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Validity of ATI Exams in Predicting Nursing Outcomes and NCLEX, Lecture notes of Nursing

The concurrent and predictive validity of ati exams in relation to nursing course outcomes and nclex performance. The study examines the correlation between ati exam scores and course grades, as well as the relationship between ati scores and overall gpa. The document also investigates the effectiveness of remediation in improving ati test scores.

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2021/2022

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IR 1/19/16
Evaluating the Validity of ATI Exams for Predicting MCCC Registered Nursing Course and
Program Outcomes
Concurrent validity refers to the extent to which the results of a particular test or measure correspond
to those of a previously established measure of the same construct. Both measures are taken at the
same point in time. For example, how well does an automated measurement of blood pressure
correspond with a manual cuff measurement? Predictive validity refers to the extent to which the scores
on a particular measure (predictor) correspond with the actual construct they are designed to predict
(criterion). The criterion is measured at a later time. For example, how well does a nursing entrance
exam predict first-semester program performance?
Method
To determine the utility of using ATI exams to predict MCCC registered nursing course and program
outcomes, student data were tracked on ATI subject matter exams, ATI exam retakes, the ATI
Comprehensive Predictor Exam, course grades, overall GPA, and the National Council Licensure
Examination (NCLEX). The ATI subject matter exams are intended to have concurrent validity in
predicting course outcomes, as well as predictive validity in determining NCLEX readiness. The ATI
Comprehensive Predictor Exam is intended to have predictive validity in predicting NCLEX performance.
Passing the NCLEX is necessary for state licensure.
Fall 2012 (N = 29) and Winter 2013 (N = 30) nursing cohorts were examined for a period of two years.
The graduation rate within this two-year period was 62.1% (N = 18) for the Fall 2012 cohort, 33.3% (N =
10) for the Winter 2013 cohort, and 47.5% for the data combined. The limited cohort sample size and
program attrition warrant viewing these findings as a preliminary analysis.
To test the concurrent validity of the ATI subject tests, each one was correlated with a course(s) that
covered the same topic (e.g. mental health). Overall GPA was used instead of a course grade when ATI
content was identified as being covered throughout the program. ATI subject matter exams were
administered at the end of each course. Students scored <1, 1, 2, or 3 (most proficient) on each ATI
exam and also received a percentage score. The levels are described by ATI as being produced by nurse
educator content experts. While levels correspond with slightly different percentage scores across tests,
an example of the level percentage correspondence for RN Adult Medical Surgical Test can be found in
Table 1.
Table 1
RN Adult Medical Surgical 2013 Form Proficiency Correspondence
ATI Proficiency Level
NCLEX Standard
ATI Proficiency Percentage
Level 3
Likely to Exceed
81.1% - 100.0%
Level 2
Fairly Certain to Meet
68.9% - 80.0%
Level 1
Just Likely to Meet
56.7% - 67.8%
Below Level 1
Significant Risk
0.0% - 55.6%
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Evaluating the Validity of ATI Exams for Predicting MCCC Registered Nursing Course and

Program Outcomes

Concurrent validity refers to the extent to which the results of a particular test or measure correspond to those of a previously established measure of the same construct. Both measures are taken at the same point in time. For example, how well does an automated measurement of blood pressure correspond with a manual cuff measurement? Predictive validity refers to the extent to which the scores on a particular measure (predictor) correspond with the actual construct they are designed to predict (criterion). The criterion is measured at a later time. For example, how well does a nursing entrance exam predict first-semester program performance?

Method

To determine the utility of using ATI exams to predict MCCC registered nursing course and program outcomes, student data were tracked on ATI subject matter exams, ATI exam retakes, the ATI Comprehensive Predictor Exam, course grades, overall GPA, and the National Council Licensure Examination (NCLEX). The ATI subject matter exams are intended to have concurrent validity in predicting course outcomes, as well as predictive validity in determining NCLEX readiness. The ATI Comprehensive Predictor Exam is intended to have predictive validity in predicting NCLEX performance. Passing the NCLEX is necessary for state licensure.

