Shouldn't we be able to take the HESI?

valmor1984 · Jul 20, 2009

"I have lots I want to cover,and want to be sure I am covering at least the HESI in the 11 weeks I try to cover my ideals.

but the predominate nursing education politics right now seem to center on standardized testing (HESI).... It seems like a paradox to me. I am struggling very much with this.

This is not what I signed up for. "

Dorimar, we all struggle with this....if you are in nursing education, standardized testing is exactly what you and your students "signed up for".

Nursing education has always "center(ed) on standardized testing "....it is called NCLEX. There has been a need to measure mastery of the information in a nursing curriculum, not just retention of the small amount of information presented by the educator in the classroom.

Please take my next comment only as an observation: it sounds like you want to "teach to the test" . Believe me, we have all been there, or at least been tempted to do so. It goes like this: the educator emphasizes what will be on the test, the students focus on that information to the exclusion of pretty much everything else, get good test scores, and everyone is happy.

But have students really mastered the information? If you asked them a question on any (non-obscure) topic in the readings for that exam (that had not been discussed in class) , would they have the knowledge base and critical thinking skills to answer it?

This might be a solution for you: HESI (and others) have custom exams for various sections of the curriculum. They base your exam on the content of your syllabus, so you know (in general terms) what will be in the exam.

My University uses HESI midcurriucular and exit exams for progression and graduation. Recently, students taking the midcurricular exam reported some content that we felt might not be a good "fit". Faculty who taught in courses leading up to the midcurricular exam requested from Elsevier (HESI) the opportunity to "take" (review) the entire exam. We did not find a single question that was not reasonable to include.

I got a pretty good score, too. :-)

As far as the exit exam goes, you won't be able to fit your teaching to the exam. Every student gets an exam that is pulled from a bank of questions, and Student A will not get the same exam as Student B.

Talk to the HESI representatives, and ask that a member of the development team be brought to your school and answer questions and offer instructional strategies. We did this recently (after 6 years of using HESI) and it was extremely helpful.

I wish you success in finding a balance. It is NOT easy. Remember the reason why we use standardized testing...it is to prepare our students for NCLEX, and for safe and successful nursing practice.

dorimar, BSN, RN · Jul 20, 2009

Hello Valmor,

Thanks for your response. I know it sounds like I want to teach to the test, but honestly that is not what I mean. For instance, in lecturing on sedation and pain management in critical care last week I started to tell my students, "You don't have to memorize all the different sedation scales. Every facility uses one and displays it for your to access readily. You just have to know , given a specific sedation scale, how to use it and why" Then I talked about an example of titrating propofol to a Ramsey score.

But then I got home and realized, wait a minute, I do not know they do not have to memorize every sedation scale for HESI : Ramsey, RASS, SAS, etc. It makes no sense to me that they would be required this, because in practice we have ready access to the chosen scale. I want them to focus on why and how they use the scale to titrate sedation not on memorizing every scale... But I may be hindering them in this way.

My students are required to take the critical care HESI and get a specific score in order to pass the course. I have asked Evolve if I can take it and athis is not an option. It is not based on my objectives or critical care curriculum. Well, maybe it is, but I have know way of knowing that. My college has paid a great deal of money for case studies and practice tests to help prepare students. None of this is available for the Critical Care HESI, and yet i am the only class so far requried to make it the final and have them get a specific score to pass the course.

I do understand the need for testing. I explain this to the students every day. We have to ensure they are safe to practice. But, I haven't taken boards in over 20 years. I think we should be able to see what it is we are asking them to demonstrate, before we teach them how to demonstrate it.

I was taught to align my assessment of learning to the objectives and my content to the objectives. Instead, I feel pressured to align my content to the assessment of learning (or teach to the test, as you stated). They are writing the test, but I am doing the teaching. Perhaps if they wrote my objectives and syllabus for me, it would be fine. I had to choose all the objectives. I have to choose all the content. I spent a very great deal of time making those choices. And now I have to hope someone else's assessment of learning is in line with that.

llg, PhD, RN · Jul 20, 2009

As Valmor1984 wrote, you should be able to get your questions answered sufficiently without seeing the actual test questions. You should be able to ask a question such as: "Do students need to memorize a specific pain or sedation scale to do well on the test?"

You should also be able to get information on the general content covered in the test. That should enable you to write objectives that will be a fairly close match with the test.

I suggest you make a list of you questions and ask them of the people who produce the test and/or of people very familiar with it. Perhaps if you met with a more experienced teacher, he/she can give you some tips on how to design your classes around the course objectives and focusing on teaching skills without feeling the need to focus on the answers to specific (unknown) questions. Really, if the students have truly mastered the principles of the course content, they should be able to do well on the test even if the questions were written by someone else -- because that someone else is testing their knowledge of the principles that you taught even if their specific application examples of those priniciples are different from yours.

