March 2016   Comments

Questions on the exam

I did my RN training in Kansas but have worked in the U.S. and Canada. After talking with new RNs here in Alberta about their training, I now believe that the focus on inquiry-based small group learning is the reason for the low scores on the NCLEX-RN exam (Feature, November). One of them told me that even when the small group she was part of asked for help, they were told to go back and find the answer themselves. I do not think that any of us would be willing to go to physicians who taught themselves! Students should be receiving instruction or at least be able to call on someone when needed. I am so grateful for the training I had, which combined inquiry-based learning, instruction in class and opportunities to interact with instructors and fellow students. When my daughter, who completed a similar RN program at Penn State University, wrote the NCLEX, she passed after answering only 75 questions! I think it is time to re-evaluate the training program in Alberta to ensure students come out of school with the knowledge they need to work as competent nurses.

– Donna Sharp, RN
Fairview, Alta.

We were thrilled to read that parties are discussing the NCLEX-RN but disappointed that there was no mention of how the National Council of State Boards of Nursing gathers data for the practice analyses, which inform the Test Plan. Although this is a licensing exam for new graduate nurses, many of the RNs being surveyed about their daily nursing activities have taken additional courses such as advanced cardiac life support or critical care, meaning respondents have different credentials than the people for whom the exam is designed. Unfortunately, data from RNs who received additional education post-graduation to work in specialized areas such as ICU or dialysis were not disqualified. Perhaps this partially explains how 57.61 per cent of respondents claimed to “monitor and maintain arterial lines” as a nursing activity that applies to their setting. The explanation relayed to us was that this additional training could not possibly influence the nursing activities of the respondents because they were only in practice for an average of six months. Really?

The processes of having three Canadian subject matter experts and representatives of the regulatory bodies examine test items seem to have failed to catch inappropriate items because activities such as “monitor and care for clients on a ventilator,” “perform and manage care of client receiving peritoneal dialysis” and “manage the care of a client on telemetry” are also in the Test Plan and therefore included on the current NCLEX-RN.

We invite readers to review the documents on the NCSBN website and contact their regulatory body with their concerns.

– Brenda Dafoe Enns, RN, BA, MN
Karlene Cifuentes, RN, BN, M.Ed.
Winnipeg, Man.

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