Sam Houston State University | SACSCOC Fifth Year Interim Report

Assessment : 2013 - 2014 : Educational Programs :
Nursing BSN

2 Goals 3 Objectives 3 Indicators 3 Criteria 3 Findings 3 Actions

GOAL: Mastery Of Specific Nursing Sub-Specialty Content

Objective

Specialty

Nursing students will achieve mastery of a specialty content area (med-surg, pediatrics, obstetrics, psych-mental health, community, fundamentals, health assessment) by the end of each of their specialty courses.

Indicator

Standardized ATI Specialty Examinations

Criterion

Score Of Level 2 Or Greater By At Least 60%

60% of cohorts taking specialty exams by ATI will achieve set score of Level 2 (Proficient) or more. Range of levels goes from zero to 3 (highly proficient)

Finding

Findings Of ATI Specialty Exam Results From 2013-14

Out of 16 examinations given to 16 different groups of students in 8 classes, only 3 groups (18.75%) achieved the criterion on 60% of the class scoring equal to or greater than level 2. This goal was met only 18.75% of the time.

Actions for Objective:

Action

Assessment And Remediation For Specialty Exams

Students will be taking the ATI assessment tests in nearly every nursing course. Policies and procedures are being developed by the Testing Committee to ensure that students who obtain a score of 1 or less on any test will have a given number of hours of remediation. They will then be required to take a re-test over the same material. This will prepare them better for the Exit Exam and the NCLEX. Also, each student is assigned a faculty mentor as they enter our program. The faculty mentor's role is to follow that student's progress on grades and ATI scores throughout the program. They mentor the student on study and testing skills. Scores on specialty exams count as 5% of a course grade.

GOAL: Mastery Of Curriculum Content In Order To Pass The NCLEX Exam For Licensure

Objective

Mastery By Graduation

Nursing students will achieve mastery of all nursing content just prior to graduation.

Indicator

Standardized ATI Exit Examination

Assessment Technologies Institute, LLC (ATI) is a software-based testing company that produces standardized tests and learning software for nursing students. Each student is administered the comprehensive nurse exam that tests the student' overall knowledge in key areas of the nursing curriculum. In many ways, the ATI Exit Exam is similar to the National Council of Licensing Examination for the Registered Nurse (NCLEX-RN) and, therefore, performance on the ATI Exit Exam is considered to be a good predictor of a student's readiness for the licensing exam.

Criterion

Achievement Of Graduating Seniors On Comprehensive ATI Exam

At the time of graduation, sixty percent (60%) of students taking a standardized exit examination will achieve at least the baseline score of national BSN mean on their last attempt. In 2013-14 the national BSN mean on the Exit ATI was 68.1%. The faculty felt that if the national population of BSN graduates had 50% attaining above the mean of 68.1%, then SHSU would be good to have 60% above the mean of 68.1%.

Finding

Achievement Of Graduating Seniors On ATI Exit Exam 2014

The 25 students who took the ATI exit exam in April, 2014 did not perform well on the Exit Comprehensive ATI exam. Only 20% (n=5) of the class scored above the national mean of 68.1%. Of the remaining 20 students, 5 scored a PROBABILITY OF PASSING NCLEX ON FIRST TAKE between 1-28%, 6 scored between 31-56%, 6 scored between 59-71%, 2 between 73-78%, and 1 between 80-82% These probablility scores translate to actual raw scores as follows:

Actions for Objective:

Action

Continuous Assessment And Remediation Throughout Curriculum

Students will be taking the ATI comprehensive assessment test at the end of the 2-year nursing upper division curriculum. The test is a well-known predictor of NCLEX success and is used by a majority of BSN and ADN programs to identify both individul students who are at risk for failing the NCLEX and to identify curricular areas of weakness.

A national ADN, BSN, and combined mean is provided with a thorough analysis of the test for our program, including individual scores.

