I've been scanning posts in the nursing student section for awhile to get a "pulse point" Check about what's on students' minds. I'm a longtime educator (11+) years at a major university and a longer time nurse (29 years). I'm also an acute care NP with a PhD. I understand that this site has forums for networking, venting, problem solving and support for students of various levels. I find it utterly fascinating and disturbing about how much of the frustration is displaced to instructors when students' achievements don't match their personal expectations.
Timefor a few realities about faculty:
1. It's hard to recruit and retain good clinicians to teach when the academic side pays much less than the corporate side.
2. We don't set out to trick or "weed" anyone out. We need to know that students have achieved a minimal mastery level of key concepts.
3. There is an expectation that students who want to be nurses will do the work in terms of preparation, reading, asking questions, and coming to class.
4. We expect you to be a thinker and apply the information to different contexts. It is not unreasonable to expect you to pull prior content from other courses through to the patient in front of you right now. Patients will die and/or have bad outcomes if you can't minimally apply key content to different situations and critically think.
i think I'm done lurking here. I wish all the students the best of luck going forward!
I fully agree there are some lousy faculty. So use the time to teach yourself using the book and syllabus, then blast the instructor in the evaluations. They matter a lot, and are the single biggest factor behind non-renewal of a contract. You may not see that immediately, but in a year or two, she will be gone.
"One day a few of us were sitting around and they were discussing the final exam and some were saying if they don't score at least a 90 on the test they will fail the class and they were all complaining about the instructor and the exams and blah blah blah..... so eventually I got tired of hearing it so I asked one basic question I said:
It sounds like you all are deflecting your poor performance in the class on the instructor but let me ask you "What could YOU have done better to receive a better outcome" ..... The entire table got quiet....
and I never received a answer."
Ready2baRN
Wow! That was a really brave and a really critical thing to say. I am sure as few people thought about it. If they did and shifted their mindsets even a bit, you words may very well have changed the entire trajectory of their education and their careers.
I would love to have you for a student. And welcome to nursing--you are exactly the kind of mature, responsible, self-motivated, thinking person I want working alongside me as a colleague.
I am currently a nursing student who just passed (barely) my 1st semester at a prominent nursing school. Lets just say it is not a BSN program. I am an older student with a 4-year degree in Computer Science. I worked many years at a Fortune 500 company before being laid off because my job was moved to another state; therefore, I was laid off through no fault of my own. I wanted to use my computer science degree and the knowledge and skills I learned while working in the telecommunications field so I am hoping to eventually work as a Nurse Informaticist.
I have several things to comment about what you have said and what others have said. I struggled to do well on the exams during the semester even though I obtained exceptional marks during clinical and Practice Labs. I scored in the top 98% on my Nursing entrance exam required by the Nursing School. I've attended a failing program before switching to the nursing school I am at now. What I mean by failing is that the program had a 70% NCLEX pass rate. They have since dropped to below 70%. The school I am at now is approx. 90%+. Here is my bottom line observation of BOTH programs. The primary focus of both programs is their school's NCLEX ranking. Therefore, instructors want good test takers regardless of how they perform during clinical or labs. Exams are worth as much as 70 to 75% of your semester grade. Quizzes, classroom activities, projects are worth less than 10%. All the time and effort put into clinical prep, writeup, performance, does not help your semester average. The time spent preparing for Practice Labs and Sim Labs which include theory knowledge does not help you semester average. Therefore, this supports my statement that these schools are primarily focused on their NCLEX rating. With that said, I have seen students totally miss the main concept of their Sim Lab scenario test (which accounts for both skill and theory knowledge). One particular student missed all Sim Lab testing for the semester, but performed well enough on the exams to pass. For example, during Sim Lab, their postop patient had NO bowl sounds and had not had a BM in 3 days. This student wanted to give the patient an enema. Need I say more? When writing nursing diagnosis during practice labs, this student constantly asked their peers for help. This is an example where performance in Sim Labs should be included in some percentage in the average semester grade.
