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Institutional Research
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Outcomes for focus group research. Purpose of the focus groups was to explore
factors associated with Nursing graduate’s success on the NCLEX.
Nursing Focus Group –NCLEX
Spring 2008
How did you prepare for the NCLEX?
1. Who took the Drexel Review course and who took the Kaplan Review?
Summary of Responses
All focus group students participated in the Drexel Review. Their general
assessment was that the program was inadequate as a review course but having a
review structure set up was useful. Although no students formally participated in a
Kaplan review they were familiar with the program, thought is was better
organized than the Drexel program, and felt it was a more realistic experience.
Response highlights
 Drexel
 Comments of dissatisfaction ranged from program delivery to technology:
o Lecture style review was not effective
o Facilitator did not seem knowledgeable, appeared to be reading
directly from the review manual.
o The review did not seem logically focused, presented numerous
random case studies rather than developing a systematic approach.
The study questions were not well organized and consequently did
not seem especially helpful.
o Poor rational was provided in response to many study questions.
o The technology was problematic and worked sporadically. Cited
example of frequently experiencing a system freeze up after
answering all 75 questions. Consequently no results were provided
and had to answer 75 questions again.
o In the computer application no explanations were provided for
incorrect responses helping student to understand where their logic
was faulty.
o General comments: Felt like the experience lacked credibility, was
unorganized, chaotic, left after the first day, facilitator was not
helpful, could have read the book myself.
o Drexel’s reputation for a quality nursing program was not reflected
in the review session; expectations were not met.
 Comments of satisfaction were primarily focused on the structure provided by
participating in the Drexel program and the benefit of learning testing techniques
o Students expressed satisfaction with the structure provided by
having a set review schedule established.
o The Drexel program provided software for pharmacology that was
helpful to one student and provided increased confidence in an area
of weakness.
o Appreciated the first day test taking strategies; provided a logical
way to approach working through uncertain responses; helped to
reduce anxiety; provided a logical methodology for analyzing
questions.
 Kaplan
o Several students were familiar with the Kaplan review program
through friends and other students.
o The Kaplan review provided a more realistic experience.
o The practice tests seemed to be more effective.
o Seemed like a more comprehensive review.
2. In retrospect (after taking the test), what would have been the most effective
strategy to use in preparation for the test?
Summary of Responses
Consensus agreed that there is no more effective strategy than just time spent in
focused study; no test preparation program can replace the role of personal
responsibility.
Response highlights
 It just takes hours of study and review using both the study questions provided
in the book and the computer simulated review.
 All a review course can do is to provide structure; no review course can reduce
the necessary number of hours spent in focused study.
3. Was the test as you expected? If not, how was it different?
Summary of Responses
Expected the experience to be intense but this was maximum anxiety.
Response highlights
 The whole entire test was a surprise, there seemed to be a disconnect between
the material studied and the questions on the test.
 Many questions seemed foreign, many responses were guesses.
 Expected there to be more quantitative questions on the test; spent significant
time studying measures and number related questions; ended up there were none
on the test.
 Overall the test was not nearly as concrete as expected
4. What preparation activity was the most helpful?
Each student found unique preparation strategies but all agreed that preparation is
improved by using multiple strategies.
Response highlights
 Using multiple methods is helpful.
 Moving between the book and computer is necessary. Neither method by itself
is sufficient.
 Assess your weaknesses and focus on these areas.
 Exchanged review books and CDs with friends to provide a fresh perspective,
change of review styles. Each review method has its own strengths and
weaknesses.
 Important to remain focused every day and must do something every day. If
one day was especially intensive don’t take the next day off, just attempt a
lighter study load.
 Developed a code for level of certainty when responding to study questions. For
example if a response was uncertain that question was circled and notes made in
the margin with respect to the rational used in the selection of that response.
After completing all study questions the rational provided in the review book
was compared with the rational noted in the margins for all questions that were
coded as uncertain, even if the answer was correct. This allowed that student to
affirm or revise any uncertainties in their rational.
 Used mnemonics strategies and coding to review and remember anatomy and
physiology material.
 The HESI provided good detail of weaknesses and appropriate remediation
strategies.
a. Taking the HESI twice will be a definite advantage for future students
5. Describe the supplemental self-directed resources you used to prepare for the
NCLEX.
