By Lana Sweeten-Shults
GCU News Bureau
Grand Canyon University’s recent nursing graduates posted an impressive 98.21% first-time pass rate for the first quarter of 2019 on a notoriously rigorous national licensure examination. Of the 112 GCU nursing students who took the standardized exam from January to March, 110 passed the test on their first go-round.
GCU’s nursing students exceeded the first-time pass-rate state average of 95.16% for the quarter.
That stellar first-time pass-rate continues the ascension of GCU’s scores from 2018, when the University registered a 91.5% first-time pass rate for the year.
“I couldn’t have ever dreamed that we would have been this high (on the first-time pass rate). It’s really a blessing,” said the College of Nursing and Health Care Professions’ Amy Leach, Success Manager for the National Council Licensure Examination, or NCLEX. “… It’s really a testament to the quality of the program and the engagement of the students.”
The NCLEX is used by each state board – in this case, the Arizona Board of Nursing – to determine whether a candidate is prepared to become an entry-level nurse. GCU’s candidates become eligible to take the test after graduating from the pre-licensure program, and passing it is required to receive a professional license and begin working as a registered nurse in the field.
What makes GCU’s first-time pass rate stand out even more is that the University also is graduating more pre-licensure nurses than any school in Arizona at a time when there is a significant nationwide nursing shortage.
College of Nursing and Health Care Professions Dean Dr. Lisa Smith said the college has been working hard over the last two years with two goals in mind: to ensure that GCU’s graduates not only have a 90%-plus eventual pass rate (for those who take the NCLEX multiple times), but also to have a 90-plus first-time pass rate (for which nursing schools are judged), while continuing to graduate the most pre-licensure nurses in the state.
“It is really a combination of interventions,” Smith said of GCU’s recent outstanding performance on the NCLEX.
Not only has the college hired faculty and administration with strong nursing experience, it has revised its curriculum by adding immersive simulation, which encourages the nursing student to demonstrate the kind of critical thinking and clinical reasoning skills tested by the NCLEX.
In spring 2018, the college debuted an immersive simulation lab to replicate, as closely as possible, real-world environments students might find themselves in as nurses. The facility includes four hospital rooms, two debrief rooms, a nursing station, a room for at-home simulation and a control room. Each student completes 60 clinical hours in the lab in real-world situations designed to get them ready for their careers as nurses.
The students get to know the lab’s manikins (the medical spelling for mannequins), which tout everything from a pulse to blood pressure and the ability to blink and cry. Rooms are wired for video and sound so that when a nursing student asks the manikin a question, a facilitator can help the simulated patient respond.
Beyond boosting the curriculum with immersive simulation, Smith said students also practice standardized tests more than ever so that they are more equipped to pass the NCLEX on their first attempt.
The standardized testing practice the college uses is by Health Education Systems Incorporated (HESI).
“We increased the number of times students take practice standardized test,” Smith said. “It used to be just at the very end. Now we’ve threaded it throughout their entire program. Every semester, they get practice on taking a standardized test that would be similar to what they would expect on the NCLEX. We’re giving them more exposure, and we also have added a product that provides everyday practice with those types of questions as part of their curriculum, too, so they’re getting a lot of exposure.”
Leach said students on the verge of graduating were once required, as an extra component to their studies, to sign up and meet with Leach. She would walk them through an NCLEX test plan and how they would prepare for the NCLEX and also would review their HESI data.
“Now, because leadership has worked so well with me, we’ve actually incorporated that into time in the classroom,” Leach said. “… I’m working on helping faculty to understand maybe how to do the same thing (walk students through an NCLEX test plan and their HESI data to prepare for the test).”
Smith credits Leach, as the dedicated NCLEX success manager, for being part of the reason behind the college’s first-time pass rate success of late.
“She really has a full focus and has helped be a part of curriculum changes,” Smith said.
Leach focuses much of her work on helping faculty and students understand the standardized tests they’ll need to take “so they can go in and look at them themselves and have a better idea where they stand.”
Just this week, she and some of the nursing faculty analyzed HESI data for the last nursing cohort.
“How does it look? How can they use that to speak to how they might change some strategies in their classroom?” Leach asked. “That’s how we influence the curriculum and future program improvements.”
She also has invited faculty to sit in on one-on-one coaching sessions, with students’ permission, to give them exposure on how to coach students.
She tracks students' scores on practice standardized exams, and if a student scores low, she reaches out to them, meets with them one on one, goes over their scores, helps them understand where they scored low and gives them strategies on how to increase their scores.
Every semester, Leach also leads test-taking strategy sessions so students can further strengthen their test-taking skills, and she keeps abreast of the latest changes to the NCLEX exam.
Another factor that has facilitated the uptick in GCU nursing students’ first-time NCLEX scores is that the college revised its admission criteria two years ago.
Research has shown a correlation between admission criteria and first-time pass-rate success, Smith said, “so we tightened our criteria to be consistent with the research.”
The University is now seeing the students admitted under the new criteria coming through the program.
Leach attributes students’ first-time pass-rate success on the NCLEX to the immersive simulation, adjustments to the curriculum, more test practice, student interventions, faculty training and more. “But I really think we’ve done a better job messaging to students what’s required for the NCLEX and what they can do to kind of build a plan, know what their HESI scores are and take them seriously.”
While the college is celebrating its nursing students’ recent NCLEX success, that high first-time pass rate doesn't mean that the college will start slowing down.
“This summer we’re adding to the immersive simulation program where we will use live actors as our patients,” Smith said. “They will have a script they’ll work off of to provide that nursing student with a very realistic scenario.”
Smith said while many actors will come from the community, she’s hoping some of the actors, called standardized patients, will come from GCU’s own College of Fine Arts and Production.
“We’re hoping to have that in place in the fall,” she said, which adds yet one more facet to the nursing program to assure its students will be successful.
Leach added that making sure nursing candidates can pass the NCLEX and start working in the field is vital.
“The more (nurses) that we can get out there the faster, the more that we’re helping the nursing shortage,” said Leach. “… I think we’re doing good things here.”
Contact GCU senior writer Lana Sweeten-Shults at [email protected] or at 602-639-7901.