NCLEX Strategy: Just the beginning

* WARNING * This is a LOOOOONG post. I will be amazed if any of my non-nursing friends actually make it through the entire post. If you aren't in nursing school, this will probably be lost on you.  And if you aren't a S-T-J or aren't devoted to the theories of Myers-Briggs personality typing, you may think me insane. I am not. I am simply an X-STJ who is "...extremely talented at devising systems and plans for action, and at being able to see what steps need to be taken to complete a specific task."  Yep, that's me in a bullet point. However, here's my horrible, deep, dark secret:  I can devise plans and see what steps need to be taken, BUT I am also the worst offender of procrastination! The worst. But here marks the beginning of my strategy for studying for NCLEX!  (Feel free to stop reading here).

I've been doing some research regarding NCLEX prep and various strategies. Most of my research has been done via reading discussions/postings on AllNurses.com (a GREAT discussion site for nursing information in general). You can spend ALL day reading about what people have found helpful and not helpful (and sometimes there's little consensus --as what works for one person, doesn't work for another). It really comes down to knowing yourself, what you need and how you best study, but this site does provide helpful information/tips from those who have taken NCLEX and passed and those who have taken NCLEX and failed.

I don't have a strategy or plan yet for studying and I'm not actually going to sit down and really think strategy until I'm DONE with my actual classes and have graduated. But I thought I'd list out the resources that I expect that I'll be using to study/prep for NCLEX.

Saunders Comprehensive Review (4th/5th ed): During school I used the 4th edition and found it VERY helpful during school as I studied for tests. The content review is EXCELLENT and it has good NCLEX questions (along with CD allowing for focused review in the computer format (like the NCLEX). Every Q&A comes with rationales/strategy for how to figure out answer. I haven't purchased the newest edition yet because it's another $50 and I still don't have a definitive answer as to whether the NCLEX questions are any different from 4th edition to the 5th edition. However, I've read online that there is additional content in the 5th edition. I may still buy this. But this book gets RAVE reviews on allnurses.com for content and NCLEX questions (that's why I bought 4th edition for use during nursing school).

The CD also has an assessment test that will help determine weak areas and will create a recommended study plan based on how much time you've got to study before the NCLEX! Helpful.

Post-NCLEX thoughts: I did not end up buying the updated edition. I really didn't even use Saunders after graduating. I still wholeheartedly recommend it for nursing school. I simply did not have enough time to use Saunders in addition to Kaplan. Also Kaplan suggested not doing more than 150 questions a day so that proper attention could be given to reviewing the Kaplan questions rationales. Kaplan provided plenty of tests and questions...that I did not need more!

LaCharity's Prioritization, Delegation and Assignment (2nd ed): This too has been recommended on AllNurses. Prioritization and delegation questions can be challenging. I will certainly benefit from doing practice questions focused on PDA. 

Post-NCLEX thoughts: I did the first few chapters, but the Kaplan course really gave me the knowledge I needed to be able to answer the prioritization, delegation and assignment questions. Nursing school did not prepare us at all for these type questions. And Kaplan really helped. If you cannot take Kaplan, this is still an excellent resource.

Saunders Q &A Review Cards (1st ed) and Mosby's Review Cards (2nd ed): I've ordered these and I'm hoping that the Saunder's pack has different questions than what's in the 4th/5th editions of the Comprehensive Review books. These are not really flash cards because the paper is on the thin side (or so I've read). I plan to bundle these based on topic/content, hole punch them, put them on rings and then take them with me to the gym. I'm a little concerned about how they'll hold up as they'll probably hang out in my gym bag, but I might have to get creative in how I store them -- otherwise the thin cards will quickly become dog-eared and a bent up mess.

Post-NCLEX thoughts: I took full advantage of these cards! I did hole-punch them and put them on rings and it worked out GREAT! They held up fine, as cards did not sit around long in my purse or bag...I pretty much whipped through them quickly and returned the completed questions back to the box. I highly recommend either of these sets. I primarily used these between graduation and when I took the Kaplan course. I did manage to continue to use them after my Kaplan course, but pretty much only when I was at the gym.