 Other review resources that were used:
a. Kaplan
b. Lippincott
c. Saunders
d. Mosbys
i. The Mosby book was very much like the test.
ii. The review could be structure as a random or focused review.
 One student mentioned a dissatisfaction with books that included the correct
response directly just below the study question. It is too easy to sneak a peak,
negating the benefit of the review. (Note: did not get the name of the book used
by this student but think it may have been Mosbys). I think it was Lippincott’s
Describe how you used the available test banks.
6. How many questions used to prepare?
100 questions a day is not enough, it’s just a start. By the end of the review most
students mentioned answering up to 200 per day; one participant mentioned
working up to 300/day.
 How much time did you devote to doing questions?
 Test prep was treated like a full time job.
 Time was spent working on the computer tests and review the rationales
until they were blind (description provided by participant).
7. Did you space out your use of the test bank or do it all at once?
8. Did you improve progressively as you worked through the test bank?
9. Did you review all the rationales or just the correct rationale?
There was consensus agreement that all rationales should be reviewed. This is a
valuable learning tool: (1) an answer may be correct but the rational incorrect or
(2) provides effective reinforcement for a correct response.
10. Did you work on a computer or with a book?
Most participants used multiple review books and CDs and agreed that rotating
between using a review book and CD was helpful. One student always used the
Lippincott book but used a variety of different review CDs.
11. Did you work with a study group? Was it helpful?
Although some students participated in group study sessions when the studying
became serious all agreed that group study was not effective, was less focused,
became primarily social, but helped reduce some stress and anxiety.
12. What competing responsibilities competed for your time as you prepared for
NCLEX?
Family was the only competing responsibility mentioned by the participants. In all
cases, test prep remained the primary focus; time and activities were prioritized
accordingly. Boundaries were established with family.
13. How much time elapsed between graduation and taking the NCLEX?
 Generally two months
 Consensus was that July was optimal
 Taking a short break immediately after graduation and then engaging in prep as
a full-time endeavor was the preferred model. Scheduling your test as soon as
eligibility is granted is helpful and provides focus.
 Do NOT assume you will get the test date close in time to when you call and
schedule. Most likely will get a date several weeks from the call, so don’t wait
long to call and schedule.
14. Did you start working right after graduation?
 Most participants did not work during their test preparation; test prep was their
sole focus
 One participant worked weekends both during school and during test prep. This
required huge personal discipline.
 Most participants did not feel they could effectively study for the exam and
work at the same time.
 In many cases hiring was dependent upon licensure.
15. Parting thoughts
 The first week clinical test is valuable. Students should know that information
inside and out. Make flash cards to study and review from.
 The CCP LPN practice test was exactly like the real test, it would be helpful to
have a similar tool for the NCLEX.
 It is critical to become comfortable working in a computerized testing
environment. All the books, reading, and study in the world does not take the
place of computer practice.
 There is not time to think, answering questions must become almost
automatic.
 Wear ear plugs to help block our distractions; it is easy to become
distracted by movement and noise around you in the testing room.
 Participants tested in various testing sites, King of Prussia and Horsham were
mentioned. The facilities were different; Horsham was smaller and more
crowded.
 Just the process of getting signed in, finger printed, and waiting was
stressful.
 If possible make a practice run to your testing facility prior to the day of
the test so you are familiar with the route. This may help reduce some
anxiety.
 Relaxing just before the test is very important, get calm, don’t study the day of
the test, and be well rested.
 One participant stayed at a hotel the night before
 Take HESI exam very seriously; use this opportunity to identify your
weaknesses. Drexel students are not allowed to graduate until passing the HESI
with a score sufficient to predict success on the NCLEX
 Do not pick up your text books to study; stay with the NCLEX test prep
material, there is not enough time to start pouring through the texts.
 Take two weeks off after graduation to relax then focus completely on test prep
 Do something everyday
 Treat this as your primary job
 Develop a structure
 Pull questions apart, understand your weaknesses
 Getting practice questions wrong is a good thing – learn from it.
 Don’t walk in over confident.
 NCLEX is a tale of persistence.
 Practically everyone thought they failed the test when they walked out of the test
room