I am not a good test taker. I am a true analyst. It is my greatest strength. This attests to the comments someone on this post made about nursing instructors preaching "critical thinking" and assuming if a student performs poorly on tests that they didn't read the material or show up for class or just were not nursing material. I agree with that person who said that nursing is not the only critical thinking job out there. You cannot obtain a 4 year degree in programming without being able to think critically. There are many more fields that absolutely require critical thinking. I can relate my previous employment to nursing easily. My patient was a system. If it malfunctioned, I had to trouble shoot to find the problem and then had to come up with a resolution to fix the problem. The difference is that nursing exams do not simply test ability to think critically, it tests a students ability to pick the best right answer when more than one option is a right answer. And, there are times, its the instructor's opinion.
I busted my behind to read all the information in the textbooks, powerpoints, listened to recorded lectures, and studied with other students but still failed to pick the right best answer.
My question is, what is the purpose of having 4 or 3 or 2 right answers? Either you know what to do or you don't. Why can't the questions have 3 wrong answers and 1 right answer? What's the purpose?
The first school I attended was a joke. The instructors read straight from powerpoints. If the students stopped the instructor to ask more than a couple questions, the instructors would tell them they needed to move on to get through the powerpoint. This program had no classroom activities to help the students learn. This program could have easily been an online program except for the signing off of skills. The practice labs were a joke. There was not enough time allotted for lab. The instructors often used this time to finish a lecture (aka reading from powerpoints). There were approx. 25 students in a small lab with 5 beds. The instructor stood in front of the lab and hollered out the steps of the particular procedure as fast as she could and then went to lunch. I always read the book to get the steps down. But during sign off of skills, the instructors had their own opinion as to how the skill was to be performed. And they often disagreed from one another. Every exam there were at least 3 questions thrown out because students could prove the correct answer was not necessarily the best right answer the instructors deemed correct. A lot of times, students could prove contradicting statements made by the instructors. Finally, I truly believed that that students who struggled to perform well on exams were discriminated against in that the instructors did not want them to squeak by. They wanted good test takers so that they could raise their NCLEX rating. If one of the struggling students debated an exam question, they were told it was too late or flat out ignored. When struggling students went to instructors who were also advisors for help, they were told that maybe nursing was not their calling and that was it.
The school I am in now does have a much better program. Instructors are knowledgeable but if you continue to question something, you might get yelled at or ridiculed and continue to be ridiculed days later. Now, I am an older student and I may be a little more sensitive to being publically ridiculed than my younger classmates. But I truly feel disrespected at times. I always show my instructors respect. I behave respectfully at all times. I am a professional. In my previous career, I had employees reporting to me. There is protocol on how to deal with an employee that is "misbehaving" or has done something wrong. The same protocol should be followed in all settings. There is a time and place to handle issues with a specific employee/student and in front of coworkers/classmates is not it. It belittles the student and hinders learning.
Finally, about deflecting poor performance onto instructors, I do not do this. I own my poor performance in testing. I like to review my tests so that I can categorize the ones I missed. Is it a knowledge question, meaning I missed reading it in the textbook or powerpoint? Did I misread or misinterpret the question? Did I miss key words? I know all the testing strategies. I know my problem is that I try to know and understand everything in the textbook and take a lot of notes. This is time-consuming and does not leave much time to do higher thinking activities like concept mapping and practice questions. I can always narrow the possible right answers down to 2, but often choose the wrong one. As I said, I am a analyst at heart. In my opinion, this an attribute a nurse should have. They are not robots. But when taking these tests, you have to think very narrow-mindedly. It's hard for those of us that consider EVERYTHING and needs data to rule out possibilities. This does not mesh well with a multiple choice question that can have as many a 4 right answers.
I do have a couple issues where I feel instructors are not providing the learning experience necessary to perform well on tests. Its when they use "peer based learning". Now, here I will say that I am not paying my peers to teach me. I am paying the faculty of my school. These peers may know less than I do. During a lecture on Oxygenation, one instructor was always splitting us into groups to discuss things or come up with things. For example, we were split into groups and were to create a comparative chart with assessment data for the 4 main nursing diagnosis associated with Oxygenation problems. This particular day, one member of the 3 member group was working on her laptop and didn't participate. The other member in my group was not understanding what was to be done at all. This information was not easily found in our textbook. It was not explicit. Sometimes, the textbook is so detailed and wordy that you can get lost in the words that you don't see the concept. After the class activity was over, the instructor did not go over what we should have come up with. So, I do have a problem here. I am paying the instructor to teach me exactly what this assessment data is for each nursing diagnosis, not my classmates. I think it is important enough that the instructor should ensure we had the right information. If the info is truly in our textbook and the instructor or anyone else thinks that its "hand-holding" if the instructor tells us what the assessment data is for each nursing diagnosis, then why am I driving 35 miles to school and why am I paying thousands of dollars to this school if I am supposed to get the info from the textbook and not the instructor? I can assure you, I looked and looked but the textbook did not spell it out clearly. It didn't even include all 4 diagnoses. I used our nursing diagnosis book and found it on the internet after hours of searching. And this cuts into my study time.
