjectivesTo examine differences in final course grades, Assessment Technologies Institute, LLC (ATi) scores and course satisfaction in 2 groups of fundamentals nursing students where one group experienced Process Oriented Guided Inquiry Learning (POGIL) as a teaching strategy and one group did not. Satisfaction with performing in the varied roles used during POGIL was also examined. Design/MethodsThis quantitative descriptive study used a comparative design, with one group of students who experienced POGIL while analyzing case scenarios in class and a control group who did not experience POGIL. A t-test was used to compare final grades, ATi scores, and satisfaction survey results. SettingA mid-size, private university in the northeastern United States was the setting. ParticipantsA convenience sample of pre-licensure baccalaureate nursing students taking Fundamental in Nursing Courses during the junior semester. ResultsThe experimental group (N=63) had higher final course grades (p=0.046), better understanding of the course material (p=0.005), and greater satisfaction with grades (p=0.008) than the control group (N=75). ConclusionThe results of this study revealed that Fundamental nursing students who experienced POGIL had significantly higher final grades and course satisfaction compared with students who did not experience POGIL. The active learning and teamwork experienced during POGIL, may be beneficial to students as they transition to practicing nurses. Additional research using POGIL with a variety of nursing courses could be beneficial in educating undergraduate nursing students.

A Model of Practical Nurse to Registered Nurse Educational Articulation: A Successful Approach to Advancing the Nursing Workforce

A consortium of practical nurse (PN) and associate degree (AD) nurse educators in New York State developed a voluntary statewide articulation model in 2003. The model is designed to promote educational mobility, moving qualified PNs into the second year of participating AD programs as advanced placed students. In the model, PNs who otherwise meet admission criteria are awarded 12 to 15 credits in nursing for their PN education. In 2005, 2 hospital-based “sister school” AD programs that share a common curriculum implemented the model. This study compared the outcomes (National Council Licensure Exam RN pass rates, course grades, and Assessment Technologies Institute Content Mastery Series assessment proficiency levels) of matched pairs of PN and generic students. No statistically significant difference in outcomes was found on any measure. This articulation model may offer a successful approach to seamless academic progression for PNs.

Decision-Tree Analysis for Predicting First-Time Pass/Fail Rates for the NCLEX-RN® in Associate Degree Nursing Students.

Little evidence shows the use of decision-tree algorithms in identifying predictors and analyzing their associations with pass rates for the NCLEX-RN(®) in associate degree nursing students. This longitudinal and retrospective cohort study investigated whether a decision-tree algorithm could be used to develop an accurate prediction model for the students' passing or failing the NCLEX-RN. This study used archived data from 453 associate degree nursing students in a selected program. The chi-squared automatic interaction detection analysis of the decision trees module was used to examine the effect of the collected predictors on passing/failing the NCLEX-RN. The actual percentage scores of Assessment Technologies Institute®'s RN Comprehensive Predictor(®) accurately identified students at risk of failing. The classification model correctly classified 92.7% of the students for passing. This study applied the decision-tree model to analyze a sequence database for developing a prediction model for early remediation in preparation for the NCLEXRN. [J Nurs Educ. 2016;55(8):454-457.].

Testing for success: A logistic regression analysis to determine which pre-admission exam best predicts success in an associate degree in nursing program

This study is a logistic regression analysis of data collected over a period of 5 years to determine which of three preadmission examinations best predicted success in an associate degree in nursing program. The three tests included in this study were the Pre-Admission Examination for Registered Nurses from the National League of Nursing, the admission assessment examination (A2) from Health Education Systems Inc. (HESI), and the Test of Essential Academic Skills from Assessment Technologies Institute. Data analysis revealed the HESI A2 examination scores can explain success in the nursing program better than the other tests included in this study.

A comparison of two nursing program exit exams that predict first-time NCLEX-RN outcome.

This retrospective descriptive correlational study compared the predictive accuracy of the Health Education Systems, Inc, Exit Exam (Elsevier) and Assessment Technologies Institute's RN Comprehensive Predictor, both of which were administered to nursing students in an upper-division baccalaureate nursing program during their final semester of study. Using logistic regression analyses, it was determined that the two examinations were statistically significant but weak predictors of success on the RN licensure examination. The RN Comprehensive Predictor had a slightly better odds ratio; however, both examinations had similar sensitivity, specificity, and overall accuracy. Because the RN Comprehensive Predictor was included in the Assessment Technologies Institute's Comprehensive Assessment and Review Program already being used by the BSN program, based on the results of this study, the nursing faculty decided to use only the RN Comprehensive Predictor during its NCLEX-RN preparation course.

