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.