National Council Licensure Examination-Registered Nurse Research Articles

Interactive audio human organ model combined with team-based learning improves the motivation and performance of nursing students in learning anatomy and physiology.

Among the basic medical sciences, anatomy and physiology (anatomy & physiology) is a fundamental subject for students majoring in nursing. Due to its diversity and difficulty, nursing students experience stress when studying it. Previous graduates generally presented lower achievements in anatomy & physiology than in other nursing-related subjects in the National Council Licensure Examination-Registered Nurse, indicating that anatomy & physiology education requires improvement. Accordingly, we examined the impact of innovative teaching on students' motivation and performance when learning anatomy & physiology through a quasi-experimental pre-/post-test design. For innovative teaching, we used the novel interactive audio human organ model, followed by team-based learning. The participants were 200 lower-grade students in the nursing department of a junior college in Taiwan, divided into two groups receiving innovative teaching (experimental group) or traditional teaching (control group). Questionnaire surveys were administered, and the collected data were statistically analyzed. The innovative teaching in anatomy & physiology improved learning motivation, especially in terms of affect, executive volition, and learning performance. The essential components of learning motivation, such as value, expectation, affect, and executive volition, were positively correlated with the reaction levels of learning performance. Regarding the improvement in academic performance, the experimental group performed significantly better than the control group. The use of innovative teaching in class enhances students' learning motivation and learning performance when studying anatomy & physiology. Interactive teaching aids enhance the enjoyment of learning anatomy & physiology while facilitating in-depth exploration of the human organs and systems.

Effect of Unfolding Case-Based Learning on Clinical Judgment Among Undergraduate Nursing Students.

To prepare students for Next Generation National Council Licensure Examination-Registered Nurse (NCLEX-RN), nurse educators need to develop teaching strategies to foster students' clinical judgment. This study examined the effects of unfolding case-based learning (CBL) on baccalaureate nursing students' clinical judgment upon graduation. A prospective cohort design was adopted. Students' self-reported responses to the Lasater Clinical Judgment Rubric were compared between the unfolding CBL (n = 140) and non-CBL (n = 126) cohorts at a school of nursing in the United States. While students' responses were similar between the study cohorts, a trend was noted for improved clinical judgment among students in the unfolding CBL cohort. Furthermore, unfolding CBL significantly enhanced students' perceived proficiency in conducting focused observation. The findings support early introduction and consistent use of the unfolding CBL throughout the undergraduate nursing program so that students have ample opportunities and contexts to cultivate clinical judgment skills in the classroom.

A 15-Year Trend Study of Internationally Educated Nurses' NCLEX-RN Performance.

The aim of the study was to describe trends in internationally educated nurses' (IEN) National Council Licensure Examination-Registered Nurses (NCLEX®-RN) performance from 2003 to 2017 and to determine the odds of passing the exam based on country of nursing education. IEN comprise 5.6 percent of US nurses; more than half come from the Philippines. There is a lack of research on IEN NCLEX-RN performance. Correlational research was used to determine the performance and likelihood of passing the NCLEX-RN based on country of nursing education using secondary data analysis. Odds ratios were estimated to express the odds of passing. IEN NCLEX-RN applications and pass rates are decreasing. The odds of passing the NCLEX-RN among Philippine-educated nurses are lower compared to all other IEN. The odds of passing the Canadian NCLEX-RN are higher for all IEN. The low NCLEX-RN pass rate of IEN reflects differences in nursing education and practice across countries.

A comparison of RN licensure test plans: the United States and China with implications for the Chinese nursing licensure exam

Abstract Objectives The purpose of this paper was to compare test plans between the National Council Licensure Examination-Registered Nurse (NCLEX-RN) in the United States and the National Nursing Licensure Examination (NNLE) in China, to discuss the influence of passing standards and critical thinking in the test plans on candidates and nursing education, and to provide implications to improve the NNLE test plan. Methods After reading the 2019 NCLEX-RN test plan and the 2019 NNLE test plan, a side-by-side comparison was done to evaluate both test plans. Results In the NCLEX-RN test plan, a periodical RN practice analysis provides fundamental principles for the development of test content based on the Client Needs framework. Item writing and coding is guided by the theory of Bloom’s taxonomy. The passing standard for the NCLEX-RN is based on a criterion-referenced method to assess candidates’ competencies as newly licensed nurses. In the NNLE test plan, test content comprises primary nursing tasks, nursing knowledge, and knowledge of common diseases. The standard score, a norm-referenced method, is used as the passing standard. The NNLE test plan does not present information concerning principles used in the development of test content, and the guidance related to item writing and coding. Conclusion The NCLEX-RN provides systematic and evidence-based procedures to determine and evaluate test content and passing standards as compared with the NNLE. The standard score used in the NNLE disadvantages candidates of secondary nursing education. The lack of principles to guide item writing and coding in the NNLE fails to foster students’ critical thinking. To improve the NNLE test plan, further research should be conducted to improve test content, item writing, and examination evaluation methods.

