The Nursing Shortage
By Beth Cusatis Phillips, PhD, RN, CNE, CHSE, ATI Strategic Nursing Advisor; Yolanda M. VanRiel, PhD, RN, MEDSURG-BC, OCN, CNE, ANEF; and Elizabeth A. Gazza, PhD, RN, LCCE, FACCE, ANEF
A strategic tactic in helping to solve the nursing shortage rests on getting more nursing students interested in becoming nurse educators. What can current faculty do to encourage students to consider this career choice? Two researchers interviewed students to find out.
Diversity, equity, & inclusion
By Nicole Petsas Blodgett, PhD, RN, CHSE; Valerie M. Howard, EdD, MSN, RN, CNE, ANEF, FAAN; Beth Cusatis Phillips, PhD, RN, CNE, CHSE, ATI Strategic Nursing Advisor; Kathryn Andolsek, MD, MPH; Angela Richard-Eaglin, DNP, MSN, FNP-BC, CNE, FAANP; and Margory A. Molloy, DNP, RN, CNE, CHSE
Healthcare educators do not feel equipped to deal with the bias and racism that are present against Black, Indigenous, and People of Color within the health professions. This team of researchers focused on identifying best practices that educators can use in simulation to confront these issues.
By Janice Brewington, PhD, RN, FAAN; Beth Cusatis Phillips, PhD, RN, CNE, CHSE, ATI Strategic Nursing Advisor; and Nelda Godfrey, PhD, RN, ACNS-BC, FAAN, ANEF
The concept of professional identify in nursing (PIN) is becoming more common within the profession. Its concepts, definition, and domains fit synergistically with a systems-level lens of diversity, equity, and inclusion. But, before anyone in nursing can understand this systems perspective, they need to participate in a discussion of structural racism.
Civility & healthy work environments
By Beth Cusatis Phillips, PhD, RN, CNE, CHSE, ATI Strategic Nursing Advisor, and Kristen Priddy, PhD, RN
Professional identity in nursing (PIN) impacts patient safety and quality, as well as nurse well-being. All of these are factors of a healthy work environment. So, how do more nurses develop their PIN? Nurse leaders must step up and work on creating work environments in which nurses can flourish in their professional identity.
By Cynthia M. Clark, PhD, RN, ANEF, FAAN
Nurse leaders play a pivotal role in fostering civility by setting a compelling vision and a positive course for the future. Surviving and thriving in any crisis begins with a vision for what is possible.
By Cynthia M. Clark, PhD, RN, ANEF, FAAN, and Susan Luparell, PhD, RN, CNE, ANEF
Cyber-incivility, cyber-bullying, and other forms of online aggressive behavior by current and future nurses are particularly troubling phenomena, since research has firmly established a link between disruptive behavior and a host of negative outcomes, including patient harm. Difficult conversations are needed by nurse educators to discern their role in preventing, mitigating, and remediating cyber-incivility by students as they relate to the profession's responsibility to self-regulate.
By Cynthia M. Clark, PhD, RN, ANEF, FAAN, and Mary K. Fey, PhD, RN, CHSE-A, ANEF
Incivility triggers fear and humiliation, impairs clinical judgment and learning, reduces psychological safety, and increases cognitive load. These factors converge to make learners less likely to incorporate feedback, speak up when there is a problem, and discuss practice errors and patient safety issues. Thus, the authors note, cCivility, psychological safety, and effective stress management are essential for meaningful learning conversations.
By Cynthia M. Clark, PhD, RN, ANEF, FAAN, and Michelle Dunham, PhD
Teaching nursing students about how to handle uncivil behaviors with others hasn’t typically been based on evidence. But research into a new tool, Civility Mentor, has proven it is successful in educating students about the consequences of incivility. The product also can help students develop skills to foster civility, communicate more assertively, and address incivility in academic and healthcare environments.
By Cynthia M. Clark, PhD, RN, ANEF, FAAN, and Karen L. Gorton, PhD, RN, FNP
The detrimental impact of incivility in healthcare is well-documented. Nursing students and new graduate nurses are particularly vulnerable to its effects. An intervention study using a mixed methodology revealed that the use of evidence-based civility education strategies is one answer to addressing this need and protecting patient safety. These strategies — a combination of cognitive rehearsal, HeartMath, and simulation using the TeamSTEPPS CUS model — proved students could build resilience to effectively address incivility in the patient-care environment.
By Cynthia M. Clark, PhD, RN, ANEF, FAAN
Harm from disrespect has been identified as the next frontier in patient safety efforts. Disrespectful and uncivil behaviors in healthcare settings can have detrimental effects on individuals, teams, organizations, and patient safety — including life-threatening mistakes, preventable complications, or harm to a patient. This article focuses on the impact of incivility on the patient care environment; explores ethical, legal, regulatory, and educational implications of workplace incivility; and provides evidence-based strategies to promote a culture of civility and respect in healthcare.
Next Generation NCLEX
By Sheryl K. Sommer, PhD, MSN, RN, CNE
Nurse educators have been wondering how to teach clinical judgment since the National Council of State Boards of Nursing (NCSBN) introduced its Clinical Judgment Measurement Model (CJMM). This new model is part of the organization’s efforts to develop its Next Generation NCLEX. While many are concerned about the differences between this model and existing models, research comparing the three shows they have specific similarities.
Live Review
ATI’s Live Review is an intensive review that assists students in the final phases of preparation for NCLEX. To evaluate the effectiveness of the Live Review, self-reported NCLEX pass rates and survey data were analyzed. A preliminary pass rate of 97% for students completing the Live Review suggests that it is an effective aid in NCLEX preparation.
NCLEX Prep
James Montegrico, University of North Carolina at Charlotte
This study examined the predictive ability of Assessment Technologies Institute (ATI) standardized tests on Fundamentals of Nursing (FON), Pharmacology (PHARM), Medical-Surgical Nursing (MSN), and RN Comprehensive Predictor (RNCP) on the National Council Licensure Examination-Registered Nurses (NCLEX-RN) performance of nursing graduates. Background: Various assessment tools in nursing education are used to predict the success of students in nursing licensure examinations. There are inconsistent findings on the predictive ability of course-specific standardized tests on NCLEX-RN success.
At a Pennsylvania nursing program, educators implemented a prescribed remediation protocol to assist students achieve the necessary scores on the Comprehensive Predictor exam to increase their likelihood of success on NCLEX. Research showed the integration of a remediation program had a positive effect on the Comprehensive Predictor scores.
Following the completion of any nursing program is a critical period during which future nurses are faced with studying for and passing the NCLEX. This paper outlines a survey of 32,665 students to determine content areas that are assessed as predictors of NCLEX anxiety.
By Xin Liu and Christine Mills
The 2013 NCLEX-RN® test plans specified an underlying general entry-level nursing ability encompassing all the tested specific categories and subcategories, as indicated by a second-order factor structure. This study attempted to verify this hierarchical factor structure in real data.
This paper explores the accuracy of the 2010 RN Comprehensive Predictor exam.
Although end-of-program testing is an important indicator of readiness for NCLEX, it often comes too late to help those students most at risk for failure. Formative information about students’ content mastery as they progress through the nursing program is of key importance. However, educators may struggle to determine which indicators and benchmarks of student learning are most indicative of a need for remediation.
TEAS prediction
A recent 5-year data from 2019 to 2023 demonstrates that TEAS scores remain a reliable predictor of early nursing academic performance post-pandemic.
By Michelle Dunham and Joshua MacInnes
What happens when a student makes multiple attempts at a nursing program’s admissions assessment? Do you simply use the most recent score to determine whether to admit him or her? Do you take an average? This paper examines patterns in retesting scores from a nursing admissions assessment and the correlations of four retesting score treatments with scores on an early program assessment.
By Xin Liu and Christine Mills
When schools are determining the best admission criteria that lead to student success, an important question is whether adding an additional criterion into the admission tools improve the prediction accuracy. This paper answers this question by demonstrating how to evaluate the incremental effect of added measures to achieve cost-effective as well as accurate admission criteria.
By Michelle L. Dunham, PhD, and Marshall Alameida, PhD, RN, CNS
When institutions choose to implement an admission test cut score, responsible use requires periodic evaluation of its impact. Institutional data from admitted students can be used to evaluate both an existing cut score and potential alternatives. This article details the process a large system of community colleges undertook to evaluate its existing admissions test cut score and illustrates possible methods of choosing, calculating, and comparing key metrics for cut score options.
This analysis examines the relationship between the ATI TEAS scores, specifically the academic preparedness categories, and early academic performance in an ADN nursing program as measured by ATI’s RN Content Mastery Series (CMS) Fundamentals 2019 and 2020 assessments.
This analysis examines the relationship between the ATI TEAS scores, specifically the academic preparedness categories, and early academic performance in a PN nursing program as measured by ATI’s PN Content Mastery Series (CMS) Fundamentals of Nursing 2019 and 2020 assessments.
This analysis examines the relationship between the ATI TEAS scores, specifically the academic preparedness categories, and early academic performance in a BSN nursing program as measured by ATI’s RN Content Mastery Series (CMS) Fundamentals 2019 and 2020 assessments.
The ATI Test of Essential Academic Skills (TEAS) is an assessment of academic preparedness to enter a nursing program. As such, it is often used by schools of nursing as one of the criteria to select students for entrance into a program. Some programs choose to adopt one of several performance level descriptors, known as academic preparedness categories, associated with the ATI TEAS as a minimum score for admission. This analysis examines the relationship between the ATI TEAS scores, specifically the academic preparedness categories, and early academic performance in a nursing program as measured by ATI’s Content Mastery Series (CMS) Fundamentals assessments.
TEAS TEST TAKER RESEARCH
A June 2022 online survey conducted among a sample of TEAS test-takers was aimed at understanding test-takers’ academic, emotional, and financial preparedness for nursing school, their current sentiment regarding application to nursing school, and any COVID-related impacts that were driving these trends.
Curriculum Development
By Beth Cusatis Phillips, PhD, RN, CNE, CHSE, ATI Senior Manager Content Strategy, and Lori Hill, PhD., RN, APRN-WHNP, Associate Professor
Mount Carmel College of Nursing has restructured its prelicensure curriculum with a concept-based, competency-driven approach, utilizing the Engage™ Series to replace textbooks. This strategic update, aligning with the American Association of Colleges of Nursing (AACN) recommendations, has led to improved student outcomes and satisfaction by focusing on essential information and interactive learning.
By Jennifer Brussow, M.A.; Karin Roberts, PhD, RN, CNE; Matthew Scaruto, MA; Sheryl Sommer, PhD, RN, CNE; and Christine Mills, PhD
As nursing education struggles to address a rapidly changing healthcare system, overcrowded curricula, and an increased focus on clinical-reasoning skills, many programs have adopted or transitioned to concept-based curricula (CBCs), which are structured around key concepts and exemplars. Despite CBC’s promised benefits, the process of developing a CBC framework may pose a challenge to programs. To address this barrier, a national study was conducted to develop a representative list of concepts and exemplars. This initiative expands on prior work by suggesting a leveled approach to positioning exemplars within a curricular sequence.
By Dianna Johnston, DNP, RN, NE-BC, CNE
This white paper introduces the process for developing a Concept-Based Curriculum that includes identification of concepts and selection of exemplars. A radical transformation in the delivery of nursing education is necessary to ensure nursing program graduates enter the workforce with the ability to think and act like a nurse. A concept-based curriculum provides a comprehensive approach using concepts, evidence-based exemplars, and active learning strategies, whereby students build on prior knowledge to integrate new learning into clinical practice. Developing a Concept-Based Curriculum is both a complex and a creative process that includes identification of concepts, appropriate exemplars, and delivery methods that connect content, skills, and actions throughout the life span, across the wellness-illness continuum, and in a variety of healthcare settings.
By Dianna Johnston, DNP, RN, NE-BC, CNE
Implementing a concept-based curriculum involves more than identifying concepts and exemplars. It requires a paradigm shift in how content is delivered in the classroom, laboratory, and clinical settings. This White Paper discusses the multifaceted process involved in changing the focus from content-heavy lecture to engaging students in active learning that allows them to think and reason at a deeper level.
Teaching & Learning Strategies
By Lucia Xin Liu, PhD.; Jihang Chen; Beth Phillips, PhD, RN, CNE, CHSE
Students often cringe at the thought of remediation. After all, it can carry a negative connotation. At ATI, we understand students have much to learn in a short period. Reviewing learned information does not demonstrate a deficit. It shows a student’s strength and self-awareness to understand we need to review previously learned content. That’s the beauty of Focused Review®.
By Beth Cusatis Phillips, PhD, RN, CNE, CHSE; Janean Johnson, DNP, RN, CNE; Nikita Khalid, MS; Nicole Zapparrata, MA; and Glenn Albright, PhD
The significance of technology in nursing education has grown significantly. Online educational platforms are proving to be more valuable than conventional textbooks when it comes to fostering active learning, engagement, and overall satisfaction. In this research study, a novel online interactive education program (OIEP) was assessed as a replacement for traditional textbooks. The study aimed to investigate levels of student and faculty satisfaction, the perceived effectiveness of the program, student engagement, and the potential of the OIEP to enhance NCLEX preparation while also mitigating burnout.
By Janean Johnson, MSN, RN, CNE, and Beth Cusatis Phillips, PhD, RN, CNE, CHSE
Assessment is the first step in the nursing process and an essential skill for all nurses. Nevertheless, little evidence supports the direct connection between a thorough nursing assessment to improved patient outcomes. In looking into the topic, the authors identified that eliminating nonessential assessment skills from a nursing course could allow students to spend more time focusing on the essential assessment skills that are required to safely care for patients in the various settings of nurses’ work. Using essential assessment skills when encountering or caring for a patient improves the nurse’s ability to observe and recognize subtle cues, interpret or gather additional information or data, and respond to the patient’s health care needs.
By Annie Moore-Cox, PhD, RN
Lesson planning is a documentation process used extensively in education from kindergarten through 12th grade, but rarely in higher education, including undergraduate, prelicensure nursing education. Lesson plans help teachers plan what will happen during a class period from moment to moment. Trends in nursing education, such as the incorporation of active learning strategies in the classroom, make lesson plans a timely addition to the nurse educator's toolkit. This article describes the components of a lesson plan and offers an author-developed template for use in nursing education. Using the template helps nurse educators map out activities for all class participants, such as students, student pairs and teams, and faculty. This article demonstrates how the lesson plan enables faculty to plot out the many dynamic components of an active learning class period. It also serves as a road map for subsequent faculty, which is an important feature as the profession faces a wave of retirements in the coming decade.
- Scrambling the active learning classroom: Achieving balance between traditional lecture and flipping
By Karin K. Roberts, PhD, RN, CNE
A paradigm shift is occurring in nursing education that is asking the educator to move away from lecture and engage students in activities that allow them to use newly learned knowledge. “Flipping the classroom”, which requires students to come to class having completed selected pre-class activities, structures class time so students can participate in active learning strategies using knowledge gained from the pre-class activities. In a “scrambled” classroom, both lecture and active learning strategies are used in a complimentary manner giving educators the opportunity to select the strategy they feel most effectively fits the content at any one time. This White Paper will review the research and issues related to both lecture and flipping the classroom and describe how scrambling the classroom provides educators the opportunity to use the best of both methods at their discretion.
By Sheryl Sommer, PhD, RN, CNE; Timothy Beitzel, MSN, RN; Pamela Osuri, MSN, RN, CNS; and Erin Rosfeld, MSN, RN
Increasing diversity in the population and development of a stronger global focus create concern about language bias. Hesitance among patients to seek medical care and poorer patient outcomes may result from language bias among health care providers. Nurse educators can reduce the use of language bias in healthcare by increasing awareness and using inclusive language with students. The creation of educational experiences that embrace diversity and inclusion promote the delivery of culturally competent care.
Attrition
Nursing student attrition continues to pose a problem and, when paired with an already understaffed nursing workforce, interventions are urgently needed. Inconsistent measurement of attrition data has historically impeded studying the causes of nursing school attrition.
Nursing student attrition continues to pose a problem and, when paired with an already understaffed nursing workforce, interventions are urgently needed. Inconsistent measurement of attrition data has historically impeded studying the causes of nursing school attrition.
Student attrition is generally characterized as the departure or delay in successful completion of program requirements. Learn more about student attrition and how ATI’s product solutions help reduce attrition in nursing programs.
Effective implementation of ATI products is a critical step towards addressing nursing student attrition. This paper outlines the relationship between varying levels of CARP usage and program level attrition rates. Findings show that a programs with high CARP utilization have, on average 34% less student attrition compared to programs with low CARP utilization.
This paper explores the results of two studies. Study 1 examined 52 different nursing programs and sought to understand and catalogue the common methods used to compute nursing student attrition. Study 2 was a larger scale survey (729 nurse educators spanning 529 nursing programs) and explored the variety of reasons for nursing student attrition. Both study 1 and study 2 serve to uncover the critical details necessary for effective research into and prevention of nursing student attrition.
Nurse's Touch
By Lucia Xin Liu, PhD, and Cynthia M. Clark, PhD, RN, ANEF, FAAN
Can the completion of at least one of ATI’s Nurse’s Touch proctored assessments lead to improved scores on the RN Comprehensive Predictor (CP) or an increased probability of passing the NCLEX-RN exam? Yes, according to researchers studying the question.
Soft skills in the nursing profession are undoubtedly important skills to possess albeit they aren’t emphasized as much as “hard” skills (e.g., knowledge and psychomotor skills). Learn more about how the ATI Nurse’s Touch product line addresses these issues.
Soft skills in the nursing profession are undoubtedly important skills to possess albeit they aren’t emphasized as much as “hard” skills (e.g., knowledge and psychomotor skills). This paper focused specifically on how the ATI Nurse’s Touch product line addresses Professional Communication skills.
Computerized Learning & Curricular Assistive Tools
Dr. Joy Shoemaker demonstrates the change of intervention strategies in an effort to improve her institution's first time NCLEX pass rate from below the national average to above the national average. The implementation of the ATI package is shown to be more appropriate for their need in improving their struggling NCLEX pass rate than their previous package of HESI. This article shares the nursing program’s experiences in incorporating best practices in using computerized testing and study modules with curricular assistive tools throughout the curriculum and evaluating their results.