Progression Testing In Nursing Education
What Is Progression Testing
Progression testing is the use of standardized tests in designated content areas to assess mastery of essential nursing content as students' progress through a nursing curriculum. As a result of progression testing students gain experience in taking a variety of challenging tests in content areas similar to those addressed by the National Council Licensure Examination for Registered Nurses (NCLEX-RN”). Thus, progression testing complements professor-prepared examinations that also prepare graduates for the NCLEX-RN (Mosser, Williams, & Wood, 2006).
Implementations of Progression Testing In Nursing Education
First time pass rates on the NCLEX-RN are deemed important determinants of program quality by national accrediting agencies. In addition, graduates of nursing programs may not practice as registered nurses until passing the NCLEX-RN. The NCLEX test plan was revised in 2013 and the passing standard increased as well, reflecting the fact that safe and effective entry-level practice requires a greater level of knowledge, abilities, and skills, due to increased acuity levels of clients (National Council of State Boards of Nursing [NCSBN], 2013).
Pressure to pass the NCLEX-RN on the first attempt is important to both nursing programs and graduates, and the NCLEX-RN has become a more challenging exam. Progression testing is one mechanism that can be employed to assist students in mastering and retaining content as they progress through a nursing program, contributing to successful NCLEX-RN pass rates.
The adoption of progression testing within a nursing program is a decision that should be made by the entire faculty, as so many aspects of the program will be affected: how the testing will be used within courses and between levels of the program; policies for the catalog, student handbook, and syllabi of affected courses; and decisions related to fees for testing.
Commercially developed standardized assessment programs are available through educational testing and review companies such as Assessment Technologies Institute (ATI) and Elsevier's Health Education Systems, Inc. (HESI testing), with corresponding psychometric parameters for each program. Faculty members are responsible for investigating and selecting the standardized assessment program; determining passing, remediation, and progression policies; and developing an overall progression testing proposal for institutional approval prior to implementation of a progression testing program (Mosser et al. 2006).
Benefits of Progression Testing In Nursing Education
Progression testing provides the opportunity for students to test out of each level. of a program to progress to the next, and then pass a standardized test to graduate. Utilization of computerized tests that mimic the NCLEX-RN provides additional practice for taking the NCLEX-RN. It is recommended that policies addressing progression testing provide an opportunity for students to review and focus on identified areas of weakness before retesting (Thomas) & Baker, 2011).
While comprehensive assessments administered at the end of programs are accurate in predicting success, they do not predict failure as well (Harding, 2010). Therefore, early identification of students with low knowledge acquisition is essential in helping them to acquire the necessary content and skills to successfully progress in a program of study (Emory, 2013; Holstein, Zangrilli, & Taboos, 2006).
Outcomes of Progression Testing In Nursing Education
The pressure for nursing programs to have successful NCLEX-RN pass rates is great, and schools have responded to the challenge in various ways, Morrison, Free, and Newman (2002) reported on seven schools that required a certain score on a designated comprehensive test in order to graduate or take the NCLEX-RN, Nibert, Young, and Britt (2003) examined 45 programs with progression policies and found that progression consequences existed for students who did not pass an end of program comprehensive assessment: denial of eligibility for graduation, a failing or incomplete grade in a capstone course, and/or denial of approval to take the NCLEX-RN.
Several groups have expressed concern related to using a standardized test to block eligibility to take the NCLEX-RN, with the NLN referring to the practice as “high stakes” testing (Cart, 2011; National League for Nursing [NIN], 2012).In response to concerns about the use of standardized testing, the NLN (2012) developed fair testing guidelines for faculty and administrators to implement. These guidelines:
(a) ensure that tests and decisions based on tests are valid
(b) hold faculty responsible for assessing the abilities of students
(c) use multiple sources of evidence to evaluate basic nursing competence
(d) use tests not only for evaluative measurement, but to support student learning and guide program improvements
(e) develop comprehensive testing policies that are made readily available to students, informing students as to the purpose of the tests.
These guidelines were developed to assist faculty in creating ethical progression policies.Progression testing provides one mechanism to assist graduates of nursing programs to be successful in passing the NCLEX-RN on the initial attempt. Using progression testing throughout a program provides students with experience in taking NCLEX-RN based examinations in specific content areas, assisting them to identify their own strengths and weaknesses, and remediating appropriately.
Progression testing should not be done in isolation, but accompanied by other intervention strategies to promote students' success study groups, tutoring, test taking strategy sessions, and stress reduction techniques (Thomas & Baker, 2011). It is incumbent upon faculty members to regularly review and refine processes used to assess students, in the spirit of continuous quality improvement, and to report results in the literature.
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