Education Interventions to Pass NCLEX

barb4575 · Dec 22, 2003

that no one has replied to this thread....I wish someone would...thank you! I could use some assistance. From what my students have told me they can't seem to get faculty interested in the topic...wonder why? Perhaps the low pass rate has something to do with it or it takes too much effort or what else?

Barbara

LadyT618, MSN, APRN, NP · Dec 22, 2003

Hi Barb,

I'm an ADN student and I would have to agree with you with the correlation between low pass rates and a disinterest in the topic of NCLEX review. I know the professors at my school just discovered a couple of weeks ago (mind you this is my first semester) that it would be a good idea to set aside quality time to go over some NCLEX style review questions for our exams that we have in class.

I feel this is something that all schools should do, from the beginning of the semester. Hey, maybe that can even make it some type of mandatory class that all students should take. Although, personally I don't feel the review sessions we've been getting are all that helpful (it could be the way they are handled). However, another student may find them extremely helpful.

As for tips on how to review, I guess you can have students buy one book each so you have a wide variety of questions to ask. I know my professor suggested that to us for study groups.

I also think it is very important that you mix both psychomotor and critical thinking skills. Both are equally important and depend on one another, in my opinion.

Toni

barb4575 · Dec 23, 2003

Toni,

I appreciate your comments and I do know a student who has passed the NCLEX who has many resources....she is going to place them in the office for other students to use. I do use Practice Questions in the beginning of class for my higher level course .... I get them online from Delmar and Kaplan. The students seem to like doing this too. So, perhaps I need to do this with Foundations students too.

I always wonder what people mean when they say they are taking a test with NCLEX-type questions...I think as long as the faculty utilizes Bloom's Taxonomy and provides questions that are at the Analysis and Application levels, we should be providing NCLEX-type questions. One of my students said that her final consisted of NCLEX-type questions and she said it was extremely difficult. I am asking the professor for a copy of that exam to evaluate it.

As in the real world of education, it is my students who assist me the most often...thank you for your assistance!

Barbara

LadyT618, MSN, APRN, NP · Dec 24, 2003

No problem, glad to be of help! Let me know how those questions (from the final) are.

Talk to ya.

Toni

indie · Dec 24, 2003

In my school we revamped all our examinations to be in the form of NCLEX style questions. It took a few years to get to that point, but it did help our students by their own reports.

Writing NCLEX style questions is a skill in itself - I had been an 'item writer' in another state and was also used to teaching part time for Kaplan, so I gave a workshop on how to write appropriate questions - this needed DON support and some staff were against it at first. I was also surprised at the low level of educational knowledge of the instructors - things like Bloom's taxonomy were new to so many. Eventually, with DON support, we gave workshops/CEUs for staff in these areas too.

Schools with 'low' pass rates do not continue to receive BoN approval for the program; this is one thing the BoN monitors well because they are a consumer advocate agency and the students, to some extent, are consumers of what the school purports to offer. So I question the issues over 'low' pass rates. How does your school compare to the average in your state, or nationwide?

When pushed by students to recommend an NCLEX style question book I would suggest the National Student Nurses' Association book - it seemed closest to what I knew about NCLEX questions.

I do think it is very important to dispel the myths about NCLEX-RN (CAT) for students. Hold a fact session about the test with exact details on how a student is determined to pass or fail (this is complex - best illustrated by a graph with a hurdle on it, I believe), about the time issues involved and the mandatory break and optional break.

Remind them to take water and possibly a snack and to take a test run to be sure they know how to get there and where to park etc. Do reinforce, 'while the computer is running, you still have a chance to show you can pass the test. Keep on.' I've had students take five hours and get thru nearly all the questions and still pass. Or had students failed with a shut off at 75.

Remind students that the first questions are for practice, but they run into the real test with no clear break. Tell them that if a question just reads in a weird manner, to make a choice and move on (it is just possible that question is not part of the test, but is itself being 'tested'.

Warn students that the test center may not have ideal conditions e.g. some students of mine took NCLEX with road works and drills outside the window or noise in the test center.

