Obtaining success with baccalaureate students first time pass rates on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) is a key outcome for any nursing school and influences many aspects of the program itself. One common goal for nursing faculty members and administrators, is to utilize a curriculum that lends to NCLEX success. The ability for a school to successfully grow their program is reliant on the effectiveness of the curriculum, accrediting body recognition and ability to meet state board of nursing education standards. Factors such as: accreditation agencies, state boards of nursing, faculty and students rely on this rate to measure success of a program influencing admission process, curriculum, retention, remediation and nursing school selection. The curriculum and progression policies for nursing programs have many factors than can positively or negatively influence NCLEX pass rates. Additionally, many outside resources are available to students and faculty to assist in enhancing nursing student education. Many educational companies rely on their product to be utilized, in conjunction with the nursing curriculum, to improve NCLEX pass rates.
Methods:
Our team began a project to examine various factors that influence NCLEX success. Our project has completed the first stage in realizing which courses and tools are most influential in leading students to be more successful on NCLEX-RN. This retrospective review evaluated program success and failures over a 2-year period. Our research questions measured: (1) number of attempts to pass nursing courses on prediction of NCLEX-RN outcomes, (2) nursing course grades to determine influence on pass rates, (3) is Assessment Technologies Institute (ATI) as an assessment tool stronger at predicting NCLEX-RN outcomes, and (4) impact of cut off points in nursing course grades as a predictor of success on NCLEX-RN outcomes. Data was gathered from July 2014 - May 2016 and statistically analyzed using SPSS. Information collected included: final grades in 7 theory courses required for graduation, ATI (2017) Comprehensive Predictor Scores, and number of attempts to pass the course. Students marked as unsuccessful were further classified as: withdrew failing, withdrew passing, failed or other to explain possible reasons for unsuccessful completion of the course. Students were also divided into cohorts based on expected graduation dates. All students were required to complete the ATI proctored assessment in all content areas and the final ATI Comprehensive Predictor exam in the final semester of the curriculum.
Results:
After evaluating 196 students who had taken the NCLEX-RN, 162 passed; 34 failed which resulted in a 82.7% pass rate. Means and standard deviations of 7 course grades paired with NCLEX-RN outcomes were reported. Little impact can be seen with the number of attempts a student receives to take a course on NCLEX-RN success. Adult/Gerontology (II) course is the best predictor of success on NCLEX-RN pass rates. However, ATI-Med Surg and Nutrition assessments were most predictive for passing NCLEX-RN. Increasing the cutoff point to pass a course, raising it from 70% to 74% was not significant enough to recommend curricular changes because grade average does not serve as a single predictor of success. As a result, the cutoff point remained the same and the current utilization of ATI was not changed.
Conclusion:
After close review of the data collected, faculty members began to rely on the outcomes of the Adult/Gerontology II course grades to predict NCLEX success of the graduating class. Moreover, the ATI Med-Surg and Nutrition assessments are administered in this Adult/Gerontology II course. The faculty members are able to analyze the all influential scores of the particular cohort and try to strengthen any areas in which the students may be scoring low or appear to be weak. Because this course is taken during the fourth semester of a five-semester program, there is time for remediation and enhancement of certain content areas. The value in the knowledge gained from the study has great impact for students and faculty. Students could use this information to determine nursing school admission/acceptance by determining which tools are required in the program. Additionally, knowing curricular expectations of when the Adult/Gerontology course would be taken and course score pass rates would be important for students as they apply. Faculty can further use this information to determine curricular changes in the sequence of courses, pass rate scores, remediation procedures and enhancement with assessment tools, such as ATI.