National Council Licensure Examination for Registered Nurses (NCLEX-RN(R)) success among first-time test takers is of great concern to nurse educators. The NCLEX-RN is used for regulation and accreditation purposes and determines if graduates are safe and competent to practice as nurses (Blozen, 2017). To increase pass rates and solidify trust with students, an innovative approach to mentoring bachelor of science in nursing graduates while preparing for the NCLEX-RN was developed.
The postgraduate mentorship program was created to focus on communicating with, supporting, mentoring, and tutoring BSN students after graduation while they prepared to take the NCLEX-RN. Through the mentorship program, nurse educators concentrated on enhancing self-esteem and decreasing anxiety and stress while focusing on strengths, learning styles, and individual areas requiring further development and the implementation of remediation plans.
BACKGROUND
Mentoring is an expansive topic utilized within the profession in both practice and education. Mentoring can provide a formulated success plan based on the student's individual needs. Numerous studies focus on the mentorship goal of meeting benchmark employment rates for new graduates (Pudpong et al., 2017). Career development is essential for newly graduated nursing students, but first, the student must be successful on the NCLEX-RN to be allowed to gain employment. Many mentoring studies focus on mentorship while students are enrolled in nursing courses but lack the development of postgraduation mentoring (Crooks, 2013). Postgraduation mentorship begins at the time of graduation and lasts until the student takes the NCLEX-RN.
Lack of postgraduation mentorship can leave students in a vulnerable position with a limited number of resources that ensure their success on the NCLEX-RN, career services, and more. One of the most commonly cited reasons for delay in taking the NCLEX-RN is students' lack of confidence in their ability to pass (Serembus, 2016). The development of the nursing profession and the development of psychosocial skills can provide a therapeutic relationship between nurse educators and nursing students (Hnatiuk, 2012). Supporting students after graduation through mentorship can provide the bridge between being a student and becoming a licensed professional RN. Providing emotional support for new graduates can help increase self-confidence, enhance communication skills, and reduce stress (Hnatiuk, 2012). Mijares, Baxley, and Bond (2013) recommended continuing mentorship to guide newly graduated nurses to improve self-confidence, adjust to new roles, and develop new skills. The primary aim of this project was to initiate a postgraduation mentorship with the goal to increase the first-time NCLEX-RN pass rate.
POSTGRADUATE MENTORSHIP PROGRAM
The postgraduate mentorship program was created through communication, support, mentoring, and tutoring of BSN students after graduation while they prepared to take the NCLEX-RN. The mentors selected were the two nurse educators who taught the nursing NCLEX-RN review course. These nurse educators had a close working relationship with students during their last semester and continued working with them postgraduation with the mentorship program.
Before graduation, students were notified of the postgraduate mentorship program and were aware of the process. After commencement, the mentorship program began with weekly emails, at a minimum, from the nurse educators; 91 students partipated. Email communication consisted of asking for an update on students' NCLEX-RN preparation and whether or not the student was engaged in an NCLEX-RN review program, such as Virtual ATI or U-World. If students were engaged in a review program, their progress within the program was requested. Other email communication consisted of inquiring if the student's study schedule was being followed and if the student had the needed support to be successful. In addition, words of encouragement, test-taking strategies, and resource distribution were given to all students. Phone calls or text messages were also made if there was no response to emails or if the mentee preferred that type of communication.
Mentorship also varied based on individual student needs. This innovative postgraduate mentorship gave students one-on-one tailored mentoring after graduation, which currently is not common practice. Graduates were invited to come back to the college to talk with the mentors, receive resources, or set up a tutoring session. If graduates were unable to visit the college, they were invited to video chat at their convenience. Furthermore, anxiety-decreasing techniques, stress reduction, and positive affirmations were implemented.
PROGRAM EVALUATION
To evaluate the effectiveness of the postgraduate mentorship program, a questionnaire utilizing SurveyMonkey(R) was distributed to graduates. The mentors developed a questionnaire that consisted of nine questions, with one question consisting of demographics. The other questions pertained to the program and its effectiveness. One question asked graduates to select all that apply; six questions were multiple choice; and two open-ended questions asked for comments on participants' experience with the mentorship program. NCLEX-RN pass rates were collected for 2017 and 2018 to compare pass rates before and after implementation of the mentorship program.
DISCUSSION
The graduate mentorship program was successful in increasing NCLEX-RN pass rates. The first-time pass rate for 2018 was 91 percent, up from 71 percent in 2017. Participants stated that the nurse educators gave support, answered their questions, provided additional information, and advocated on their behalf. Nearly all participants (92.3 percent) said that the nurse educators assisted, inspired, and mentored them as they prepared for the NCLEX-RN. Most participants (89.46 percent) recommended the mentorship program for other graduates. One participant stated, "It was a great experience! I believe I was successful partially because my questions were always answered, my nerves were calmed, and knowing I always had people rooting for me the entire time!"
The findings demonstrated that participants were satisfied with the use of the postgraduate mentorship program provided by the college and recommended that it be continued. Discussions with graduates included concrete mentorship tasks incorporating NCLEX-RN test-taking skills, support with NCLEX-RN preparation products, and the testing process itself. Psychosocial support of graduates included emotional support and inspiration to perform at one's best and to stay motivated throughout the process.
With positive feedback from graduates and improvement in NCLEX-RN pass rates, the postgraduate mentorship will continue. Continuation can be expanded based on graduate needs and feedback. Quality improvement of the program could include increasing communication and screening graduates to identify the various interventions they need. The mentors' role will expand to include the continued mentorship of graduates who do not pass the NCLEX-RN for the first time.
A complete review of the nursing literature did not identify similar postgraduate mentorship programs. We recommend duplication with larger, more geographically diverse BSN nursing programs and more participants. A study with a large sample that focuses on nurse educator preparedness, training, and resources would be useful for nursing education.
CONCLUSION
Although NCLEX-RN preparation initiatives need to be incorporated throughout the nursing program, initiatives in place after graduation are also needed. The postgraduate mentorship program was created to focus on communication, support, mentoring, and tutoring BSN students after graduation while they prepared to take the licensure example. The mentorship program has been effective in helping students succeed, increasing the program's pass rate, and restoring the reputation of the program.
REFERENCES