Effect of NCLEX® Pass Rate With the Replacement of Live Review With Virtual Review

Purpose: The National Council Licensure Examination (NCLEX) serves as a measurement of competency for entry-level registered nurses (RN) and in many cases, the NCLEX-RN pass rate reflects the level of preparation provided to the learner by their School of Nursing (Taylor, Loftin, & Reyes, 2014; Conklin & Cutright, 2019). Nursing curricula must incorporate critical thinking and problem-solving opportunities to ensure students are properly prepared for a successful NCLEX-RN outcome (Mager, Beauvais, & Kazer, 2017). The use of NCLEX preparation varies among nursing programs; however, it is vital to ensure the use of evidenced-based strategies such as standardized examinations (Quinn, Smolinski, & Peters, 2018; Randoph, 2017). According to Chen & Bennett (2016), there is a correlation between Assessment Technologies Institute’s (ATI) RN Comprehensive Predictor scores and NCLEX-RN success.

Methods: In 2014, with the intent to increase baseline NCLEX scores, the School of Nursing restructured the one credit hour Nursing Internship (Capstone) course in the Associate of Science in Nursing curriculum to include an individualized virtual review. This course is taken fifth term and is comprised of career preparation, discussion posts, two homework capstone exams (medical-surgical and pharmacology), 10 proctored subject exams, two comprehensive ATI assessments (one baseline assessment the first day of class and another before the predictor), and a final ATI proctored predictor assessment. The previous live review was replaced with an individualized virtual review that was based on the learner’s ATI scores. The learners would work through the virtual material and assignments until they were “green lighted” to take the NCLEX exam.

Results: The baseline average NCLEX pass rate for the previous three years (2011 – 2013) prior to virtual review implementation was 62.5% (n= 160). Since implementation NCLEX pass rates for the School of Nursing are as follows: 2014 - 80% (n=65); 2015 - 84.6% (n=39); 2016 - 100% (n=12); 2017 - 89.5% (n=19); 2018 - 96.3% (n=54). The National Council of State Boards of Nursing (NCSBN) publishes year to date NCLEX pass rates for learners who are educated in the United States and pass on the first NCLEX attempt. For comparison, NCSBN reported national pass rates as: 2014 – 79.3% (n=86,377); 2015 - 82.0% (n=84,379); 2016 – 81.7% (n=81,653); 2017 - 84.2% (n=79,511); 2018 - 85.1% (n=82,000).

Conclusion: The implementation of the individualized virtual review has consistently demonstrated the School of Nursing pass rates are above the national average.