Academic journal article Educational Research Quarterly

Program Exit Examinations in Nursing Education: Using a Value Added Assessment as a Measure of the Impact of a New Curriculum

Academic journal article Educational Research Quarterly

Program Exit Examinations in Nursing Education: Using a Value Added Assessment as a Measure of the Impact of a New Curriculum

Article excerpt

To become a registered nurse in the United States, one must pass the National Council License Examination for Registered Nurses (NCLEX-RN). To address the growing national nursing shortage, nurse preparation programs must better prepare students to pass this national licensure examination. The purpose of this study was to determine whether a new nursing program at a large university in the southeast United States improved learning outcomes as measured by the Evolve Reach (formerly named the Health Education Systems Incorporated - HESI) exit examination and better prepared its graduates to pass the NCLEX-RN. Although there was no statistically significant difference in the Evolve Reach performance of students in the old versus new nursing programs, a positive relationship existed between the Evolve Reach results and first-time NCLEX-RN pass rates. These results suggested that the Evolve Reach exit examination was a value added assessment for the new nursing program and was useful for determining student readiness for the national licensure examination.

The United States is approaching an unprecedented shortage of nurses. Additional nurses will be needed to care for an aging and increasingly diverse population. Nurse educators face multiple challenges in creating an educational program to prepare sufficient numbers of students for practice in a constantly evolving healthcare environment. Simultaneously they must prepare candidates to be successful on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) - an examination for which the national pass rate averages 87% (National Council for State Boards of Nursing, 2008b). Success on the NCLEX-RN is required before candidates can practice as registered nurses. Schools of nursing use a variety of methods to prepare students for success on the licensure examination, including administering tests such as the Evolve Reach (formerly Health Education Systems Incorporated, or HESI) Exit examination. The examination was designed to predict student readiness for the licensure examination. Because the test provides an outcome score, it can be used as a measure of quality for nursing curricula.

Purpose of the Study

The purpose of this study was to determine whether a new nursing curriculum improved program outcomes as measured the NCLEXRN and HESI Exit Exam. The study addressed two questions: How did the new curriculum impact learning as measured by the HESI Exit Exam? Is there was a relationship between the HESI Exit Exam score and the first time pass rate on die NCLEX-RN? The presence or absence of this relationship would determine if the HESI Exit Exam was truly a value added assessment of the student's knowledge.

Brief Literature Review

In the United States, nursing candidates who meet the educational requirements take the NCLEX-RN by completing an associate degree, baccalaureate degree, or diploma educational program. There is no national curriculum for any type of nursing program. Therefore, nursing education lacks standardization. Developed by the faculty at each School of Nursing, the curriculum may be based on current practice, accreditation standards, regulation requirements, or even areas of personal faculty interest. This process of curriculum development creates the risk that the curriculum may be narrowly focused, failing to produce a candidate prepared to pass the licensure examination and enter practice prepared to deliver care.

Multiple national organizations, including the accrediting bodies of nursing education, require that nursing education programs assess outcomes as part of their overall program evaluation. In addition to demonstrating accountability, "Outcomes assessment should primarily serve the learners' needs, with the goal of improving learning" (Thompson & Bartels, 1999). Improving individual student outcomes in turn improves program outcomes.

Student learning from a nursing education program can be measured by a variety of methods. …

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