Identifying Priorities for Interventions to Improve Nursing Examination Performance

Transcription

1 Identifying Priorities for Interventions to Improve Nursing Examination Performance Vaneta M. Condon, PhD, RN Earline W. Miller, PhD, RN Loma Linda University School of Nursing

2 Purpose Prioritize problems related to poor examination performance as determined by The Exam Analysis Identify interventions that improve nursing exam scores Compare test scores before and after Exam Analysis

3 Description of The Exam Analysis A diagnostic and prescriptive tool Developed at LLUSN A student and an instructor analyze incorrect answers on an exam Priority areas are diagnosed into four problem categories Specific interventions to improve priority categories are prescribed See handout for detailed procedure

4 Student Comments Regarding The Exam Analysis This is such a wonderful program. Exam Analysis gave me the strength and encouragement to continue my nursing career. I really appreciate the help from the faculty who went over the Exam Analysis with me in detail.

5 The Exam Analysis Four Problem Categories Lack of Knowledge English Skills Exam Panic Exam-taking Skills

6 Frequency of Problem Categories Lack of Knowledge 90.8% Exam-taking Skills 89.2% English Skills 49.2% Exam Panic 18.3%

7 Suggested Interventions Lack of Knowledge Use study guide/objectivesto identify & write out key points Take careful notes in class Review ASAP after class and weekly Participate in study group Practice application (NCLEX????) Pre-exam review schedule Note weak content area/s

8 Suggested Interventions Exam-taking Skills Focus on what the question is asking Write down own answer PRIOR to seeing options Mark each option carefully (T, F,?,?T,?F) Choose the best answer Do not change your answer/s Practice application (NCLEX????)

9 Suggested Interventions Exam Anxiety Over-prepare for exams Use exam-taking skills to think critically one step at a time Use positive self-talk Don t spend long on difficult??? Pray that God will help you feel calm and help you remember Practice relaxation techniques

10 Suggested Interventions English Skills Look up vocab terms/new words identified in reading/lecture Write out meaning of words Drill on these words, with flash cards, several times each week If you don t understand question or options ask for clarification

11 Exam Analysis Survey Survey sent to 81 students who participated in an Exam Analysis - Fall quarter, 2007 and Winter quarter, 2008 Survey included Demographics Rating level of importance to academic success (17 items) Ranking of exam skills and outcomes Three open ended questions

12 Survey Demographics Response rate: 45.7% (n=37) 28 Females and 3 males 58.8% of the sample are ESL Age range: 20 to 44 years, fairly even spread between those in their 20 s, 30 s, and 40 s Majority (76%) to graduate in

13 Ranking of Level of Importance to Academic Success Three most important of 17 considerations 1) Improved my performance on examinations 2) Improved my exam taking strategies 3) Improved reviewing notes/objectives as soon as possible after class lecture Least important was predicting exam questions

14 Ranking of Five Exam-taking Skills Top 3 skills: 1) Identifying key words while reading the question (64.9%) 2) Writing own answer before reading the answer options on the exam (21.6%) 3) Eliminating wrong answers and then choosing the best (21.6%)

15 Ranking of Exam Analysis Outcomes Top 3 outcomes: 1) Improved knowledge of subject matter through use of better study habits/skills (45.9%) 2) Improved exam-taking strategies (27.0%) 3) Decreased anxiety (18.9%)

16 What Encouraged You the Most with the Exam Analysis? Going over tests and analyzing what I did wrong and right. Using the test strategies I was able to understand the info and better my test scores. Support from faculty lowers the level of anxiety during the exam and improves selfconfidence.

17 Quantitative Study Pre Exam Analysis test scores were compared to the final test scores to evaluate effectiveness of The Exam Analysis process Current study from October, 2007 through March, 2009

18 Sample At-risk students (n=120) Initial test score below 81% Age Mean 24 years Gender 80% female, 20% male

19 Sample cont. Ethnic Background: Asian 46.7% Caucasian 29.2% Hispanic 16.7% Black 6.7% American Indian 0.8%

20 Exam Score Comparison Increase in percent from pretest to posttest N = 111 (9 students withdrew) Mean = 6.46% score change 50% increased by 7.10% or > 30% increased by 10.76% or > 10% increased by 15.68% or >

21 Paired Samples Test (pretest vs posttest) Total Class Mean increased by 1.2% (p=.005) R/T to 9 students withdrawing Exam Analysis group Mean increased by 6.5% (p=.000) Increased 5.3% more than total class Five percent can make the difference btw passing/failing

22 83.6% failed pretest/passed posttest 82.9% passed both 16.4% failed both 17.1% passed pretest/failed posttest

23 Future Considerations Identify the extent that exam skills are related to anxiety, i.e. What was your level of anxiety prior to taking the exam on a score of 1-10 with 10 being the most anxiety? (in progress starting April, 2009) Encourage all teachers to provide rationale along with their key for each examination.

24 Suggestions for Further Study Continue Exam Analysis Evaluation to increase sample size Expand qualitative research to evaluate the student s lived experience, i.e. How are things going for you? Level of anxiety? etc. Video taped interviews with participants of The Exam Analysis process to provide data for Practice-Based Evidence research