Kaplan : Background: My program initially required my cohort to purchase ATI, but there were some problems with ATI's contract/agreement. So they cancelled ATI and contracted with Kaplan for this year. The first year students were required to purchase Kaplan, but the second years (my class) were not - because we'd already paid for ATI (but lost access when we cancelled). But because my school is contracted with Kaplan, I knew I could get a better deal which would INCLUDE a review course through Kaplan. So rather than paying $499 through Kaplan's website, I paid around $375 when purchased through my school. When I signed up for Kaplan through my school, they gave me a copy of "The Basics" book which is basically just content in outline/bullet format.  No NCLEX questions-- just content.

My purchase of Kaplan through my school allows me to sign up for one of their review courses. They have three basic formats for their review course. The course, whatever the format, is focused on teaching Kaplan's approach to answering NCLEX questions using their "Decision Tree."  During the course, their method is applied to various subjects (straight from Kaplan's website: Pharmacology/Reduction of Risk, Reduction of Risk/Physiological Adaptation, Physiological Adaptation/Basic Care & Comfort/Mgmt of Care, Management of Care/Safety and Infection Control, Safety and Infection Control/HMP/Psychosocial). There's no content or systems review done during this course, at least from what I've read from others who have taken the course. It's been rumored (but I'm NOT for sure) that there are some body system/content videos available if you sign up for one of the 3 review courses. If you buy one of the Kaplan review courses, you also get access to their question bank, online practice tests and diagnostic/readiness tests. If you want more info, go to Kaplan's website and also visit AllNurses.com and search Kaplan for a variety of reviews and perspectives.

Here are the three formats for the Kaplan Review Course. (OMG. Are you still reading?)

"Classroom Review" - this format takes place in a live/classroom setting. We no longer have a Kaplan location in my community, so I would have to travel to Richmond or DC to do this. It's 21 hours of teaching over the course of 1 week or weekend, or two weeks or two weekends. It allows you to plug in your zip code. But in order to find something further away, I have to plug in zip codes in those areas to have them come up. I have read plenty of negatives about the live classroom sessions--so I do not plan to do this (I initially thought I would because I knew one of the instructors--but since they closed our center, she's not teaching it anymore). Direct from Kaplan, this runs $499. Post-NCLEX thoughts: I had two friends who did this live course in Richmond the week after I did my online course. They were disappointed. The teacher ran through questions and answers and did not allow adequate time for the students to actually READ the questions for themselves and to formulate an answer. She basically read the question and then told them which was the right answer and why...did not really give them time to practice what they'd learned. They got out of class early EVERY DAY because the teacher rushed through the material. While I'm sure many of the live instructors do much better than this lady, there's no telling what teacher you'll get (perhaps just avoid the Richmond classes?)

"Classroom Anywhere" - this is live setting also, but it's done from convenience of your bedroom, office, library, or wherever you've got internet access. Because these are still live teaching sessions, you have to clear your schedule to attend the online classes. Schedule is similar to the live settings. You can choose to get the 21 hours of instruction during early, mid-day or evening over the course of 4 or 8 days--depending on the schedule they offer. Because this course runs similarly to a classroom setting, there is a chat feature and there are TA's that can help answer specific questions, so as to not interrupt the entire online class. Direct from Kaplan, this runs $499. This is the likely format for me. Now I just have to pick the dates/schedule that I prefer. Right now I'm looking at late May or early June. Post-NCLEX thoughts: Chose this one. Highly recommend! My instructors were great! They gave us tons of helpful hints (even in written form for us to copy-paste off the classroom site!) Each day during Kaplan, I wrote down my thoughts.  You can search Kaplan using the search box above to find all my Kaplan-related posts, or you can simply go look for my archived posts from May 29-June 1.

