© 2010 jim mcgraw, rn, mn tarrant county college © 2010 jim mcgraw, rn, mn tarrant county college...
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© 2010 Jim McGraw, RN, MNTarrant County College© 2010 Jim McGraw, RN, MNTarrant County College
Yield: A New Measure of Nursing Program Performance
Jim McGraw, RN, MN
Asst. Professor
Tarrant County College
© 2010 Jim McGraw, RN, MNTarrant County College
How do we currently assess program outcomes?
Measures
• NCLEX Pass Rate
• Graduation Rate
• Graduate Employment Rate
Impressions
• Reputation
• Warm Fuzzy Feeling
© 2010 Jim McGraw, RN, MNTarrant County College
Strengths of NCLEX pass rate as a measure:
• A measure of effectiveness
• Standardized / Uniform
• Easily understood by insiders and outsiders.
• Readily available.
© 2010 Jim McGraw, RN, MNTarrant County College
Weaknesses of NCLEX Pass Rate as a measure
Easily distorted by:
• Removing students not HIGHLY likely to pass NCLEX.
• Delaying graduation of high risk students
• Post-Graduation – Tutoring– Review Courses
Limited to “first try”
© 2010 Jim McGraw, RN, MNTarrant County College
Weaknesses of NCLEX Pass Rate as a measure
Creates a conflict of interest for the school.
• Excessively restrictive admissions
• Removing students with some risk of NCLEX failure… who might pass.
© 2010 Jim McGraw, RN, MNTarrant County College
Weaknesses of NCLEX Pass Rate as a measure
• Is based on the assumption that admission criteria effectively screen for capacity to be successful.
• Is based on the political position that all students are capable if taught properly.
© 2010 Jim McGraw, RN, MNTarrant County College
Predicting NCLEX Success
Predicted to Pass
Not Predicted to Pass
Passes Exam GREAT! Potential loss of a new nurse!
Fails Exam Re-takes exam Not a problem
© 2010 Jim McGraw, RN, MNTarrant County College
Strengths of using retention as a measure
• Addresses how efficient the program is.
• Encourages schools to support students to retain/graduate them.
• Retention is a hot issue in public education.– Good numbers satisfy key stakeholders.
© 2010 Jim McGraw, RN, MNTarrant County College
Weaknesses of retention rate as a measure:
Students leave for MANY reasons:
• Some students discover this is the wrong field for them.– Partially out of the control of the school.
• Some perform poorly – Partially out of control of the school.
• Some have private life issues– Often completely out of control of the school.
© 2010 Jim McGraw, RN, MNTarrant County College
Weaknesses of retention rate as a measure:
• Current admission criteria are often NON-predictive of success.
• Is based on the political position that all students are capable if taught properly.
• 100% retention might be a problem too!
© 2010 Jim McGraw, RN, MNTarrant County College
Weaknesses of retention rate as a measure:
Measurement issues:
• What is graduation “on time”?– 100% – 150%
• Transfers in and out
• Student Death
© 2010 Jim McGraw, RN, MNTarrant County College
Result is gaming the system.
• Only graduating those students who are very likely to pass NCLEX on the first try.– What is the cost to students and the communities that
we serve?
© 2010 Jim McGraw, RN, MNTarrant County College
2007 ADN Programs
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Graduation Rate
NCLE
X Pa
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ate
© 2010 Jim McGraw, RN, MNTarrant County College
2007 ADN Programs
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Graduation Rate
NCLE
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ate
© 2010 Jim McGraw, RN, MNTarrant County College
2007 ADN Programs
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Graduation Rate
NCLE
X Pa
ss R
ate
© 2010 Jim McGraw, RN, MNTarrant County College
2007 ADN Programs
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Graduation Rate
NCLE
X Pa
ss R
ate
© 2010 Jim McGraw, RN, MNTarrant County College
Calculating the Yield
• Of all the students admitted, what portion will be licensed on the first try?
© 2010 Jim McGraw, RN, MNTarrant County College
Calculating the Yield
• Combines NCLEX pass rate with retention.
• Pass Rate x Graduation Rate = Yield
© 2010 Jim McGraw, RN, MNTarrant County College
Calculating the Yield
• 90% x 90% = 81%
• 85% x 85% = 72%
© 2010 Jim McGraw, RN, MNTarrant County College
Ordered by Pass Rate- 2007
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% Grad
2007 % PASSED
YIELD
© 2010 Jim McGraw, RN, MNTarrant County College
Strengths of Yield as a measure
• A single value• Easily understood• Addresses effectiveness AND efficiency• Prevents gaming the pass rate by manipulating
the graduation rate.
© 2010 Jim McGraw, RN, MNTarrant County College
Weaknesses of Yield as a measure
• Shares most of the weaknesses of the pass rate and graduation rate.
• New, and not yet understood by all.
© 2010 Jim McGraw, RN, MNTarrant County College
Case 1: High Pass Rate
• 2007• Five A.D.N. schools had 100% NCLEX pass rate• Three of the five had graduation rates <50%• Yields for these five schools:
– 83.3%– 58.2%– 44.6%– 42.9%– 29.0%
© 2010 Jim McGraw, RN, MNTarrant County College
Case 2: Low Pass Rate
2007 Pass Rate %
Grad Rate %
Yield
%
A71.43 47.30 33.79
B73.53 37.40 27.50
C75.00 72.20 54.15
D75.41 69.40 52.33
© 2010 Jim McGraw, RN, MNTarrant County College
Case 3: Low Yield2007 Pass
Rate %Grad
Rate %Yield
%
A98.44 22.30 21.95
B73.53 37.40 27.50
C100.00 29.00 29.00
D95.00 32.80 31.16
© 2010 Jim McGraw, RN, MNTarrant County College
Case 4: High Yield
2007 Pass Rate %
Grad Rate %
Yield
%
A96.88 94.10 91.16
B96.00 87.50 84.00
C100.00 83.30 83.30
D94.59 86.90 82.20
© 2010 Jim McGraw, RN, MNTarrant County College
Case 4: High Yield2007 Pass
Rate %Grad
Rate %Yield
%
Lamar State College-Orange
96.88 94.10 91.16
Midland College96.00 87.50 84.00
Brookhaven College (DCCD)
100.00 83.30 83.30
Tyler Junior College94.59 86.90 82.20
© 2010 Jim McGraw, RN, MNTarrant County College
Change in Rank from Pass Rate to Yield
-60
-50
-40
-30
-20
-10
0
10
20
30
Chan
ge in
Ran
k fro
m P
ass
Rate
to Y
ield
© 2010 Jim McGraw, RN, MNTarrant County College
Summary
• NCLEX pass rate and Graduation rate are both important.
• Combining them into a single value provides a different way too look at program performance.
• Yield tells our stakeholders if they are getting their $$$ worth from us!
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