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Learning Plans Guided By HESI Specialty Exams To Enhance NCLEX-RN Outcomes

J.K. Macke PhD and R. Dunnington PhD Capital University, Columbus, OH

ABSTRACT

CURRICULUM ENHANCEMENTS

With pressure to increase NCLEX-RN outcomes, this BSN Program has moved to adopting individual learning plans to remediate students with scores under 900 on Evolve HESI Specialty Exams. Results from student’s scores on specialty exams are recorded and individual plans created. Students are then guided through the completion of assignments in the nursing process, client needs and content areas using the Evolve Adaptive Quizzing program. A minimum score for areas are set and students work independently to complete the assignments. Seminars meet every other week and focus on test taking strategies and content areas identified on the class’s summary of the Specialty Exam. As students complete the nursing process and client need assignments, they move into mastery exams in their weakest content or concept scores. In addition to these efforts, the curriculum has set higher criteria for course pass rates on teacher developed exams and use class exam summaries to evaluate and refine course content. With the addition of the individualized learning plans and seminars, the Department of Nursing’s outcomes for NCLEX-RN pass rates has increased by over 15%.

•  All nursing courses allot 50% of grade to faculty constructed NCLEX-RN style examinations.

•  Students must pass examinations at a 78% level before other assignments factor into grade.

•  Test strategies are introduced in Fundamental courses and in each Supplemental Learning Plan (SLP) seminar.

•  An NCLEX-RN and Prioritization/Delegation Text is required in courses

•  Attendance at the seminar is mandatory and students lose a per cent of the next course grade allotted to Supplemental Learning.

•  Faculty review of Evolve Specialty Exams each semester to evaluate course content and curriculum

•  Capital University’s focus on Caring incorporates Mindfulness into courses to enhance student focus and stress reduction.

STUDENT’S JOURNEY •  Evolve Specialty Exams are administered in each clinical course. •  Students who score < 850 on a specialty exam are assigned a Supplemental

Learning Plan (SLP) in the next semester and attend seminars every other week. •  Students record Specialty exam scores on the tool and indicate if > or < 850. •  Supplemental Learning Plans (SLP) are individualized based on the student’s score on

subcategories of the exam. •  Using the Computer Adaptive Quizzing, Non Mastery assignments in Nursing Process or

Client Needs are created. •  After students have completed an 80% on non Mastery assignments, mastery assignment are

completed at level 2 or 3.

STUDENT ‘S JOURNEY AND TOOLS

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Long Term Outcome: 95% of graduates will be successful on NLCEX-RN on their first attempt BY 2020 Medium Term Outcome: Students will have a 90% pass rate on NCLEX-RN on their first attempt for Class of 2015. Met DON OVERALL NCLEX-RN RATES 2013-2015

76.62% to 93.6% - 17% Increase Accelerated Program NCLEX-RN RATES for 2013-1015

76.7 to 96.9% – 20.2% Increase Traditional Program May NCLEX-RN RATES for 2013-2015

76.6 to 91% - 14.4% Increase DON OVERALL NCLEX-RN RATES 2013-2014

76.62% to 78.95 % - 2.3% Increase Accelerated Program NCLEX-RN RATES for 2013-2014

76.7 to 90.9% - 14.2 % Increase MET Traditional Program NCLEX-RN RATES for 2013-2014

76.6 to 76.4% - Decrease DON OVERALL NCLEX-RN RATES 2014-2015

78.95 % to 93.6% - 14.7% Increase Accelerated Program NCLEX-RN RATES for 2014-1015

90.9 to 96.9% – 6% Increase MET Traditional Program NCLEX-RN RATES for 2014-2015

76.4 to 91% - 14.6% Increase MET

OUTCOME

EVALUATION of OUTCOMES

Nursing Process Scores pg. 2   Client Needs Scores pg. 3  

  Exit-RN I  

Comm   Psych     Exit- RN 2  

Comm   Psych  

Assess         Safe/Effective Environment        

Analysis         Mgmt of Care        

Planning         Safety/infect control        

Implement         Health promotion/Maintenance        

Evaluation         Psychosocial Integrity        

        Physiologic Integrity                 Basic Care/Comfort        

        Pharm/Parenteral Tx        

        Reduce Risk Potential        

        Physio Adaptation                  

Sub-Specialty Scores pg 5     Exit-RN I   Communit

y  Psych     Exit

RN-I  Community  

Psych  

Fundamentals         Clinical Concepts        

Med Administration         Cardiovascular        

Math         Endocrine        

Basic Nursing Skills         GI/Hepatic        

Maternity         Growth & Development        

Antepartum         Immune/Hematologic        

Intrapartum         Integumentary        

Newborn         Musculoskeletal        

Postpartum         Neurological        

Professional Issues         Oncology        

Cultural/Spiritual         Operative        

Documentation         Physical Assessment        

Leadership         Renal        

Legal/Ethical         Respiratory        

Nursing Process         Reproductive        

Teaching         Sensory        

Psychiatric/Mental Health         Trauma/ER        

Abuse                

Anxiety/Communication                

Depression/Grief                

Psychosis                

Quality and Safety Education (QSEN) pg. 9  Patient-Centered Care         Teamwork & Collaboration        

Dimensions of Pt. Care         Member of Team        

Pain & Suffering         Scope of Practice        

Safety & Quality         Communication        

Ethical Legal         Systems/Team Functions        

Effective Communication                

Tool For Recording Scores from Specialty Exams

Week One Orientation Test Strategies and NP

Fill in Specialty Exam & Hand in copy to Professor In Class Exam

None

Week Three Psychosocial Integrity Culture/Spiritual

Review Silvestri Ch 6 & do Questions

In Class Exam

DUE: Non Mastery Assignment One Check your individual plan for which step you need to do

Week Five Pharmacologic and Parenteral Therapies Med. Adm. & Calculations &

Skills:

Review Silvestri 17 & 55 Do questions at end of chapter In Class Exam

DUE: Non Mastery Assignment Two On Nursing Process – Check Your individual plan for your NP Steps to complete

Week Seven Safety and Infection Control Reduction of Risk Pot.

Silvestri et al. Chapter 11 & 16 Do Questions In Class Exam

DUE Mastery Assignment Three: Fundamental Basic Needs

Week Nine Basic Nursing Skills and Laboratory Values

Silvestri et al. Chapter 12 & 14

In Class Exam

DUE Mastery Assignment Four: Fundamental Physiological

Easter Break No Class

Week 11 Basic Care/Comfort Needs – Concept of Pain

Silvestri Ch 12 & 20 Do Questions In Class Exam

DUE Mastery or Non Mastery Assignment Five on Individual Plan

Week 13 Individual Meetings on Progress

Class Meeting Date Assignment for Class Individual Adaptive Quiz

SAMPLE: SLP Seminars

Seminar Classes are on the following Fridays 1-2:50

Annual evaluation of outcomes with interventions implemented •  Computer Adaptive testing was added in 2013 to enhance ease of

assignments •  Requirement scores on HESI Exams have varied from 750 to 850 in

2013 to 900 in 2014. •  The Accelerated Program Class of 2015 has been under all

curricular enhancements and 850 scores since their entry in 2013