Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

The problem addressed in this study was the assessment of the knowledge of newly graduated registered Purse candidates about Total Parenteral Nutrition and the effects of practice on knowledge. The study used a quasi-experimental approach to determine the amount of knowledge the subjects possess about Total Parenteral Nutrition at the time of employment and after a period of six months working with patients receiving this therapy.An investiagtor made multiple choice test consisting of thiry items was used to assess the knowledge of the subjects. A score of 75% on the test instrument was considered to indicate adequate knowledge of Total Parenteral Nutrition therapy.The sample was a convenience sample consisting of 33 newly graduated registered nurse candidates. Associate, diploma and baccalaureate graduates were represented in the study.All subjects in the study scored less than 67% on either test during the study. The results of this study may have been influenced by the small number of exposures to patients receiving Total Parenteral Nutrition therapy.Ball State UniversityMuncie, IN 47306

The growing diversity of the United States (US) population demands an equally diverse nursing workforce to meet its healthcare needs effectively. It is a priority to assist students who are English Speakers of Other Languages (ESOL) to succeed, not just to take care of ESOL and non-English-speaking clients but to add to the nursing workforce. ESOL nursing and client language barriers in healthcare are challenging, but one leading solution is to help ESOL nursing students succeed. For all nursing students to succeed, they must pass the National Council Licensure Examination - Registered Nurse (NCLEX-RN), a multiple-choice high-stakes assessment offered only in English. The problem: ESOL nursing students, who are otherwise knowledgeable, often do poorly on such tests. The NCLEX-RN can be difficult for ESOL nursing students since their lack of proficiency in American English slows their ability to interpret words and phrases in written format. This hinders the student’s ability to understand the relevancy of the words and how the words combine to produce meaningful scenarios and discourse. If test writers removed slang and words with multiple meanings, ESOL nursing students might have greater success on high-stakes examinations, such as the NCLEX-RN. To find appropriate linguistically challenging questions, a search panel comprised of volunteering ESOL Associate Degree in Nursing graduates assembled relevant, challenging multiple-choice questions from high-stakes examination test banks. Each linguistically challenging question was categorized as containing idioms, unclear or unnecessary wording, or slang/difficult American English words. The researcher created a linguistically modified version by removing or replacing the problematic language identified by the search panel. An examination evaluation committee of experienced nursing instructors examined the linguistically modified questions to ensure that the true nursing clinical intention of the question had not been altered. This study used a convenience sample of ADN nursing students (N=169) who had completed Fundamentals of Nursing and Medical/Surgical Nursing 1. The research control group (n=85) received unmodified questions, whereas the experimental group (n=84) received linguistically modified questions. Examinations were distributed by alternating control and experimental examinations to each student. This dissertation presents three reports on the results of removing linguistic complexity from examination questions. The first report presented in Chapter 2 examines the question, "Does ESOL nursing students' performance on linguistically modified examinations differ from performance on unmodified examinations?" This report examined the differences in scores achieved on the experimental versus the control versions of the examination. Nursing students performed statistically better in the experimental group (M = 79.9, SD 7.48) than in the control group (M = 75.08, SD 10.51), t(151.8) = 2.973, p = .003. The second report, presented in Chapter 3, assesses if specific forms of American English adversely affect the performance of low-acculturated nursing students. This chapter presents an attempt to identify the possible effects of idioms, slang, or difficult vocabulary on the success of nursing students in high-stakes nursing examinations. Furthermore, this chapter compares which form of American English, idioms, slang, or difficult vocabulary is more difficult for low-acculturated nursing students. A mixed ANOVA using control versus experimental tests as the between variable and item category as the within variable showed that the group by item type interaction was nonsignificant (F (2, 56) = .016, p = .984), indicating that idioms, slang, and difficult vocabulary do not differ in the likelihood of leading students to select incorrect answers. The third report, in Chapter 4, presents an investigation of the effect of linguistic bias on ESOL nursing students' success. Chapter 4 presents analyses of pass rates on the unmodified examinations achieved by high-acculturated and low-acculturated nursing students. Chapter 4 also presents an examination of the impact of language acculturation on the pass rates on linguistically modified and unmodified nursing examinations based on modified NCLEX-style questions that remove linguistic biases. This chapter presents an investigation of whether low acculturated nursing students who take the linguistically modified nursing examination achieve higher pass rates than those who take the unmodified examination. Based on the results of the chi-square analysis, 35 (81.4%) of the 43 students in the low acculturation group received a passing grade on the modified (experimental) examination, compared to 12 (30.8%) of 39 students in this group passing the unmodified (control) examination. This difference was statistically significant, χ2(1) = 21.42, p = <.001. Results also showed that there is a relationship between high-stakes nursing examination questions containing idioms, slang, and unnecessary words and ESOL nursing student success. The study supported the impact of substituting idioms, slang, and unnecessary vocabulary with more standard English terms on students’ success on multiple choice high-stakes examinations. Although the results do not indicate that ESOL nursing students are more severely or directly affected by specific forms of American English, it does show that identifying these linguistic obstacles may help provide valuable information that may guide creators of high-stakes examinations in designing more bias-free examinations to assist ESOL nursing students succeed and enter the workforce.

The purpose of this study was to compare the relationship between the American College Test (ACT) sub-test scores, nursing courses' grade point average, college cumulative grade point average and the State Board Test Pool Examination (SBTPE) sub-test scores. Data from 227 nurses were analyzed utilizing three procedures: Pearson product-moment coefficient; multiple correlation coefficient; and linear regression equations. Conclusions were that several ACT sub-test scores could yield useful information on admission; the college cumulative grade point average was the most reliable indicator of success on the SBTPE; and an ACT composite score of eleven was the minimum value required to pass the SBTPE sub-tests with a score of at least 350.

