Before going into nursing, I did a bachelor of science and I can really tell the difference between the exams in nursing and in science .... in a BAD way. I always did really well on my science exams (even though they were hard and you had to study ten times harder). The concepts built on one another, and the test was cohesive. Tests were mostly written responses, in which you had to recall information on your own!
When I write a nursing exam, it feels like there's all these bits of information scattered everywhere, nothing feels cohesive about it. Exam questions are almost exclusively multiple choice and either OVERLY simple (i.e. anyone could get the correct answer even without studying) or OVERLY weird (not hard, WEIRD.... as in you don't know what the question is asking.... or the correct answer is missing.... or there are 3 equally correct answers!) I am so sick of not earning the marks I deserve in this course! The exams should be validated by an external reviewer, and then maybe change would occur!
There are several major problems with this. For me, I end up studying overboard for every exam (30 hours plus), which doesn't help anyway!!! (My average on a nursing exam is 80% but I can get an A+ on advanced organic chem? HUHHHHH?????) Others end up with the attitude that "you cannot study for a nursing exam." What's up with that? I think it would be better to give an exam that is well validated and structured with correctly worded questions and answers that truly test our knowledge. In the end, students will end up with the grades they worked for rather than settling for something less than they deserve because of horribly written questions!!
nursebet seems far more interested in being right and in carrying the day than in taking in what anyone has to say. As a result, he/she will be less likely to "get" how those exams are constructed and will be unable to see that they mirror aspects of the Nursing Process. Oh well! We won't be suprised then when he or she struggles to pass NCLEX. That said, what does this stubborn refusal to adapt say about his or her ability to deal with workplace changes or ability to find ways to think out of the box?
It's not about being right or wrong... In my experience, I haven't found that these tests challenge my critical thinking - good for you if they challenge yours.
Don't make assumptions about me - As much as you'd like to think I'm throwing tantrums wherever I go, I'm not the drama queen you make me out to be.
I simply think that a strictly MC based exam is not comprehensive and is not entirely fair. I'm not going to change my mind based on a few opinions posted here, although there have been some interesting perspectives and I agree with much (but not all) of it.
Just because I disagree, doesn't mean that I'm unwilling to adapt~~ quite the contrary, I'm willing to agree to disagree... :)
I left a well thought out comment but it didn't post. Long story short: I don't think anyone would think you're throwing a tantrum if you didn't cite your grades from things like ochem as evidence that there's nothing that you need to work on, but there must be something wrong with the exams you're taking. I know those who have PHD's in chemistry, who would dance circles around you in chemistry and would still do poorly on a nursing exam. The two are not even remotely related, take it for what it's worth.
Also, those who create and provide the curriculum may or may not know more about ochem than you, but they do know a LOT more about nursing and how to evaluate nursing students. Take that for what it's worth, too.
Specializes in Progressive, Intermediate Care, and Stepdown.
Boy O Boy! I relate to what you are going through!!! I don't have a Bachelor's in Science. However, I too, aced science tests. I could recall just about anything. I would study 30 + hours a week for one course and in the end, I would do very well.
When I got into the RN program, it was totally different. The testing really through me off. I didn't understand it. And, more importantly, I didn't agree with how they were testing us. I was an A student to B's and below sometimes. How could this possibly be? I'm smart. I can discuss all this beautiful pathophysiology with you. I can discuss causes of lab values. I could discuss the findings of a diagnostics such as a Chest Xray and sometimes an ECHO.
However, my grades started to fall. My resentment started to increase and increase. I discuss that in a bit. However, back to what you said about your previous experiences with science tests. Yes, they are definitely cohesive and build off one another. For instance, the relationship between organs and organ systems. It's like scientific information is like A + B + C + D= E. In our scientific mindset, this makes perfect sense. I love when something builds upon each other. Science is really for me.