Fall 2012 ( N = 29) and Winter 2013 ( N = 30) nursing cohorts were examined for a period of two years. The graduation rate within this two-year period was 62.1% ( N = 18) for the Fall 2012 cohort, 33.3% ( N =

  1. for the Winter 2013 cohort, and 47.5% for the data combined. The limited cohort sample size and program attrition warrant viewing these findings as a preliminary analysis.

To test the concurrent validity of the ATI subject tests, each one was correlated with a course(s) that covered the same topic (e.g. mental health). Overall GPA was used instead of a course grade when ATI content was identified as being covered throughout the program. ATI subject matter exams were administered at the end of each course. Students scored <1, 1, 2, or 3 (most proficient) on each ATI exam and also received a percentage score. The levels are described by ATI as being produced by nurse educator content experts. While levels correspond with slightly different percentage scores across tests, an example of the level – percentage correspondence for RN Adult Medical Surgical Test can be found in Table 1.

Table 1 RN Adult Medical Surgical 2013 Form Proficiency Correspondence

ATI Proficiency Level NCLEX Standard ATI Proficiency Percentage

Level 3 Likely to Exceed 81.1% - 100.0% Level 2 Fairly Certain to Meet 68.9% - 80.0% Level 1 Just Likely to Meet 56.7% - 67.8% Below Level 1 Significant Risk 0.0% - 55.6%

Results

ATI Subject Tests

Table 2 illustrates the results of the correlation between course grade on a 4.0 scale and ATI level and ATI percentage score. The number of students with scores is displayed within the parentheses, which also provides some insight as to when students exited or took a break from the program. Generally in social science a correlation of plus or minus .1 to .3 is considered weak, .3 to .5 is moderate, and >.5 is strong. Findings with a p-value below .05 are considered reliable. The ATI subject matter exams with the strongest relationship with corresponding course grades were MH – N110, OB – N204, PED – N205, F – N105, and MS – N208. For instance we are 33.6% better off predicting performance in N110 upon knowing one’s performance on the ATI Mental Health exam. The number of statistically significant relationships indicates that ATI level served as a slightly more useful predictor than ATI percentage score when calculating the relationship with course grades. The ATI Leadership Test was least useful in course performance and overall GPA (see Table 3) prediction.

Table 2 Relationship between ATI Subject Tests (First-Attempt) and Course Performance

ATI Test Course Course Grade & ATI Level Correlation (Kendall’s tau-b)

Course Grade & ATI Percentage Correlation (Kendall’s tau-b) F = Fundamentals N103 -.10 (43) .12 (43) F = Fundamentals N105 .33* (45) .28^ (45) MH = Mental Health N110 .58** (49) .57*** (49) OB = Obstetrics N204 .44** (37) .30* (37) PED = Pediatrics N205 .33* (38) .39** (38) MS = Medical Surgical N105 .11 (36) .18 (36) MS = Medical Surgical N208 .33* (33) .22 (33) L = Leadership N210 .02 (28) -.08 (28) L = Leadership N212 .34+^ (28) .23 (28)

Note: +^ p < .10, * p < .05, ** p < .01, *** p <.

Table 3 Relationship between ATI Subject Tests and GPA

ATI Test Course Overall GPA & ATI Level Correlation (Kendall’s tau-b)

Overall GPA & ATI Percentage Correlation (Kendall’s tau-b) N = Nutrition Throughout program .32* (28) .17 (28)

PHM = Pharmaceutical Throughout program .34* (28) .27* (28)

L = Leadership Throughout program .23 (28) .17 (28)

Note: * p <.

of the contribution of each of the eight ATI subject tests (final performance level) and their combined effect in predicting ATI Comprehensive Predictor Exam performance. With increased data collection over time, this analysis could be conducted, and the analyses within this paper rerun with the new data, to extend the findings beyond “preliminary”.