Is the Nursing Licensure Exam effective?

[Double-Helix]

I'm posting this here, rather than the NCLEX board because I wanted the opinion of seasoned nurses, and the NCLEX board is primarily visited by students.

Spend a day on the NCLEX board and you'll see numerous threads that contain the phrasing, "I just took the NCLEX and I KNOW I failed!" or "It was so hard there is no way I passed!" or "I got the good pop-up but there is no way that I passed!"

It's gotten me thinking recently. The NCLEX gives you the opportunity to pass in 75 questions (only 60 of which count). It's a huge difference from the two day, multiple hours per day testing that many of you went through to get your license.

What often concerns me is that graduates can leave the NCLEX feeling sure that they failed, thinking that the test was super hard, and there is no way they could have passed. But, they did. Is this right? Should nursing licensure be summed up in 60 questions? If a student passes the NCLEX, but feels their performance was terrible, is that a red flag?

What's your opinion of the nursing licensure exam, and what changes should be made to the system?

[Good Morning, Gil]

I don't think there is any test that can ensure that one will be an effective or good nurse just as there really isn't a test that can ensure there will be good doctors, so I feel the 75 question or more computer adapted exam is fine. I think it's the best they can do, but no written test alone can ensure competency. That's why there's a clinical component in nursing programs; they're hoping they can weed out students that way if they're not safe. And, the exams in school leading up to the NCLEX should weed out those who just academically are not intelligent enough to be a nurse. I'm not saying that you have to be a genius to be a nurse, but to be an effective, skilled nurse that is able to put clinical s/s together quickly for his/her patient, that requires intellect. And, then there are those unfortunate souls that are great nurses, but just can't take a standardized test.

[healthstar, BSN, RN]

You stated: ? If a student passes the NCLEX, but feels their performance was terrible, is that a red flag?I don't understand how this can be a red flag!!! Reasons for feeling their performance was terrible:1.anxiety2. Reading other people's post about how hard nclex is and how some people are taking it for the 10th time.3. Low self-esteem or low confidence4. Some people assume the worst........nclex only test your minimum knowledge about nursing.In my opinion: Nclex is simply a waste of time and not effective at all, period!Isnt it enough that you went to school for 4 years and passed all your tests......required passing grade over 80%. What bothers me the most about nclex, is knowing that people in my class failed nursing classes, who barely passed a class, who would never show up in class, who did not have communication skills, who would guess on VS, do not know the basics in their senior year, who cheat who were constantly disrespectful to instructors etc...........all they have to do it study 1-2 months straight for the nclex and ......you are a nurse!!! Same goes for the straight A students. Nclex is pointless....bc everyone will study hard core for that test for one month just to pass it and once that test is complete .........most likely people will not remember or care to remember the stuff they learned for nclex. Passing nursing tests should be enough.

[OnlybyHisgraceRN, ASN, RN]

I personally believe that written exams can be taken and passed by anyone now days. Whether its a CAT or a 2 day written exam. Both exams does not test your ability to be a nurse but test your ability to answer test questions correctly. There was once a man who had no nursing or medical background but was able to pass a nursing exam with an A, all because he was an expert on test taking.

What can change? Having simulation where GN can actually be tested on how to do certain procedures on sim men along with taking the written exam. We should have both written and clinical aspects of the exam.

So far as the " I think I failed" I think people say that d/t anxiety. I know I did. I also didn't want to jinx it by being superconfident that I passed.

I know seasoned nurses that also thought they failed after taking their boards.

[Klimpys]

What can change? Having simulation where GN can actually be tested on how to do certain procedures on sim men along with taking the written exam. We should have both written and clinical aspects of the exam.

This could be an interesting concept, but I think it would depend on how it was administered. When I took my Nurse Aid I certification I had a written test and skills assessment test. I usually do not have test anxiety, but I admit to being a little freaked out. My class had heard horror stories of people failing because of forgetting one tiny detail, such as forgetting to lock the wheels on the bed when helping the "patient" (other test taker) out of the bed. We were given five random tasks (out of the 25+ we learned) to do such as washing hands properly, feeding "patient", mouth care, using bed pan, ambulating patient, etc...that were different from the other test taker. If we messed up we were not told until the very end that we failed. However, if we were towards the end of a task and we remembered we forgot to lock the bed wheels earlier and we admitted it to the teacher we could get checked off on it, as long as we had not moved on to the skill set that was different. Oh, and no trying to help the other student if you were lying there being her patient and you knew she just screwed up! No whispering, or trying to make eye gestures. The poor girl I was with knew she messed something up and was crying while she was attending to me. She must have fixed it because she passed.

[Double-Helix, BSN, RN]

You stated: ? If a student passes the NCLEX, but feels their performance was terrible, is that a red flag?I don't understand how this can be a red flag!!! Reasons for feeling their performance was terrible:1.anxiety2. Reading other people's post about how hard nclex is and how some people are taking it for the 10th time.3. Low self-esteem or low confidence4.!!

I understand that there are several reasons why someone might feel they didn't pass. However, if you walk out a testing thinking that you did horribly because the test was super hard, it does show a lack of confidence in your answers and a lack of confidence in your knowledge of the material. I suppose that, as long as they pass, it shouldn't really matter how you feel about your test, but it seems like a lot of students are graduating and taking the NCLEX without a thorough understanding of the material. Or at least feeling like they have a thorough understanding of the material, as evidenced by the lack of confidence following the exam. In my opinion, if a graduate is doubting his or her knowledge of the material that much, he or she may also doubt her knowledge and judgement in the clinical setting and exhibit lack of confidence, anxiety, etc. That would be the point that it's a red flag.

