A Deep Dive into NCLEX Next Generation 2023

[londonflo]

On 7/21/2022 at 2:20 PM, nitenurse said:

Curriculums do not teach critical thinking,

I almost want to say "Good night, Nurse! " I do not know if you have actually taught in a formal/informal structure but critical thinking is embedded in nursing courses.

On 7/21/2022 at 2:20 PM, nitenurse said:

Just pepper real-life scenarios/cases throughout the anatomy/physiology curriculum to get the students prepared for what they will see on standardized exams

Okay, "Your patient (Chad) was born with out legs... What would you say to the grandparents who expect Chad will be mobile by the end of their first year". Agree/disagree and explain your answer. 

A college curriculum cannot dove tail all courses to the outcome required of a nursing professional. Many disciplines take A/P, Chemistry, Human Growth and Development, etc. that are supportive of their eventual degree. How do you design a  question such as the one above that meets the needs of a college student in  a pre-law, pre-med, pre-nursing, pre-theology, pre-psych, pre-physical / occupational therapy etc? 

Look ..it took us 100 years to get out of the "hospital-based "nursing program where we 'train our own'. It is imperative that nursing students be main-streamed and not tunneled into 'nursing thinking' on day one.

[nitenurse]

As I stated, pepper scenarios that would be found on standardized exams, not every situation that a nurse could possibly encounter (that's just plain silly to even attempt). So, for example, the if taking anatomy & physiology II and the section is covering the endocrine system, once the basics of hormones and associated glands/organs are covered, add a scenario that encompasses what was just covered to tie it all together as opposed to the checklist method that is so common today.

[hppygr8ful, ASN, RN, EMT-I]

Not everyone who takes A&P is studying to be a nurse so how does the above suugestion helo thoses folks

 

[Nurse233]

Absolutely correct. And the majority of nursing students seem to leave all their pre reps at the door when they leave that class and the nursing faculty must reteach the A&P instead of just review prior to application of information the nursing concept they are teaching. If students have a solid foundation in the science pre reps it is much easier to grasp the nursing concepts(perfusion, oxygenation, etc). Our school worked with the science department to move to application of the science, not just rote memorization of facts. The retention of info improved for students who took their sciences at our college. 
Nursing is not easy and patient safety and care will always remain the priority!

[londonflo]

13 hours ago, hppygr8ful said:

Not everyone who takes A&P is studying to be a nurse so how does the above suugestion helo thoses folks

A foundational science course should not be geared to only one future discipline or use of that information. 

 

11 hours ago, Nurse233 said:

And the majority of nursing students seem to leave all their pre reps at the door when they leave that class and the nursing faculty must reteach the A&P instead of just review prior to application of information the nursing concept they are teaching.

What nursing faculty have time in the nursing curriculum to teach pre-reqs again?  Most nursing textbooks have chapters to assist the student to review the application of information from A & P (medical surg texts, pharmacology texts) and of course a student would need to actually read those chapters, . When do we stop spoon feeding a student and instead say "you have access to the resources that you need?"

I was surprised when my son in medical school said he did not have specific required textbooks. From day one, it was instilled that a professional is responsible for their own education. Through communication, collaboration, personal reflection on study skills, etc. the medical students shared what would be the best resources with each other.

[FiremedicMike, RN, EMT-P]

I'll say this.

I genuinely appreciate the work you guys are putting effort into changing the exam to try to better prepare new grads for practice.

With that said, we must accept the fact that there is no medical profession where new grads are 100% ready to go out of the gate.  No test is going to take the place of quality new hire orientation.

[NICU Guy, BSN, RN]

I am not sure if it be a viable way of testing the NCLEX- Next Generation validity, but they could have sent emails to random people that passed at 75 questions and ask them if they would be willing to take the Next Gen. test to see how they would perform. If a high percentage of those people "pass" the Next Gen test quickly, then the validity would be pretty high based on current nursing school teaching (old NCLEX format).

My fear is that it could take time for all nursing schools and NCLEX test prep companies to accurately hone in on how to teach students to get into the mind set of taking the new NCLEX format. I think that it will take at least a year before the pass rates will return to old format levels. 

