The Influences of Nursing School Characteristics on NCLEX-RN® Pass Rates: A National Study

Abstract

Introduction Institutional characteristics impact the development of evidence-based regulatory policies and may influence NCLEX-RN® first-time pass rates (FTPR). Interventions addressing poor NCLEX-RN outcomes have focused on raising admission requirements and including standardized exams in classes. Aim A national study was conducted to examine institutional characteristics among nursing programs associated with NCLEX-RN FTPR. Methods A self-reported survey was sent to 2,093 nursing program administrators in the United States, with a response rate of 40% (n = 832). Multilevel modeling (MLM) examined the association between NCLEX-RN FTPR with institutional characteristics and with faculty, admission, progression, and program and curricular characteristics. Results Results (odds ratio [OR], 95% confidence interval [CI], p value) from a multivariable model indicated that higher FTPR were associated with three attributes: (a) public schools (OR = 1.65, 95% CI [1.12, 2.43], p = 0.03), (b) a higher percentage (an increase of 10) of full-time faculty (OR = 1.12, 95% CI [1.03, 1.21], p = 0.003), and (c) no required use of a standardized exam for admission (OR = 2.28, 95% CI [1.30, 3.99], p = 0.002). Conclusion Nursing programs with a higher percentage of full-time faculty, schools that do not require a standardized exam as part of the admission criteria, and public schools were associated with higher FTPR. Low-performing schools may have implemented interventions to improve pass rates; however, the effects may not have impacted 2014 FTPR, limiting this study’s findings. Implications for future research include a longitudinal study with student attributes, as well as more recent data. Nursing programs can compare their characteristics to this national sample to align data collection efforts. Standardized data collection on institution, program, faculty, and student attributes would strengthen future studies. Institutional characteristics impact the development of evidence-based regulatory policies and may influence NCLEX-RN® first-time pass rates (FTPR). Interventions addressing poor NCLEX-RN outcomes have focused on raising admission requirements and including standardized exams in classes. A national study was conducted to examine institutional characteristics among nursing programs associated with NCLEX-RN FTPR. A self-reported survey was sent to 2,093 nursing program administrators in the United States, with a response rate of 40% (n = 832). Multilevel modeling (MLM) examined the association between NCLEX-RN FTPR with institutional characteristics and with faculty, admission, progression, and program and curricular characteristics. Results (odds ratio [OR], 95% confidence interval [CI], p value) from a multivariable model indicated that higher FTPR were associated with three attributes: (a) public schools (OR = 1.65, 95% CI [1.12, 2.43], p = 0.03), (b) a higher percentage (an increase of 10) of full-time faculty (OR = 1.12, 95% CI [1.03, 1.21], p = 0.003), and (c) no required use of a standardized exam for admission (OR = 2.28, 95% CI [1.30, 3.99], p = 0.002). Nursing programs with a higher percentage of full-time faculty, schools that do not require a standardized exam as part of the admission criteria, and public schools were associated with higher FTPR. Low-performing schools may have implemented interventions to improve pass rates; however, the effects may not have impacted 2014 FTPR, limiting this study’s findings. Implications for future research include a longitudinal study with student attributes, as well as more recent data. Nursing programs can compare their characteristics to this national sample to align data collection efforts. Standardized data collection on institution, program, faculty, and student attributes would strengthen future studies.