[melmarie23, MSN, RN]

There are times when I leave my job and wonder if I could have done anything different. If I had missed something. Or a plethora of other "what ifs?" I dont necessarily think that is my not having enough knowledge or judgement in the clinical setting or makes me any less of a nurse. It is though what makes me human and makes me continually reassess myself as a RN and able to admit that there is always room for growth. Expert RNs are not made right after graduation and passing the boards. That comes from a lot of time and with a lot of experience. And even then, they are not a "true" expert. There is always something new to learn or to see.

[classicdame, MSN, EdD]

Seasoned nurses have no idea what NCLEX is like now. It changes regularly. The emphasis is on critical thinking, so if the nurse can utilize that on a test they should be able to do so in person. You learn by doing anyway.

[tokmom, BSN, RN]

IIRC, back then you had to wait 6mo. to retest. I don't think I could have survived a second go-round with that.

In a way, I feel sorry for new grads. They're bombarded with which study plan is better: Kaplan? Saunders? LaCharity? I remember briefly looking over a few things, but I don't remember really studying. There wasn't anything out there to help you prepare.

I agree with aky. Sitting there with hundreds of people in a huge auditorium for two days was indeed a rite of passage.

Yep, those were the days. You couldn't even use the bathroom unless it was dire emergency and then they went with you.

I remember being on breaks and seeing people crying in the corners of the lobby thinking they failed and it was only day 1 !!

[OnlybyHisgraceRN, ASN, RN]

I think at the end of the day we can all agree that a written or CAT exam does not determine how great or bad a nurse is going to be. Only time will tell... either they will sink or swim.

So far as feeling bad after the exam.... I think it is a normal response. After each LPN and RN exam I felt that I failed and ended up crying. However, I passed both times. In a clinical setting I don't cry if I feel that I could have done something better, I'm as cool as a cumber. Apples and oranges. NCLEX is nursing in Pearsvonvue world, nursing is nursing in the real world.

[Hygiene Queen]

I was disturbed by the NCLEX.

It took me far longer to drive to the testing site than it took me to take the exam.

I was prepared for the "hardest test ever" and found it ridiculously easy.

I, too, managed it in 45 minutes with 75 questions.

Was that what I had busted my butt for?

What did it prove?

Could anyone have passed this test?

My fiance thought different. He thought it was more about busting your butt and studying until your brain bleeds in order to have the privilege to sit. Period. And that whether is was "hard" or not was a moot point.

I don't know about that, but I found more satisfaction in passing my hemodynamics and shock exams than I did the NCLEX.

I guess I wanted an exam that was really really rough so I could say, "Yes! I did it! It was the toughest exam in the whole wide world! I'm not stupid! I dood it!"

lol

I didn't get that ego feed I must have been (pathetically) craving.

I got no math and maybe a drug question... wow.

I don't remember any questions from my exam. I remember putting stuff in order, but common sense pulled that off.

Maybe I just have a chip on my shoulder and wanted some sort of validation that I was a very smart person.

That's my honest take on my experience with the NCLEX, anyway.

By the way, I am anonymous here, so I will tell you how I feel about it, but I keep it to myself in real life.

I know people who find the NCLEX very hard. Maybe they got harder questions? But I'm not going to say, "How could you not pass? It's soooooooo easy!" even though I may wonder.

And, while I do read the NCLEX forum, I don't answer.

I thinks it's for the best.

[yuzzamatuzz]

The current NCLEX is very different from the old test and is not based off of how many questions you got right and wrong out of 75 random questions. If you answer a question correctly, the computer throws you a more difficult question. If you answer that correctly, it throws you an even harder one. If you answer a question incorrectly, it gives you an easier one. It statistically figures out what level of "difficulty" you can answer. If you are well above or well below the acceptable level, the computer will shut off after 75 questions because it is statistically certain where you stand. If it is not certain, it will continue to ask questions to get a larger sample size. When the computer finally is certain of your abilities, you should be answering about one question wrong for every question right (one wrong, one right, one wrong, one right, etc). This is why so many people feel like they failed. I'm not bothered by people feeling this way at all because most people are not used to taking a test and answering only 50% correct. I'm also not bothered by people only having to answer 75-275 questions. Back in the day when there were paper tests, the questions were pre-determined and random. The computer now analyzes the difficulty of the questions the person can answer and interacts accordingly as that person is taking the test. Because of this, it is more efficient and in theory gives the same results in a shorter amount of time. Just because the old test was longer does not mean it was better. I was very prepared for the NCLEX and finished in 75 questions, but that was by far the most difficult 75 questions of my life. We've all taken the NCLEX in some form, and I don't think it has ever been or ever will be anything but a very difficult test.

[nurseprnRN, BSN, RN]

aky, did you take your boards in that big convention center in phoenix with me? i had just moved there from a new england state (what was i thinking?) and they told me to bring a sweater and i thought they were out of their minds, it was a hunnert and ten or more outdoors.

i brought the sweater the second day. and i was working evenings months later when i got my results.