But, nursing is not cohesive. Let's think for a moment. When is patient's situation ever straigt forward? When do we ever get an A + B + C + D= E type of patient. Our patient situations are sooo complex with many different factors involved. Imagine this. Patient X
Patient X, 60 y/o male
Admit for shortness of breath
History of CAD, CHF, pneumonia, hypothyroidism, smoking X 35 years, COPD, BPH, PVD, bilateral femur fracture and repair, depression, and bipolar disorder type 2
Patient is on 12 medications at home but only brought 6 with him
Patient has a CxR, ECHO, and circulatory studies done
MD admits him for CHF exacerbation
While admitted, has a stroke from a-fib
Transferred to acute neuro unit
On the neuro unit, falls and hits his head. 12 stitches required for the laceration
Etc.
Etc.
Etc.
Ad nauseum
I don't mean to sarcastic but do you see where I'm coming from. This situation is very feasible. And, this situation is very non-cohesive and very complex. Where does one begin? If I had this patient, he would be a handful. About the only cohesive action a nurse could do is start from square one. Work the nursing process. If you're a fan of cohesiveness, the nursing process is where to go. Of course, the nursing process is dynamic and changing according to patient condition. Assessment leading to diagnosis to etc. is where one can begin.
I really, really, really see where you are coming from. I battled with similar thoughts early on. I mentioned resentment earlier. I was tired of the way the nursing instructors were teaching. I thought they could do different methods. The powerpoints are bland. There are no pictures. It was always approached with the same lame and boring methodology. I was just bored, pis*ed, and resentful. I wasn't willing to change because I thought the instructors were the problem. Yes, there is always room for improvement! But, I wasn't willing to change and adapt (a useful nursing characteristic). My grades fell and I ultimately begged for a break from the program. I took the rest of the semester off and I cleared my head. I needed it dramatically. I learned that I needed to adapt, change, and take my learning in my own hands. I don't blame the nursing instructors anymore but I also don't rely on their teaching. I'm proactive in it.
I would strongly recommend to you to let this one go. Seriously, I was in a similar mindset. It almost ended my nursing career before it began. I know it will be tough as it was for me. Accept what you cannot change at this immediate time. For what it's worth, there is extensive research about how nursing instructors should test students. Extensive! I looked some of it up. It's really tough formulating tests that effectively evoke the knowledge we are supposed to have. Imagine trying to formulate a test for Patient X. I personally wouldn't know where to begin in a nursing sense. I could test all day on the pathophysiology of the diseases sure but in a way that effectively prepares one for the nursing field. Probably not. Furthermore, I'm pretty sure all the test are reviewed among the nursing staff. If there is a question that causes problems, the staff should adjust and make changes. If you're curious, you could just ask about it. I'm sure they would be willing to answer your questions about it.
Most importantly, try to let this one go. Festering about testing that is out of your control will do you no good. I assure you. I can relate to this. I festered and festered until I exploded. Also, try to talk to someone either in the staff, a friend, spouse, counselor, or someone. It really is beneficial to do so. I did and it felt good to get all of those crap thoughts out of my mind. Anyway, I hope this helps! Take care and good luck!
I'm in my last semester and a portion of our exams are short answer essay style questions - worth 20 points. Mostly Pharm questions. They are actually a lot easier IMO than the MC questions. Go figure.
Also, if you are doing care plans - Wouldn't you consider that akin to essay type questions? Also how are your clinicals structured? For us, we had to be prepared. At any time, our CIs would "quiz" us on patho,pharm,interventions,teachings, whys,hows,whats. Its not just all about the MC exams that test our knowledge. At least not in my program.
Sorry, I didn't intend to sound like I was throwing a tantrum. . . It was just an incredibly frustrating experience for me. . .
I had some wicked exams in ochem, but I was able to pull through by focussing on what I had learned and applying my skills. . . I realize ochem is not remotely related to nursing, but it is frustrating that nursing exams seem "easy" but the wording is "tricky" and no one pulls an A... Even if you think you know your stuff inside and out going in... even if you've analyzed everything to death...
However, a lot of people here have helped me put the tests in perspective and have offered alternative ways of studying for the exams - so thanks for that! I still don't agree with strictly M/C for any exam, whatever the subject..... It doesn't show what you actually know, it simply reveals whether you can weed out the right answer among options. (In my opinion). But I appreciate all the different perspectives about the tests :) it's helped me lots!
