NCLEX to Be Changed as Fail Rates Climb

Passing the National Council Licensure Exam (NCLEX) isn’t easy. Just ask any licensed registered nurse. But more and more students are having trouble passing the exam, which is only compounding the ongoing nurse shortage. Experts believe the COVID-19 pandemic is largely to blame. The health crisis forced nursing schools to conduct their operations online, depriving thousands of aspiring nurses the chance to learn and practice their skills in person. Now that the pandemic is officially ending in May, the NCLEX is getting a much-needed update. Here’s how it could affect the staffing shortage:

Pass rates for first-time takers of the national licensure exam have been steadily declining over the last few years. The pass rate fell from 88.2% in 2019 to 82.5% in 2021, depriving the industry of thousands of potential providers. Experts estimate that about 20% of those who graduate from nursing school aren’t passing the test, which means they won’t be able to enter the nursing profession.

“Anecdotally, we are fairly certain that the pandemic has had an outsized impact on NCLEX pass rates over the past three years,” said David Benton, PhD, CEO of the National Council of State Boards of Nursing (NCSBN).

He says lots of aspiring professionals aren’t getting the training they need to pass the exam. “Clinical placements were limited and sometimes eliminated from the curriculum, which reduced the ability of the students to consolidate learning as they were not able to apply theory in practice,” Dr. Benton said. “Also, the education sector had to pivot to providing material via the internet, and not all students had the same access to such facilities.”

The NCSBN updates the national licensure exam every three years to make sure new graduates have the skills they need to succeed on the job. The organization plans to release its next update in April of this year. Benson says it includes more information on caring for patients with multiple chronic conditions as the population ages.

The change focuses on areas of “critical judgment,” which is defined as “the observed outcome of critical thinking and decision-making, an iterative process that uses nursing knowledge to observe and assess presenting situations, identify a prioritized client concern, and generate the best possible evidence-based solutions to deliver safe client care.”

The NCSBN will also release a workplace study around the same time that will identify weaknesses in the current planning model to address gaps in the labor workforce. The study will also focus on issues of burnout and rising rates of workplace violence. Benson says the current system for tracking these incidents is out of date. The group is encouraging the use of a unique identifier, the NCSBN ID, that will enable better healthcare workforce planning.

He also said nurses should be ready to take the wheel when it comes to creating actionable policy solutions. “Nurses need to step out of their comfort zone of working on health policy, and get active in designing policy that is coherent, increases access to services, prevents disease burden and increases life expectancy,” Benson stated. “This can be done by scaling existing solutions, working collaboratively and being prepared to learn from each other.”

The Next Gen NCLEX is set to launch on April 1. Students who attended nursing school in or after Fall 2021 will be tested on this new version of the NCLEX.