Collaborative Testing as NCLEX Enrichment

Nursing programs across the United States strive for student success on the NCLEX-RN. Failure can be devastating for new graduates, and low pass rates can have a detrimental effect on program accreditation, funding, and reputation. Desire to maintain high first-time NCLEX-RN pass rates has prompted nursing programs to invest time and energy into remediation when students perform poorly on standardized comprehensive exit examinations. Nursing programs use various strategies to provide enrichment and preparation for the NCLEX examination. Standardized exit examinations are widely used in nursing education as a method to predict success on the NCLEX-RN. It has been reported that approximately 20% of nursing programs require students to achieve success on the exit examination to graduate. Collaborative learning activities associated with test taking could improve students’ scores on standardized exit examinations, thus promoting success on the NCLEX. A large body of evidence in education supports collaborative learning across disciplines. Collaborative testing (CT) is not a new concept to nursing education but has reportedly been used infrequently. By definition, CT is an interactive learning strategy in which students work together to answer questions on a test. Nursing practice requires collaboration, and students need opportunities to develop and practice skills that will prepare them to assume their role as members of the health care team. This study evaluates the effectiveness of CT, its use as a preparatory strategy for improving performance on standardized exit examination scores, and student satisfaction with the CT process. Background Research in nursing education has shown that CT is an active learning strategy that enhances communication, criticalthinking, and clinical reasoning skills, as well as group interaction, positive interdependence, and interpersonal skills. Several learning theories including cognitive-developmental, behavioral learning, social interdependence, and constructivism (cooperative learning) underpin CT. Knowledge increases as students work together using active problem solving while defending their position as they answer test questions in groups of 3 to 5 students. Nursing programs have used CT in various ways. A strategy known as double testing allows students to take examinations individually, then as a member of a small group. This approachalsohasbeenusedasposttest review. Mennenga and Smyer incorporated CT into a team-based learning approach. Students took a readiness assurance test to assess their preparation level for class, then repeated the same test in groups as a group activity. The most significant benefit of CT is the opportunity for students to actively practice communication skills by expressing rationale and negotiating, especially when required to arrive at consensus. Research has shown that CT enhances the student’s ability to master skills necessary for collaboration, communication with others, critical thinking, and clinical reasoning. Double testing promotes group interaction and processing skills, positive interdependence, and interpersonal skills. Research on CT in nursing education has focused on student and faculty perception of CT and the impact of CT on grades. Students have consistently evaluated their overall CT testing experiences as positive. They also have reported that CT helped them understand the course material better while allowing them to practice communication skills they will need in nursing practice. Faculty response has been positive, noting fewer negative and argumentative behaviors from students following double testing or test review using CT. In this study, CT was implemented as part of NCLEX-RN enrichment to determine the effectiveness of the strategy in improving standardized exit examination scores. Students