Arizona — Edition 19
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CNA Corner
Lila Van Cuyk

Nurse PrACtiCe CoNsultANt/ CNA ProgrAMs

The Board has found that over the last year and a half there has been a downward trend in the first time pass rates for Nursing Assistant certification. Candidates are required to score a minimum of 75% on the written exam which consists of 72 multiple questions. For the skills exam, candidates are required to score a minimum of 80% on each task without missing any key steps. (see Table 1) A Notice of Low Pass Rates was sent to the 48 programs that had at least 10 first time testers and who were at least 10 points below the 2009 State average. The Board also sent out a Request for Plan of Remediation to the 8 programs that had either a Written or Skills testing average below 50%.

The programs developed Plans of Remediation and did a great job in evaluating the reasons for their low pass rate and making suggestions for remediation.

Wanted to share these so that all of the NA Training programs may benefit.


1. Long classroom sessions

• break up the classroom time with concurrent skill practice.

• do not have didactic over 4 hours per day.

2. Not utilizing the Candidate Handbook Vocabulary list

• learn definitions for each word.

• teach words that have high rate of being missed on written exam.

3. English is a second language

• have student take English as a second language course prior to starting NA training.

• have the student prepare the vocabulary list in English and a translation of their primary language. If this list is only the direct translation, e.g. house = casa, not the definition, the list can be taken into the State written test.

4. Cultural differences of students

• sensitivity to cultural needs and difference in learning style.

5. Low reading and/or math skill

• provide tutorial in reading and math skills prior to starting training.

• provide textbook at student reading level.

6. Students have low motivation

• interview students prior to entrance to determine if they understand the role and expectations to complete the program.

7. High turnover of instructors

• determine primary causes and strategies to address.

8. Inexperienced instructors

• provide orientation, encourage enrollment in courses related to methods of teaching classroom and clinical training

• encourage enrollment for D&S Technologies Instructor Training.

• provide other appropriate teaching tools and resources.

9. Inconsistent teaching by instructors

• develop lesson plans for each didactic class used by all instructors.

• provide opportunities for mentoring/ communication between instructors.

• hold regularly schedule faculty meetings to discuss new teaching developments.

• develop policies and procedures for conducting classroom and clinical training.

10. Written exams are of lower difficulty than the State written exam

• use instructor handbook for test questions to write initial and make-up exams that have valid, reliable questions.

• purchase practice exams at the D&S website, for use as teaching tool or for students to practice test taking.


11. Inconsistent teaching by instructors

• use Candidate Handbook and mock skills step by step testing forms when teaching skills.

12. Clinical training sight did not have the opportunity to perform required skills

• need blocks of clinical time, preferably 8 hours.

• vary the clinical training schedule to include days, evenings and weekends.

• ensure that students perform direct care activities and do not just observe instructor or staff do tasks.

13. Students learned “shortcuts” from the facility staff and no longer provided care based on classroom learning

• educate staff regarding requirement; ie students are to perform tasks as they learned in class.

14. The program has insufficient lab practice time or does not utilize the lab practice time well

• intersperse skills practice with didactic learning.

• have multiple beds/ skills stations so that all students are actively engaged.

15. Not utilizing the Candidate Handbook

• give current Handbook to each student at the start of class.

• handbooks are revised annually(April) and are available for free from D&S Technologies or it can be printed at D&S Technologies website.

• have students create study cards for each skill.

16. Instructors are not thorough in assessing skill competency

• be precise when assessing skill competency.

• give a skills final exam in addition to the final theoretical exam.

• do not rely on facility preceptors to verify competency in skills.

17. Delays in taking the certification test

• schedule test to be given at training site as soon as possible after the end of class.

• if test cost is paid by outside source request payment at start of class.

• assist students to complete the test application to D&S Technologies and submit application.

18. Concerns related to the D&S test observers

• email concerns to D&S Technologies at and A more in depth guideline in program assessment with more suggestions for improvement is available at the Board of Nursing website, Education/ Education Resources in the updated Suggestions for Improving NA Training Program Pass Rate.