Teachers should never be allowed to see the actual test bank questions on such an exam. That would completely destroy the integrity of the test. No one could trust the results if the teachers would be able to give the students the actual questions and answers. Classes would be "taught to test" in the most extreme forms and there would always be some people who would overtly tell the students what was on the test. Even if people tried not to do that, it is inevitable that teachers would be subconciously biased and "lean" the course towards the questions they had seen. That would ruin the test and render it useless.

valmor1984 · Jul 20, 2009

As Valmor1984 wrote, you should be able to get your questions answered sufficiently without seeing the actual test questions. You should be able to ask a question such as: "Do students need to memorize a specific pain or sedation scale to do well on the test?"
You should also be able to get information on the general content covered in the test. That should enable you to write objectives that will be a fairly close match with the test.

That is really the heart of the matter, dorimar. Get in touch with Elsevier/HESI, and they can help you with customization of your CC exam. In our case, (in the day when we used periodic HESI tests) WE set the objectives, and the exam was customized based on the information in our syllabus.

Your Elsevier rep should be able to help you with this. If not, send me a PM, and I will be happy to put you in contact with the right people at Elsevier/HESI.

There IS a way to make your CC test work for you....to provide you and your students with helpful data. However, I do NOT think your CC course should be the only one carrying the evaluative load, so to speak. This is another area where the HESI representative can suggest better, more equitable, ways of assessing learning in your program.

Best,

Val

dorimar, BSN, RN · Jul 21, 2009

The progressive course HESIs are not customized. Your school can purchase customized mid-curricular HESIs. This is a general critical care HESI and there is only one-so re-testing after remediation is not an option. There are no practice tests either.

I do not want to give my students the answers. Not in the slightest. For either of you to say that means you miss my point entirely. Do you not try to align your learning assessment with your objectives???? This is basic education theory. Unfortunately this is not an option for me...

I want to teach a great deal, and plan to this quarter. I actually think the teaching I plan is more beneficial than maybe what is on a HESI.. I just wanted to be sure I also got in there what was on the HESI to give them a chance to graduate and use the stuff I want them to learn that will impact outcomes.

I did make a decision today that I belive academia is not for me....

valmor1984 · Jul 21, 2009

I do not want to give my students the answers. Not in the slightest. For either of you to say that means you miss my point entirely. Do you not try to align your learning assessment with your objectives???? This is basic education theory. Unfortunately this is not an option for me...
I want to teach a great deal, and plan to this quarter. I actually think the teaching I plan is more beneficial than maybe what is on a HESI.. I just wanted to be sure I also got in there what was on the HESI to give them a chance to graduate and use the stuff I want them to learn that will impact outcomes.
I did make a decision today that I belive academia is not for me....

Dorimar, the HESI is a nationally normed exam. It is possible to get a list of the general topics on the CC HESI, then you can align your classroom presentations to the content on the HESI (and then, of course, go well beyond that in your teaching). If your teaching is beneficial (and I am sure it is!) AND reflects the general content areas on the HESI/NCLEX, students should be able to score well.

I look at the NCLEX test plan, and the HESI midcurricular and exit topics, to give me guidance on what my objectives should be. So far, that has worked pretty well.

I hope that you re-think whether you belong in academe. I sense a real frustration with the process you must work under, and I must say that I would be frustrated, too. If your CC course is the "make or break" course, you are the one that gets all the angst, the drama, and the responsibility for student progression. That is not a fair, equitable, or even a very balanced way to assess program outcomes.

My recommendation still remains: talk to your Elsevier rep, and let him or her help you out.

Best,

Val

VickyRN, MSN, DNP, RN · Jul 21, 2009

I have been following your posts. I very much empathize with what you are going through, even though I have not experienced the HESI issue. During my first 3 years of teaching (or so), I struggled almost to the point of a nervous breakdown. I had very little support of my fellow faculty. I taught most of the "hard" courses in a very high-stress ADN community college program. I spent most of my free time trying to get my curriculum and teaching aligned in a way that the students would have the most benefit. Most of the time, I felt I was spinning my wheels, entirely on my own. It was a chaotic program with high turnover and much infighting among teaching staff.

Finally, I quit this scenario and was hired in the university (BSN) setting. The difference is night and day. I teach clinicals, assessment and fundamental labs, and one course (gerontology). Though I do have my struggles, the professional environment is much more supportive.

I would implore you to reconsider leaving academia. We need you!!! If your present work environment is unbearable, consider going elsewhere. You might find another teaching environment a much better fit.

If you'd ever like to talk, please send me a PM. I care and would hate for you to quit teaching entirely.

dorimar, BSN, RN · Jul 21, 2009

Thank you VickyRN. I had not thought about a BSN program. I was making the assumption it is like this everywhere. I will keep you posted, and very much appreciate your understanding of my situation and your advice.