Nursing Students Excel on National Exam

Curriculum changes made to help students better prepare for the test are having a positive effect.

<p>Leah Goldberg, a nursing student, discusses a patient's treatment with Peggy Stolfi a nurse and School of Nursing  instructor, at Connecticut Children's Medical Center in Hartford. Photo by Peter Morenus</p>
A UConn nursing student discusses a patient's treatment with a School of Nursing instructor at Connecticut Children's Medical Center. File photo

Ninety-five percent of UConn nursing students who took the most recent national licensing exam passed the test on their first try – evidence that recent curriculum changes are having a positive effect.

Several years ago, the School of Nursing expanded its curriculum in order to help students better prepare for the test and allow them to become more familiar with the exam’s computerized format.

“Passing on the first try is important because that is the number that is always discussed; that is the benchmark that everyone uses to measure their program’s success,” says Associate Professor E. Carol Polifroni, director of the nursing school’s prelicensure task force.

Each year, students who graduate from UConn’s School of Nursing are given an opportunity to take the National Council Licensure Examination or NCLEX – a standard exam used to license nurses in every state in the U.S. The National Council of State Boards of Nursing requires individuals to pass the licensure exam in order to practice nursing.

The exam tests what nurses need to know to be safe and competent to practice. It assesses all nursing students’ knowledge and skills, regardless of whether they plan to specialize in adult care, neonatal care, intensive care, geriatric care, or other aspects of nursing.

The University of Connecticut School of Nursing has always been proud of the high levels of knowledge and clinical experience students receive. Many alumni say that the school’s high standards and knowledgeable and talented faculty have helped them accomplish distinguished careers in their chosen nursing field.

Yet the NCLEX presents a particular challenge for nursing students in that it is not like other standardized tests. First, the test is taken on a computer and individuals are presented only one question at a time. If they answer the question correctly, they proceed to another, slightly harder question. If they answer incorrectly, they proceed to a slightly easier question and so on. The test does not allow students to go back and answer questions they missed, or to change their answers. Students who show strong proficiency on the test may pass by answering a minimum of 75 questions. Students who do less well are given more questions – up to a maximum of 265 – so that the computerized program can assess their knowledge and proficiency. There may be more than one correct answer to a question: the student must pick the best one in the scenario given. Students are allowed a maximum of six hours to finish the test.

Polifroni says the test requires students to apply their knowledge of the physical sciences (biology, anatomy, physiology), the social sciences (psychology, sociology, anthropology), and nursing science in a practical way.

For instance, she says, a question may deal with cardiac rehabilitation. Some common forms of rehabilitation include increasing the mobility of the arms and legs, taking short walks, lifting light weights while sitting in a chair, and making changes in diet. Each of these is correct. But the question may ask the student: What is the best form of initial rehabilitation for a 50-year-old male smoker who just had a serious heart attack?

“Being able to integrate their knowledge and make decisions that promote proper care is something nurses do every day,” Polifroni says. “For many of our students, this is a new way of thinking, a new way of test taking, a new way of looking at the world.”

In order to help its students translate what they learn and to familiarize them with the NCLEX test format, the School of Nursing adjusted its curriculum three years ago. Students now begin taking computerized practice tests in the second semester of their sophomore year. By the time students reach their senior year, they are introduced to two-hour NCLEX exam reviews hosted by faculty once a week. Students are also paired up with faculty advisors, who help identify and address the students’ strengths and weaknesses, says Polifroni. Judging by the success of the Class of 2010 – the first to complete the new rigorous protocol – all that mentoring, monitoring, and preparation is paying off.

“The Class of 2010 met their potential,” Polifroni says. “Their SAT scores were around 1,200 and you would expect them to do well and they did.”