The Adoption of NCLEX-RN in Canada: A Failure of Leadership at the Intersection of Nursing Regulation, Education and Practice.

This commentary presents perspectives of two senior nursing professors who have extensive faculty and leadership experience in both Canada and the United States. To understand more about how the adoption of the National Council Licensure Examination-Registered Nurses (NCLEX-RN) examination in Canada came to be, the authors conducted conversations with 29 Canadian nurse educators and nursing education and practice leaders. Based on these conversations as well as a review of published materials on the topic, the authors conclude that regulatory leaders failed to involve key leaders and stakeholders from nursing education and practice in this decision, and the resulting negative consequences have been borne primarily by the education and practice sectors. The authors argue that the NCLEX-RN adoption has introduced a misalignment into what had been a well-aligned model of education, regulation and practice in Canada and invite readers to consider the following discussion points. First, the NCLEX-RN has been designed to operate within a healthcare system that should not, by any reasonable argument, be replicated elsewhere; therefore, what are the contextual factors that led to the Canadian adoption of the NCLEX-RN? Second, American regulators stipulate that the examination must fit associate degree graduate competencies and that the additional knowledge and competencies gained at the baccalaureate level are irrelevant for licensure purposes; however, is this a fit for Canadian nursing licensure that requires the baccalaureate degree as an entry for practice? In conclusion, as American higher education in nursing now begins to move toward a competency-based model, further changes will have to be implemented to shape and frame the future of nursing education in the United States, and by extension, the future development of the NCLEX-RN within Canada's distinct historical, social, political and institutional context.

A Closer Look at the Introduction of the NCLEX-RN in Canada.

In 2015, the nursing faculty across most of Canada were informed by provincial nursing regulators that the America-based National Council Licensure Examination-Registered Nurse (NCLEX-RN) was going to replace the Canadian Registered Nurse Examination for our nursing students to become registered as nurses. This change in the exam has presented a number of challenges to both faculty and students as they transitioned from a Canadian exam for the Canadian context to an exam that was originally formulated for nursing registration in the United States. This manuscript examines the differences in the Canadian and American healthcare systems; explores the variations in Canadian and American nursing practice and education; outlines concerns surrounding the use of standardized testing that panders to corporate interests, encourages "teaching to the test" and is costing nursing programs and nursing students considerable resources; and explores the controversy surrounding the validity of the NCLEX-RN in both Canada and the United States. This manuscript asks Canadian nursing leaders, educators, clinicians and researchers to question why Canadians have taken on this exam when Americans themselves state that this exam "gives a false and incomplete picture of practice readiness."

The relation between standardized test scores and NCLEX-RN failure

First time pass rates on the National Council Licensure Examination – Registered Nurses (NCLEX-RN) are the desired outcome of Schools of Nursing across the United States. The purpose of this study was to determine if there was a relation between standardized testing scores and NCLEX-RN failure among students in a baccalaureate nursing program. This study utilized a retrospective correlational design to identify relations between the dependent variables NCLEX-RN failure and the independent variables. The 16 Independent Variables were: Fundamentals of Nursing Practice and Repeat, Adult Health Nursing and Repeat, Mental Health Nursing and Repeat, Pediatric Nursing and repeat, Obstetrical Nursing and Repeat, Community Health Nursing and Repeat, RN Exit Exam and Repeat, and Pharmacology and Pharmacology Repeat. The statistical tests utilized for data analysis were: logistic regression, multiple logistic regression model, and Pearson’s χ2 cross-tabulations. Significant findings identified students “at risk” for NCLEX-RN failure. Faculty intervention early on and throughout the students’ nursing program will help improve student outcomes, NCLEX-RN success, and ultimately helping to alleviate the nursing shortage.

A comparative analysis of NCLEX pass rates: Nursing health human resources considerations.