Students who obtain a score of less than the national BSN mean on their exit test will have a given number of hours of mandatory remediation with either their instructor or our nursing resource coach. They will then be required to take a re-test over the same material with a different test. This will prepare them better for the NCLEX.

GOAL: Mastery Of Curriculum Content In Order To Pass The NCLEX Exam For Licensure

Objective

Nursing Graduates From SHSU Will Pass The NCLEX Exam On The First Attempt

The NCLEX is a national licensing exam that is regulated by each state. In Texas that regulation agency is the Texas Board of Nursing. Students take the exam in a highly controlled Pearson Vue Center and must show two forms of identification. No objects are allowed into the testing site. Prior to registering to take the exam, the Board must approve them after receiving an affidavit of graduation from the Dean or Director of their school of nursing. Schools are expected to produce graduates who will pass on the first attempt.

Indicator

First-attempt NCLEX Pass Rate

The NCLEX is a national licensing exam regulated by the Texas Board of Nursing. It is a computer-adapted test that can take up to 4 hours. The test is comprehensive over the entire 2-year nursing curriculum.

Criterion

NCLEX Passing Rate

80% of graduating nursing students will pass the NCLEX licensing exam on the first attempt.

Finding

2013-14 NCLEX Results

The preliminary results of the 2013-14 were 78.26% passing rate or 17 out of 23 students. the official results will be distributed by the Texas Board of Nursing in mid to late October, 2014.

Actions for Objective:

Action

NCLEX Pass Rate Improvement

With a pass rate below 80% we have one more year in which to raise the rate before being placed on warning. Our first year rate was 87.5 and second year rate is approximately 78.26%. The action plan is as follows:
1. Each faculty to review the ATI Exit exam in detail for the weakest areas and consciously boost the appropriate course content in those areas.
2. Instead of giving one practice and two proctored exit exams, give one practice and three proctored exit exams. Have students who scored below the mean do mandatory remediation with the teacher.
3. Have a review day toward the end of the semeste in which instructors from each specialty area come into the class and review important content in their respective areas.
4. Each course is to add more NCLEX style questions to their quizzes and exams.
5. Continue the 3-day ATI live review.

Previous Cycle's "Plan for Continuous Improvement"

On both of these objectives, we had unrealistic goals. We also have decided to change from the HESI to ATI in the 2013-14 academic year. They have a better way of interpreting their scores in terms of probability of passing the NCLEX. We will have to set new goal for 2013-14.

Update on Previous Cycle's "Plan for Continuous Improvement"

Continue to develop policies and procedures in the Testing Committee for administering and remediating students on ATI standardized exams.
Continue assigning each student a faculty mentor to follow the student for the 2 years of the program. Their role is to keep track of ATI test scores and remediation compliance, mentor on test and study skills, and generally support the student.
Review the detailed reports provided by ATI for program and course evaluation and improvement. Correlate test scores to eventual passing of NCLEX on the first time.

Plan for Continuous Improvement

We only had one graduating class in 2013-4 and that class of 23 did poortly on all specialty ATI exams and on the ATI Exit Exam. They also did below par on the NCLEX, having only a 74% pass rate. Texas Board of Nursing requires schools to have an 80% or greater pass rate to remain state approved, therefore it is imperative that we take steps to improve our students' performance. The faculty has met and decided on the following strategies:
1. Give 3 instead of 2 ATI specialty exams in each course to increase their practice
2. Give more quizzes that are NCLEX style question (perhaps even every week)
3. Purchase Exam Soft which will provide better psychometrics on tests
4. Send all students scoring below a proficiency level of 2 to our Resource Coach for intensive remediation of that content.
5. Give 3 instead of 2 Exit Exams the final semester and give them at least 2 weeks apart to allow time for remediation.
6. Provide one 8 hour day at the end of the final semester in Concepts II to have a content faculty expert come to class and review the important conent from their area: content that may be on the NCLEX based on the published test blueprint.
7. Continue to provide a mandatory 3-day live NCLEX Review
8. Urge students to take the NCLEX as soon after graduation as they are permitted to.

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