Tommie L. Norris, DNS, RNAssociate Dean Evaluation & Effectiveness

Using ExamSoft Coding to Identify Gaps and Strengths with the NCLEX-RN Test Plan

Why Code to NCLEX-RN

• Map content in each course• Map content across the program• Identify gaps related to NCLEX-RN content• Identify redundancies • Prevent content “drift”• Compare to student outcomes

– Standardized exams

Let’s Get Ready to Map

• Faculty’s best friend is the NCLEX-RN Examination Detailed Test Plan (Nurse Educator Version)

• What is important to map for your program?• Where do you start?

– Do you start with only mapping the 4 main categories of the NCLEX-RN

– or include the Integrated Processes?– or include Bloom’s Taxonomy?– or include disease processes?

NCLEX-RN Detailed Test Plan

• Effective April 2016• https://www.ncsbn.org/2016_RN_DetTestPlan_Educator.pdf• Report of findings from the 2014 RN Practice Analysis• Serves as guide for candidate preparation

– “don’t teach to the test”

Cultural & Spiritual

• Add cultural and spiritual client preference to assessment and plan of care

• Integrated processes added culture and spirituality

Bloom’s Taxonomy

Major Client Needs Categories

1. Safe and Effective Care Environment Management of Care Safety and Infection Control

2. Health Promotion and Maintenance3. Psychosocial Integrity4. Physiological Integrity

Basic Care and Comfort Pharmacological and Parenteral Therapies Physiological Adaptation

Integrated Processes-Fundamental to Practice of Nursing

• Nursing Process• Caring• Communication and Documentation• Teaching/Learning• Culture and Spirituality Defined page 5

Client Needs % from Each Category/subcategory

Safe & Effective Care Environment Management of Care Safety & Infection Control

17-23%9-15%

Health Promotion & Maintenance 6-12%

Psychosocial Integrity 6-12%

Physiological Integrity Basic Care & Comfort Pharmacological & Parenteral

Therapies Reduction of Risk Potentials Physiological Adaptation

6-12%12-18%

9-15%11-17%

What Content is Coded Where?

Subcategory-Management of CareAdvanced DirectivesDelegationCollaboration with Interdisciplinary TeamInformed consent

BSN Program Outcomes• (PO1) - Use verbal, nonverbal, written, and emerging technology

methods to communicate and collaborate effectively with members of the healthcare team, including patients and the patient’s support network;

• (PO2) – Deliver safe, spiritually and culturally appropriate evidence-based, patient-centered health promotion and disease and injury prevention interventions;

• (PO3) – Integrate evidence, clinical judgement, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of patient-centered care;

• (PO4) – Demonstrate professional standards of moral, ethical, and legal conduct;

NCLEX-RN Categories

• (NX1) – Safe/Effective Care Environment. (Select from one below)– NX1a – Management of Care– NX1b – Safety/Inf. Cont.

• (NX2) – Health Promotion/Maintenance

• (NX3) – Psychological Integrity

• (NX4) – Physiological Integrity (Select one from below)

– NX4a – Basic Care/Comfort

– NX4b – Pharm./Parental Therapies

– NX4c – Reduction of Potential

– NX4d – Physiological Adaptation

Integrated Processes

• (IP 1). Nursing Process (Select one from below)– IP1a. Assessment – IP1b. Diagnosis – IP1c. Planning – IP1d. Implementation – IP1e. Evaluation

• (IP 2). Caring• (IP 3). Communication and documentation• (IP 4). Teaching/learning• (IP 5). Culture and Spirituality

Bloom’s Taxonomy

• (BK) Knowledge• (BC) Comprehension• (Bap) Application• (Ban) Analysis

Course Outcomes

NSG 421 Pathophysiology•(CO421-1) – Associate disruptions of physiological processes to the development of disease across the life span.•(CO421-2) – Use technology to interpret clinical data as indicators of normal or altered physiologic processes.•(CO421-3) – Apply evidence based practice to the study of disease processes. •(CO421-4) – Assume accountability for personal and professional behaviors.

Disease Processes

• (DP_Integ) Integumentary• (DP_ENT) Head, Eyes, Mouth, Nose,

Neck• (DP_CV) Cardiac• (DP_Pulm) Pulmonary• (DP_MSK) Musculoskeletal• (DP_Neuro) Neurological System• (DP_Renal) Renal• (DP_GI) Gastrointestinal• (DP_Repro) Reproductive System

Disease Processes (continued)

• (DP_Endo) Metabolic/Endocrine System• (DP_Hem) Hematological System• (DP_Onc) Cancer• (DP_EOL) End of Life• (DP_Imm/Infect) Immune System/Infectious Diseases• (DP_Gen) Genetics• (DP_APM) Antepartum• (DP_IPM) Intrapartum• (DP_PPM) Postpartum • (DP_NB) Newborn• (DP_HRPG) High Risk Pregnancy

Professional Role• (LM_Style) Leadership Style• (LM_Power) Leadership Power• (LM_Mgmt Res) Management Resources• (LM_NCDS) Nursing Care Delivery

System• (LM_Comm) Communication• (LM_Legal) Legal• (LM_Ethical) Ethical• (LM_Delegation) Delegation• (LM_Change) Change• (LM_Budget) Budget• (LM_QI) Quality Improvement

Psychiatric Mental Health DSM Classifications

• (DSM-Neuro dis) Neurodevelopmental Disorders: Autism, ADHD

• (DSM-Schz) Schizophrenia Spectrum and Other Psychotic Disorders

• (DSM-Bipolar) Bipolar and Related Disorders• (DSM-Depress) Depressive Disorders• (DSM-Anx) Anxiety Disorders• (DSM-Obsess) Obsessive-Compulsive and

Related Disorders• (DSM-Trauma) Trauma-and Stressor-Related

Disorders

Category Report

• Provides in depth analysis of learning outcomes• Identify strengths and weaknesses of individual exam users or

entire course• Checking “category statistics” will include the KR20, standard

deviation, mean, median, minimum, and maximum • http://university.examsoft.com/h/i/222431643-category-report/

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Course Report for Disease Processes

NX4 Across the ProgramNX1-Safe/Effective Care Envir.

NX1a-Mgmt of Care 144

NX1b-Safety/Inf. Cont. 120

NX2-Health Promotion/Maintenance 168

NX3-Psychological Integrity 11

NX4-Physiological Integrity

NX4a-Basic Care/Comfort 21

NX4b-Pharm./Parental Therapies 174

NX4c-Reduction of Potential 94

NX4d-Physiological Adaptation 228