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Discussion

Can any Nursing Educators explain the rationale behind licensing/certification exams?

Hi Venerable and wise nursing educators:

I was hoping one of you could give me some insight into the thinking behind nursing licensing and certification exams.

I just took and passed my CCRN certification exam on 8/20 and of course I am very happy that I passed but am left with lingering frustration regarding the exam. First of all, there were 25 questions that were not graded on the exam and according to one of the teachers of a course I used to prepare for the exam, you could be in the middle of a medical library and would not be able to answer most of those questions. There were some unbelievably obscure questions, that none of my prep courses had even remotely touched on. In the middle, of my test, I am wondering is this one of those unanswerable questions or not? It was very disconcerting to say the least. The CCRN requires 70% to pass, and I passed with 85%, but I left the exam feeling like if anything I "lucked out". I now have my CCRN certification, but what have I really mastered?? Is the intent to see if one can handle stress?

Personally I think these exams should absolutely be tough and test nurses knowledge and critical thinking, but would it be so wrong if the exam itself actually empowered one? I also believe the NCLEX is even worse...why does it have to be so demoralizing? I watch a lot of the graduate nurses posts and it is very frustrating for me, because I don't understand it. It would seem to me that nurses would want to empower new nurses as they left nursing school...does anyone ever feel that they really 'aced' or 'nailed' any of these exams??

I don't know, perhaps all licensing exams are like this.

Just let me say that preparing for the CCRN exam itself was very empowering, taking the exam was disempowering, even though I passed....is that what we really want our examinations to do??

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I agree with you. I took the CCRN and the CEN and do not feel like I have 'more knowledge' now to care for critically ill patients than I did before. I feel broke, in a sense that I spent over $1000 for study, prep, book and fees for both tests. I will admit it looks good to put on resumes, however, I do not feel like it made me a more knowledgeable nurse.

As far as NCLEX, I am still trying to find out why the state boards of nursing grade nursing school on first time test takers??? In fact, if the first time test taker score gets to low, the board can actually shut you down. Don't get me wrong, I think a certain number of students should pass the NCLEX, however, I think their should be more criteria than just " first time test taker"

Anyway, just letting you know, you're not alone!!!

  • Author

As far as NCLEX, I am still trying to find out why the state boards of nursing grade nursing school on first time test takers??? In fact, if the first time test taker score gets to low, the board can actually shut you down. Don't get me wrong, I think a certain number of students should pass the NCLEX, however, I think their should be more criteria than just " first time test taker"

Anyway, just letting you know, you're not alone!!!

Thank you for the response to my post. Can you explain what you mean. Are nursing schools actually judged on how many students pass or don't pass the boards the first time and what their scores are? This whole scenario is becoming even more convoluted! So the board of nursing actually controls nursing schools as well? Yow!!

  • Expert
Are nursing schools actually judged on how many students pass or don't pass the boards the first time and what their scores are? This whole scenario is becoming even more convoluted! So the board of nursing actually controls nursing schools as well? Yow!!

Who did you think controls schools of nursing? Yes, they answer to the state BON (among other entitities). The state BONs exist to protect the public by regulating the practice of nursing within the state -- if a school of nursing is turning out significant numbers of graduates who can't pass the licensing exam the first time, that is considered evidence that the school is doing a poor job of educating potential nurses, and the school is placed on probation and monitored to see that it fixes whatever the problems are, and it can eventually be shut down if the situation isn't improved. (But it's purely on a pass/fail basis, not what individual scores people get). I know that doesn't appear to protect the public, since the licensing exam weeds those people out, but think of it as protecting the nursing students (who are members of the public, too! :)) from poor-quality schools.

As for certification exams, they are not intended to make you more knowledgeable in your specialty -- they are intended to verify ("certify") that you are knowledgeable and experienced in your specialty. I took the generalist certification and advanced practice (after I got my MSN) certification exams in my specialty and, in both cases, there was stuff on the exam I had never heard of before. But I passed in both cases so, hey, I'm not complaining! There does seem to be a certain degree of "Ooooh, look how much I know!" in the test-writing process, though. :wink2:

The NCLEX is another matter -- I cannot begin to shed any light on the thought process there ... I'm now officially an old fogey, from the days when the boards were only offered twice a year; you showed up on that date or you didn't, and it was two 8-hour days of testing. Now the exam seems more like playing the lottery than taking an exam to measure your knowlege and competence to enter practice. I'm not saying this to ruffle any individual's feathers here, but I am pretty offended (and I'm certainly not the only one!) by the idea that people are now getting licensed as RNs on the basis of having answered fewer questions total than my "generation" had to answer in each specific specialty area of nursing.

I can guarantee you, though, that "empowering" nurses or boosting their sense of self-esteem is not considered a function of any of these exams, and why should it be? The point is to (attempt to, as much as possible,) objectively measure your knowledge and competence, and to weed out people who aren't up to snuff. I doubt v. much that anyone, in any profession, has ever come out of her/his licensure exam feeling pumped that s/he "aced" the exam -- you take it, you pass it, and you get on with your life ...

  • Author
who did you think controls schools of nursing? yes, they answer to the state bon (among other entitities).

if i had known who controls schools of nursing, i wouldn't have asked the question....what i thought was the acrediting institution would be the one's monitoring their compliance with certain standards. but, i appreciate your edification in the manner.

i would prefer a more comprehensive approach on the nclex and on the ccrn...i would definitely be more empowered by an expressing of my knowledge in a complete way. this studying of questions and their rationales does not to me contribute to a holographic understanding of the material. but of course, it would be too expensive to grade, i would imagine.

i spoke with a psychologist friend of mine and apparently their licensing exams are just as brutal. a master's level psychologist passes at 50% and a phd at 85%. also, i hear that accountants exams are also extraordinarily difficult. apparently this is the nature of the beast.

we may not like it but that is the way it is.

Testing is a business unto itself. There is a whole science behind how to create tests that actually measure what you want to measure. Cert exams generally are designed to measure application and critical thinking as well as, or even more than. knowledge. Knowledge fluctuates. The math behind reliability and variability is what tests are based on. So to answer your question - nope. The test was probably set up to measure the "average" person taking the test so that the test can be updated to reflect current practice. So glad you passed. I hear that is a hard one. Mine is in staff development.

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