NCLEX-RN: 2015 performance of Alberta graduates. College & Association of Registered Nurses of Alberta

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NCLEX-RN: 2015 performance of Alberta graduates College & Association of Registered Nurses of Alberta March 31, 2015

Contents Background on the NCLEX-RN 1 Alberta results 2 Exam duration statistics 3 NCLEX-RN test plan performance 7

Background on the NCLEX-RN This report provides statistics on the performance of graduates of Alberta nursing education programs who wrote the NCLEX-RN in 2015 as a part of their registration/licensure application process with a provincial or territorial RN regulator in Canada. The report includes only attempts made on the NCLEX-RN. Any attempts at the nursing regulator s exam in years prior to 2015 are not included here. The ultimate pass rate displayed in this report measures the percentage of graduates who wrote the exam during 2015 and had passed the exam by their latest attempt in 2015. It indicates how many graduates passed the NCLEX-RN during 2015, and are therefore available to the health care workforce (pending completion of all other registration/licensure requirements). See How the 2015 first-attempt and ultimate pass rates is calculated section in the NCLEX-RN 2015: Canadian Results report for more information on pass rates and how they are determined. Page 1

Alberta results The 1,637 Alberta graduates who wrote NCLEX-RN in 2015 represented 18.1% of graduates nationally. Of this total, 83.9% succeeded at passing the exam by the end of 2015. Table 1. NCLEX-RN ultimate pass rate of Alberta graduates in 2015 PASSED FAILED TOTAL WRITERS ULTIMATE PASS RATE Number of graduates and ultimate pass rate 1,374 263 1,637 83.9% Table 2. NCLEX-RN number of attempts taken by Alberta graduates in 2015 PASS RATE TOTAL PASSED FAILED ON THIS WRITERS ATTEMPT First attempt 1,131 506 1,637 69.1% Second attempt 229 114 343 66.8% Third attempt 14 13 27 51.9% Fourth attempt 0 1 1 0.0% Ultimate result: of the 1,637 Alberta graduates who wrote NCLEX-RN in 2015, 83.9% passed the exam by the end of 2015. 1 st attempt: Of the 1,637 Alberta graduates who wrote the NCLEX-RN in 2015, 1,131 (69.1%) passed the exam on their first attempt and 506 were unsuccessful. 2 nd attempt: Of those 506 who were unsuccessful on their first attempt, 343 attempted the exam for the second time, with 66.8% (or 229) passing. 3 rd attempt: Of the 114 graduates who did not pass on their second attempt, 27 attempted the exam for the third time, with 14 (51.9%) succeeding. 4th attempt: Of those 14 graduates who were not successful on their third attempt, one graduated attempted the exam for the fourth time, unsuccessfully. Page 2

Exam duration statistics Writers of the NCLEX-RN answer from a minimum of 75 questions to a maximum of 265 questions. For most writers, the computer program will stop asking questions once the program has calculated with 95% certainty that the writer is clearly above or below the passing standard (see How a pass or fail is determined section in the NCLEX-RN 2015: Canadian Results report for more information). With computer-adaptive tests (CATs), the number of questions an exam writer answers and how long it took them to complete the exam shows how quickly the writer demonstrates whether they meet the required level of competence (the passing standard). Page 3