I'm in my last semester and a portion of our exams are short answer essay style questions - worth 20 points. Mostly Pharm questions. They are actually a lot easier IMO than the MC questions. Go figure.
Also, if you are doing care plans - Wouldn't you consider that akin to essay type questions? Also how are your clinicals structured? For us, we had to be prepared. At any time, our CIs would "quiz" us on patho,pharm,interventions,teachings, whys,hows,whats. Its not just all about the MC exams that test our knowledge. At least not in my program.
Yes, I would consider care plans like an essay type question - that's a great point. However, apart from the clinicals, apart from any essays I write, apart from tutorials, etc....
I still think the test itself needs to be carefully analyzed for what it's worth - is a strictly M/C based exam just as effective as a mixed test, with written answers included? I think you can evaluate what a student has learned more effectively from a mixed test.
"how is the content validity assessed? sometimes it feels like the tests are not comprehensive enough and important areas are being missed. are the tests reviewed by a review board prior to writing the tests? to ensure adequate coverage of all important content? are all the questions reviewed for grammar and accuracy?
furthermore, shouldn't the tests be validated (somewhat) before administering them to students? after they are administered, the results might provide further evidence of the test's validity... but we need to know the tests are valid prior to administration! also, even if there is a standard bell curve, are enough students earning as/a+s on the exam? "
i once had a legal case involving these very issues. not being an expert in the educational statistics used by the faculty whose work was in question, i called my daughter the professor of education research, who actually is. she explained that the stats used to validate questions look at things from a few different directions.
one is the straight "how many people got this wrong/right?" imbalance can indicate either the item is very easy or too hard/misleading. however, it's not enough to look at this and make a decision on the validity of an individual item.
then they get into, "what students got this wrong/right? did their answers on this question relate to/predict how they did on the exam as a whole? that is, did more people who passed get this one right, and did more people who failed get this one wrong?" stats can look at the power of this prediction, which is a measure of how good the question is. if the correlations are weak, the question is tossed or reworked for the next edition of the test. if the correlation is strong, that means that no matter what you think, the better students did get it right, and the not-so-good ones got it wrong. this is confirmatory, not unfair or illogical. the not-so-good students hate this, especially the ones who want to argue that their answer could be right, too!!! (and it rarely is) but it's a valid way to look at exam outcomes.
there is no such thing as "enough" students earning as/a+s on exams. schools are under no compulsion to use a bell curve, or if they do, to slide it to the right to gift the higher-scoring students with as. think about it. if nobody gets better than a 75 on a test of required knowledge, that doesn't mean the people that got a 75 get as. if you only get 3/4 med math questions correct, you do not get an a.
in a related issue, there was a post about how sometimes there is more than one correct answer but the test pushes you to choose only one best answer. this is partly true; more nclex test items are going to the "select all that apply" (sata) format, where you must recognize the outlier(s). these are challenging items, because of the four choices, sometimes one or teo or three are wrong choices.
the other thing to remember about nclex-style testing items is that while a distractor may be true, it may not be a good answer. as an example, here's one i saw. the situation was in a clinic. the nurse was talking with a woman with a history of being abused by her husband. the woman says that this time he apologized, brought her flowers, and vowed that he loved her. she does not want to leave him. which of the following is the best answer for the nurse? i'm leaving out the two you can pretty much see are wrong.
a. "and yet you are here. let's work on a plan to keep you safe."
b. "research on domestic abuse shows that his behavior will only get worse."
to know what to say, you have to know about domestic abuse statistics, of course. but you also need to stop and look at the higher level issues. the nurse cannot browbeat this woman with statistics, even if they are true (and they are). she has made up her mind. even if (b) is really truly true, it is not the best answer. why is that? why can't there be two "best" answers?
the reason (in this example) is that the role of the nurse in a therapeutic relationship is to help the woman find her own path to better health (in this case, to safety). she has already told you she is not going to leave him. that is her choice, whether or not you like it or agree with it. you do not have the option of making her change her mind at this point. you can help her make other choices that will help move her along that better path, though. this is a higher-level question .... and that's why the poorer students, still fixated on evidence-based practice, fall for the distractor on research and fail to look beyond to the time when they will be responsible for creating therapeutic relationships.
