A program of cognitive apprenticeship focusing on problem solving skills through reflection, discussion, and actions shared between novice and experienced students was developed and piloted in a large baccalaureate nursing program in the midwestern United States. The program paired senior students in a leadership course with instructor-led groups of first-year students in the clinical and laboratory setting. Senior students developed leadership skills associated with best practices including preparation, planning, clear communication, feedback, and change, while gaining a better appreciation of individual learning needs. First-year students gained confidence with their knowledge and skills and were able to refine communications with patients, patients' families, and staff members and think more critically about patient care issues. Unanticipated benefits included patient, family, and staff recognition and appreciation for a new model for patient care delivery.

With the rapid introduction of technology in nursing education, information regarding its implementation in undergraduate curricula is emerging. The authors describe the implementation process used to integrate personal digital assistants into an undergraduate nursing curriculum. Barriers such as potential for device loss, issues related to patient confidentiality, and infection control are addressed.

This study evaluated students' demographic and nursing program variables and standardized test scores to determine whether significant differences existed between students who successfully completed the National Council Licensure Examination for Registered Nurses (NCLEX-RN®) and those who were unsuccessful. In addition, the predictive accuracy of two standardized examinations, the Mosby AssessTest and the Health Education Systems, Incorporated (HESI) Exit Examination were compared. Two cohorts of graduating senior nursing students were studied (1999 cohort N = 121; 2000 cohort N = 103). Demographic and nursing program variables were obtained from student records. The Undergraduate Studies Committee provided standardized test scores (Mosby AssessTest in 1999; HESI Exit Examination in 2000). Only two program variables were consistently associated with success on the NCLEX-RN - final course grade for a didactic, senior-level medical-surgical nursing course and cumulative program grade point average. Scores on both standardized tests were significantly different in students who were successful on the NCLEX-RN and those who were not. The HESI Exit Examination demonstrated greater sensitivity, specificity, positive and negative predictive value, and test efficiency, compared with the Mosby AssessTest. Use of program variables and students' standardized test scores may allow faculty to identify students at risk for failing the NCLEX-RN and to provide structured remediation so these students may be successful on the licensing examination and begin their nursing careers.

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