On average, successful graduates were able to demonstrate their competence quickly, within 2 hours and 15 minutes (see Table 3 (a)). The average number of questions taken by Alberta graduates who were successful on their first exam attempt was 127 which is closer to the minimum number of questions a writer could receive (75) than it is to the maximum number (265). In 2015, almost half (or 44%) of writers who were successful on their first attempt answered the minimum number of questions (75 questions). This means they were able to demonstrate the required level of competence with the minimum required number of questions. Almost a quarter (23.9%) of those graduates, who were not successful on their first attempt, needed only a minimum number of questions to demonstrate that they did not meet the required level of competence. The proportion answering the maximum number of questions reflects how many graduates were close to the passing standard at the end of their exam. Only 16.2% of 1,131 Alberta graduates who passed the exam on their first attempt, passed by a small margin: they had to answer the maximum number of questions in order to demonstrate their competency. Of the 506 Alberta graduates who were not successful on their first attempt, 33% answered the maximum number of questions in other words, over a third of those who failed were close to meeting the passing standard at the end of the test. Table 3 (a). Exam Duration Statistics: first NCLEX-RN attempt in 2015 First attempt BY WRITERS WHO PASSED BY WRITERS WHO FAILED BY ALL WRITERS Average number of questions answered 127 171 140 % of writers answering minimum number of questions % of writers answering maximum number of questions 44.0% 23.9% 37.8% 16.2% 33.0% 21.4% Average exam duration 2 h 15 min 3 h 4 min 2 h 30 min TOTAL NUMBER OF GRADUATES TAKING FIRST ATTEMPT 1,131 506 1,637 (FOR REFERENCE) Number of questions: minimum of 75 and maximum of 265 Maximum test time: 6 hours Page 4

With the second attempt, 343 graduates answered more questions on average (154 questions vs. 140 questions as per Table 3 (a)) and took longer time to write the exam (average of 3 hours compared to 2.5 taken on the first attempt). Of the 229 graduates who were successful on their second attempt, 29.7% answered the minimum number of questions, which is a decrease compared to the first-attempt s 44% rate. There was also an increased rate of answering the maximum number of questions for successful graduates. This means that a higher proportion of successful graduates passed by just a small margin. In addition, a smaller proportion demonstrated their required level of competence with the minimum required number of questions on their second attempt. Of the 114 graduates who were not successful, a smaller proportion failed after taking the minimum number of questions. This means that on their second attempt, graduates answered more questions in attempt to demonstrate their candidate ability. Table 3 (b). Exam Duration Statistics: second NCLEX-RN attempt in 2015 Second attempt BY WRITERS WHO PASSED BY WRITERS WHO FAILED BY ALL WRITERS Average number of questions answered 143 175 154 % of writers answering minimum number of questions % of writers answering maximum number of questions 29.7% 15.8% 25.1% 20.5% 29.8% 23.6% Average exam duration 2 h 52 min 3 h 32 min 3 h 5 min TOTAL NUMBER OF GRADUATES TAKING SECOND ATTEMPT 229 114 343 (FOR REFERENCE) Number of questions: minimum of 75 and maximum of 265 Maximum test time: 6 hours Page 5

With the third and fourth attempts, 28 graduates, on average, answered even more questions (170 vs. 154 as per Table 3(b)) but took almost the same time as second attempt writers. Of the 14 graduates who were successful on their third attempt, 4 (or 28.6%) answered the minimum number of questions. There were 3 (or 21.4%) writers who passed by a small margin, answering the maximum number of questions. Of the 14 graduates who were not successful, only 1 (7.1%) failed after answering the minimum number of questions, and 7 graduates (50%) answered the maximum number of questions, being close to the passing standard. Table 3 (c). Exam Duration Statistics: third and fourth NCLEX-RN attempts in 2015 Third and fourth attempts BY WRITERS WHO PASSED BY WRITERS WHO FAILED BY ALL WRITERS Average number of questions answered 139 200 170 % of writers answering minimum number of questions % of writers answering maximum number of questions 28.6% 7.1% 17.9% 21.4% 50.0% 35.7% Average exam duration 2 h 54 min 3 h 14 min 3 h 4 min TOTAL NUMBER OF GRADUATES TAKING THIRD AND FOURTH 14 14 28 ATTEMPTS (FOR REFERENCE) Number of questions: minimum of 75 and maximum of 265 Maximum test time: 6 hours Page 6

