Mastering the Content: A Systematic Evidence-Based Approach to Nursing Program Success

Nurse educators have been looking for an elusive set of pre-licensure nursing program admission criteria resulting in zero attrition and 100% first time National Council Licensure Examination – Registered Nurse (NCLEX-RN) pass rate since nursing education left the hospitals and moved into the collegiate setting (Romero, 2013). Should face-to-face interviews or essays be required? What is the minimum grade point average (GPA) to guarantee not just program completion, but passing NCLEX-RN the very first time? Should programs require a minimum score on a standardized nursing admission test and what should the score be? Will these preadmission requirements lead to a zero attrition rate due to course or clinical failure? Research has determined a system wide approach to program development, evaluation, and revision is linked to high rates of continued progression and NCLEX-RN first time pass rate success (Carr, 2011; Cole & Adams, 2014; Koestler, 2015; Serumbus, 2016). The system wide approach is based on continuous program assessment and evaluation providing data to guide improvements and change based on the evidence.

At a small southeastern university traditional prelicensure Bachelor of Science in Nursing (BSN) program the most recent evidence indicates the science GPA of the admission criteria as most predictive of program success and has shown the importance of learners “Mastering the Content” of the nursing curriculum in order to be successful in both program completion and the first time when taking NCLEX-RN. Mastering the Content is not just passing courses, achieving the 75% exam average for course exams, or obtaining a specific benchmark on a standardized end of course exam (Wiles, 2014). Mastering the Content starts with building a strong curriculum founded on the knowledge and skills of general nursing practice, exemplary teaching, and student utilization of metacognitive learning strategies. Mastering the Content continues with student application of the comprehensive foundation and metacognitive strategies to perform an accurate nursing analysis and judgment in order to choose the safest, best, or priority nursing action. Implementation of an introduction to nursing school success course, identification of and working with at-risk students, course exam review, and ending with an NCLEX prep course are also important for learner success in Mastering the Content.

The results obtained during the continuous process of program assessment and evaluation, implementation of the Mastering of Content curriculum and active learning enhancements, and regression analysis of student admission requirements support an evidence-based multifaceted system approach to program reform. Analysis of the data supported (a) modification of admission criteria, (b) implementation of a nursing program orientation course, (c) using technology enhanced active learning strategies to promote retention of learning, (d) providing students with opportunities to learn how to develop metacognitive learning tools to assist in Mastering the Content, and (e) an NCLEX preparation course. The end result demonstrated a greater than 10% increase in NCLEX-RN first attempt pass rates and decrease in attrition rate for course failure.