BMJ Open (Jul 2023)

Comprehensive licensure review and adaptive quizzing assignments for enhancement of end-of-programme exit examination scores in Saudi Arabia: a quasi-experimental study

  • Adnan Innab,
  • Naji Alqahtani,
  • Monir M Almotairy,
  • Ahmed Nahari,
  • Reem Alghamdi,
  • Hamza Moafa,
  • Dalal Alshael

DOI
https://doi.org/10.1136/bmjopen-2023-074469
Journal volume & issue
Vol. 13, no. 7

Abstract

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Objective This study explores the effectiveness of a comprehensive licensure review and adaptive quizzing assignments intervention in improving the performance of undergraduate senior nursing students on the end-of-programme exit exam.Design A quasi-experimental single-group design was used to compare pretest and post-test scores through computerised adaptive tests.Setting The setting was a nursing college in Saudi Arabia.Participants The study included 292 senior nursing students enrolled in the Bachelor of Science in Nursing programme.Intervention A comprehensive licensure review bundled with adaptive quizzing assignments was delivered over 15 weeks in the academic year 2021–2022. The bundle was guided by the elaboration theory, and it included 3-hour synchronous lectures every week and 23 adaptive quizzing assignments that covered weekly content.Primary and secondary outcome measures Students’ mastery scores and the percentage of correct answers were the primary and secondary measures, respectively. Both measures were collected in the pretest and post-test (exit examination). Additionally, demographic characteristics were collected in the pre-test using an online survey.Results The overall mean of the mastery score was statistically significantly higher in the exit exam (M=2.51, SD=1.70) than in the pretest (M=1.45, SD=0.44; p<0.001). Although the overall mean of the mastery score in the exit exam did not reach the cut-off score, students who demonstrated the required knowledge and satisfactory performance in the pretest achieved a mastery score above the cut-off. The percentage of correct answers was statistically significantly higher in the exit exam (M=58.59%, SD=9.50) than in the pretest (M=49.32%, SD=9.78; p<0.001). A statistically significant difference in students’ performance based on gender, age and grade point average was observed.Conclusions A comprehensive licensure review and adaptive quizzing assignments intervention bundle fostered the performance of undergraduate nursing students in the end-of-programme exit exam.