Indiana University-Purdue University Indianapolis (IUPUI) / Clinical nursing faculty members often work with students who underperform in the clinical area. Underperforming students are those who exhibit deficits in nursing knowledge, the application of nursing knowledge, psychomotor skills, motivation, and/or interpersonal skills. The outcomes of faculty work with underperforming students have implications for patient safety and the nursing workforce, yet little is known about how faculty work with underperforming students. The purpose of this project was to develop a theoretical framework that describes how clinical faculty work with underperforming students in the clinical area. Twenty-eight nursing faculty who had worked with underperforming nursing students during clinical rotations were interviewed and invited to tell stories about working with these students. Their narratives were analyzed using constant comparison analysis, and a theoretical framework was developed. The framework included three stages that unfolded as faculty worked with underperforming students over time. The first stage, Being Present, was the process by which faculty came to know students were underperforming. They did this by noticing red flags, taking extra time with students, working side-by-side with students, and connecting with students "where they were at." The second stage, Setting a New Course, was the process by which faculty attempted to provide remedial experiences to improve the performance of those students determined to be underperforming. The participants did this by beginning a new course of instruction for the students, bringing in new people to help the students, and creating new learning experiences for them. This process could result in students turning it [their performance] around, making it through [the clinical rotation], or not making it. The final stage, Being Objective, was the process by which participants made negative progression decisions. They did this by relying on objective indices, documenting problematic student behaviors, and obtaining validation for their decisions.

This ex post facto study sought to examine: the efficacy of Mosby's Assess Test as a valid predictor of NCLEX (National Council of State Boards of Nursing Licensure Examination) scores; significant correlations among semester averages, semester tests failed, Nelson Denny Reading Test scores, and NCLEX scores; and differences in NCLEX outcomes in relation to ethnicity, age, and prior practical nursing licensure for 558 associate degree nursing graduates who wrote the NCLEX in 1983 and 1984. Significant positive relationships were found among Mosby scores, Nelson Denny scores, semester averages, and NCLEX scores. A significant negative relationship was found between number of semester tests failed and NCLEX scores. The mean NCLEX score of older graduates was higher than the mean NCLEX score of younger graduates. LPN graduates had a higher mean NCLEX score than non-LPN graduates. White graduates' mean NCLEX score was greater than the average score for black graduates. Combined predictor variables which yielded the best estimate of the criterion variable (NCLEX scores) for all graduates included mean semester average, Mosby scores, age above thirty-three, and Nelson Denny scores, respectively. The most important predictor of black graduates' NCLEX success was prior practical nursing licensure. Other significant predictors for black graduates' NCLEX success were mean semester average, Mosby scores, mean number of semester tests failed, age above thirty-three, and Nelson Denny scores, respectively. Mean semester average, mean score of the Mosby test, mean number of semester tests failed, and age above thirty-three were the most significant predictors of white graduates' NCLEX success. Older graduates had a higher mean Mosby score, a higher mean semester average, and failed fewer semester tests than younger graduates. The study results will be of interest to nurse educators and counselors who are concerned with curricular revision, student counseling, and remediation procedures as these relate to enhancement of graduates' potential for success on the NCLEX.

Within the nursing profession, the transition from the student to a graduate nurse is a common rite of passage that marks the end of initial educational preparation in the discipline and the beginning of a professional journey as a nurse and a member of the multidisciplinary team (Nash, Lemcke & Sacre. 2009:48). This is a period of adjustment, stress, growth and development and the transitional nurse is likely to feel uncomfortable, fearful and may experience feelings of inadequacy. This study was undertaken to explore and describe the experiences of final year nursing students at a public college of nursing in the Eastern Cape regarding their preparedness to become registered nurses, with the aim to identify gaps and make recommendations on strategies to close the gaps. The objectives were to explore and describe the experiences of final year nursing students at the public college of nursing in the Eastern Cape Province with regard to their preparedness to become registered nurses and to recommend strategies to improve the preparation of nursing students for transition to become registered nurses. To answer the research question “What are the experiences of final year nursing students at a public college of nursing in the Eastern Cape Province with regard their preparedness to become registered nurses”, a qualitative, explorative and descriptive design was used as a framework for the study. Data were collected by means of unstructured focus group interviews with a purposively selected sample of 27 final year nursing students at the particular college of nursing. Data were analysed using Tesch’s method of analysis for qualitative research. Two themes emerged, revealing that participants at the college experienced preparedness and lack of preparedness to assume the role of a professional nurse. This related to certain aspects that had an impact on the preparation of the final year nursing students for practice and included: curriculum-related aspects; clinical teaching and learning support; learning opportunities; interpersonal relationships between lecturers, students and clinical staff; equipment; and library resources. It was concluded that the learning needs of the nursing students were not adequately catered for, leading to lack of preparedness. Through the involvement of nursing students in the evaluation of their learning, shortfalls in both education and practice areas could therefore be detected. Recommendations regarding strategies to be used to promote preparedness of final year nursing students included: continuous feedback on student performance in the form of exit evaluations on the part of students to identify learning needs; writing of progress reports on the part of clinical practice; and the employment of clinical preceptors with clear role specifications between the lecturers, ward sisters and preceptors to avoid role confusion.