"On Demand" - these are prerecorded "classes" - and you chose WHEN you want to watch them. There's less accountability to getting them done and it would be easy to procrastinate and possibly never get around to doing them. I'm not sure if this format has the content videos or not, as it's not entirely clear from the people discussing it online. Because I have a real issue with procrastination, this format is not ideal for me. I think I need the accountability of the live schedule. Direct from Kaplan, this runs $418.

There are TONS of other resources available online for NCLEX prep. Someone on AllNurses.com has even posted a helpful (yet disorganized) NCLEX Study Guide with tons of mneumonics and tricks to help with remembering, along with things to remember to study (lab values, meds etc...).  I also like the ABCDZ Strategy that someone posted (follow link and scroll down to it).

So... these are the resources that I plan to use. I will definitely need to develop a strategy and schedule of how, when, and in what order or combination I will use these resources. I may start with the Kaplan review course and based on how that goes, develop a study plan/schedule. Some folks online suggest 100, 200, 300 NCLEX questions per day. I think I could manage a 100-150/day. Not sure I could manage 300 per day. I've heard that with Kaplan, they provide a suggested study schedule/plan based on how far out your are from taking the NCLEX. Six week plan, four week plan, two week plan.  I've also heard, statistically speaking, that taking the NCLEX more than 45 days after graduation leads to far higher failure rates.  Of course I don't have a source for that...but it seems reasonable enough.

Here is a sample plan of study posted on the Kansas Organization of Nurse Leader's website. There's also an interesting list of questions recommended be posed to students who failed and are retaking the NCLEX (it sounds like they are recommending 3,000 NCLEX questions before taking NCLEX--Good to know!). They've got a handful of other good resources here--even article about foods that can help with memory/learning! When you get to the website, follow KNEP Commission link on left sidebar > Graduate Nurse Toolkit > Graduate Nurse Index... you might find some helpful articles/resources... Check it out.

I've heard from nursing faculty and possibly somewhere else, that there's a correlation between GPA and pass/fail of NCLEX. I've done a search of academic nursing journals online and can't find anything recent or specific. But my nursing school GPA is around 3.75. And if you take into account A&P, Developmental Psychology and Microbiology (all required prereqs taken a year within starting school), I have a 3.8 GPA. I have consistently tested well in nursing school. I've never missed a question because I didn't understand the question, it was 99% me not knowing the content to be able to answer the question (lab values). So because of that, I'm not too worried about NCLEX style questions. Rather I'm more concerned about my retention of information related to diseases and pathophysiology. It feels like every semester I pack my head full of information only for it to leak out the next semester. Ack!  My nursing school has just recently changed their minimum requirements for passing nursing courses. For us, it used to be that you had to earn at least a 75% or higher to pass a class (and stay in program) but now it's 80%! And I think they've also changed the grading scale as to what is considered an A, B, etc... So things just got tougher!

So after graduation, I will work on my NCLEX prep strategy. What's my goal date for NCLEX exam? When is Kaplan available and when do I take it? How many weeks do I have to study? How many days a week will I study? How many hours a day? How many NCLEX questions/day? WHERE will I study (home? campus? library? coffee shop? Study Center?) and what time of day will work best for me? Study partner/ no study partner? What about an accountability partner? Who would that be? How would that work?

Overwelmed? Not at the moment, but without a plan I am certain to be quickly overwelmed and certain to procrastinate! I have a few days between graduation and my trip to Ohio that I can sit down and really sketch out a preliminary plan. I think I just saw May and June slip away :( Boo hoo hoo!

And if you are a lurker here who is in nursing school or graduating and thinking about the NCLEX, I hope you've found some helpful resources or links. Leave a comment and let me know!

Update 20 July 2012 |  So what actually happened?
Graduated May 11 | Kaplan Course May 29-June 1 | NCLEX on June 29 and PASSED at 75 questions! If you scroll to the bottom of this post, you can click on the NCLEX label and it should pull up all other NCLEX-related posts.



(I don't drink coffee, but there are times when I wish I liked it.)