this example shows why nursing is so difficult for some people. nursing school is hard for a reason-- it's hard to develop this form of critical thinking that integrates all you've learned. it's hard to stop and think of all the implications in a situation. nursing demands this of us. if it were easy, anyone could be a nurse. anyone can't be a nurse without the ability to learn this.it is not as easy as yes/no, one answer only, all the time.
nursebet seems far more interested in being right and in carrying the day than in taking in what anyone has to say. As a result, he/she will be less likely to "get" how those exams are constructed and will be unable to see that they mirror aspects of the Nursing Process. Oh well! We won't be suprised then when he or she struggles to pass NCLEX. That said, what does this stubborn refusal to adapt say about his or her ability to deal with workplace changes or ability to find ways to think out of the box?
Perhaps nursebet's particular school simply is doing a lousy job of making it clear how those questions DO tie to "the nursing process." Science and tech people expect instructors to know their stuff, be prepared, and concisely and efficiently teach it to students. With the intent of making it EASIER, NOT MORE DIFFICULT! to learn. In order to do critical thinking, the students must first have some basic knowledge and "rules of the road" to start with and branch off from.
I went through 1 year of RN school at a school where the instructors couldn't teach. They might have known a lot about how to do the nurse job, but they were pee-poor at explaining concepts to students. Additionally, their "integrated" curriculum was also not developed make it easy to learn. In fact, I've never seen a more inefficient and illogical hodgepodge dumped on students in my life.
"Obfuscate" was what my ex-instructors did best. People who come from science and tech backgrounds, who hear nursing instructors speak of The Nursing Process, expect the instructors to be able to describe that system. A flowchart. A decision tree. But nursing rambles all over the place, and either doesn't have any rules or won't tell the students what they are, and makes the students "discover" them for themselves.
I just finally got tired of dealing with all the rambling nonsense of nursing ed. If there's a system and a logical order to it, my ex-school certainly was not aware of that. LOL
Coming from a different major, political science, and then taking all of the basic sciences for nursing school, I think it's valuable for nurses who have never experienced another form of higher education to realize that the way nursing education is structured is not the best way to learn.
By far, I felt more comfortable and have retained more knowledge in political science and pure science classes as compared to nursing, which seems to be a spattering of random facts (no depth required in knowing the disease process etc.). I am a person who likes to know things in an out. In my accelerated program, there is not enough time to know everything in and out which has been demoralizing.
Nursing's random shallowness has lowered my drive and subsequently I've made the calculation to stress less by studying less to get roughly the same grades.
Sorry, I didn't intend to sound like I was throwing a tantrum. . . It was just an incredibly frustrating experience for me. . .
I had some wicked exams in ochem, but I was able to pull through by focussing on what I had learned and applying my skills. . . I realize ochem is not remotely related to nursing, but it is frustrating that nursing exams seem "easy" but the wording is "tricky" and no one pulls an A... Even if you think you know your stuff inside and out going in... even if you've analyzed everything to death...
However, a lot of people here have helped me put the tests in perspective and have offered alternative ways of studying for the exams - so thanks for that! I still don't agree with strictly M/C for any exam, whatever the subject..... It doesn't show what you actually know, it simply reveals whether you can weed out the right answer among options. (In my opinion). But I appreciate all the different perspectives about the tests :) it's helped me lots!
I honestly think MC questions are a bunch of hog wash. That's MY perspective, but I also understand that the people who structure these things probably know more than I do about this.
I don't think you were throwing a tantrum, I just think you are/were frustrated. That's okay.
BUT... I Will say about nursing M/C questions and 'weeding out' the wrong answers: that's actually very useful in the clinical setting because there is often several 'right' answers but one is more important than the others.
cnmbfa
151 Posts
Mindlor
Good approach.
nursebet seems far more interested in being right and in carrying the day than in taking in what anyone has to say. As a result, he/she will be less likely to "get" how those exams are constructed and will be unable to see that they mirror aspects of the Nursing Process. Oh well! We won't be suprised then when he or she struggles to pass NCLEX. That said, what does this stubborn refusal to adapt say about his or her ability to deal with workplace changes or ability to find ways to think out of the box?