NCLEX-RN test plan performance Each writer of the NCLEX-RN must answer questions across four major categories, all of which are based on client needs. The content for these question topics is referred to as the test plan (for more information, see Topics covered on the exam section in the NCLEX-RN: Canadian Results report). To pass the NCLEX-RN, the exam writer must perform above the passing standard, which is set at 0.00 logits (for more information, see How a pass or fail is determined and What is a logit? in the NCLEX-RN: Canadian Results report). The longer bars indicate better performance. The average performance of Alberta graduates can be compared against the passing standard itself as well as each test plan category. Figure 1 shows how well an average Alberta graduate taking the NCLEX-RN examination for the first time in 2015 performed overall and on each test plan category. Figure 1. Average test plan category performance of Alberta graduates on their first NCLEX-RN attempt in 2015 compared to average national performance in 2015 Alberta National Overall Performance Management of Care Safety and Infection Control Health Promotion and Maintenance Psychosocial Integrity Basic Care and Comfort Pharmacological and Parenteral Therapies Reduction of Risk Potential Physiological Adaptation 0.12 0.18 0.18 0.22 0.26 0.22 0.26 0.31 0.28 0.32 0.29 0.28 0.27 0.28 0.21 0.21 0.25 0.31 0.00 0.05 0.10 0.15 0.20 0.25 0.30 0.35 Average logit Passing Standard: 0.00 logit Page 7

In 2015, Alberta graduates, on average, were 0.22 logits above the passing standard on their overall test plan performance. They were also 0.04 logits below the national average, which was at 0.26 logits in 2015. Compared to the national average and the passing standard, Alberta graduates were doing best at the Psychosocial Integrity and on Health Promotion and Maintenance test plan categories. Psychosocial Integrity tests the competency of nursing care that promotes and supports the emotional, mental and social wellbeing of the client experiencing stressful events, and clients with acute or chronic mental illness. Health Promotion and Maintenance tests the competency of nursing care of the client that incorporates the knowledge of expected growth and development principles, prevention and/or early detection of health problems, and strategies to achieve optimal health. The lowest average logit of 0.12 was with Safety and Infection Control test plan category, which was 0.13 logits lower than the average national performance on this category. Safety and Infection Control tests the competency of protecting clients and health care personnel from health and environmental hazards. For more information on each test plan category, see Topics covered on the exam in the report NCLEX-RN: Canadian Results. Page 8

The further the bar is to the right of the passing standard of 0.00 logits, the better the average performance. For those writers who were not successful, the further the bar is to the left from the passing standard, the worse the average performance. Figure 2 breaks down the information presented in Figure 1 by the exam result: average performance of those graduates who passed the exam, who failed the exam, and the average of overall writers (for reference). The further the bar is to the right of the passing standard of 0.00 logits, the better the average performance. For those writers who were not successful, the further the bar is to the left from the passing standard, the worse the average performance. Figure 2. Average test plan category performance of Alberta graduates on their first NCLEX-RN attempt in 2015 (presented separately for those who passed and failed) Failed Average Passed Overall Performance -0.31 0.22 0.47 Management of Care -0.35 0.18 0.42 Safety and Infection Control -0.40 0.12 0.35 Health Promotion and Maintenance -0.17 0.31 0.53 Psychosocial Integrity -0.19 0.32 0.54 Basic Care and Comfort -0.18 0.29 0.50 Pharmacological and Parenteral Therapies -0.33 0.27 0.53 Reduction of Risk Potential -0.38 0.18 0.43 Physiological Adaptation -0.39 0.21 0.48-0.60-0.40-0.20 0.00 0.20 0.40 0.60 Average logit Passing Standard: 0.00 logit Page 9

There is a positive skew in three test plan categories: Psychosocial Integrity, Health Promotion and Maintenance, and Basic Care and Comfort. The positive skew (where data tends to cluster on the right side) represents a high average passing performance, and in particular, higher performance for those who fail (e.g., -0.19 logit is closer to a passing standard of 0.00 logit, than for example, -0.33). Both passed and failed first-attempt writers, on average, were performing well on these three test categories. There is a noticeable negative skew in Safety and Infection Control test plan category, where most of the values tend to cluster to the left. Both passed and failed first-attempt writers, on average, performed poorest on this category than on any other (-0.40 logits below the passing standard for not successful writers, and 0.35 logits above the passing standard for those who were successful). The second lowest-performing category for those who failed on their first attempt was Physiological Adaptation (-0.39 logits below the passing standard). However, for those who were successful on their first write, this category was only fourth worst performing (0.48 logits above the passing standard). Page 10