We are writing in response to Dr. Joanne Noone's letter regarding our recent publication (). We appreciate the insightful thoughts that were mentioned in the letter. We wanted to clarify several points:
First, it is important to note that the study's data examined NCLEX-RN first-time pass from a single institution and that the results may not be generalizable to all educational institutions. We considered the admission criteria in the institution, which included GRE. Regarding recommending GRE for the accelerated baccalaureate program, our study found that the overall GRE score did not predict an Accelerated Bachelor of Science in Nursing (ABSN) first-time NCLEX-RN pass. However, only GRE verbal reasoning significantly predicted first-time NCLEX-RN pass among ABSN students. Thus, GRE verbal reasoning score may be more reflective of students' critical thinking and logical reasoning attributes, which may be critical for passing the NCLEX-RN exam (). Given the fast-paced nature of the ABSN program, in which students are expected to graduate within 12 to 18 months, identifying the academic predictors, including GRE verbal reasoning as a factor, may provide an argument for an institution to identify ways to assess the ABSN applicants on critical thinking and/or reasoning, an essential skill for future practicing nurses. Regarding gender and race and ethnicity, the Miller and Stassun () study stated that overall GRE scores and/or GRE quantitative measures were primarily scrutinized as an admission criterion for the STEM (science, technology, engineering, and math) programs. In addition, Miller and Stassun () point out some admission committees' use of minimum GRE scores to filter potential applicants. Our study used the overall GRE, GRE quantitative, and verbal reasoning as continuous variables. Moreover, our conclusion indicated the need for further studies before recommending the use of GRE verbal reasoning as an admission criterion. We also suggested considering other admission criteria that could evaluate ABSN students' critical thinking and logical reasoning, which could be a viable alternative to using GRE verbal reasoning. We agree with Dr. Noone that graduate programs have dropped the GRE as an admission requirement. To remove the financial burden of the applicants in the institution referred to in this article, starting the 2019 admission cycle, GRE was no longer a required criterion for ABSN applicants. Instead, admitted applicants were offered a free voucher for the GRE, which was required before starting the program (, p. 11–12). The intent of requiring GRE was to allow ABSN graduates not to take the exam if they applied to a graduate program in the institution that required the GRE for admission. In addition, our article focused on examining the graduating cumulative GPA, and not the GPA at admission, for ABSN students who have different degrees (Baccalaureate or higher degree) from various schools with different measures of academic grading (). As Dr. Noone's letter indicates, the final GPA was a predictor of passing NCLEX first-time passing.
Second, we agree that factors other than academic predictors should be examined. However, when writing the article, few studies investigated the ABSN student population. Thus, we aimed to identify potential predictors of ABSN NCLEX-RN first-time pass, including academic ones. We recognize a shortage of such studies using an inclusive equity lens. Although our study has demonstrated that academic factors were significant predictors of ABSN students' first-time NCLEX-RN pass, we did argue the need to consider other factors, such as attributes and experiences that could contribute to ABSN students' success in passing the NCLEX-RN for the first time (). In addition, our study investigated whether the use of Kaplan Diagnostic and Comprehensive tests as predictors of ABSN NCLEX first-time pass, which were also significant predictors. Thus, nursing education programs may incorporate Kaplan tests or other standardized examinations to help gauge ABSN students' preparedness for the NCLEX-RN exam and to promote their licensure success. In the conclusion, we also highlighted the importance of the program's academic environment in ABSN students' NCLEX-RN first-time pass, such as peer tutorial fellows or graduate teaching assistants, as well as faculty members' role in helping students who need further academic support while in the program.
Finally, Noone () recommends considering either second attempt pass rates or passing the NCLEX-RN within a 6-month to 1-year period. As we mentioned, our study () focused on first-time NCLEX-RN pass as a means to address the current shortage in the nursing workforce. Thus, ABSN students passing NCLEX-RN for the first time can join the nursing workforce as an RN faster.
We appreciate the opportunity to respond to Dr. Noone's valuable comments, and we hope we have addressed the concerns outlined. We aim to build upon our study's findings to examine strategies adopted by nursing education programs and nurse educators to foster licensure success among a diverse nursing workforce.
Khadejah F. Mahmoud, PhD, MSN
The Hashemite University, Zarqa, Jordan
Jian Zhao, MSN, RN
University of Pittsburgh School of
Nursing
Do Kyung Kim, MPH, BSN, RN
University of Pittsburgh School of
Nursing
Vivian Hui, PhD, RN
The Hong Kong Polytechnic University
Julius Kitutu, PhD, MSc, MEd
University of Pittsburgh School of
Nursing
References
- Mahmoud , K. F., Zhao , J., Kyung Kim , D., Hui , V., Kitutu , J. (2024). Predictors of first-time NCLEX-RN pass rate in accelerated Bachelor of Science in nursing students. Journal of Nursing Education, 63(1), 10–16–. PMID:
- Miller , C., Stassun , K. (2014). A test that fails. Nature, 510(7504), 303–304–.
- Noone , J. (2022). Creating inclusive learning environments: Challenging and changing the paradigm. Journal of Nursing Education, 61(3), 115–116–. PMID: