© 2010 jim mcgraw, rn, mn tarrant county college © 2010 jim mcgraw, rn, mn tarrant county college...

© 2010 Jim McGraw, RN, MNTarrant County College© 2010 Jim McGraw, RN, MNTarrant County College

Yield: A New Measure of Nursing Program Performance

Jim McGraw, RN, MN

Asst. Professor

Tarrant County College

© 2010 Jim McGraw, RN, MNTarrant County College

How do we currently assess program outcomes?

Measures

• NCLEX Pass Rate

• Graduation Rate

• Graduate Employment Rate

Impressions

• Reputation

• Warm Fuzzy Feeling

© 2010 Jim McGraw, RN, MNTarrant County College

Strengths of NCLEX pass rate as a measure:

• A measure of effectiveness

• Standardized / Uniform

• Easily understood by insiders and outsiders.

• Readily available.

© 2010 Jim McGraw, RN, MNTarrant County College

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”

© 2010 Jim McGraw, RN, MNTarrant County College

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.

© 2010 Jim McGraw, RN, MNTarrant County College

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.

© 2010 Jim McGraw, RN, MNTarrant County College

Predicting NCLEX Success

Predicted to Pass

Not Predicted to Pass

Passes Exam GREAT! Potential loss of a new nurse!

Fails Exam Re-takes exam Not a problem

© 2010 Jim McGraw, RN, MNTarrant County College

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.

© 2010 Jim McGraw, RN, MNTarrant County College

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.

© 2010 Jim McGraw, RN, MNTarrant County College

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!

© 2010 Jim McGraw, RN, MNTarrant County College

Weaknesses of retention rate as a measure:

Measurement issues:

• What is graduation “on time”?– 100% – 150%

• Transfers in and out

• Student Death

© 2010 Jim McGraw, RN, MNTarrant County College

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?

© 2010 Jim McGraw, RN, MNTarrant County College

2007 ADN Programs

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© 2010 Jim McGraw, RN, MNTarrant County College

2007 ADN Programs

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© 2010 Jim McGraw, RN, MNTarrant County College

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© 2010 Jim McGraw, RN, MNTarrant County College

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© 2010 Jim McGraw, RN, MNTarrant County College

Calculating the Yield

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

© 2010 Jim McGraw, RN, MNTarrant County College

Calculating the Yield

• Combines NCLEX pass rate with retention.

• Pass Rate x Graduation Rate = Yield

© 2010 Jim McGraw, RN, MNTarrant County College

Calculating the Yield

• 90% x 90% = 81%

• 85% x 85% = 72%

© 2010 Jim McGraw, RN, MNTarrant County College

Ordered by Pass Rate- 2007

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YIELD

© 2010 Jim McGraw, RN, MNTarrant County College

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.

© 2010 Jim McGraw, RN, MNTarrant County College

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.

© 2010 Jim McGraw, RN, MNTarrant County College

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%

© 2010 Jim McGraw, RN, MNTarrant County College

Case 2: Low Pass Rate

2007 Pass Rate %

Grad Rate %

Yield

%

A71.43 47.30 33.79

B73.53 37.40 27.50

C75.00 72.20 54.15

D75.41 69.40 52.33

© 2010 Jim McGraw, RN, MNTarrant County College

Case 3: Low Yield2007 Pass

Rate %Grad

Rate %Yield

%

A98.44 22.30 21.95

B73.53 37.40 27.50

C100.00 29.00 29.00

D95.00 32.80 31.16

© 2010 Jim McGraw, RN, MNTarrant County College

Case 4: High Yield

2007 Pass Rate %

Grad Rate %

Yield

%

A96.88 94.10 91.16

B96.00 87.50 84.00

C100.00 83.30 83.30

D94.59 86.90 82.20

© 2010 Jim McGraw, RN, MNTarrant County College

Case 4: High Yield2007 Pass

Rate %Grad

Rate %Yield

%

Lamar State College-Orange

96.88 94.10 91.16

Midland College96.00 87.50 84.00

Brookhaven College (DCCD)

100.00 83.30 83.30

Tyler Junior College94.59 86.90 82.20

© 2010 Jim McGraw, RN, MNTarrant County College

Change in Rank from Pass Rate to Yield

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© 2010 Jim McGraw, RN, MNTarrant County College

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!