Friday, 20 April 2018
Nursing education programs have evolved overtime to prepare registered nurses. The National Council Licensure Examination Registered Nurses (NCLEX-RN) pass rate is an important measure of quality in nursing education programs. Previous research has shown that various factors influence pass rates. The purpose of this mixed methods study is to investigate factors influencing NCLEX-RN pass rates at one baccalaureate nursing program. The first phase of this study used the student record of those who graduated between 2013-2016. The data includes preadmission information and Health Education Systems Incorporated (HESI) scores, which were administered during the program. The preadmission data included: main vs. satellite campus location, accepted from the initial applicant pool or wait list, first vs. second baccalaureate degree, native or transfer student, Test of Essential Academic Skills (TEAS) score, prerequisite grade point average (GPA), overall preadmission GPA, and English as a first language. HESI scores on fundamental health, med-surg, pediatric, and the exit exam were included as potential predictors of NCLEX-RN pass rates. Data was analyzed using logistic regression. The initial analysis indicated students with a higher prerequisite GPA (β= 1.367, p<.05) and English as the first language (β= .988, p<.05) were successful in passing NCLEX-RN. Students with a higher med-surg, HESI exam (β=.004, p<.05), and exit HESI exam (β= .006, p<.05) were also successful at passing the NCLEX-RN. The second phase included a survey with 12 semi-structured questions using the online survey tool, Survey Monkey©. Emails containing the online survey tool were sent between the spring 2015 and fall 2016 semesters to 355 recent nursing baccalaureate program graduates. Of this number, 170 (47.8%) emails were opened and 4.9% bounced because the email address was incorrect. The survey emails were sent to the students at four different points in time, approximately a week apart, using their school and personal email addresses. The response rate is 28.7% based on the first round emails sent. However, when exluding emails that were not opened and bounced, the response rate increased to 60%. The majority of respondents graduated between spring and fall of 2016. Approximately half way through the survey administration, internal funding was secured and $10.00 gift cards were offered to improve response rates. A total of 26 gift cards were sent to respondents. Survey questions included “How did you prepare for the NCLEX-RN exam”, “Did anything happen during the exam that influenced your performance?” and “Why do you think you passed/didn’t pass the exam on the first try?” Several common themes emerged from the results as for reasons of passing the NCLEX-RN on the first try: taking a review course, aggressive use of practice questions, and studying. The most common perception for not passing the NCLEX-RN on the first attempt was anxiety. The results from the second phase of study presented a description of what the students’ perspectives are prior to and after taking the NCLEX-RN exam. The results of this study can be utilized to develop strategies in nursing programs to support students as they prepare to take the NCLEX-RN exam and to be successful when taking the NCLEX-RN exam. In conclusion, there are many factors influencing NCLEX-RN pass rates and they should be considered as the cornerstone of nursing programs.