NCLEX-RN pass rate peril: one school's journey through curriculum revision, standardized testing, and attitudinal change

Processes used by a university to reverse the downward spiral of NCLEX-RN pass rates are described. Reasons for poor pass rates were found to be multifaceted and included gaps in curriculum content, student attitudes toward taking the licensure exam, delays in taking the exam following graduation, inadequate student preparation for taking standardized exams, and inappropriate and ineffective exit examinations. Various strategies for reversing the trend of the NCLEX failure rate included: addressing areas of weakness in the curriculum; revising courses; engaging students; changing standardized exit exams; employing a midcurricular and other standardized exams; and implementing remedial courses for poor performance on standardized exams. Change was effected and pass rates on the NCLEX-RN improved dramatically. Future possibilities and proactive measure are described.