Here is a similarity between the two programs I attended, they will not allow you to spend the amount of time you need to review the entire test. Actually, the first program which was the worst, did go over the entire test. It was faster than lightening and we were not allowed to hold our test in our hands when they were going over it. The second program, the better program, did not go over the test, but did hand it out so that you could see what you got wrong. You had to match it up to an answer key to get the right answer which was time-consuming. If you missed more than 10 questions (out of 50), then time ran out for you to analyze what you did. I believe I can learn from my mistakes. Just let me hold the darn test for as long as I need to figure out why I missed the questions I missed!!!!! Here is where I would really like to curse. I am not a cheater if that's the reason we are or not allowed to learn from what we missed.
I do not want to place blame on individual instructors. But I am placing blame on the philosophy nursing schools have adopted. They are driven by the NCLEX rating, not on producing quality nurses. I'm not saying these great test takers won't be quality nurses. Some I am sure will be. I am talking about the students who fail simply because they are not good test takers. I have actually developed testing anxiety because of it. No matter what any instructor says, there are questions that are simply trick questions. The exams are more about semantics than about theory, critical thinking, knowledge or memory. And for God's sake, why are nursing programs ranked by first time pass rate and how many questions it took to pass it? Everyone knows, first time NCLEX takers suffer from anxiety simply from not knowing what to expect. The second time around they will know what to expect and therefore will perform better simply for that reason. Or, maybe it just a bad day for the candidate but the candidate did not reschedule. Maybe a student starts cramping because they start their period or their head starts to hurt??? These things can make you care a little less and not spend as much time analyzing the question.
So often we hear that nursing school is difficult. I'm not disagreeing with that. But so are may other fields, such as engineering. This is being over used to explain away why so many nursing students do not graduate. Faculty are too concerned about NCLEX ratings. Nursing programs should use more than one source to determine a student's ability to be a quality nurse. Exams are worth 70, 72, 74% of total grade. Practice labs, clinical performance and nursing care plans, and sim labs do not factor into the number grade which determines whether a student passes. The semester average is to be 80 for most schools. All this points to test taking ability and not a student's performance in totality. Clinical performance and write-ups (nursing care plans), practice labs, and sim labs should contribute at least a small percentage to the total semester average. They take up a considerable amount of a student's time. I know these are pass/fail but do instructors ever fail a student? I've seen it when they don't. If sim lab performance impacts overall semester average, it can keep a student who performs badly in labs and clinical as well as hovers over a 79/80 test average from passing. It can help that student who can apply the theory in the lab and clinical setting and writes great nursing care plans but has testing anxiety. And the NCBON needs to take a look at what they have caused by ranking nursing programs by how many students pass the NCLEX the first time.
Specializes in OR, Nursing Professional Development.
My question is, what is the purpose of having 4 or 3 or 2 right answers? Either you know what to do or you don't. Why can't the questions have 3 wrong answers and 1 right answer? What's the purpose?
Nursing and patient care isn't black and white. There are a lot of gray areas. This is why a nursing student needs to evaluate different available options and determine which is the right one for that patient at that time. Sure, A,B, and C may all be appropriate interventions for a patient experiencing a COPD exacerbation, but maybe A isn't appropriate for that particular patient. Nursing isn't just about being able to regurgitate what was read or heard; it's about applying that information in choosing the best path forward in patient care.