Otherwise I just taught good nursing care, did not get into expert care scenarios with students as NCLEX tests a new graduate, not a critical care RN, critical thinking skills (e.g. we all know that to prevent osteoporosis, regular weight bearing exercise on the long bones is a good idea - make sure they can translate these sort of stylized responses into real life and realize this includes dancing, safe weight lifting.) I was surprised at the number of students who could trot out the text book statements, but did not know what these statements really meant in practice.

Hope this helps.

TSELBER · Dec 24, 2003

i recently passed the NCLEX RN i used the Saunders NCLEX review i found it very helpful.

Tara

barb4575 · Dec 26, 2003

I just tried to check on how my college rates with the state of IL, but I cannot find the information. At this school, it seems to be a secret what the pass rates are...I recently asked the Dean who stated it was 84%...which is the exact pass rate of the last BSN program where I had taught, but did go up during my time there. Could you direct me to a site that would inform me how this number compares to other nursing schools? I had not thought of doing that until you mentioned it here so thank you. I merely was not pleased with the number and decided something proactive must be done.

I was also wanting to ask you if you had learned how to write questions for tests in graduate school? We had to do this in exercises and identify which of Bloom's taxonomy we were testing. I learned a great deal from those exercises. Also, several years ago, I had discussed test item writing with another faculty member who wrote questions for NCLEX. When I reviewed some of her questions, I did not see that it was critical thinking that was being tested...many were at the knowledge level. So, I am confused about what exactly writing questions like NCLEX means....to me, it would be testing at the application or analysis level of Bloom's taxonomy.

I appreciate your assistance,

Barbara

Tim-GNP · Dec 26, 2003

I can't remember... I think it was in the most recent issue of Nursing Education-- there was a fairly well done study that discussed preparation for NCLEX. I can't remember the entire content of the article, but it was pretty good. If your school subscribes, check it out.

SteelTownRN · Dec 27, 2003

Here are some of the things that I've done in class and clinical to foster critical thinking/NCLEX success:

1. 5 multiple choice questions at the end of a lecture. Review them with the students. Talk about how to reason through each question.

2. Advocate buying an NCLEX review book during the first semester of clinicals and using it throughout clinicals, not just at the end of the program.

3. Test review for the entire class is immediate. Students can silently look at a copy of the test taped down to a table in the back of the room, as they finish they can go back and look. Immediate test review helps them to learn from their mistakes. I require students who fail exams to do a 1:1 review with me in my office within a week of the exam. Not as punishment, but to pinpoint their weaknesses before the next exam.

4. After AM report, I ask each student individually to rank the patients in priority order (ie who needs them the most according to what they heard in report). I also ask them to list nursing diagnoses for each patient that they heard about in report.

5. My clinical group has a "drug of the day" discussion in post conference once a week. I tell them the name of an OB drug, and they have to look it up during their shift and memorize whatever they can about the drug. In postconference, they each must tell a fact about the drug, but not repeat what another student said.

Hope some of these ideas work for others!

STG

barb4575 · Dec 31, 2003

I am printing out all of your replies and they are excellent and helpful strategies. SteelTown...I love the idea of giving five MC review questions at the end of the lecture....do you do this in written form or verbally? I do some of the other things that you mentioned already, but it is helpful to be reminded as well.

Happy New Year,

Barbara

GN2RN · Mar 2, 2004

I must say I like your approach. I bet it proved to be very beneficial for your students.I sure could have used an instructor with your style of educating when I was in nursing school.

I would like to see more emphases directed towards the preparation for the skills needed to become successful when sitting for state boards. This needs to take place from the very begining and throughout the students educational experience. Gaining the knowledge of the nursing curriculum along with the application of that knowledge in any given situation, nomatter how simple or complex it presents, is the basis for which we can build our critical thinking skills.

I love the idea of prioritizing the clients based on report. The more you do the better you become at recagnising what takes priority over what. Very important.

You have to know, what is the question asking me? break it down. exercise your thought process, reason it down. The more you do the better at it you become.If the nursing program i attended prepared me my utilizing these simple but so crucial study skills,I would have been well prepared for state boards. Keep up your great work

Please excuse my spelling and grammer but this leasure time for me