CCN
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Crit Care Nurse 2004 Feb; 24(1): 13
This Article
Right arrow Full Text (PDF)
Right arrow Respond to This Article
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Jenkins, J. A.
Right arrow Articles by Nibert, A. T.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Jenkins, J. A.
Right arrow Articles by Nibert, A. T.

Letters to the Editor

Preceptors helping with remediation

As a nurse educator working within an undergraduate program, I was very interested in the ideas presented in the article, "New Graduates: A Precious Critical Care Resource" (October 2003:47–50). Although our program uses a different comprehensive test than the Exit Exam (E2) of Health Education Systems, it does use a standardized series of testing to identify students who are at risk for NCLEX-RN and it requires these students to do remediation. Although our remediation program has been successful in NCLEX pass rate, it is certainly not the complete answer. The idea of using preceptors to help with this remediation seems exciting; however, I do see a problem. Unless the preceptors are also members of the faculty, students’ rights to privacy would prevent disclosure of scores without student consent. Because students often do not feel that a test score truly reflects their knowledge, I question that all students would wish for the preceptors to be aware of their low scores. Perhaps a better approach would be if all nurses working with students would try to take the time to share decision-making approaches and/or ask students questions about how a decision could be reached. Frequently, staff nurses/preceptors only ask factual questions or even tell the student what needs to be done. This approach does not allow the students to grow or have any insight into their own deficits; thus the student perception, "I really know the information. I am just a bad test taker."

Students tend to believe that the preceptor is much more realistic about what a nurse really needs to know than the nursing faculty. Therefore, if the students can follow the preceptor’s directions, the student believes he or she is being successful. Of course, there are times when direction is the only safe thing to do, but if the experienced nurse truly values the student/new graduate, the time spent helping all students, not just the ones with low test scores, learn to think critically will be an investment in our profession and in our own future healthcare. I believe the author is on the correct path; I would just like to see the path widened.

Jo Ann Jenkins, RN, MSN, CCRN
 Kansas City, Mo

 

The author responds

I agree with this reader—student consent is essential for disclosure of exam scores. However, I believe that many students will willingly share such information if it is sought as a means of assisting them in becoming successful candidates to the NCLEX-RN, as well as successful new staff members. Use of exam findings for a positive outcome is likely to encourage the new graduate to share such information so that the preceptor has a base upon which to build teaching-learning experiences. Additionally, because many nursing programs require a minimally acceptable score on these exams for the student to progress to graduation,1 new graduates from such programs will have achieved at least this minimally acceptable score. Therefore, exam findings related to the individual’s strengths and weaknesses can be addressed in a safe and helpful environment, an environment created by the preceptor and one in which the preceptor is viewed as an advocate of the new graduate.

There is no question that the "Socratic questioning" approach to teaching and learning in the clinical area is extremely valuable for all those involved. However, the use of such an approach does not negate the value of additional information, such as those data provided by standardized exams, NCLEX-RN performance, and hospital-based competency assessments. Use of this information to guide orientation to a specific clinical area, while providing an atmosphere that is nonthreatening and one that encourages use of Socratic questioning, seems to me the best use of available resources—the preceptors’ guidance and the data provided by reliable and valid measurement tools. Orientation is an expensive endeavor, and the use of objective data to help determine which new graduates are most likely to be successful within a specific work environment is, I believe, an economic use of the limited resources available for new employee orientation.

Today’s healthcare environment, and the current nursing shortage, require us to work together creatively to provide the best possible care for the critically ill. We cannot afford to lose even one new RN who wishes to pursue a career in critical care nursing. We owe it to ourselves as experienced critical care nurses, and we owe it to our patients, to find new ways of "widening the path" so that we can conserve our precious resources: the next generation of nurses, who will one day care for us!

Reference

  1. Nibert A, Young A, Adamson C. Predicting NCLEX success with the HESI Exit Exam: fourth annual validity study. CIN: Comput, Inform, Nurs. 2003;20:261–267.
Ainslie T. Nibert, RN, PhD
 Houston, Tex





This Article
Right arrow Full Text (PDF)
Right arrow Respond to This Article
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Jenkins, J. A.
Right arrow Articles by Nibert, A. T.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Jenkins, J. A.
Right arrow Articles by Nibert, A. T.

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS