Effectiveness of an Adaptive Quizzing System as a Self-Regulated Study Tool to Improve Nursing Students' Learning

Abstract

Citation: Simon-Campbell E, Phelan JC (2018) Effectiveness of an Adaptive Quizzing System as a Self-Regulated Study Tool to Improve Nursing Students' Learning. Int J Nurs Clin Pract 5: 290. doi: https://doi. shown to be positively associated with NCLEX success [4,5,6]. In addition, research evidence on best practices in testing and assessment directs nurse educators to systematically evaluate student ability with more than one indicator especially when making important decisions, which affect students' futures [7,8, 9,10]. As Spurlock and Hunt (2008) noted: "Looking at a single, clinical-only indicator to represent students' readiness for graduation devalues the rest of their education, whether it occurred in a community college, diploma school, or university setting [11]". This means not making an important decision, like whether a student will graduate or not, on the basis of a single test score. Non-academic factors also impact success rates for nursing students. For example, Eddy and Epeneter (2002) interviewed students who had not succeeded on the NCLEX and identified test anxiety along with lack of preparation to answer higher-level, critical thinking questions to be common factors [12]. Other factors such as self-efficacy, self-esteem, age, timing of test-taking, critical thinking skills and ethnicity have also all been found to impact NCLEX-success for some students [13]. Abstract Exploring ways to help students achieve success in nursing programs is critical to improving student learning, success in nursing programs, and ultimately the number of graduates. Strategies for increasing NCLEX-RN pass rates range from modifying admission criteria, altering the number of times students can retake courses, and implementing remediation and progression policies. There does not appear, however, to be one single strategy which, when employed, can assure NCLEX-RN success. There is clear evidence, however, that studying using repeated self-testing has greater learning benefits that repeated reading, although it is unclear to what extent students understand and apply this principle on their own. In this paper we describe the implementation and use of an adaptive quizzing and learning system to provide students an environment for studying by self-testing to better master curricular material and prepare for exams. The study implemented a retrospective descriptive and correlational design to explore the relationship between usage and mastery measured in the system, course outcome data, standardized testing (ATI) scores, and NCLEX outcomes. Use of the system was voluntary and no course credit was assigned. All students (N = 36) used the practice quizzing feature of the system, answered an average of 574 questions with an overall average quizzing mastery level of 3.48 (on a scale of 1-8). There was a strong, positive correlation between the number of questions answered and overall mastery level; with increased usage students were better able to correctly answer more difficult questions and mastery of the content improved. All students in the group passed the NCLEX-RN (on the first or second attempt). Findings support the use of adaptive quizzing as a self-regulated learning strategy for nursing students and indicate that as students actively study and learn in the system, their mastery of course content increases. Additional implications will be discussed.