I RETURNED TO SCHOOL after working in the media industry for several years. Having graduated from an Ivy League university with a master's of science degree in journalism, I felt confident about pursuing an associate degree in nursing (ADN). What I discovered was that the nursing curriculum challenged me in ways I hadn't anticipated. In addition, my exam scores have often fallen short of my own expectations. I decided to interview nursing students to discover their studying secrets.
Here's what I learned
Those nursing students hoping to snag a better grade on their next exam say they often start focused studying at least 2 weeks ahead of time. They memorize highlighted signs and symptoms of various disorders, such as myocardial infarction, in their textbooks. They constantly review homemade flash cards and sticky notes plastered on their bathroom mirrors. They also repeatedly review their class notes. Despite all of these steps, they often get a disappointing grade.
“You feel like a failure—like you let yourself down,” said Anna Liza Sampayan, a part-time student at Phillips Beth Israel School of Nursing (PBISN) in New York City. “It makes you wonder, 'What did I do wrong?'”
Nursing students say their curriculum requires them to know more than facts such as the normal BP parameters or signs and symptoms of dehydration. “Students need to have the knowledge and skills to apply what they've learned,” said PBISN professor Tina Heinz. “Exams evaluate students' abilities to provide safe and evidence-based care to patients.”
Many students like Sampayan say less-than-stellar exam results have prompted them to ponder the same question: “How can I integrate information, learn to adopt an RN's perspective, and improve my exam grades?”
Differing coursework, similar frustrations
Sampayan is one of about 300 students pursuing an ADN at PBISN. Some students complete science prerequisites, nursing courses, and clinical rotations over the course of 3 years. Others opt to complete coursework within 2 years. Though students may have different course loads, many often feel frustrated. Students say their frustration results from receiving lower-than-expected grades, forcing them to find new ways to study. In addition, nurse educators say part of students' frustrations stem from the time and developmental processes required to learn how to think critically.
In Sampayan's case, she said her frustration prompted action, causing her to spend more time in her school's learning resource center. The resource center is where students consult additional textbooks made available for loan through the student library. They also take advantage of texts that facilitate the learning process with easily understood explanations.
Many students say they benefit from using various media to augment their individual learning styles. PBISN student Lisa Kelly says watching online videos has helped her review parenteral medication administration, among other skills. Other students say watching DVDs that accompany their textbooks help them visualize congenital heart defects such as tetralogy of Fallot and coarctation of the aorta.
Tapping into simulation labs
Some students say they've benefited from PBISN's simulation lab. Nursing students role-play during a structured simulation scenario. Students continuously assess the patient's changing clinical status while attempting to prioritize patient-care needs and nursing interventions. Students might evaluate a cardiac rhythm strip, insert a urinary catheter, or initiate CPR. They might also hold a patient's hand or provide reassurance during a traumatic situation.
During a structured postsimulation debriefing, faculty members assist students by assessing what they did, how they did it, and how they can improve.
PBISN student Sarah Cady participated in a simulation scenario involving a patient with preeclampsia. “It helps to have the simulation experience when studying for the exam,” said Cady. “Also, having participated in the scenario, I feel more confident if I have to care for a patient with preeclampsia.”
Putting theory into practice
PBISN student Katrina Chardavoine said clinical rotations at Beth Israel Medical Center in New York City crystallized theories she learned in class. During her rotations, Chardavoine said she worked with patients who had such diagnoses as coronary artery disease, Parkinson disease, and heart failure. “I was nosy. Aside from my assignments, I tried to see as many things as I could.”
When it came to learning about white blood cells, Chardavoine said she relied upon mnemonics. “You use some type of memory aid like 'Never Let Monkeys Eat Bananas' to remember neutrophils, lymphocytes, monocytes, eosinophils, and basophils.”
Students often turn to books or DVDs filled with the NCLEX-RN practice questions to prepare for exams. They say practice questions improve their test-taking skills and that preparation helps alleviate test anxiety.
In addition, students say practicing with NCLEX-style questions helps them prepare for the licensure exam they're required to take after graduating.
What works best for you?
School of Nursing faculty say the most effective studying strategy is one the student develops that yields desired results. “I think the goal of higher education is to take something very difficult and understand it. However one can achieve this goal, be it by using a variety of methods or just one, is reasonable and effective,” Professor Heinz said. In addition to studying, she stresses that students must maintain the conviction that they'll be successful.
Students say improving study habits and, subsequently, improving exam scores requires them to apply the steps of the nursing process. They must assess their study methods, diagnose difficulties, and create and implement a study plan while simultaneously evaluating its outcomes. The students I interviewed hope that by developing their own individualized study plans, with methods that crystallize concepts, they'll ensure their future success in nursing school.