Baccalaureate education and NCLEX: the causes of success

A systems framework was used to study the unusual failure rate on the National Council Licensing Examination (NCLEX) experienced by one-third of the 1983 graduates of a Northwestern Bachelor of Science Nursing (BSN) program. The study group included 176 graduates; 28 were nonsuccessful and 148 were successful candidates. All candidates experienced an integrated curriculum in the two-year nursing major. This comprehensive study addressed the conceptual and experiential areas of the curriculum as well as student academic potential and performance. It is one of the first research reports to include the new NCLEX as the dependent variable. Data were analyzed for correlational and causal relationships using regression analysis and tests of statistical inference. Results indicated that graduates who entered the program with low SAT scores, low cumulative and Science GPAs, who scored below the class mean on School of Nursing examinations and whose cumulative grade point averages drifted downward while in the School of Nursing were at a significantly high risk of failing the NCLEX. It was demonstrated that the bulk of the learners attracted to the University program fell in the B to C range of academic performance, some graduates were dissatisfied with faculty teaching skill and methods, as well as with the amount of hands-on experience available either in skills labs or clinical settings. The integrated curriculum used by the School of Nursing, threading concepts across practice areas, also presented a difficulty for students. Overall, the study indicated a concern about whether the avant-garde integrated curriculum and teaching methods used by the School of Nursing met the needs of average learners attracted to the program.