The nursing shortage is a concern that has been plaguing the healthcare industry for some time now. Many solutions have been proposed and implemented to alleviate this shortage, but the new pass rates for the Next Generation NCLEX have sparked both hope and skepticism. 


The New Next Generation NCLEX: A Game-Changer? 

You may have heard that in 2023 the exam to license nurses in the United States went through a massive overhaul.  The first quarter of the Next Generation NCLEX (April-June) saw a significant 24% increase in the number of people who passed the NCLEX-RN exam compared to the previously administered exam. The increase was prominent across all test takers both domestically and internationally. 

On the surface, these numbers appear to be a positive development. More people passing the exam means more qualified nurses entering the workforce, right? However, a closer inspection of these statistics raises some questions about the sudden increase and its potential impacts on patient safety. 

If we look at just at US students: 

  • In the first quarter of 2023 (January to March), the pass rate for NCLEX-RN was 80.48%​​. 
  • For the second (April to June) and third quarters (July to September), the pass rates improved to 94.32% and 90.69%, respectively​​. 

When you look at international pass rates: 

  • In the first quarter (January to March), the pass rate for first-time internationally educated nurses was 39.87%​​. 
  • For the second quarter (April to June), that pass rate increased to 61.23%.
  • For the third quarter (July to September), the pass rate was 56.27%​​. 

This improvement in pass rates indicates that a significantly higher number of nurses were able to pass the NCLEX in the later quarters of the year and enter the workforce.   

Compared to the overall Q1 pass rate (57.79%) there were 6,963 more nurses who passed the NCLEX in Q2, and 15,945 more in Q3.   That means almost 23,000 new nurses entered the workforce who we would have said were not ready just a few months prior.  


Patient Safety: The Main Objective

The changes made to the Next Generation NCLEX were aimed at increasing patient safety and reducing errors associated with the clinical judgment decision-making of novice nurses. The National Council of State Boards of Nursing (NCSBN) has touted this as evidence of the new exam’s effectiveness. But does this increased pass rate truly correlate with better patient outcomes and safety? 

Speaking from the standpoint of someone who has spent my career helping international students create career trajectories in the US, I am not advocating for creating additional barriers for anyone.  However, I must express concern over the rapid change in pass rates from a purely statistical perspective which makes me question the potential unintended outcomes.  We must ask, are we compromising the quality of care in a quest to resolve the nursing shortage? 


A Balanced Approach is Needed 

A balanced approach is crucial in addressing these concerns. It’s vital to resolve the nursing shortage, but not at the expense of patient safety and care quality. Nursing demands continuous assessment, critical thinking, and clinical judgment. The influx of new nurses should be seen as a positive development, provided it genuinely reflects their competence and readiness to provide top-quality patient care. 

Further studies, open discussions, and potential adjustments to the examination process are necessary. Ensuring that the Next Generation NCLEX meets its objectives without unforeseen negative outcomes is essential. In healthcare, where stakes are high, the priority must always be to offer safe, compassionate, and skilled care to patients. 

To support nursing students in becoming more career and real-world ready, educational institutions could consider offering more diverse and comprehensive training solutions. These might include enhanced clinical simulations, expanded curricula that cover emerging healthcare challenges, and partnerships with healthcare facilities for real-world exposure. By doing so, schools can help bridge the gap between academic training and the practical demands of nursing, ensuring graduates are not only ready to pass exams but also to excel in their nursing careers.