Yield: A New Measure of Nursing Program Performance

1. Yield: A New Measure of Nursing Program Performance Jim McGraw, RN, MN Asst. Professor Tarrant County College

2. How do we currently assess program outcomes? Measures • NCLEX Pass Rate • Graduation Rate • Graduate Employment Rate Impressions • Reputation • Warm Fuzzy Feeling

3. Strengths of NCLEX pass rate as a measure: • A measure of effectiveness • Standardized / Uniform • Easily understood by insiders and outsiders. • Readily available.

4. Weaknesses of NCLEX Pass Rate as a measure Easily distorted by: • Removing students not HIGHLY likely to pass NCLEX. • Delaying graduation of high risk students • Post-Graduation • Tutoring • Review Courses Limited to “first try”

5. Weaknesses of NCLEX Pass Rate as a measure Creates a conflict of interest for the school. • Excessively restrictive admissions • Removing students with some risk of NCLEX failure… who might pass.

6. Weaknesses of NCLEX Pass Rate as a measure • Is based on the assumption that admission criteria effectively screen for capacity to be successful. • Is based on the political position that all students are capable if taught properly.

7. Predicting NCLEX Success

8. Strengths of using retention as a measure • Addresses how efficient the program is. • Encourages schools to support students to retain/graduate them. • Retention is a hot issue in public education. • Good numbers satisfy key stakeholders.

9. Weaknesses of retention rate as a measure: Students leave for MANY reasons: • Some students discover this is the wrong field for them. • Partially out of the control of the school. • Some perform poorly • Partially out of control of the school. • Some have private life issues • Often completely out of control of the school.

10. Weaknesses of retention rate as a measure: • Current admission criteria are often NON-predictive of success. • Is based on the political position that all students are capable if taught properly. • 100% retention might be a problem too!

11. Weaknesses of retention rate as a measure: Measurement issues: • What is graduation “on time”? • 100% • 150% • Transfers in and out • Student Death

12. Result is gaming the system. • Only graduating those students who are very likely to pass NCLEX on the first try. • What is the cost to students and the communities that we serve?

17. Calculating the Yield • Of all the students admitted, what portion will be licensed on the first try?

18. Calculating the Yield • Combines NCLEX pass rate with retention. • Pass Rate x Graduation Rate = Yield

19. Calculating the Yield • 90% x 90% = 81% • 85% x 85% = 72%

21. Strengths of Yield as a measure • A single value • Easily understood • Addresses effectiveness AND efficiency • Prevents gaming the pass rate by manipulating the graduation rate.

22. Weaknesses of Yield as a measure • Shares most of the weaknesses of the pass rate and graduation rate. • New, and not yet understood by all.

23. Case 1: High Pass Rate • 2007 • Five A.D.N. schools had 100% NCLEX pass rate • Three of the five had graduation rates <50% • Yields for these five schools: • 83.3% • 58.2% • 44.6% • 42.9% • 29.0%

24. Case 2: Low Pass Rate

25. Case 3: Low Yield

26. Case 4: High Yield

27. Case 4: High Yield

29. Summary • NCLEX pass rate and Graduation rate are both important. • Combining them into a single value provides a different way too look at program performance. • Yield tells our stakeholders if they are getting their $$$ worth from us!