The relationship of critical thinking to performance on the National Council Licensure Examination for Registered Nurses (NCLEX-RN)

Abstract

This purpose of this ex-post-facto research study was to investigate the relationship of critical thinking to performance (pass or fail) on the NCLEX-RN. The sample (N= 218) was composed of baccalaureate nursing students who graduated between 1998 and 2001 from a university-based nursing program in the Southwest. The participants completed two critical thinking instruments: the California Critical Thinking Skills Test (CCTST) and the California Critical Thinking Disposition Inventory (CCTDI). Both instruments generate a total score and several sub-scale scores. Participants completed these instruments during their final semester of nursing school. About half of the sample also completed these instruments upon entry into the program. Results of t-test analyses showed that there was a statistically significant difference between participants who passed and failed NCLEX-RN on the exit CCTST. Pass group scores exceeded fail group scores on all 6 scales; the effect size for each was medium to large. Scores for the pass group also exceeded the fail group on 3 of 6 scales upon program entry. On the exit CCTDI, the pass group had statistically significantly higher scores on 5 of 8 scales with medium to large effect sizes. The CCTDI scores for the fail group, however, were comparable with national norms for student nurses. There was no change in CCTST or CCTDI total scores over time between program entry and exit; improvement was noted on one sub-scale for both instruments. There was no difference in gain scores between the pass and fail groups. The prediction of NCLEX-RN performance (as determined by multiple regression analysis and discriminant analysis) was not improved by adding CCTST and CCTDI to the prediction from nursing grade point average. There was no difference in age or gender between pass and foil groups. Chi-square analysis revealed a statistically significant difference in NCLEX-RN performance based on ethnicity. The effect size for this finding was small to medium. In conclusion, results from this study show that critical thinking skills are related to NCLEX-RN performance, however, the relationship of critical thinking disposition to NCELX-RN performance remains unclear. These results enhance the understanding of factors associated with NCLEX.