Understanding the NCLEX: How to Increase Success on the Revised 2013 Examination

Abstract

The National Council State Boards of Nursing (NCSBN) revised the NCLEX-RN examination test plan and increased the passing standard in April 2013. Now more than ever, faculty must understand the structure of the exam and how to prepare students for NCLEX success. If a nursing education program's pass rate drops repeatedly, the program can be placed on limited admissions and/or denied accreditation. The authors are educators in New York City schools of nursing that offer associate, LPN to RN completion, RN to BSN, accelerated baccalaureate, and generic baccalaureate degree programs. Their students are urban, multiethnic, and multiracial; more than 60 percent come from educationally disadvantaged backgrounds, and many are former high school dropouts who received high school equivalency diplomas. The programs have consistent NCLEX-RN pass rates above 90 percent as well as three-year graduation rates above 75 percent. The recommendations for preparing students for the NCLEX offered in this article are derived from the authors' experiences as educators and as test consultants for the National League for Nursing (NLN) Testing Services. Understanding the NCLEX-RN and How It Is Scored The NCSBN Board of Directors reconsiders the passing standard every three years in an effort to ensure minimum competence and safe practice by new nurse graduates. Modifying the passing score is meant to ensure that each candidate meets the minimum qualifications for a new nurse and can function in today's changing health care environment. (The latest version of the test plan, abbreviated as well as detailed, is available at www.ncsbn.org/2013_NCLEX_RN_Test_Plan.pdf.) The NCLEX-RN and the NCLEX-PN are administered online, and each candidate has a unique exam. However, all exams follow the test blueprint so that the examination experience is equivalent for all candidates. It is important to understand the exam format and how the exam is scored. The length of the exam for each candidate, as well as specific test items, is determined by the candidate's knowledge level and ability to choose correct answers. Each test item is presented on the computer screen, and answers are processed immediately. The computer selects subsequent items from an item bank, which contains items classified by test plan content area and sorted by level of difficulty. If an item is answered correctly, then a more difficult item is answered next. If an item is answered incorrectly, then an easier item is answered next. This process is repeated each rime an item is administered, creating an examination tailored to the individual's ability while fulfilling the NCLEX-RN test plan requirements. Passing the NCLEX is determined by logits, rather than a specific score or percentage of items answered correctly. In April 2013, the passing standard increased from -.16 logits to .00 logits (NCSBN, 2013). When a candidate achieves this probability level, she/he has passed the exam. A logit is the unit of measure used by Rasch (Rasch, 1961; Wright & Stone, 1999) for calibrating items and measuring persons. It is a prediction of the probability of an event (in this case that a candidate will answer an item correctly) achieved by placing data on a logistic curve. Interval units in this measurement system have equal differences between each point on the scale. In the Rasch model, the probability of a specified response (e.g., right/wrong answer) is modeled as a function of person and item parameters. Item parameters pertain to the difficulty of items while person parameters pertain to the ability or attainment level of people who are assessed. The higher a person's ability relative to the difficulty of an item, the higher the probability is of a correct response on that item. The probability of a correct response is given as a logistic function of the difference between the person and item parameters. In the NCLEX examinations, logits provide a determination of a candidate's ability based on both the average difficulty level of the item as well as the average ability of the candidate to answer an item correctly. …