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Adaptive Quizzing Improves End-of-Program Exit Examination Scores

Presti, Carmen Rosa, DNP, RN, ACNP-BC; Sanko, Jill S., PhD, ARNP, CHSE-A

doi: 10.1097/NNE.0000000000000566
Feature Articles

Background A third of nursing schools use a standardized, end-of-program exit examination requiring minimum passing scores for student progression. Student failures on high-stakes tests have negative implications for students and schools of nursing. Adaptive quizzing has increased grades, graduation rates, and NCLEX-RN passing rates and reduced test anxiety in nursing students.

Purpose To diminish the negative effects of high-stakes testing and increase standardized exit examination scores, an undergraduate nursing program incorporated customized adaptive quizzing for nursing students in their final nursing course before graduation.

Methods End-of-program exit examination scores were compared in a preintervention cohort of students and postintervention cohort assigned individualized adaptive quizzing.

Results Statistically significant increases in end-of-program exit examination scores were evident in groups of students completing the customized adaptive quizzing assignments.

Conclusion The use of tailored adaptive quizzing increased exit examination scores, supporting the implementation of customized assignments for remediation.

Author Affiliations: Assistant Professors (Drs Presti and Sanko), University of Miami School of Nursing and Health Studies, Coral Gables; Acute Care Nurse Practitioner (Dr Presti), Jackson Memorial Hospital, Miami, Florida.

The authors declare no conflicts of interest.

Correspondence: Dr Presti, University of Miami School of Nursing and Health Studies, 5030 Brunson Dr, Suite 405, Coral Gables, FL 33146 (

Accepted for publication: May 1, 2018

Published ahead of print: July 13, 2018

Cite this article as: Presti CR, Sanko JS. Adaptive quizzing improves end-of-program exit examination scores. Nurse Educ. 2019;44(3):151-153. doi: 10.1097/NNE.0000000000000566

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