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Eight remediation strategies to improve test performance
By Kelley Strout, PhD, RN, and Karen Haidemenos, MSN, RN
DO YOU FEEL anxious about critical thinking-style nursing exams?
Many students and practicing nurses
perform quite well in clinical settings but struggle to earn the scores
they desire on exams for nursing
school, staff development, or continuing education and certification
purposes. Remediation (from the
Latin for cure or amend) is one tool
learners should implement after
answering practice questions to
improve future performance. Use
these eight strategies to improve
your remediation process and ace
the test.
Mediating remediation
Throughout the past several years,
the authors have mentored a wide
range of learners to improve their
performance on tests like the
NCLEX. The primary activity during these mentoring sessions comprises reviewing, examining, and
correcting practice questions. This
process is called remediation, and
it’s associated with improved performance on exams.1 There are various approaches to remediation for
nurses; however, detailed, published procedures for effective
remediation are lacking.2
We ask learners to answer a set of
practice questions and then review
the correct and incorrect answers
independently before our meeting.
We also ask that they write out their
remediation process so that we can
review it together. Using the learner’s
written remediation during mentoring sessions, we can see how they
thought through the question. Over
time, we noticed that some remediated learners were significantly
improving their performance,
while others weren’t. We analyzed
the self-remediation of learners who
improved to determine if they were
remediating differently than learners
who weren’t improving. Sure
enough, they were!
After reviewing a sample of 60
written remediations and comparing them to the score differences
between the first and second practice
exams, we identified 22 learners who
significantly improved their score
from the first practice test to the second. We e-mailed them to determine
the factors that contributed to their
improvement. All 22 learners
responded and stated that remediation was the most influential factor
in improving their scores.
We critically reviewed improved
learner’s remediation strategies and
identified eight distinct methods that
students who significantly improved
were using to help them achieve tremendous success. Although not all
students were using all eight strategies initially, we began requiring all
of these strategies as a part of the
mentoring process. When learners
consistently applied these strategies
during remediation, they reported
that they felt more confident answering sample critical thinking and
NCLEX questions, and they
achieved higher test scores.
DIY remediation
This process can help you prepare
for successful outcomes on quizzes,
nursing school exams, the NCLEX,
and certification exams. Most learners spend too much time focusing on
memorizing content; rote memorization won’t facilitate critical thinking,
which is the key concept behind
most nursing tests and certification
exams. Effective remediation is a primary method for preventing wrong
answers.
You must use practice questions
as an essential component of any
exam preparation. Numerous critical
thinking and NCLEX practice questions are available to you in textbooks, resources that accompany
textbooks, and online. Once you’ve
completed a practice exam, dedicate
time to effective remediation. Create
a remediation worksheet for yourself, or use the Sample remediation
questions provided. Then apply these
eight strategies for success on
upcoming tests.
Strategy 1
Write or type out the entire question
into your worksheet. This will help
you create a study guide that you
can return to for review after your
initial remediation. You’ll know
exactly what the question asked, so
you don’t have to guess.
Strategy 2
Identify why you answered the question incorrectly. This allows you to
examine your personal testing habits. If you’re missing questions
because of content, you can improve
your memorization and understanding of the content. If you tend to
skim the question text, or answer
test questions too quickly, you can
learn to slow down.
Strategy 3
Explain exactly why the incorrect
answer you selected for that
item is wrong. Then, note the
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correct answer. For example, if the
question is:
The RN receives Mrs. Smith from the
ED and notes absent palpable pedal
pulses bilaterally. Which of the following
actions should the RN do first?
a. Wrap her extremities with warm
blankets and reassess pulses.
b. Assess oxygen saturation.
c. Assess the pulses with a handheld
portable ultrasound device.
d. Notify the healthcare provider.
You might write:
I selected “Wrap her extremities with
warm blankets and reassess pulses.”
This is incorrect because I should complete my assessment first before moving
to intervention. The correct answer is
“Assess the pulses with a handheld portable ultrasound device.”
Strategy 4
If you missed a question because you
didn’t remember the content, as in
the example above, go to your textbook or review guide and review the
content for that entire topic. Chances
are the next time you get a question
about the topic, you’ll need to know
a different but related fact within that
content area.
For example, if the question you
answered incorrectly is about child
development, you should review all
the developmental milestones for
infants month by month, not just the
particular milestone covered by that
Sample remediation
questions
• Why is the correct answer correct?
• Why did you answer the question
incorrectly?
• Why are all of the incorrect
answers incorrect?
• Why did you answer the question
correctly?
• What content deficits can you
identify?
question. Placing the information in
context is a more effective learning
strategy than just trying to memorize
a discrete fact.
Strategy 5
Add in the page numbers from your
text and study guides where the content deficit is discussed. This will
save you time later when you review
your notes postremediation.
Strategy 6
If the answer choices are complex
and involve multiple unknown
terms, define each term for
future reference. For example, if
the question is:
An 80-year-old male patient has
lived alone for the past 10 years. He
states that his life is hopeless and has
very little meaning. Which of the following best describes the age-related issue
to be resolved?
And the answer choices include
words such as generativity, stagnation,
self-actualization, and ego integrity,
return to your textbook for full definitions of these terms.
Strategy 7
Align your remediation process with
your personal learning style: visual,
kinesthetic, or auditory. If you’re not
sure what your learning style is, find
out by completing a free assessment
online: www.how-to-study.com/
learning-style-assessment.
Once you know your learning
style, you can find a way to cement
content in your brain that works
with your learning style. If you’re an
auditory learner, for example, find
an audio file or record your lecture.
If you’re a visual learner, find a picture that demonstrates the principle
you’re trying to remember, or create
your own photo/diagram. If you’re a
kinesthetic learner, be physically
active as you study; for example,
construct models of difficult concepts or practice assessment techniques in order to retain information.
For maximum effectiveness and
retention, integrate two or more
learning styles.
Strategy 8
Remediate correct answer choices.
This one might seem counterintuitive, but many times you’ve merely
guessed the correct answer. If you
can articulate why a particular
answer is the correct one, you
know for sure that you’ve learned
that concept fully.
One more time
As you begin to think about applying the eight steps of effective remediation, you might think that this
process will be time consuming.
That’s correct. This process requires
a significant time investment, but it’s
an efficient and effective method to
improve your performance on critical thinking exams. Writing out
your remediation helps you identify
trends in your thinking, learning
style, or knowledge base.3 Written
remediation is an effective study
technique that supports test preparation and critical thinking, and
leads to successful outcomes.
REFERENCES
1. Horton C, Polek C, Hardie TL. The relationship
between enhanced remediation and NCLEX success. Teach Learn Nurs. 2012;7(4):146-151.
2. Pennington TD, Spurlock D Jr. A systematic
review of the effectiveness of remediation interventions to improve NCLEX-RN pass rates. J Nurs
Educ. 2010;49(9):485-492.
3. Wiles L. “Why can’t I pass these exams?”: Providing individualized feedback for nursing students. J Nurs Educ. 2015;54(3):1-4.
Kelley Strout is an assistant professor of nursing at
the University of Maine in Orono, Me. Karen Haidemenos is an educational nurse consultant at Kaplan
Test Prep in New York, N.Y.
The authors have disclosed no financial relationships
related to this article.
DOI-10.1097/01.NURSE.0000481435.17425.88
22 l Nursing2016 l Volume 46, Number 4
Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
www.Nursing2016.com