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

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.

In January 2015, the entry-to-practice licensing examination changed from the Canadian Registered Nurse Examination to the NCLEX-RN, and pass rates declined.

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.

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).

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.

A loss of entry-level workers to the nursing profession in Canada affects workforce management strategies, particularly with respect to worker shortages.