Teaching Strategies to Improve NCLEX Passing Rate

• Yamilka Pichardo

Abstract

The 5 articles reports different teaching and learning strategies used in nursing students and their evaluation. The strategies described here are based on Humanistic theory, and the author of the five of them uses Abraham Maslow humanist theorist as a reference.

Key Words

Nclex, Teaching Strategies, Success.

Introduction

Humanistic Theory as applied to learning is largely constructivist and emphasizes cognitive and affective process. It address people‘s capabilities and potentialities as they make certain choice and seek control over their lives. (schunk et al.,2008)

Maslow’s theory emphasizes motivation to develop one‘s full potential, he also believe that human actions are unified by being directed toward goal attainment. His Hierarchy of needs can help teachers understand students and create an environment to enhance learning. It’s unrealistic to expect students to show interest in classroom activities if they have physiological or safety deficiencies. (Maslow 1968, 1970)

Literature Review

Title: Teaching around the cycle: strategies for teaching theory to undergraduate nursing students.

Author: Nancy A. Flanagan and Linda McCausland

The Idea of this article is to incorporate a variety of teaching techniques, with this pedagogy students are encourage to recognize and cope with numerous ways of acquiring information.

A teaching technique applied to teaching nursing theory in an undergraduate nursing program is presented. This technique acknowledges a variety of learning styles to facilitate student learning. Activities highlight the importance of acquiring a variety of knowledge acquisition and information-processing skills required in a profession. Students use critical thinking, communication, group process, and research analysis skills to learn and apply information about theory.

Method: The methods and activities have been developed over four years and implemented in small classes of eight students and in classes as large as 140 students with equal success.

Understanding nursing theory requires critical and complex thought process, the more advanced theory knowledge and cognitive skills of application analysis, synthesis and evaluation are facilitated through active collaborative strategies featuring faculty and student interaction.

A nurse theorist outline developed by the instructor serves as study guide and assist student with subsequent class activities.

THE THEORY GAME :( Board game/ Case studies)

Gaming is a technique that requires active learning and collaborative cooperative learning strategies with a group. The game is design to increase student familiarity with new abstract theoretical content and reinforces student knowledge.

Evaluation: The journal article evaluation and case study / care plan activities were added to the curriculum, since then summative evaluation, measured by quiz grades has improve, these finding are consistent with educational theory on active learning strategies that incorporate group collaboration through gaming analysis and case study.

(Nancy A. Flanagan and Linda McCausland, Nov/ Dec 2007)

Title: Learning Nursing Concepts through Television Programs

Author: Raines, Deborah A

The Idea: These activities are designed to engage students and to facilitate their developing understanding of nursing concepts and behaviors.

The following are just a few examples of how television programs can be used to teach nursing concept and behavior in an Introduction to nursing course early in the curriculum.

Engaging students while developing an understanding of nursing concept is a challenge to nurse educators. In nursing education, one of the primary pedagogical goals is to ensure students develop a set of analytical and critical thinking skills to be safe and efficient nurses in the practice setting.

Instructors and textbooks try to structure case studies for teaching, but these activities can be sterile and lack the richness and the uniqueness of getting to know others in a nursing situation. Audiovisual images, such as television programs, compress complex stories into rich, visually intense images and bring situations to life in a more powerful way than the traditional lecture approach does.

Method: Students are asked to find clips of the four main characters from Seinfeld (Seinfeld, Mehlmanard, Gross, & Greenburg, 1989) to demonstrate the principles of Maslow's hierarchy of needs. Students assess and analyze each character's behavior in relationship to Maslow's levels. Through the years, programs have been based on the concept of family. Segments can be shown as a montage of programs clips to reveal the changing meaning of family, differing family types and structures over time, or to compare and contrast the variety of ways families cope with a particular situation.

Soap operas such as General Hospital (Hursley & Hursley, 1963) and All My Children (Nixon, 1970) have many scenes involving nurses in hospitals Segments from these programs showing nurses in action can illustrate teachable moments on a variety of topics including professional appearance and comportment, interdisciplinary collaboration and communication, the role of the nurse, and nurse-patient interaction, as well as the concept of professional boundaries.