Academic and nursing aptitude and the NCLEX-RN in baccalaureate programs.

Accurately predicting NCLEX-RN® success has a positive impact on all nursing education stakeholders. This study focused on the ability to predict NCLEX-RN pass rates on the basis of prenursing academic aptitude variables and the Assessment Technologies Institute (ATI) nursing aptitude program. The ATI predictors were the Test of Essential Academic Skills (TEAS) and fi ve ATI subject tests: Fundamentals, Medical Surgical, Nursing Care of Children, Mental Health, and Maternal Newborn. The prenursing variables comprised the prenursing grade point average, a prerequisite communication course, and the ATI TEAS composite subscores of TEAS Reading, TEAS Math, TEAS Science, and TEAS English. This study included participants from four baccalaureate nursing programs in the California State University system. Results of canonical correlation, multiple linear regression, and logistic regression revealed a significant correlation among prenursing, ATI scores, and NCLEXRN fi rst-try pass rates. Prediction of NCLEX-RN success rate using standardized testing data was supported, with the strongest predictors being the ATI Medical Surgical and ATI Mental Health tests.

Community College Nursing Student Success on Professional Qualifying Examinations from Admission to Licensure

The purpose of this study was threefold: (1) to investigate variables associated with learning and performance as measured by the National Council Licensure Examination for Registered Nurses (NCLEX-RN), (2) to validate the predictive value of the Assessment Technologies Institute (ATI) achievement exit exam, and (3) to provide a model that could be used to predict performance on the NCLEX-RN, with implications for admission and curriculum development. The study was based on school learning theory, which implies that acquisition in school learning is a function of aptitude (preadmission measures), opportunity to learn (program length), and quality of instruction (program measures). Participants were 298 graduates of an associate degree nursing program in southeastern U.S. Of the 298 graduates, 142 were Hispanic, 87 Black, non-Hispanic, 54 White, non-Hispanic, and 15 others. The graduates took the NCLEX-RN for the first time (2003–2005). This study was a predictive, correlational design that relied upon retrospective data. Point biserial correlations and chi-square analyses were used to investigate relationships between 19 selected predictor variables and a dichotomous criterion variable, NCLEX-RN. Correlation and chi-square findings indicated men did better than women on the NCLEX-RN; Blacks had the highest failure rates, followed by Hispanics; older students were more likely to pass the exam than younger students; and students who passed the exam started and completed the nursing program with a higher grade point average than those who failed the exam.

Predicting NCLEX-RN Success in a Diverse Student Population

Many schools of nursing have implemented standardized testing using platforms such as those developed by Assessment Technologies Institute (ATI) to better prepare students for success on the National Council Licensure Examination for Registered Nurses® (NCLEX-RN). This study extends and replicates the research on standardized testing to predict first-time pass success in a diverse student population and across two prelicensure program types. The final sample consisted of 589 students who graduated between 2003 and 2009. Demographic data, as well as academic performance and scores on the ATI RN Comprehensive Predictor, were analyzed. The findings in this study indicate that scores on the ATI RN Comprehensive Predictor were positively, significantly associated with first-time pass success. Students in jeopardy of failing the NCLEX-RN on their first attempt can be identified prior to graduation and remediation efforts can be strengthened to improve their success.

Revision and Evaluation of the Indiana University School of Nursing Baccalaureate Admission Process

This descriptive study evaluated the implementation of a revised admission policy for the Indiana University School of Nursing baccalaureate program. On the basis of our decision that grade point average (GPA) alone should not determine admission, new admission criteria were developed and implemented in spring 2007. In addition to a weighted GPA, criteria were added to include an interview, a writing sample, and a service requirement. Following the completion of all interviews and prior to notification of applicants of their admission status, students and interviewers who participated in the first admission cycle were mailed a survey asking their anonymous perceptions regarding the new process for application to the program. Responses indicate that both interviewers (n = 45) and students (n = 165) thought that the new policy and the interview were extremely positive. Results suggest that this comprehensive and varied approach to student admission was successful in its initial implementation. Further longitudinal studies are needed to determine how the new criteria affect student diversity; examination and course grades; progression, retention, and graduation; Assessment Technologies Institute tests; National Council Licensure Examination for Registered Nurses (NCLEX-RN) scores; admission to graduate school; and satisfaction of faculty with students and future employers with graduates.

