Preparation for the Struggling Student 1. What about those students who struggle? As nursing graduates begin to take a licensing exam that more closely represents clinical practice, we can expect that the NCLEX exam will be viewed by most test-takers as more difficult than past tests. Students who may struggle with the rigors of nursing school in general may have particular difficulty with the new version of the NCLEX. A strong remediation/support program offered throughout the course of study is important to ensure these students’ success. According to Mee and Schreiner (2016) “ Any structured process, including multiple modes of instruction, should be consistently implemented throughout the program. ” Here are some suggestions to help struggling students overcome the barriers that may prevent them from being successful in nursing. 1. Plan to offer remediation/support services for students beginning with the first term of the nursing program and continuing until students graduate. Whether the school has a “remediation specialist” responsible for all remediation/support activities, or the nursing faculty are responsible for working with their own students, or a combination of approaches, the structure of the remediation/support process should be fully considered. The following questions provide guidance for a thoughtfully designed remediation/support program. a. What are the criteria for student participation in the program? b. Which staff or faculty members are going to evaluate individual student’s performance and encourage them to participate? c. Should the remediation/support program be required or encouraged? d. Once students are referred to the program, what criteria should they achieve to no longer participate? e. How is the overall program evaluated and who is responsible? Too often remediation is an afterthought; students may or may not participate regularly; the learning activities are not clearly defined; and the outcomes of the program may not be regularly evaluated so improvements can be made. Under such unstructured circumstances, the remediation/support process is likely to fail. Careful planning is key to developing and maintaining a program that helps students become safe and effective nurses. In addition, the model identifies possible environmental and individual factors that might affect the nurse’s clinical judgment (https://ncsbn.org/clinical-judgment-measurement-model). The CJMM model is important to NCLEX test-takers and the faculty who teach them because the new, Next Generation NCLEX® (NGN) uses this model to develop the questions that are included in the examination. In short, all of the questions, regardless of their structure, will require test-takers to use these clinical judgment steps to correctly answer the NCLEX questions. The emphasis on evaluating new nursing graduates’ clinical judgment in a variety of scenarios in the licensing exam is designed to better evaluate their ability to provide safe care to patients immediately as they move into the practice environment. For this reason, all new graduates must be prepared to make decisions using this model. This heightened expectation points to changes in preparing ALL students for licensure and practice. For example, avoiding a straight lecture format, using active learning strategies to engage students in class, structuring learning activities to represent actual clinical situations, revising faculty-made testing formats to replicate questions on the Next Gen NCLEX, and giving students plenty of practice with new question formats are all necessary steps to prepare students for the new examination.
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