Evaluation: Student response has been overwhelmingly positive. The activity generates significant discussion, and even a little laughter, among class members. The use of familiar television programs situations and characters to introduce beginning nursing students to new concept associated with the study of nursing provides a way for them to begin to build a knowledge base and to see the dynamic nature of nursing concept as applied to a variety of situations

(Raines, Deborah A Mar 2010): 173-4.

Title: How Can I Fail the NCLEX-RN® With a 3.5 GPA?" Approaches to Help This Unexpected High-Risk Group.

Author: Rollant, Paulette Desmaske

Idea: This article describes two self-report inventories useful for tracking and predicting risk for failure or success on tests and the NCLEX-RN

Most of these studies focus on objective data, such as preadmissions standards, progression examinations, overall grade point average, course grades, and comprehensive examinations. Significant correlations were found between success on the NCLEX-RN and five factors: cumulative nursing program grade point average, English as the primary language spoken at home, lack of family responsibilities or demands, lack of emotional distress, and sense of competency in critical thinking.

The journal provides information on predictors and tools to identify students who are at risk for failure on the NCLEX-RN. It also indicates the importance of other factors - such as fatigue and anxiety - on passing the NCLEX-RN.

Method:

• The Test Anxiety Inventory (TAI) a self-report scale, measures individual differences in test anxiety as a situation-specific trait.

This one-page test contains 20 items that asks respondents to indicate how frequently they experience specific symptoms of anxiety before, during, and after examinations. The subscales also assess worry and emotionality as major components of test anxiety (Spielberger et al., 1990).

• The Learning Assessment Study Skills Inventory (LASSI) is an 80item assessment of students' awareness about and their use of learning and study strategies. The results are related to the skill, will, and self-regulation components of strategic learning. This valid and reliable assessment inventory contains 10 scales: stress, attitude, motivation, concentration, self testing, time management, test-taking skills, anxiety, information processing, and study aids.

Evaluation: All of these methods are taken from the "5 Cs for Test Success" model (Rollant, 2006). The final action is to help students identify tools to use when they do not know. Using these strategies, educators can open the pathway to success for students at potential risk for test failure.

(Rollant, Paulette Desmaske)

Title: Teaching Critical Thinking in an introductory leadership course utilizing active learning strategies: A confirmatory

Author: Burbach, Mark E, Matkin, Gina, Susan M

Idea: Critical Thinking is often seen as a universal goal of higher education but is seldom confirmed as an outcome. This study was conducted to determine whether an introductory level college leadership course encouraged active learning increased critical thinking skills. (Journal writing, service learning, small groups, scenarios, case study, and questioning).

Method: A pre- and post-assessment of critical thinking skills was conducted using the Watson-Glaser Appraisal. An integrative studies course is intended to engage students in actively developing their ability and desire to analyze, evaluate, and communicate complex material and positions. One objective of the studies is to enhance critical thinking through a variety of approaches in which students investigate arguments, engage in research, gather data, perform qualitative and quantitative analysis, and assess conclusions. The underlying philosophy of this article is that improvements in interpersonal skills for leadership are an interactive function of increased self awareness, increased understanding of others, and learning from life experiences.

To engage students in critical thinking, active learning methods (e.g. Meyers & Jones, 1993) are emphasized in this class. For example, a service-learning project is required. Students are encouraged to work in an area that is outside of their previous range of experiences. An attempt is made to expose them to new perspectives and/or different cultural experiences. The project comprises a large portion of the each student's final grade. Instructor-mediated reaction journals to complement classroom activities and the service-learning project are also required. Classroom activities include small group projects involving contextual scenarios, case studies, role-plays, and student presentations. Socratic questioning between instructors and students is strongly encouraged.

Reflective journal writing can improve critical thinking as well as growth in self-awareness and self-actualization (Maslow, 1979) and the development of new knowledge (Boyd & Fales, 1983), also can increase student learning and promote meaningful personal insights more than lecture and reading assignments (ConnorGreene, 2000; Mayo, 2003a, 2003b; Seshachari, 1994). Journal writing helps students to document observations, question, speculate, develop self-awareness, synthesize ideas, and gain insights for problem-solving (de Acosta, 1995). Evidence derived from case studies suggests that the development of critical thinking is likely to be linked to an emphasis on writing and rewriting (Tsui, 2002).