Point and click! Review of the literature on utilization of online materials in nursing education programs

This article presents an introduction to the history of Web-based and Web-assisted teaching, learning, and assessment. The development of the field of distance education and its relevance to nursing will be documented. Published utilization studies of one set of online nurse educational tools, the Assessment Technologies Institute content mastery and comprehensive predictor, will be reviewed and discussed. Methods by which schools of nursing can access and integrate these online nursing education resources will be explored.

Implementing a Standardized Testing Program: Preparing Students for the NCLEX-RN

The undergraduate nursing faculty of a large Midwestern university initiated a program of standardized computerized testing for two purposes: to provide students experience with standardized computerized testing prior to taking the National Council Licensure Exam for Registered Nurses (NCLEX-RN) and to increase the students' NCLEX-RN passing rate. This article chronicles the process of implementing a comprehensive testing program developed by the Assessment Technologies Institute (Overland Park, KS). Although the first class of students to have taken the entire testing package has just graduated, midprogram results have demonstrated potential as key indicators for identifying at-risk students. The trends in scores on standardized computerized tests, grades in prerequisite science courses, and grades in medical-surgical courses are used to identify students who are at risk for failure in the program and on the NCLEX-RN. Faculty advisors meet with these students to develop individual plans of study and to provide additional resources. The testing process is going on smoothly, and faculty members are learning to use the extensive information on students' test scores to further assist them in passing the NCLEX-RN.

Comparison of Native Versus Nonnative English-speaking Nurses on Critical Thinking Assessments at Entry and Exit

Diversity of language among healthcare employees and nursing students is growing as diversity increases among the general population. Institutions have begun to develop systems to accommodate diversity and to assimilate workers. One barrier to nonnative English-speaking nurse hires may be posed by readiness for the licensure exam and the critical thinking assessments that are now an expected outcome of nursing programs, and act as a gatekeeper to graduation and to employment. To assist in preparing for high-stakes testing, the Assessment Technologies Institute Critical Thinking Assessment was developed in compliance with credentialing bodies' educational outcomes criteria. This pilot study of 209 nursing students was designed to reveal any possible language bias that might act as a barrier to nonnative English speakers. Nursing students were entered as whole classes to the study to control for selection bias. A sample representative of national nursing enrollment was obtained from 21 universities, with 192 (92%) native English-speaking students and 17 (8%) nonnative English speakers participating in the study. All students were given the Assessment Technologies Institute Critical Thinking Assessment at entry and exit to their nursing program. Average scores on entry were 66% for nonnative speakers and 72% for native speakers. At exit, the nonnative speakers had closed the gap in academic outcomes. They had an average score of 72% compared to 73% for native speakers. The study found that the slight differences between the native and nonnative speakers on 2 exit outcome measures-National Council licensure examination (NCLEX-RN) pass rates and Critical Thinking Assessment-were not statistically significant, demonstrating that nonnative English speakers achieved parity with native English-speaking peers on the Critical Thinking Assessment tool, which is often believed to be related to employment readiness.

Use of NCLEX Preparation Strategies in a Hospital Orientation Program for Graduate Nurses

This article describes outcomes from the first year of a hospital orientation program for graduate nurses that was expanded to systematize and enrich preparation of graduate nurses for success on the NCLEX-RN licensure examination. The study protocol provided the Assessment Technologies Institute predictor examination to assess risk for licensure examination failure, review materials, and a meeting with an education specialist to identify and prioritize study needs. Those at highest risk for failure were also provided an in-depth written study plan and ongoing follow-up and support until the licensure examination was taken. The study sample consisted of 90 graduate nurses who were hired from May through August of 2005 at the University of Kansas Hospital. The pass rate for participants was 86.7% on the first attempt in year 1 of the program. At-risk graduates who reported that the predictor results impacted their study habits and followed the study recommendations were more likely to pass the licensure examination. Graduate nurses reported a high level of satisfaction with the support provided. Specific challenges faced by hospital nurse administrators in recruitment and retention and return on investment over a 3-year improvement plan are described.