3/5/2013
Learning objectives:
Integrating HESI for Program
Improvement
Karen Montalto, PhD
kmontalto@comcast.net
• 1. State ways to improve curricula to enhance
NCLEX-RN outcomes.
• 2. State ways to integrate HESI products into
curricula to enhance NCLEX-RN outcomes.
• 3. State ways to evaluate student readiness for
NCLEX-RN
• 4. State ways to assist student self learning
throughout the BSN program.
ELEVATE OUTCOMES WITH HESI
References
Assess
Product
Student
Diversity?
Needs?
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Included at the end of the presentation
Literature supports
Changing the teaching and learning environment
Research lacking
Nursing student’s approach to learning
Benefit of innovative student centered learning
environments
• Most effective use of NCLEX-RN assessment
products (Carrick, 2011).
Progression
Withdrawals
Failures
GPA
What are your programs’ predictors?
Students
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Within course?
Course to course?
Progression criteria?
Standardized tests?
Science core?
Overall GPA?
Preparation
SAT
GPA
Science
Math
Diversity
Weak in math/science
Little exposure to standardized tests
No exposure to “remediation”
Reluctance to be “labeled”
Reluctance to go to CAE or “tutors”
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What are your program supports?
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Facilitators of academic success for students
Center for Academic Enhancement
Peer Tutors
CONSULT grant
ROL:
Measures to increase NCLEX – RN success?
• High academic standards for admission
• If you can’t change admission.. Change
progression
• One course failure and repeat
• One withdraw failing and repeat
• Raise minimum passing score?
• Change how you “get them ready”
• Curriculum and teaching approaches
Student Support
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Diagnose:
Knowledge Deficit Students and Faculty
Early identification of at-risk student
Test anxiety counseling
Support groups-meet weekly
Anything we “couldn’t do”.. Put it into the new
curriculum
• Weekly review classes… grant
Identify at risk students
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Test taking / Study skills
Testing /review/blueprinting
Use of active learning
Case studies/Simulation
Practice questions and tests
NCLEX-RN readiness tests
Make it count
NCLEX-RN review course
Do faculty know..
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Current NCLEX style questions
NCLEX blueprint
How to review an IA
Behaviors on the practice analysis
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Plan-Implement
Implementation
• 1. New Curriculum
• 2. Emergency procedures
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HESI Comprehensive Review for the NCLEX
HESI 2 Year Case Studies
HESI Practice Test
HESI Fundamentals, Pharmacology, Maternity
HESI NCLEX-RN Comprehensive Exam
New Curriculum: more specialty exams
Implementation strategies continued
• 1. Evolve Live Review
• 2. Weekly Review Sessions
• Assess courses: course coordinators, level
coordinators
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Detailed Course Outlines
Test banks
Active learning
Case studies
Testing practices
Testing Practices
–Faculty workshop on item writing
–Parscore/partest
–Test peer review committee
–Standardized testing practices
• IA review with program chair
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3-5 per content hour
Application only
50 questions/exam-75 per final exam
Up to 5 math per exam
Test committee reviews
30% difference for different sections
Post test item analysis review
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IA Review
• Blueprinting to NCLEX test plan
• And practice analysis survey
– Additional layer.. Are there activities we have not taught?
– IV day added
• .4 to .8 difficulty
• Don’t throw out questions – unless there is a
problem with how the question is written, validity of
the question, etc.
Review for the NCLEX and Case Studies
Remediation Policies
• Given to first semester juniors
• Start students practicing with questions (required in
each course)
• Case studies required in each course (2-3 per
course) mapped out through the curriculum
• Specialty exams: maternity, pharmacology,
fundamentals
• Remediation for failure to achieve 77%
Remediation
• Programs using NCLEX predictor assessments
need policies related to mandatory remediation for
at risk students based on comprehensive
predictors. (Hedderick 2009)
Evolve live review
• Given the week before classes start
• First comprehensive exam
• Weekly review classes mandatory for seniors
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Weekly Review
Determining content areas for weekly review
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• First week of semester, HESI RN Exit given
• Review aggregate data and determine what areas
are weak
• Assign weekly practice test questions due day
before review class
Lunch hour
Application questions
Faculty volunteer: review in their specialty areas
Students enjoy having faculty review/mentoring
Prizes, Food
Policies
Intermediate interventions
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• Medical surgical course content “alignment”
• Identification of at risk students with math science
prenursing GPA less than 2.75
• Weekly support class sections for test taking, study
skills, and critical thinking applcation
Attendance at weekly review mandatory
Completion of practice test questions weekly
Integrated into grade for last semester courses
Students must pass comprehensive exam
Three attempts
If they do not pass by second attempt, must take a
nationally recognized review class live prior to third
exam
End result?
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New curriculum designed concurrently
• Integrated ideas into new curriculum
• “Support” courses
– Introduction to Professional Nursing
– Transition to Clinical Nursing
– Transition to Professional Nursing
• Specialty exams
Selected References
• Carrick (2011) J. Student Achievement and NCLEX-RN success: Problems
that persist. Nursing education perspectives. 32 (2). P 78-83.
• Hedderick, V., (2009), The Utilization of NCLEX Predictor Assessments
and the effect on NCLEX success rates in Nursing Programs within the
state of Pennsylvania.
• Lewis, C. C. (2005). Predictive accuracy of the HESI exit exam on
NCLEX-RN Pass rates and effects of progression policies on nursing
student exit exam scores.Dissertation Abstracts International, (UMI no.
3195986)
• Mosser, N. R., Williams, J. and Wood, C. (2006). Use of progression
testing throughout nursing programs: How two colleges promote
success on the NCLEX-RN. Annual Review of Nursing Education, 4,
305-319.
• Nibert, A., & Young, A. (2001). A third study on predicting NCLEX
success with the HESI exam. Computers in Nursing, 19, 172-178.
• Moceri, J. (2010). Being Cabezona: Success strategies of Hispanic
Nursing Students. International Journal of Nursing Education
Scholarship. 7 (1).
• Sifford, S., and McDaniel, D. , (2007), Results of remediation program for
students at risk for failure on the NCLEX Exam. Nursing education
perspectives. 28 (1).
• Stork, P. (2004). Predictive indicators of success for baccalaureate
degree nursing students on the National Council Licensure
Examinations – Registered nurse (NCLEX). Dissertation Abstracts
International, (UMI no.3148821)
• Simon, E. (2006). Clinical course predictor variables in NCLEX-RN readiness
exam performance. Dissertation Abstracts International, (UMI no. 3206307)
• Treas, L. (2006). Using logistic regression-based procedures to
establish predictability of NCLEX- RNRTM. Dissertation Abstracts
International, (UMI no.3207590)
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• Uyehara, J., Itano, J., Magnussen, L, Zhang, S., ( 2007 ), Facilitating program
and NCLEX –RN success in a generic BSN program. Nursing Forum volume
42 (1).
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