Closing the Loop
UNLV School of Nursing
BSN Program
Susan Kowalski, RN, PhD
November 6, 2008
Academic Assessment Symposium
Our 8 program outcomes are based upon our faculty selected 8 core
concepts. The core concepts are aligned with the Essentials of
Baccalaureate Education (AACN).
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Each semester 2 program outcomes are evaluated.
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According to our program assessment plan, each
program outcome has 3-4 types of assessment
measures.
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These include: NCLEX results, ERI standardized test
scores, various surveys, clinical evaluations by
faculty/preceptors and rubric scored capstone papers.
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Use of standardized exams and NCLEX allow for
comparison with national norms and used for several
of our program outcomes and are an important part
of our analysis and decision making process.
Assessment Plan
The NCLEX Exam
Uses Bloom’s Taxonomy with the majority of items written at
the application level or higher since the practice of
nursing requires application of knowledge, skills and
abilities.
Content of the exam is organized into 4 major client needs
categories:
 Safe and Effective Care Environment
 Management of Care
 Safety and Infection Control
 Health Promotion and Maintenance
 Psychosocial Integrity
 Physiological Integrity
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Basic Care and Comfort
Pharmacological and Parenteral Therapies
Reduction of Risk Potential
Physiological Adaptation
Content is also divided into 4 major fundamental nursing
processes which are then integrated throughout the client
needs categories.
 Nursing Process – the scientific problem-solving approach to care
that includes assessment, analysis, planning, implementation and
evaluation.
 Caring – the interactions between nurse and client in an
atmosphere of respect and trust. This is a collaborative environment
where the nurse provides encouragement, hope, support and
compassion to help achieve desired outcomes.
 Communication and Documentation – the verbal/nonverbal
interactions between the nurse and client, the client’s significant
others and other members of the health care team. Client care is
validated in written and/or electronic records that reflect standards
of practice and accountability in the provision of care.
 Teaching/Learning – the facilitation of the acquisition of
knowledge, skills and attitudes promoting behavior change.
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Table IV-B.2 Performance on NCLEX-RN Licensure Examination of Baccalaureate
Graduates
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National first time pass rates
2005 87.2%
2006 88.1%
2007 85.5%
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Nevada
2005
2006
2007
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UNLV SON first time pass rates
2005
79.8%
2006
83.9%
2007
82.9%
first time pass rates
81.2%
85.1%
81.1%
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Use of NCLEX Scores allow for trending of classes over time and
comparison with state and national means. UNLV has 3 graduating
classes each year (48-56 graduates per class).
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The ERI exams give us important feedback
that is helpful in identifying specific content
areas of our curriculum that may need
improvement.

We use the exams for evaluation, and for
teaching. As part of the ERI total testing
program students receive practice tests,
remediation for weak areas, and have
monitored exams that are 10% of their
course grade.
Use of ERI Exams
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Fundamentals
Maternal Child Nursing
Gerontological Nursing
Medical Surgical Nursing
Pharmacology
Mental Health Nursing
Critical Thinking
Therapeutic Communication
Community Nursing
Critical Care Nursing
Pre-RN Assessment
RN Assessment
MOCK NCLEX (Computer Adaptive Test)
Exams given throughout program
for learning – and evalution.
Example: Program Outcome #1
 Utilize the nursing process as a framework
for nursing practice, incorporating criticalthinking skills.

Critical Thinking Exam (3rd semester)
 RN Assessment Exam (prior to
graduation) – sections on Nursing Process
and Critical Thinking
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Exams matched to Program
Outcomes –
Spring
2008 ERI
RN Assessment exam
no
= No risk
= At risk
= High risk
=

You can imagine how distraught the
faculty was when viewing the class
composite results for the Spring 08
graduating class – RN Assessment test.

An immediate decision was made based
on this data to implement a 4 day NCLEX
Prep course.
Addition of Face to Face NCLEX
prep course.
70
Composite Scores
Did Not Pass
Passed
100
90
80
60
50
40
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 ERI standardized exams are given throughout all levels –
we are presently meeting with other testing programs
which will give more specific remediation to the student.
 75% average on exam policy implemented –
Ability to perform well on exams is essential for passing
the NCLEX.
 Competitive admissions (points for NET test, selected
science and math grades). Our data indicated that
students with scores below the national mean on the NET
were most often unsuccessful in the program or unable
to be successful on the NCLEX.
 4 day NCLEX face to face review session for Spring and
Summer 08 students – and will be continued. This
replaces a previous on-line review course.
Changes related to testing

To increase skills in critical thinking and
clinical judgment as used in the nursing
process we have implemented use of
simulation in every level.

A simulation team with members from each
level are involved in the writing of scenarios
and running the scenarios – our goal is to
have simulation up to 10% of the clinical
experience in each clinical course.
Implementation of Simulation
as a Teaching Method
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Required PDAs for all students (based on
survey from students and faculty after
pilot study with optional use).
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Use of I-clickers in class – (survey)
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Implementation of on-line math
calculation course in Level I (survey)
Changes in use of Information
Technology
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Based on feedback from ERI tests, we
have incorporated more application of
pharmacology throughout the curriculum
(to augment the 2 patho-pharm courses
presented in level 1 and 2), especially in
the clinical area.
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We have fine tuned content throughout
the curriculum.
Changes in Content

2004 – Last Revision (from 5 semesters to
4 semesters)
Spring 2009 Curriculum Revision
Planned