Academic journal article Nursing Education Perspectives

The Predictive Ability of Critical Thinking, Nursing GPA, and SAT Scores on First-Time NCLEX-RN Performance

Academic journal article Nursing Education Perspectives

The Predictive Ability of Critical Thinking, Nursing GPA, and SAT Scores on First-Time NCLEX-RN Performance

Article excerpt


Aim. This study was conducted to investigate the predictabil- ity of several variables in achieving first-time success on the NCLEX-RN®.

Background. Several researchers have attempted to investi- gate the differences between students who passed the NCLEX- RN the first time and those who failed. No studies used a large enough failure group to have statistical significance.

Method. The three specific variables in this study were nurs- ing GPA, SAT combined math and verbal scores, and critical thinking measured on a standardized assessment examination. An ex post facto study design was used to examine data from the records of associate degree nursing graduates during a three-year period.

Results. The most significant predictors of NCLEX-RN success were the students' nursing GPA and the overall standardized assessment examination score.

Conclusion. The findings of this study could potentially influ- ence the identification of students at risk for NCLEX-RN failure.

Key Words. Critical Thinking - Nursing Education - NCLEX- RN Pass Rates - Predictors of NCLEX-RN Results

Critical thinking enhances skill in problem solving and decision-making, and it is a central aspect of pa- tient-centered nursing care, patient safety, and wellness promotion (Akerson, 2001). It is also an essential skill for nursing graduates taking the National Licensure Examina- tion for Registered Nurses (NCLEX-RN®) (Lyons, 2008; McDowell, 2008). The NCLEX-RN aims to test the en- try-level knowledge and skill of new nurses. Although no examination could cover everything a nurse would need to know, graduates must use complex critical thinking skills in order to answer the test questions correctly and begin practicing professionally.

For the past four decades, the concept of critical thinking has been seen as fundamental to nursing practice (Brook- field, 1987; Ennis, 1985; Stewart & Dempsey, 2005; Wat- son & Glaser, 1980) because this type of purposeful think- ing guides nurses in making sound judgments based on facts (Akerson, 2001). Clinical judgment is at the nucleus of the discipline of nursing and a direct outcome of critical thinking (National League for Nursing, 2010). The abili- ty to think critically provides the foundation for creative solutions and for successful patient outcomes (Stewart & Dempsey). Improved patient outcomes enhance quality of care and mutual satisfaction for both patients and nurses. Critical thinking is an integral part of nursing education and practice because it requires decisions based on facts rather than assumptions (Frye, Alfred, & Campbell, 1999; Henriques, 2002). Consequently, nursing education has departed from a traditional, step-by-step process of nurs- ing instruction to using pedagogical methods that strength- en critical thinking skills. Critical thinking enables the student and professional nurse to deal with a range of situations encountered in daily practice (Frye et al.). The American Association of Colleges of Nursing (2008) includes critical thinking as one of the major curricular threads woven through all of the nine "essential" outcome criteria for baccalaureate education for professional nurs- ing practice.

Literature Review

Many quantitative studies have been conducted on critical thinking in nursing education and practice, but few have focused on critical thinking as a predictor of NCLEX-RN performance, and none compared the scores of an equal number of students who passed the NCLEX-RN on the first attempt to those who failed. Several studies have developed research questions to investigate the differences between students who passed the NCLEX-RN the first time and those who failed, but they were ultimately unable to answer the question; the sample cohort had either a 100 percent pass rate (Akerson, 2001) or too small a failure rate to reach statistical significance (Giddens & Gloeckner, 2005; Hall, 1996; Henriques, 2002; Hoffman, 2009; Romeo, 2010). …

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