To examine performance differences among different writers of the National Council Licensure Examination-Registered Nurse (NCLEX-RN) examination in Canada; to compare Canadian and U.S. writer pass rate data; and to identify if changes in the Canadian nursing workforce can be related to the introduction of NCLEX-RN. In January 2015, the entry-to-practice licensing examination changed from the Canadian Registered Nurse Examination to the NCLEX-RN, and pass rates declined. This comparative analytic study examined NCLEX-RN pass rate data for 2015, 2016 and 2017 using publicly available data. The Canadian data were compared with that from U.S. nurses taking the examination. Overall year-end pass rates among Canadian writers appeared to improve significantly in 2016 (95% to 96.3%, p<0.001, from 2015 to 2016) but declined again from 96.3% to 90.4% in 2017 (p<0.001). Pass rates remain significantly lower for first attempt Canadian writers compared to first attempt U.S. writers (2015: 69.7% vs. 84.5%, p<0.001). The change in licensing examination had a major impact on pass rates for new graduates entering the nursing profession and potentially the number of new nurses entering the profession in Canada immediately after graduation. A loss of entry-level workers to the nursing profession in Canada affects workforce management strategies, particularly with respect to worker shortages.

Relevance of Program Readiness on Nursing School Completion and Success on the National Council Licensure Examination-Registered Nurse

Within nursing education, attrition from nursing programs has been problematic and impacts completion rates and workforce supply. In this study, the researcher used an ex post facto design to determine if program readiness in the areas of reading, writing, and math had an impact on nursing program completion in a community college setting. The study identified that program readiness did statistically impact program completion. Completion rates among minorities and men showed no difference in completion when compared with Caucasian and female students. Students who completed the nursing program, regardless of program readiness, successfully passed the National Council Licensure Examination-Registered Nurse (NCLEX-RN) equally.

Alternative Strategies for Providing Clinical Experiences in a Family Nursing Course

Clinical competency is essential for nursing student preparation although acute clinical experiences are limited. An innovative pedagogical strategy was utilized to meet curricular requirements in a Family Health Nursing course. National Council Licensure Examination-Registered Nurse (NCLEX-RN), Health Education Systems Incorporated (HESI) exit and HESI maternity examination scores increased, and student feedback and faculty satisfaction improved. Program outcomes were not negatively affected by elimination of the acute care clinicals. Community clinical experiences with obstetrical simulation may be utilized as a feasible strategy to meet program outcomes.

Predictors and students’ perceptions of NCLEX-RN success in a BS program

Background: First time National Council Licensure Examination-Registered Nurses (NCLEX-RN) pass rates and successful student progression in a program are considered key indicators of quality of nursing programs. The purpose of this study was to investigate the predictors of first-attempt NCLEX-RN success among multiple factors, and to explore the students’ perception for NCLEX-RN.Methods: A retrospective descriptive design was used including a total of 671 students who were admitted as a junior to the program between spring 2012 and fall 2015. Descriptive statistics and multiple logistic regression models were conducted to find significant predictors of first time NCLEX-RN success.Results: Course grades for adult health, family health, critical care health, and the repeated course history, and HESI scores for adult health, family health, and the EXIT exam were significant predictors of NCLEX-RN success. Students perceived that the review course and practice test were helpful in passing NCLEX-RN.Conclusions: Findings of this study would be beneficial for nursing programs to strategize effectively for students who are at risk of failing and support them in their NCLEX-RN preparation.

Effects of a Registered Nurse (RN) Transition Course on Preparedness and Performance on the National Council Licensure Examination - Registered Nurse (NCLEX-RN)

Effects of a Registered Nurse (RN) Transition Course on Preparedness and Performance on the National Council Licensure Examination - Registered Nurse (NCLEX-RN)

Remediation: Using Data to Prescribe Interventions for Nursing Students

This article presents the use of standardized assessments to prescribe remediation plans for midprogram and end-of-program nursing students. Remediation plans implemented for prelicensure students included a required relearning seminar taught by nurse educators. The midprogram students completed a 1-day relearning seminar and handwritten summaries and submitted concept maps for content areas in which they scored low in the assessments. End-of-program students completed a 2-day seminar and an 8-week asynchronous National Council Licensure Examination-Registered Nurses (NCLEX-RN) review course to determine NCLEX-RN readiness.

