A comparative analysis of NCLEX pass rates: Nursing health human resources considerations

AIMS: To examine performance differences among different writers of the National Council Licensure Examination-Registered Nurse (NCLEX-RN) examination in Canada; to compare Canadian and U.S. writer pass rate data; and to identify if changes in the Canadian nursing workforce can be related to the introduction of NCLEX-RN. BACKGROUND: In January 2015, the entry-to-practice licensing examination changed from the Canadian Registered Nurse Examination to the NCLEX-RN, and pass rates declined. METHODS: This comparative analytic study examined NCLEX-RN pass rate data for 2015, 2016 and 2017 using publicly available data. The Canadian data were compared with that from U.S. nurses taking the examination. RESULTS: Overall year-end pass rates among Canadian writers appeared to improve significantly in 2016 (95% to 96.3%, p < 0.001, from 2015 to 2016) but declined again from 96.3% to 90.4% in 2017 (p < 0.001). Pass rates remain significantly lower for first attempt Canadian writers compared to first attempt U.S. writers (2015: 69.7% vs. 84.5%, p < 0.001). CONCLUSIONS: The change in licensing examination had a major impact on pass rates for new graduates entering the nursing profession and potentially the number of new nurses entering the profession in Canada immediately after graduation. IMPLICATIONS FOR NURSING MANAGEMENT: A loss of entry-level workers to the nursing profession in Canada affects workforce management strategies, particularly with respect to worker shortages.