Term Paper: 1997, the Average Pass Rate

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[. . .] Twenty-three percent of participants said that they would discourage family and friends from entering the field. (American Nursing Association 2001). This prevalent hostility is fairly exceptional among the health professions, and it has been a major factor in the profession's retention problems (Federation of Nurses and Health Professionals 2001).

As a final point a study of 100 hospital administrators uncovered that 55% of respondents acknowledged they target nurses more than any other employee group when determining their retention strategy (Nursing Executive Center 2000). On the contrary, the second-largest healthcare employee group, pharmacists, was the target of only 24% of focus efforts by respondents. The survey also showed that the turnover rate among hospital staff nurses nationwide grew from 12% in 1996 to 15% in 1999. (Teich, et al.)

In the past decade, nurses educators' have been challenged to think "outside the box" when educating the future nurses (Adams et al., 2002). In addition to the increased health services delivered, changing population demographics and technical changes in education nurse educators' have increase demands when educating the 21st century nurses. Coupled with the current shortage of nurses (RNs) concerns from both inside and outside the nursing profession has generated concerns. "Innovation and change are touted as desirable for nursing education programs, before adopting trends or changes, faculty should examine research studies that under gird the innovations/changes" (Adams et al., 2002).


At present, there is a nursing faculty shortage and the potential for an even worse shortage (De Young & Bliss, 1995). The implications of this continued shortage of both nursing faculty and practicing nurses are a serious dilemma. This dilemma could lead to limitations in enrollments and consequently to a greater nursing shortage, burnout of present faculty, or a possible decline in the quality of programs. With faculty erosion increasing the number of graduate students who are interested in pursuing a faculty track are decreasing. In 1989 Bowen and Sosa evaluated national data across all disciplines and concluded that because of the age of the academy in general, faculty shortages will be most apparent between 1997 and 2012 (Bowen, 1989).

The American College of Nursing survey reported that 36% of nursing programs were experiencing faculty shortages that resulted in turning away qualified student applicants. Bowen and Schuster predicted that 32% of all faculty positions will become vacant through attrition by 1995 and 70% will become vacant by 2010 (Bowen, 1986). Today's nurses that are graduate degree prepared are finding positions in nursing administration, in-service settings, and research departments.

In addition, Zebelman and Olswang found that 35% of those who began doctoral study in 1986 or earlier planned to seek a nursing faculty position (Zebelman, 1989). However, only 10% of those beginning doctoral work in 1987 or later were pursing a faculty position. The data and trends portray a frightening picture for the future of nursing education. According to the American Association of Colleges of Nursing (AACN) of the nearly 9,000 faculty of AACN schools less than 50% have doctoral prepared faculty. In addition, the percentage of master's nursing students pursing academic careers has dropped by 27.5% (American Association of Colleges of Nursing, 1999).

The complexion of the entering student has changed in the last 10 years. The cost of college education has escalated to meet the cost of programs and faculty. The average age of the entering student in community college is between the ages of 25 to 29. Ninety percent of the average curriculum student has a part time job. Moreover, a decline in the average Grade Point Average (GPA) of nursing students has occurred from 1998 to 2002. Only 25 to 30% of community college students have a GPA of three or greater.

In 1993, the North Carolina legislature mandated a study of the North Carolina Community College System. The legislature required that the system "meet the educational and economic development needs of the 21st century," (Wesley, 2000). In 1997, North Carolina Community College system adopted a common course library (North Carolina Community College, 1997). The purpose of the common course library was to facilitate communication between community colleges and four-year colleges and universities (Shannon, 1977). In the 1980's many community colleges and four-year- institutions began to explore well-organized communication between the two institutions. (Sutton & Harre, 1979). Advocates for the common course library envisioned students that were able to take courses in any community college within a given state, and then be able to transfer those courses to a four-year college and receive appropriate college credits.

With the adoption of the common course library, the associate degree nursing programs in the state of North Carolina had the choice of an integrated or a non-integrated curriculum format. "Blocked" course content or non-integrated is best described as content that is structured around a particular clinical practice focus or body systems. Although each course includes a focused practice foundation for the content, which follows, the content tends to be unique to that course. When blocked content is utilized content related to a specific practice area is identified such as maternity nursing, mental health nursing, pediatric nursing, medical-surgical nursing, and gerontological nursing. In integrated or "threaded' course content specific educational content is woven throughout the curriculum so that there is no identifiable nursing content.

1986 to 1997 was one of the largest curriculum growth decades in nursing education (Walker and Soltis, 1992). Prior to the adoption the common course, the NCLEX-RN pass rate was 90% in North Carolina. Following the implementation of the common course library the pass rate has declined to 85% in 2001(North Carolina Board of Nursing, Dec 2001).

The development of ADN (Associate Degree Nursing) education had its inception in 1952 as the result of a research project conducted by Mildred Montag. The project sought to (1) alleviate a critical shortage of nurses by decreasing the length of the education process to two years and (2) provide a sound educational base for nursing instruction by placing the program in community/junior colleges (Hasse, 1990). According to the North Carolina Board of Nursing, 60% of all practicing nurses are graduates of an ADN program (National Council of State Boards of Nursing and Inc., 2000). Nationally, 75% of all practicing nurses are ADN graduates.

The National League for Nursing in 1990 published a reversion of educational outcomes for associate degree nursing programs (National League for Nursing, 1991). "Reform all nursing education programs to assure that graduates are competent to function in a delivery system where:

The individual and the family have primary responsibility for health care decisions;

Health and social issues are acknowledged as interactive; and Treatment effectiveness rather than the technologic imperative drives decisions (NLN, Health Care Reform, 1991). Nursing educators are responsible for developing and implementing a dynamic curriculum where learners are prepared to function in a complex society is the challenge that faces the nursing curriculum revolution of the 21st century (Valiga, & Bruderle, 1994).

Additional contributing factors to the decline of NCLEX-RN scores could be answered with the following questions:

What is the educational preparation of the faculty?

Was the faculty knowledge of the curriculum design chosen by their program?

Were the faculties prepared to convert from one curriculum design to another?

Have the demographics of the student profile changed?

Have admission requirements of the program changed?

Is there a difference in the NCLEX-RN pass rate among integrated vs. non-integrated curriculums?

Has the curriculum model chosen by the 47 different AND programs in North Carolina affected the state pass rate for the NCLEX-RN?


In the years 1995 to 1997, two significant events have impacted the associate degree nursing programs in North Carolina. The first event was the adoption of the common course library curriculums in all 58 community colleges across the state of North Carolina. The second identified outcome was the decreased state and national passage rate on the NCLEX-RN examination. This study will attempt to identify a correlation between these two occurrences.

In addition to assessing the relationship of nursing core curriculum changes and decreased NCLEX-RN scores, other variables will be identified for further clarification. Some of the independent variables include student demographics, student faculty ratio, and availability of NCLEX-RN review course taken prior to the NCLEX-RN. The intervening variable is the type of nursing program curriculum i.e. integrated (threaded curriculum) or non-integrated (blocked curriculum).

Extraneous variables will be outlined as limiting variables such as income of the student, family composition, individual student GPA, prior student educational level, descriptive demographics of the student, and environmental variables. Extraneous variables can affect the measurement of study variables and their relationships (Burns and Grove, 1997). Some extraneous variables are not recognized until the study is in progress. Due to the size of the sample population, the research has cited exclusion criteria for these variables.


Research Questions

Do ADN programs with an integrated curriculum have a higher pass rate on the NCLEX-RN… [END OF PREVIEW]

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