Evaluation: As a result significant increases were found in the Deduction and Interpretation subtests, and total critical thinking. Student engagement in active learning techniques within the context of studying interpersonal skills for leadership appeared to increase critical thinking. Although it was not possible to determine which of the active learning strategies had the greatest impact on improving students' critical think skills (journal writing, service learning, small groups, scenarios, case study, and questioning).

(Burbach, Mark E; Matkin, Gina S; Fritz, Susan M)

Title: Rx for NCLEX-RN Success: Reflections on Development of an Effective Preparation Process for Senior Baccalaureate Students

Author: March, Karen S; Ambrose, Janice M

Idea: This article highlights the process employed to support and facilitate student preparation for NCLEX-RN success strategies to augment student self-confidence, enhancement of critical thinking skills, self-assessment of test-taking abilities, and development of a feasible study plan utilizing learned effective study techniques and the acknowledgment of barriers and identification of specific methods to overcome them.

Method

ASSESSMENT: Early assessment of the situation involved a review of the senior-year curriculum, including preparation for the NCLEX-RN examination. For many years, students had been required to take a paper and- pencil end-of-program examination; students reported experiencing unexpected challenges when confronted with the computerized format of the actual examination.

PLANNING/ IMPLEMENTATION: Early in 2004, faculty began to investigate options for computerized exit examinations. During the process, consideration of both Maslow's Hierarchy of Needs and Hertzberg's Motivational Theory (Benson & Dundis, 2003; Jones, 2007) meant that faculty sought an examination that would challenge students intellectually and offer useful feedback, yet could be administered in the nursing computer lab, an environment that provided assurance for students' safety and security needs. Helping students manage their levels of anxiety was considered essential to helping them strive toward self-actualization - passing the NCLEX-RN on the first attempt.

COURSE MODIFICATION: The Nursing Leadership course was adapted to meet the changing needs of senior students. The course had always covered a range of topics,

Including ethics, legal issues in nursing, conflict resolution, and change. The new goal was to strengthen the existing topics and include leadership and management theories,

Evaluation of Outcomes: The proactive approach described in this article has already yielded measurable outcomes in the form of improved first-time pass rates on the licensure examination. 91% of graduates passed the exam on the first attempt between October 2005 and September 2006; 94 % passed between October 2006 and September 2007; 91 % passed between October 2007 and September 2008; and 94.9 % passed between October 2008 and September 2009.

(March, Karen S; Ambrose, Janice M(Jul/Aug 2010 230-2)

Conclusions

In general all the articles describe different strategies and evaluation to improve learning skills and test passing scores. Research supports the incorporation of evidence-based educational strategies to promote success on the NCLEX-RN

Nurse educators are presented with the complex challenge of adapting educational strategies to the needs of the health care industry while preparing graduates to be successful on the licensure exam. For nurse educators, this means that among the many challenges they face, they must begin to use evidence-based teaching strategies and incorporate evidence-based practices into classroom and clinical settings.

The health care system must graduate nurses capable of safe practice within the scope of appropriate, evidence-based clinical decision making; this should be the number one reason of implementing teaching strategies in nursing programs to prepare their graduates to pass the NCLEX-RN.

(Internet)

References

• How Can I Fail the NCLEX-RN® With a 3.5 GPA?": Approaches to Help This Unexpected High-Risk Group, Rollant, Paulette Desmaske Annual Review of Nursing Education5 (2007): 259-XIV.

• Learning Nursing Concepts through Television Programs Raines, Deborah A, PhD, RN,ANEF. Journal of Nursing Education49.3 (Mar 2010): 173-4.

• Rx for NCLEX-RN Success: Reflections on Development of an Effective Preparation Process for Senior Baccalaureate Students(March, Karen S; Ambrose, Janice M(Jul/Aug 2010 230-2)
• Strategies to promote success on the NCLEX-RN[R]: an evidence-based approach using The ACE Star Model of Knowledge Transformation
• Teaching around the cycle: strategies for teaching theory to undergraduate nursing students, Nancy A. Flanagan and Linda McCausland( Nov/Dec 2007):310-4.
• Teaching Critical Thinking in an introductory leadership course utilizing active learning strategies: A confirmatory Mark E Matkin, Gina S; Fritz, Susan M College Student Journal38.3 (Sep 2004): 482-493

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