Five Philly-area nursing programs are off a state watch list as more of their grads pass licensure exam

Five Philadelphia-area nursing programs are no longer on a state watch list after their graduates’ performance improved last year on the nursing licensure exam, data from the Pennsylvania State Board of Nursing shows.

Programs at universities including Thomas Jefferson and Temple are again operating without special oversight from the nursing board, after exceeding a state requirement that at least 80% of their graduates pass the licensure exam on their first attempt.

Scores have increased nationally for tests taken in the year ending September 2023, following a decline in the previous year that educators attributed to lost learning time during the COVID-19 pandemic.

The latest test scores also reflect the first round of licensure testing with a new exam format designed to better capture how well graduates are prepared to work with patients.

» READ MORE: Six Philly-area nursing schools are being watched by state board

Overall, the pass rate for first-time test takers in Pennsylvania was 91%, four points higher than the national rate. That compares to 84% last year.

The state’s nursing board pays close attention to the pass rate at each nurse training program and requires at least 80% of each institution’s first-time test takers pass. Last year, the board told six Philadelphia-area programs with pass rates below the benchmark they were operating with “provisional” approval — a status that allows the state to demand reports, make campus visits, and restrict enrollment.

Scores improved sufficiently for the board to restore the programs to “full” approval the bachelor of science in nursing programs at Gwynedd-Mercy University, Jefferson College of Nursing, Widener University, and Temple University, as well as the associate of science in nursing at Delaware County Community College.

The only local program that did not improve its test scores was Lincoln University, which was the state’s only nursing program at a historically Black college or university until it closed last spring. Only 41% of graduates of its bachelor’s program taking the test for the first time last year passed, the lowest rate in the state.

To work as a registered nurse, graduates of nursing schools need to pass the National Council Licensure Examination, or NCLEX. The exam’s annual pass rate is tracked by the Pennsylvania nursing board and is the main quality metric used to approve educational programs.

» READ MORE: Lincoln University closes its nursing program, leaving a hole in the pipeline of Black nurses

The national NCLEX pass rate dropped to 80% in the 2021-2022 testing cycle — the lowest rate in a decade. Twenty-three out of roughly 90 nursing programs in Pennsylvania fell below 80%. That included the six programs in the Philadelphia area.

But this year, only five programs across the state had a pass rate under 80%. In the Philadelphia area, the only program affected is the now-closed program in Chester County’s Lincoln University.

The increase in pass rates will help to expand the labor pool of registered nurses at a time when many hospitals are reporting they cannot hire enough nurses. Pennsylvania allows graduates to begin working before passing the exam with a temporary permit, but many other states do not.

Educators attribute the increase in scores to two factors: nursing students returning to in-person learning after the pandemic and a new version of the NCLEX exam.

At the height of the pandemic, programs struggled to give students clinical experience when hospitals had closed their doors to all nonessential workers.

“Programs are seeing a return to their pre-COVID scores,” said Anne Krouse, the dean of the school of nursing at Widener University in Chester.

Widener’s program was among the six Philadelphia-area programs that dipped below the 80% benchmark in the last testing cycle. Their latest pass rate is 90%.

Still, the impacts of the pandemic continue. Students are arriving to college from high school less prepared, especially in topics such as math.

“We’re still seeing learning losses from students coming out of high school,” Krouse said.

The National Council of State Boards of Nursing, the nonprofit that administers the exam, launched a new format last April that had been in the works for a decade.

The organization’s research had found that clinical judgment and problem solving account for 60% of a nurse’s job and wanted the exam to reflect that.

Called Next Generation NCLEX, the revised exam no longer asks only questions that tests the ability to recall a specific fact. Instead, graduates get patient scenarios and the questions walk them through the steps they would have taken at the bedside.

“There was a fundamental change in making the exam look like the work they actually do,” Philip Dickison, CEO of NCSBN, said.

» READ MORE: As many nurses say they plan to leave bedside care, these Philly-area grads can’t wait for their first hospital job

The new format incentivizes educators to focus on preparing students for nursing jobs, and to think through problems that they would face, said Marie Ann Marino, dean of the college of nursing at Jefferson.

Being ready for the job on day one is more important now than ever, she said, as many veteran nurses left the field and nurses out of schools are filling vacancies in hospitals and clinics.

“These new graduates are really playing a pivotal role in health care,” Marino said. “The Next Generation NCLEX will help us.”