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Evaluating the Impact of National Council Licensure Examination

Stephen F. Austin State University Case Study

Evaluating the Impact of National Council Licensure Examination 
Review Courses Integrated Into Nursing Capstone
Christopher Ryan DNP, RN
Joanie Selman MSN, RN
Stephen F. Austin State University
Richard and Lucille DeWitt School of Nursing


A decrease in the National Council Licensure Examination (NCLEX-RN®) pass rates in 2013 have prompted efforts to increase student preparedness in nursing programs (5). Each course within the Richard and Lucille Dewitt School of Nursing is analyzing current teaching methods and implementing evidence-based interventions to improve student testing performance on course standardized tests. The Nursing Capstone Course is one such course that integrates a comprehensive preparation for the state licensure exam with the application of that knowledge in the clinical setting. NCLEX-RN®  style review courses, although varying in structure, content, and length, as well as standardized testing, benchmarking and remediation, have shown to have a positive impact on NCLEX-RN® pass rates (1,2,3,4). The decision was made to incorporate two different structured NCLEX-RN® review courses, provided through Hurst Review Services®, within the Nursing Capstone Course, to replace previous in-class teaching methods, such as team activities, case studies, and self-guided reviews. This study is aimed at evaluating the efficacy of this Evidence-Based change in teaching/learning.


The major research questions are:
Does the inclusion of a Hurst NCLEX-RN® Live Review improve student performance on standardized comprehensive exams?
Does the inclusion of the companion product, Hurst elevate® further improve student performance on standardized comprehensive exams?
Is the inclusion of the Hurst NCLEX-RN® Live Review and the companion product, Hurst elevate®, an effective way to improve student performance on the NCLEX-RN®?


Standardized comprehensive exams
NCLEX-RN® Exam first-time test taker pass rate


Quantitative data collection was used to evaluate the efficacy of the teaching method.
Data Collection Time Period Fall 2015 to Fall 2018 (3 years)
Participation in this study was voluntary for students with the ability to opt-out of the inclusion of their testing scores.
All students participated in the review courses and webinar/internet activities.
Approval for the Study was obtained from the IRB at Stephen F. Austin State University. 
A standardized comprehensive exam was given after the Hurst NCLEX-RN® Live Review and supporting videos and a second standardized comprehensive exam was given upon completion of the companion product, Hurst Elevate®.
NCLEX-RN® first-time pass rates were collected from the Texas Board of Nursing report following graduation.



The initial standardized comprehensive exam mean scores improved slightly but had no statistical significance. 
The second standardized comprehensive exam showed marked improvement in mean test scores following the six-week intense guided study plan (companion product, Hurst elevate®)
NCLEX-RN® mean scores also showed a statistically significant improvement in first-time NCLEX pass rates. 


The inclusion into Capstone of the Hurst NCLEX-RN® Live Review and the companion product, Hurst elevate®, increased students’ test scores on the standardized comprehensive exams as well as the NCLEX-RN® pass rate for first-time test-takers.  
Implications for Practice: Although many confounding factors affect NCLEX-RN® pass rates, the implications of this study are that an intense guided study in Capstone, such as the one provided by Hurst Review Services® has a net positive impact improving NCLEX-RN ® pass rates and standardized test scores. Therefore, the Hurst NCLEX-RN® Live Review and companion product, Hurst elevate®, integrated into Nursing Capstone should continue to be utilized. 

Everything You Need to Pass the NCLEX


Bonis, S., Taft, L., & Wendler, C. (2007). STRATEGIES to Promote Success on the NCLEX-RN®: An Evidence-Based Approach Using THE ACE STAR MODEL OF KNOWLEDGE TRANSFORMATION.Nursing Education Perspectives (National League for Nursing),28(2), 82-87.
Horton, C., Polek, C., & Hardie, T. L. (2012). The relationship between enhanced remediation and NCLEX success.Teaching & Learning in Nursing,7(4), 146-151. doi:10.1016/j.teln.2012.06.002\
Hyland, J. R. (2012). Building on the evidence: Interventions promoting NCLEX success.Open Journal Of Nursing,2(3), 231-238. doi:10.4236/ojn.2012.23036
Morton, A. (2008). Improving NCLEX scores with structured learning assistance…reprinted with permission from Morton AM. Improving NCLEX scores with structured learning assistance. Nurse Educ 2006;31(4):1631-65.CIN: Computers, Informatics, Nursing, 89S-91S.
NCLEX-RN® is a federally registered trademarks and service marks of the National Council of State Boards of Nursing, Inc.
The Hurst Live Review and Hurst Elevate are registered trademarks for Hurst Review Services. Retrieved From
The Texas Board of Nursing. (2015). Report of 2014 NCLEX-RN® Examination Pass Rates for Professional Nursing Education Programs. Retrieved from