Online Case Studies: HESI Exit Exam Scores and NCLEX-RN Outcomes

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Using data obtained for the 7th HESI Exit Exam (E2) validity study, the value of Elsevier's online case studies in assisting students to prepare for the E2 and the National Council Licensure Examination for Registered Nurses (NCLEX-RN) was investigated. Of the 137 randomly selected schools of nursing, 72 (52.55%) participated in the study. The student sample consisted of 4,383 students from associate degree, baccalaureate, and diploma schools of nursing. Findings indicated that the mean E2 score and the NCLEX-RN pass rate were significantly higher for students attending schools that used the case studies than they were for students attending schools that did not use the case studies. Descriptive data indicated that the case studies were most often used for remediation and examination preparation.

Section snippets

Review of the Literature

Case studies have long been used as a teaching method in business, law, and medicine because they provide an effective means of applying content and assisting students to develop problem-solving skills (Delpier, 2006). The use of case studies for teaching is generally considered superior to lectures in promoting learners' critical thinking skills, and students report a preference for interactive teaching strategies over didactic methods (Kim et al., 2006). Interestingly, despite students'

Methodology

A nonexperimental, descriptive design was used to compare E2 scores of students who used Elsevier's online case studies with E2 scores of students who did not use the case studies. As part of the seventh E2 validity study (S7), data were obtained from deans and directors at 72 randomly selected schools of nursing that administered the E2 between September 1, 2006, and August 31, 2007 (Young & Willson, 2012). These participating deans and directors were asked to complete the S7 Participant

Instrumentation

Two instruments were used to obtain data for this study: the E2 and the S7 Participant School Survey. The E2 consists of 160 test items, 10 of which are pilot items that are not scored. It is a comprehensive exam that is administered to students near the completion of the nursing curriculum to measure their preparedness for the NCLEX-RN. The test items are written using a critical thinking model described by Morrison, Nibert, and Flick (2006) and require clinical nursing judgment to determine

Findings

Nursing schools were randomly selected to participate in S7, and of the 137 schools selected for participation, 72 (52.55%) responded to the Participant School Survey. Of the 72 responding nursing schools, 45 (62.50%) were associate degree (ADN) programs, 22 (30.56%) were baccalaureate (BSN) programs, and 5 (6.94%) were diploma programs. The total student sample consisted of 4,383: 2,557 (58.34%) ADN students; 1,617 (36.89%) BSN students; and 209 (4.77%) diploma students. Of the 72

Summary, Discussion, and Recommendations

This study was based on data obtained for S7, which investigated the predictive accuracy of the E2 by soliciting information from the deans or directors of the participating schools regarding students' NCLEX-RN outcomes. Data regarding schools' use of the Elsevier online case studies were reported by the deans or directors that responded to the S7 Participant School Survey. Mean E2 scores and NCLEX-RN pass rates of students who used the case studies and those who did not use the case studies

Conclusions

Seven previously published studies indicate that the E2 is highly accurate in predicting NCLEX-RN success, and the findings of this study provide nursing students and nursing faculty with direction in terms of preparing for the E2 and ultimately for the NCLEX-RN. Deans and directors reported that Elsevier's online case studies were most often used for remediation and exam preparation. It seems that the case studies were helpful with remediation and exam preparation because both the mean E2

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Disclosure statement: Dr. Young and Dr. Rose have participated in research activities and received presentation honoraria from HESI Review & Testing within the past 3 years. Dr. Young serves as Chairperson of the Research Advisory Board for HESI Review & Testing. Dr. Willson was employed by HESI Review & Testing at the time this research was conducted.

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