[nitenurse]

On 7/25/2022 at 5:58 PM, hppygr8ful said:

Not everyone who takes A&P is studying to be a nurse so how does the above suugestion helo thoses folks

 

A couple of thoughts:

1.The discussion here is directed specifically at the NCLEX, not overarching talking points for all healthcare disciplines, however, with that being said:

2. I state this everytime this topic comes up here; nursing should have its own specific classes just for nurses; healthcare is so hyperspecialized anyway so why not? Oddly enough, a provider told me yesterday, that he was requested to do a lumbar puncture, he said he hasn't done one since '96 and to get someone with more recent experience or a student/resident/intern. I said that to say that all of the general topics covered in A&P will not be used. Histology for example, I had more than one instructor skip those sections entirely. Every one of them said "you guys/girls will be nurses, not lab technicians looking through microscopes and preparing slides; this won't help you pass the NCLEX or help in your daily grind."  -and they were right

[nitenurse]

On 7/25/2022 at 8:19 PM, Nurse233 said:

Absolutely correct. And the majority of nursing students seem to leave all their pre reps at the door when they leave that class and the nursing faculty must reteach the A&P instead of just review prior to application of information the nursing concept they are teaching. If students have a solid foundation in the science pre reps it is much easier to grasp the nursing concepts(perfusion, oxygenation, etc). Our school worked with the science department to move to application of the science, not just rote memorization of facts. The retention of info improved for students who took their sciences at our college. 
Nursing is not easy and patient safety and care will always remain the priority!

This absolutely correct. I work at a teaching hospital and I don't believe that a single student has been able answer basic A&P questions when asked. However, its like any other experience, its use it or lose it. For example, Chemistry. Ask me the specific heat capacity of a substance at 25 degree Celsius, I couldn't tell you. I did what was necessary to slog through the class to make it to the next one. Will knowing how to determine specific heat capacity help someone pass the NCLEX with ease or push a diltiazem drip? Sciences are quantitative and formula driven. How does having a solid science foundation train one to critically think with regards to patient care? Patients are not equations that need to be solved -not by nursing anyway

[nitenurse]

On 7/26/2022 at 8:00 AM, londonflo said:

A foundational science course should not be geared to only one future discipline or use of that information. 

 

What nursing faculty have time in the nursing curriculum to teach pre-reqs again?  Most nursing textbooks have chapters to assist the student to review the application of information from A & P (medical surg texts, pharmacology texts) and of course a student would need to actually read those chapters, . When do we stop spoon feeding a student and instead say "you have access to the resources that you need?"

I was surprised when my son in medical school said he did not have specific required textbooks. From day one, it was instilled that a professional is responsible for their own education. Through communication, collaboration, personal reflection on study skills, etc. the medical students shared what would be the best resources with each other.

That's what Ben Carlson did. He never attended any lecture and just read the medical texts -he said he learned better by reading

[londonflo]

11 hours ago, nitenurse said:

nursing should have its own specific classes just for nurses; healthcare is so hyperspecialized anyway so why not?

I think I will agree to disagree. When nursing becomes a post BSN discipline, such as medicine, physical, speech and occupational therapy, and then a Master's required position I agree with what you are saying. Otherwise you are taking us back to the age when an18 year old, attended a hospital sponsored school of nursing, limited to the education to what was needed by the floor nurse. No required general education requirements. My first teaching position was in a diploma school of nursing that was well respected but...well...a diploma school. (we became the second diploma school to transition with full credentials to a BSN). The old (early 1900s) classrooms had blackout curtains so the students would not see what time of day it was. (like skid bars/taverns that blacken the windows so the patrons don't know if it is morning or night). (When I taught there, the  current classrooms had been added on) Students in that type of program, went to the hospital to do morning 'duties' and had class ( specific to nursing, only specific to nursing, specific to what they would/should do as a nurse)  in the afternoon. They went back in the evening to do night duties. They learned everything about what nursing was (circa 1900) and did it well. 

 

11 hours ago, nitenurse said:

I work at a teaching hospital and I don't believe that a single student has been able answer basic A&P questions when asked.

Why are you quizzing them?

11 hours ago, nitenurse said:

That's what Ben Carlson did. He never attended any lecture and just read the medical texts -he said he learned better by reading

I did not intend this to be a reading or attending class. My son did both.

11 hours ago, nitenurse said:

.The discussion here is directed specifically at the NCLEX, not overarching talking points for all healthcare disciplines,

That isn't how it works here.

 

[londonflo]

12 hours ago, nitenurse said:

I said that to say that all of the general topics covered in A&P will not be used. Histology for example, I had more than one instructor skip those sections entirely. Every one of them said "you guys/girls will be nurses, not lab technicians looking through microscopes and preparing slides; this won't help you pass the NCLEX or help in your daily grind."  -and they were right

I missed this in my first read but many times there are suppositions regarding that what we were taught, helped us achieve our goals and therefore should be the standing order of things. Your quote reads like you were in a nursing students only course. This is not a 'general' A&P course. You were funneled into this course because of a nursing major, and while the professor delivered the course in a belittling way (by limiting what was taught because 'you are just becoming nurses') , may be someone else in the class wanted to really learn A&P or had their passion ignited to something else (or got sucked in by the catalog course description thinking they were getting the full A & P). (read those stories on AN)  Anyway the course delivered what it was designed to do: you are a nurse,

12 hours ago, nitenurse said:

 this won't help you pass the NCLEX or help in your daily grind."  -

The professor was a genius who could see the future -- or was it created for you?