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People are living longer and sometimes dying harder from extended illness and chronic disease. People are waiting longer to seek medical care and winding up in the emergency department much sicker. Many ignore symptoms until its too late; others, lots of them, just can't afford healthcare.
All of which means new nurses are seeing sicker patients than ever before, which naturally begs the question: Is the test all nursing program grads must pass to earn a license to work in the U.S. tough enough?
It's a question the National Council of State Boards of Nursing, Inc. (NCSBN) continuously asks and, in response, routinely stiffens the passing standard for the NCLEX-RN exam, which it did again Dec. 10.
"The passing standard was increased in response to changes in U.S. healthcare delivery and nursing practice that have resulted in the greater acuity of clients seen by entry-level RNs," was the official word from NCSBN in a Dec. 15 press release
Ultimately, the NCSBN board of directors "determined safe and effective entry-level RN practice requires a greater level of knowledge, skills, and abilities than was required in 2007, when NCSBN implemented the current standard."
The new passing standard will take effect on April 1, in conjunction with the 2010 NCLEX-RN Test Plan.
Nursing Input
Prior to raising the standard, an expert panel comprised of nine nurses was convened by the NCSBN to perform a criterion-referenced standard setting procedure.
After carefully considering results of national surveys of nursing educators, nursing directors in acute care settings and administrators of long-term care facilities, the nurses announced their support for increasing the passing standards for the NCLEX-RN exam.
It's not a dramatic increase and its something done every 3 years this past decade by NCSBN which coordinates a passing standard analysis with the 3-year cycle of test plan evaluation for entry-level RNs. The 3-year cycle was developed to keep the test plan and passing standard current.
A free PDF download of the 2010 NCLEX-RN Test Plan is accessible by clicking here.
Meanwhile, with the increase in the passing standard, "there is an anticipated decrease in pass rates," the NCBSN states on its Web site. However, "over the course of a year or 2, the pass rates tend to return to the level prior to any passing standard increase," the staement concludes.
In 2007, the last time the NCSBN raised the exam's standard, pass rates dropped by around 3 percent among first time, U.S.-educated test-takers, according to Kaplan University, which projects up to 4,000 more nursing students failing the exam in 2010 than 2009 due to the tougher standards on the NCLEX-RN exam.
'Administrators of Care'
So how will this stricter grading impact senior nursing students who graduate in May?
The more than 1,100 undergraduate nursing students at Drexel University College of Nursing and Health Professions, Philadelphia, for example, will see a few changes in their leadership and management course as a result of the stricter NCLEX grading.
"Really, the changes in emphasis in subject matter are already reflected in our courses," said Mary Ellen Smith Glasgow, PhD, RN, CS, referring to the increased emphasis on the test on management of care (16-22 percent of questions will be on this area).
Glasgow, associate professor and associate dean for undergraduate programs, MSN programs and continuing nursing education, said Drexel was aware of the change because she has two faculty members assigned to monitor NCLEX and NCSBN activities.
As a result Drexel had planned to put more emphasis on delegation and safe and effective care in their leadership and management course.
"We'll tweak it so if nurses have to delegate tasks, they will know how you verify it has been done," she told ADVANCE. "How do you teach students to do that? Nurses aren't just caregivers; they're administrators of care."
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