Does the Use of Case Studies Impact Scores on Specialty Exams for Undergraduate Nursing Students?

Introduction

               Whether used for readiness or high stakes testing, standardized exams provide valuable outcomes data on the effectiveness of nursing curricula. Many undergraduate nursing programs rely on commercially prepared standardized exams to determine undergraduate nursing students’ readiness to take the National Council Licensure Examination-RN (NCLEX-RN) examination upon graduation. While some programs use the information to assist students in preparing for NCLEX-RN, others use these standardized exams for high stakes testing and graduation requirements.

Background

                Our baccalaureate nursing program at a private, faith-based university in the southern United States began using commercially prepared, standardized specialty exams in some of the clinical courses, as well as using an exit examination to determine readiness for the NCLEX-RN. The specialty exams were not consistently used in courses throughout the program. Initially most students, as well as some faculty, did not perceive the successful completion of specialty exams as valuable preparation for NCLEX-RN which led to scores well below the national average on the specialty exams.

Methods

                Case studies using the commercial package for the specialty standardized exams were implemented in the Fundamentals of Nursing and Health Assessment courses in summer 2014. Students in the courses the prior two years did not complete case studies in these courses. Additionally, the specialized fundamentals and health assessment exams were administered only to the students during summer 2012. Students who were enrolled in the foundations course during summer 2013 were administered the fundamentals specialized exam at the end of summer 2014, after completing four semesters of the nursing program.

Implementation

                Students in the foundations and health assessment courses during summer 2014 were assigned specific case studies to complete as a requirement of the course. Students who had taken foundations the previous year were instructed to complete any three case studies in the foundations content. The foundations specialty exam was administered to both groups at the end of the summer semester 2014 and the health assessment specialty exam was administered to the first semester nursing students only.

Results

                Mean scores of the second and third groups were similar and both groups had significantly higher mean scores than the first group for the fundamentals exam. The specialized health assessment exam mean score was significantly higher in the group who completed case studies than in the group who had not completed case studies.

Conclusion

                The use of the case studies was perceived to have led to the difference in scores in both health assessment and foundations courses. As a result of these outcomes, case studies will again be required for students in health assessment and foundations for the summer 2015 semester. Scores from this group will then be compared to previous cohorts for further analysis. This is a valuable ongoing strategy to improve educational outcomes.