Using Computerized Exams to Predict Nurse Practitioner Certification Exam Success: Exam Analysis and Faculty Appraisal 2005-2007

Wednesday, 15 July 2009: 4:25 PM

Brenda K. Binder, PhD, PNP
College of Nursing, Texas Woman's University, Houston, TX
Pat Jones, MSN, RN
Graduate Studies, Texas Woman's University, Denton, TX
Michelle H. Emerson, MSN, RN
Graduate Studies, Texas Woman's University, Houston, TX
Elizabeth E. Fuentes, MSN, RN, FNP-BC
Graduate Studies, Texas Woman's University, Dallas, TX

Purpose: The aim of this presentation is to describe how the process of systematic assessment of a bachelor of science in nursing (BSN) program triggered curriculum and policy changes. Lessons learned and opportunities for more comprehensive pertinent assessment methods are discussed. An instance of unexpected increase in National Council Licensure Examination (NCLEX®) failure rate in 2002 prompted faculty members to implement a number of changes. Prominent changes including the introduction of an NCLEX® preparation course that incorporated a remediation plan and an NCLEX® simulation exam.  After much consideration, the faculty voted to adopt a progression policy that required students to pass the simulation exam prior to graduation from the university.
Methods: Systematic program evaluation allowed faculty to reflect on best practices for teaching and learning in order to positively affect student outcomes on the NCLEX®.  Methods used to improve student outcomes included development of a remediation course, faculty-student mentoring with at 1:8 ratios, and the addition of a NCLEX® simulation examination.  Analysis of student performance was conducted each time the remediation course was taught. Data were also aggregated and analyzed for all courses taught using correlation and descriptive statistics.
Results: The required passing score of 85 (now equivalent to 850) for the examination was the initial benchmark set in 2003. Using aggregated data for continuous program evaluation, the passing score was raised to 900 in 2008. The progression policy has had a positive impact on improving student performance.
Conclusion: Evidence-based decision-making has dramatically improved NCLEX® pass rates in this program, though it required faculty to make tough choices when making school policies.  Continued success will be dependant on support of progression policies at the administrative level.