NCLEX-RN Pass Rates Fall to Lowest Point in the Past Decade

Both the first-time and the total pass rates for the National Council Licensure Examination for Registered Nurses (NCLEX-RN) fell to their lowest points in the last 10 years. Find out the reasons and what you can do as a student or nurse educator.

As of the third quarter, the 2022 pass rate for the NCLEX-RN examination fell to its lowest point in a decade for both first-time NCLEX test-takers and all takers. The first-time rate fell to 79.9%, more than 10 percentage points below the 2012 rate of 90.3%. For all test-takers, the drop was even larger, almost 13%. In 2014, both groups saw another sharp decline, which started to reverse the next year, but by 2019, another decline began, leading to the most recent low figures.

During a nursing shortage, any factor reducing the number of available nurses is a major concern. If the drop in the pass rate affects the diversity of the nursing workforce, the negative implications could go beyond the number of available nurses. It could affect representation in nursing, increase health disparities, and reduce the effectiveness of nursing in public health.

Because of the COVID-19 pandemic, schools switched from classroom education to online learning for nursing students, which required both students and educators to adapt with little preparation. Nursing students who were either beginning or in the middle of their studies when this change happened were among those most likely to be the ones taking the test during 2022.

Schools replaced in-person clinical fieldwork with virtual simulations for nurses, case work, volunteer work, or other substitutes. In the Summer 2021 issue of Dean’s Notes, a service of the National Student Nurses Association, more than 90% of nursing students reported that at least half of their clinical hours were canceled. Aside from being another change for teachers and students to adapt to, the new technologies for simulations are not the same as fieldwork. In addition, working nurses who might have mentored or coached nursing students and others preparing to take the test were far less likely to have had the time or energy.

Students experienced high levels of anxiety and stress during the pandemic. They saw not only the impact of COVID-19 on nurses and their motivation but how politically divisive issues like masks and vaccinations became and how nurses were affected by this politicization.

COVID-19 may not have been the only factor. The length of the test increased in 2020, with 15 pretest questions added. While the time allowed to take the test increased as well, the additional length may have had a higher impact on students who were already stressed and fatigued.

With a return to in-person clinical work, higher levels of experience and comfort with online learning among both teachers and students, and, at least for now, workloads that are closer to normal for many hospitals, some of the factors behind the decline may already be resolved. However, nurse educators and school administrators can still monitor student confidence and classroom outcomes to identify factors that lead to greater success and replicate those.

According to data from the American Association of Colleges of Nursing, there has been a steady pass rate gap of about 7% between students with a bachelor of science in nursing (BSN) and an associate degree in nursing (ADN). As the proportion of students with a BSN increases, this may help to increase overall pass rates.

However, ADNs are a faster and less-expensive pathway to nursing than BSNs, and as such, are especially important to first-time college students, students from a low-income background, and others that help nursing become more diverse and representative of the patient population. Ideally, nursing educators can identify and replicate the success factors that lead to the higher pass rate among BSNs.

Repeat and international test-takers have the lowest pass rate levels. Schools could consider ways to help these groups improve their results, as well as support traditional and U.S. students.

Nursing students should be aware of but not intimidated by this news about the decline in pass rates. Planning in advance how to succeed will help you in your class work and when you take the test.

The next iteration of the NCLEX-RN will change to emphasize critical thinking and the ability to make complex decisions, so make sure that you’ve developed those skills for the NCLEX exam. Of course, mastering NCLEX-type questions through study and test-taking skills and managing NCLEX exam stress and anxiety are key to success, no matter what the test is like. Finally, keep in mind that if you should fail the NCLEX the first time, you can increase your chances for success the next time.

While the decline in the NCLEX-RN pass rate is disappointing for all involved with nursing, the situation can reverse. In the same way that evidence-based practices improve nursing outcomes, nursing students, educators, and administrators can apply evidenced-based learning and educational practices to improve their learning outcomes.