It is important for a nursing program to determine which variables are good predictors of student success or failure on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) (1). Significant predictors for success may include such variables as National League for Nursing (NLN) Achievement Test scores, grade point averages (GPA), American College Test (ACT) and Standardized Assessment Test (SAT) scores, and grades in various nursing courses.
The purpose of this study was threefold: to determine which variables have the greatest predictive value of success on the NCLEX-RN; to investigate the efficacy of the continued use of standardized NLN Achievement Tests; and to develop and evaluate a new assessment instrument, the NCLEX-RN Risk Appraisal Instrument, which allows nursing educators to quickly assess a student's risk of failure by examining school records. Data were obtained from undergraduate nursing students at a large university in the Southeast. The potential predictors used included nursing theory course grades, nursing clinical course grades, and NLN Achievement Test scores.
It was hypothesized that students' scores on standardized tests can predict performance on the NCLEX-RN. To test this hypothesis, the relationships between students' scores on the Psychiatric, Obstetric, Pediatric, and Adult NLN Achievement Tests were investigated.
It was also hypothesized that achievement in particular nursing courses could predict performance on the NCLEX-RN. To investigate this hypothesis, the relationships between letter grades in six courses and NCLEX-RN performance were investigated. The six courses were Adult Health Nursing I and II, Psychiatric Mental Health Nursing, Obstetric Nursing, Pediatric Nursing, and Nursing Care of the Critically Ill. These specific courses were selected because their theoretical content was most consistent with information tested on the NCLEX-RN. It was also predicted that significant relationships could be found between failing the NCLEX-RN and earning Cs in theory courses and earning a C in any clinical course.
Review of the Literature A 1993 study by Wall, Miller, and Widerquist, which explored computerized NCLEX-RN success, examined variables at three time points: prior to admission, during the course of a nursing program, and at graduation (2). Of variables available prior to admission, sophomore GPA, GPA for science courses, and high school rank were found to be significant predictors of performance on the NCLEX-RN. High school rank was less significant in its ability to predict NCLEX-RN performance than the other two prenursing variables. These results suggest that early identification of "at risk" students is possible. Among academic variables obtained during the course of a nursing program, scores obtained on NLN Achievement Tests, the nursing GPA, the Mosby Assess Test, and the NLN Diagnostic Readiness Test appeared promising as predictors of success on the NCLEX-RN.
Similarly, Waterhouse, Carrol, and Beeman (1993) investigated the usefulness of certain variables in predicting NCLEX-RN performance at three different time periods: and of the junior year, between semesters of the senior years, and at graduation (3). They found that grades in physiology and pathophysiology, the second junior nursing course grade, the first senior course grade, the sophomore grade point index (GPI), and GPI at the time of graduation were all significant predictors of success on the NCLEX-RN.
Overall, success rate prediction is often reported as …