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

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.