Use of a Validation Study to Analyze Entry-Level Nursing Practice Between Triennial Practice Analysis Cycles Nicole Williams, MSN, RN-BC Nursing Content Manager, Examinations Doyoung Kim, PhD, Senior Psychometrician, Examinations
Outline Background NCLEX Practice Analysis and the Exam Construct Purpose Validation of the NCLEX Test Plan Literature Review Standards for Practice Analysis Results Entry-Level Nursing Trends Summary
BACKGROUND
NCLEX Practice Analysis Assists in defining the exam construct A triennial survey of entry-level nursing activities Approved Subject Matter Experts develop a list of activities relevant to entry-level nursing Results from the NCLEX Practice Analysis are used to develop the NCLEX Test Plan
NCLEX Practice Analysis Survey is distributed to 12,000 newly licensed entry-level nurses across all NCLEX areas Entry-level nurses are requested to rate a list of nursing activities considering two questions: 1. How important is the activity related to client safety and decreasing complications? 2. How often do you perform this activity?
NCLEX Practice Analysis Based on the data from the NCLEX Practice Analysis, the NCLEX Test Plan is developed NCSBN policy committee - NCLEX Examination Committee (NEC) and Member Boards of Nursing make test plan recommendations NCSBN Delegate Assembly approves (or makes recommendations for) the NCLEX Test Plan
NCLEX Continuous Practice Analysis Method of validating the current NCLEX Test Plan between triennial practice analysis cycles Separate sampling of newly licensed entrylevel nurses is used Same activity statements and survey format as the NCLEX Practice Analysis
NCLEX Continuous Practice Analysis Monitor the data to detect changes in entrylevel practice that would necessitate a review of the currently approved NCLEX Test Plan Overall, data in both the NCLEX Practice Analysis and Continuous Practice Analysis is similar Trends reflected were gradual over time
PURPOSE
Purpose Perform a comparative analysis of the data in the NCLEX Practice Analysis and the Continuous Practice Analysis Validate the approved NCLEX Test Plan between triennial Practice Analysis cycles
LITERATURE REVIEW
Literature Review Downing, S.M. & Haladyna, T. M. (2006). Handbook of Test Development. A critical component in test development is defining the content to be tested A systematic, comprehensive, defensible methodology outlining content definition must be utilized in high-stakes examinations
Literature Review American Educational Research Association, American Psychological Association & National Council on Measurement in Education, (1999). The Standards for Educational and Psychological Testing. While the methodology is left up to the developer, an empirical job analysis is endorsed as the beginning task in content definition
RESULTS
Results Trends Survey ratings reflected an increase in frequency and importance in activities designated in the Management of Care category Entry-level registered nurses are spending more time managing the care of the current client population The time spent by an entry-level nurse in each NCLEX Test Plan category has increased as well as their performance of multi-tasking
NCLEX-RN Test Plan Management of Care The nurse provides and directs nursing care that enhances the care delivery setting to protect the client and health care personnel.
ACTIVITY STATEMENT COMPARISONS
Activity Statement Comparison Top 30 activity statements in both importance and frequency Location position in top 30 Overall group rating in frequency and importance
Activity Statement Comparison During 2005-2007, Management of Care Minimal statements in the top 30
Activity Statement Comparison Beginning in 2008, an upward trend is noted in Management of Care Increase in statements in the top 30, more importantly, in the top 10
Activity Statement Representation Management Care 12 10 # of Activity Statements 8 6 4 2 0 2005 2006 2007 2008 2009 2010 2011 2012 2013 Practice Analysis and Continuous Practice Analysis
NCLEX-RN Test Plan 0.25 Management of Care 0.2 Test Plan Percentage 0.15 0.1 0.05 0 2004 2007 2010 2013 NCLEX-RN Approved Dates
Honorable Mention Apply principles of infection control (e.g., hand hygiene, surgical asepsis, isolation, sterile technique, universal/standard) Ensure proper identification of client when providing care
TIME SPENT IN ENTRY-LEVEL NURSING
Total Time in Each NCLEX Test Plan Category 7.00 6.00 5.00 Hours 4.00 3.00 2.00 1.00 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 0.00 2005 2006 2007 2008 2009 2010 2011 2012 2013 Practice Analysis and Continuous Practice Analysis
Overall Total Time Spent by Entry- Level Nurses 45.00 40.00 35.00 30.00 Total Time Hours 25.00 20.00 15.00 10.00 5.00 0.00 2005 2006 2007 2008 2009 2010 2011 2012 2013 Practice Analysis and Continuous Practice Analysis
Total Time in Management of Care Management of Care 7.00 6.00 5.00 Hours 4.00 3.00 2.00 1.00 0.00 2005 2006 2007 2008 2009 2010 2011 2012 2013 Practice Analysis & Continuous Practice Analysis
SUMMARY
Summary NCSBN applies rigor to established industry standards to ensure a systematic, comprehensive, defensible methodology is used to establish content domain Analysis of nursing trends using the triennial NCLEX Practice Analysis and the Continuous Practice Analysis noted entrylevel nurses are spending more time multitasking as well as coordinating and managing client care.