[COLOR=#666666]jkm0807, Thank you for your information. I am a Director of an LPN program, and neither my faculty or I agree with having to teach to a test. Unfortunately in order to keep a program open we have to meet state set standards from that BON. We often leave questions in a test that may not be that great because we Love debating the question with the students, it improves their ability to critically think. I am new to academia after 37 years at the bedside. I thought and hoped I could make a difference, and I think I am. One thing I think I have noticed about some of the RN programs is that the instructors do not always have their MSN in nursing education, and so they have not had any education on how to teach adult learners. All my faculty have their MSN/Ed and this does make a difference. Just because one has clinical experience and has been a quality clinical instructor, it does not necessarily mean they will be a good classroom instructor, it is very different. Many instructors are still teaching like they are teaching fresh out of high school students, rather than adults who have had other careers. Approach and respect from both directions is required. I know the faculty from our ADN program do not agree with a great deal of how we teach our PN students, but all my students are non traditional. They are required to have been CNA, MA, or equivalent, so they have been out there, and know what the nursing field is about. It would be disrespectful of me to not recognize these adults for what they have to offer the field of nursing. Last year we were borderline on our 1st time pass rate 80%, 100% second take, just as you said, mostly related to test anxiety not knowledge or ability. We have incorporated chaos theory into our simulations. What this does is it provides the reality of what you will see in the real world, not the perfect situation. But the NCLEX is based on the perfect situation. So spend a great deal of time just practicing NCLEX type tests/quizzes/questions. Remember when picking the best always think QSEN first. Safety, ABC's. Thank you again for your insight it helps me be a better teacher and director.[/COLOR]
I had a semester like that; with snow and ice canceling classes as well (ice and Southerners are not a good combination). I referred to that semester as the "Winter of my discontent made glorious spring by the sun of only 2 semesters left to go". Thank goodness that was over a year ago.
At my school when professors were out sick or weather happened, they would post a recorded lecture on powerpoint. In 2015, there's no excuse not to have a lecture. Students are paying for an education, not to study on their own.
At my school when professors were out sick or weather happened, they would post a recorded lecture on powerpoint. In 2015, there's no excuse not to have a lecture. Students are paying for an education, not to study on their own.
I agree about the recorded lecture. I am not sure if you meant what you said about paying for an education not study on own.
If you mean you should have guided studying I am ok with that, if you think that paying for education does not include your part of the learning process of studying on own, then I am a bit confused on that.
The primary focus of both programs is their school's NCLEX ranking. Therefore, instructors want good test takers regardless of how they perform during clinical or labs. Exams are worth as much as 70 to 75% of your semester grade. Quizzes, classroom activities, projects are worth less than 10%. All the time and effort put into clinical prep, writeup, performance, does not help your semester average.
Wrong-o. If they are using primarily NCLEX-style questions, you should realize the opportunity those care plans, classroom activities, and labs are giving you to master nursing concepts and judgment. Note that this is not all something that you can memorize, if you're heavy into learning data points. Context is everything. Sometimes the lessons you should be learning in labs and clinicals and clinical prep exercises like care planning -- and the questions being asked in NCLEX-style exams -- are not what you think they are on first glance. This is a common student error.
And critical thinking and analytic skill comes in many flavors. Clearly, for a computer science person, there can be only one outcome from such a process: THE right answer. Your subsequent comments indicating that's what you want and expect in testing make that clear. However, nursing is not computer science. Questions can have more than one plausible answer but only one correct one precisely because there is more going on in actual patient care situations. These are not binary.
The classic example I use to explain this concept is the scenario of the abused wife who, back again after another beating, states she will not leave her husband, and you, the nurse, are counseling her. Of the two plausible correct answers, one is, "And yet you are here. Let's work on a plan to keep you safe." The other is, "You must leave him for your safety. Studies show that he will do it again."
While both are true, only the first is the correct answer. Why? Because the registered nurse knows that part of her responsibility is to lead the path down to better health, and it is always the patient's decision how to choose to do that. The first acknowledges the situation as it is without judgment, and offers a way for the patient to empower herself in a way that does not deny her choice. The second answer denies the patient's feelings and her expressed desire, and will turn her away from the nurse. The nurse who has a deeper understanding of her professional role will discern the difference. This isn't something you can memorize; it's part of your assuming, internalizing, the professional role. This question is not about spousal abuse; it's about professional roles and the most basic philosophy of nursing practice.
Binary-oriented people will not get that and will argue ad infinitum about how they should get that point because there are two correct answers. No, they are wrong, and they won't.
cnmbfa
151 Posts
I fully agree there are some lousy faculty. So use the time to teach yourself using the book and syllabus, then blast the instructor in the evaluations. They matter a lot, and are the single biggest factor behind non-renewal of a contract. You may not see that immediately, but in a year or two, she will be gone.