Nursing Program Assessment and Evaluation: Evidence-Based Decision-Making Improves Outcomes Jeanne Sewell, MSN, RN Flor Culpa-Bondal, PhD, RN Martha Colvin, PhD, RN Georgia College & State University Milledgeville, Georgia
Objectives Discuss evidence-based data that influence NCLEX pass rates at the Course level Program level Discuss the pros & cons for adopting a nursing program progression policy based on outcomes.
Needs for Change Increased complexity of NCLEX exams NCLEX simulation exit exam requirement for graduation Shift towards problem-based learning Integration of critical thinking component in classroom teaching and learning
Course Level Changes Example: Mental Health Nursing
Previous Teaching Methodologies Lecture/Discussion (PowerPoint slides) Case Studies (paper) 4 Unit Tests & Final Clinical Practice o Process Recording o Traditional Nursing Care Plan o Teaching Plan o Journals
New Teaching Methodologies Mini-lecture Case studies incorporating films Simulations Online quizzes prior to class 3 Unit tests & NCLEX simulation final Self-study modules Games
New Teaching Methodologies Clinical Practices Care/Concept Maps-incorporate nursing care, process recording & self reflection (CMAP) Reflective thinking questions for all clinical rotation journals Grading rubrics for all clinical rotation journals Research articles and discussion
Course Transformations Adopted the HESI specialty exam as the course final exam Raised the HESI score to count 20% of course final grade Created a blueprint for all unit exams Computerized all unit exams Administered all unit exams in GeorgiaView with settings parallel to HESI exams
Course Level: For Example
Student Feedback I just wanted you both to know that I have NEVER in my life worked so hard to pass a class! My first test grade was a 60 and I improved a little more each test until I made an 87.7 on my final. I can't tell you how relieved I am and proud I am of the class as well as myself. If you need any words of encouragement for the incoming nursing students, tell them "It CAN be done!" Thank you so much for a great semester! Although it was stressful at times and challenging, I found it very rewarding. I learned many things that I will carry with me through the program and the years to come. Thanks Again
What were the key discipline and course specific assessment and demographic components to use for course process improvement? Brainstorm: What would or would not apply to your course?
Pros/Cons Yes! No! Pros o Students engaged in learning o Improved outcomes on simulated NCLEX exams Cons o Time intensive for faculty Creating/refining teaching resources & methods Clinical grading-initial feedback & final assessments
Program Level Changes NRSG 4981 Integrated Clinical Concepts
New Course Adopted in 2003 1 Semester hour credit Faculty-student mentoring 1:8 ratios 10 week course (hybrid) Weekly small-group meetings Learning contract Learning styles survey Text anxiety inventory
Teaching Methodologies Weekly homework & reflection Student focus: How to: Use previous NCLEX simulation exam data as a learning guide Use positive affirmations to achieve goal Understand the anatomy of a question stem Use an algorithm to determine question answer Practice with test question with associated talk aloud learning
Teaching Methodologies Attendance optional if HESI average 1050 Remediation testing Required on for specialty tests with scores <900 Optional for others NCLEX Simulation Testing 2 attempts
Student Feedback Student quotes about what they learned: How to study for boards and exit! I learned how to read and analyze HESI questions and rule out incorrect answers. Where I was going wrong in answering questions. How to apply nursing knowledge learned from clinical and class time to one big test at the end. Also I learned some great test taking skills that will prepare me for NCLEX!
Course Analysis Before the course: Analyze NCLEX specialty exam scores Identify at-risk students Analyze HESI sub-scores Review previous course grades Identify strategies that map to success Afterwards: Analyze course evaluations Trend and analyze data over time Follow NCLEX pass rates
How can program assessment and evaluation improve program outcomes?
Program Level: NCEX Simulation, For Example 100% Exit V1 % Scores 900 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%
Percent Program Level NCLEX Pass Rates 100% 80% 60% NCLEX Pass Rate - 1st Time Takers 40% 20% 0%
Pros/Cons Yes! No! Pros o Improved outcomes on simulated NCLEX exams o Improved NCLEX pass rates o Student pride when they pass the NCLEX Cons o Student reaction when not successful o Student appeal process o Can be time-consuming for faculty mentors o Don t always have 100% faculty buy-in
Conclusion Evidence-based decision making can improve program outcomes Policy changes require tough choices