No abstract

The expectations for clinically ready graduates have increased over the years, paralleling changes in the NCLEX exam with increasingly cognitively difficult items in preparation for professional nursing practice. Yet, it is widely recognized that nursing program exit standardized exams have come under increased scrutiny in several public cases. Several articles have frequently been cited in the opposing argument against use of the HESI Exit Exam or other standardized nursing exit exams. We review two of these for logical coherence and standard psychometric adherence given their recurrent use in arguing against nursing program exit standardized testing. In light of patient safety implications and school accreditation consequences, it's more important that schools use exit standardized testing and assess minimum competency of students based on an exit program standardized exam. Measurement standards are critical to these analyses. The use of a program exit standardized exam also alerts students that faculty are holding them accountable for their time in the program.

Health literacy is a relatively new concept that has been evolving at a rapid pace over the past decade. As recently as 2004, nursing researchers were contributing only a small portion of the existing body of knowledge as it related to the concept of health literacy. But in the last 4 to 5 years, this trend has changed. More interest demonstrated by nursing scholars has caused an exponential increase in the literature being produced. The research to date has shown a direct correlation between low health literacy and poor health. Older adults have been identified as a vulnerable population with an estimated two-thirds of US adults aged 60 and older having inadequate or marginal literacy skills. A concept analysis of health literacy in the older adult population is warranted at this time to further clarify the concept and provide standard terminology and definitions for future holistic nursing practice and research, leading to better identification of health-literacy deficits and intervention within vulnerable populations.