The Relationship Between Socioeconomic Status (SES) and NCLEX-RN: Comparing SES Indicators in Mediated Logistic Regression

The main purpose of this study was to examine the relationship between socioeconomic status (SES), ACT test scores, and the National Council Licensure Examination-Registered Nurse (NCLEX-RN) through a mediated logistic regression model. ACT is often considered one of the strongest predictors of success on the NCLEX-RN. Data from nursing students (N = 1,176) at a large, Midwestern university were analyzed. The goal was to determine if the predictive power of ACT on the NCLEX-RN stems from the influence of SES on ACT. A significant indirect effect through the causal chain of Pell Grant eligibility (i.e., SES)→ACT→NCLEX-RN was found.

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

First-time National Council Licensure Examination-Registered Nurse (i.e., NCLEX-RN®) pass rates are important criterion in evaluating the effectiveness of prelicensure nursing programs. This article describes one baccalaureate nursing program's approach in developing and implementing comprehensive, evidence-based strategies to effectively halt a 3-year decline in the program's annual first-time pass rates. Strategies included revisions in student policies related to admission, progression, and graduation; a comprehensive curriculum revision; and faculty development. These data-driven strategies improved first-time NCLEX-RN pass rates from 64.86% to 94.29% over 3 years—a dramatic 45% increase.

From Innovative Idea to State-Supported Policy: Academic Progression in Prelicensure Registered Nurse Education Using the Partnership Model

Changes in the registered nurse (RN) employment market in 2012 and 2013 negatively affected both employment for RNs and associate degree-prepared nurses (ADNs) and clinical placement for students in ADN preparation programs. To address this challenge, ADN nursing programs partnered with a university to create an innovative alternative to traditional prelicensure RN nursing education by sharing curricula among them. With the program, students simultaneously complete the ADN nursing degree onsite at the community college and the bachelor of science degree in nursing (BSN) online, with both degrees conferred at the end of the respective nursing programs, in time for the graduate to sit for the National Council Licensure Examination-Registered Nurse (NCLEX-RN) and enter the workforce as a BSN-prepared nurse. This example of seamless academic progression is known in Kansas as the Partnership Model.

Overview and current management of computerized adaptive testing in licensing/certification examinations.

Computerized adaptive testing (CAT) has been implemented in high-stakes examinations such as the National Council Licensure Examination-Registered Nurses in the United States since 1994. Subsequently, the National Registry of Emergency Medical Technicians in the United States adopted CAT for certifying emergency medical technicians in 2007. This was done with the goal of introducing the implementation of CAT for medical health licensing examinations. Most implementations of CAT are based on item response theory, which hypothesizes that both the examinee and items have their own characteristics that do not change. There are 5 steps for implementing CAT: first, determining whether the CAT approach is feasible for a given testing program; second, establishing an item bank; third, pretesting, calibrating, and linking item parameters via statistical analysis; fourth, determining the specification for the final CAT related to the 5 components of the CAT algorithm; and finally, deploying the final CAT after specifying all the necessary components. The 5 components of the CAT algorithm are as follows: item bank, starting item, item selection rule, scoring procedure, and termination criterion. CAT management includes content balancing, item analysis, item scoring, standard setting, practice analysis, and item bank updates. Remaining issues include the cost of constructing CAT platforms and deploying the computer technology required to build an item bank. In conclusion, in order to ensure more accurate estimations of examinees’ ability, CAT may be a good option for national licensing examinations. Measurement theory can support its implementation for high-stakes examinations.

NCLEX RN Exam: A university school of nursing case study of preparation strategies

The NCLEX-RN (National Council Licensure Examination—Registered Nurse) is the exam taken at the end of a U.S. nursing student’s education to enable him or her to become a licensed registered nurse. The purpose of this article is twofold (1) to discuss NCLEX-RN preparation strategies provided by several U.S schools of nursing; and (2) to describe a case study focusing on a university school of nursing’s preparation strategies implemented to improve NCLEX RN pass rate. Specific actions and results from case study may be useful to other nurse educators teaching in baccalaureate school of nursing.

NCLEX-RN® Success: An Integrative Lesson Plan

The National Council Licensure Examination-Registered Nurse (NCLEX-RN)® measures the mastery of essential content for safe, entry-level nursing practice. The 2016 NCLEX-RN® Detailed Test Plan is a guide for NCLEX-RN® preparation. A lesson plan was developed as a resource for nursing educators that integrated content from the Detailed Test Plan into didactic instruction according to the revised Bloom's Taxonomy. Innovative technology is used in the classroom to create a simulated clinical environment and the paradigm introduce, recall, review reinforces content.

Impact of Adaptive Quizzing as a Practice and Remediation Strategy to Prepare for the NCLEX-RN

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.