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NCLEX Pass Rates Are Falling: What Nursing Programs Are Doing About It
The Next Generation NCLEX (NGN), introduced in April 2023, changed how new nurses are evaluated by placing greater emphasis on clinical judgment and decision-making in realistic patient care scenarios. After first-time U.S.-educated pass rates climbed from 88.6% to a decade high of 91.2% in 2024, the numbers reversed. In 2025, first-time U.S.-educated RN pass rates fell to 86.7%, down from 91.2% in 2024, while the all-candidates RN pass rate declined from 73.3% to 69.1% over the same period. NCLEX pass rates are declining at the same time the nursing workforce shortage is placing even greater pressure on the pipeline of newly licensed nurses.
For program directors, that combination is both a clinical education problem and an institutional accountability problem. The programs that are maintaining strong pass rates are not doing one thing differently. They are doing several things differently, consistently, and in coordination with each other.
What NCLEX Pass Rate Trends Tell Us
The national trends suggest that the 2025 decline is more than a temporary adjustment to the Next Generation NCLEX (NGN). While some programs experienced an initial drop in pass rates following the NGN launch in 2023, many recovered by 2024 as they adapted to the new exam format and its emphasis on clinical judgment. In 14 states with five years of available data, schools that saw declines in 2023 returned to or exceeded their pre-NGN pass rates by 2024, indicating that the initial transition was temporary.
The 2025 decline points to a different challenge. By then, the NGN was no longer new, the passing standard had not changed, and nursing programs had already had time to adapt. At the same time, the number of first-time U.S.-educated RN candidates increased from 186,760 in 2024 to 192,916 in 2025, making it unlikely that a smaller testing population explains the decline.
While the data does not point to a single cause, it reinforces an important reality: the NGN measures clinical judgment differently than previous versions of the exam. As a result, nursing programs are taking a closer look at how curriculum, clinical experiences, assessment strategies, and simulation work together to prepare students for both licensure and clinical practice.
How Next Generation NCLEX Changed What Programs Need to Prepare For
The Next Generation NCLEX (NGN) evaluates clinical judgment differently than previous versions of the exam. Rather than emphasizing knowledge recall alone, it measures how students gather information, recognize cues, prioritize care, and make clinical decisions using the NCSBN Clinical Judgment Measurement Model (NCJMM).
Traditional remediation strategies, such as content review and question banks, help reinforce knowledge, but they do not fully develop the clinical reasoning skills the NGN is designed to assess. As a result, many nursing programs have expanded their approach, embedding clinical judgment throughout the curriculum rather than concentrating preparation in the weeks before the exam.
Developing clinical judgment requires repeated practice across the curriculum. Classroom instruction, skills labs, simulation, and clinical experiences each contribute to that process, giving students multiple opportunities to apply the Clinical Judgment Measurement Model before they encounter it on the NCLEX or in patient care.
What Nursing Programs With Improving Pass Rates Have in Common
While every nursing program is different, those that have maintained or improved their NCLEX pass rates tend to share several common practices. Rather than relying on a single intervention, they take a coordinated approach to developing clinical judgment throughout the curriculum.
- Align assessments with the Clinical Judgment Measurement Model (NCJMM) throughout the curriculum, not just during NCLEX preparation.
- Provide repeated opportunities for students to apply clinical reasoning in realistic learning environments before entering clinical practice.
- Use performance data to identify at-risk students early and provide timely remediation.
- Invest in faculty development so instructional strategies remain aligned with current NCLEX expectations.
Simulation supports several of these strategies by giving students repeated opportunities to apply clinical judgment in realistic patient care scenarios. Beyond developing decision-making skills, simulation performance may also provide valuable insight into student readiness. Studies have identified statistically significant relationships between simulation performance and NCLEX outcomes, suggesting simulation data can help programs identify at-risk students and target remediation before the exam.
Where Simulation Fits Within a Multi-Intervention NCLEX Strategy
Simulation is not a standalone NCLEX solution. It is a clinical judgment development tool that functions most effectively when integrated into a curriculum that already values reasoning over recall. That integration is where simulation has the greatest educational impact.
High-fidelity simulation using physiologically accurate patient responses gives students the practice conditions that written case studies cannot replicate. When a student manages a deteriorating patient whose physiology responds to their clinical decisions in real time, they are building the pattern recognition and adaptive reasoning that the NGN is designed to measure.
Simulation also provides educators with valuable insight into student readiness. Studies have identified statistically significant relationships between simulation performance and NCLEX outcomes, suggesting that simulation data can help identify at-risk students earlier and support more targeted remediation. Used alongside other assessment methods, simulation becomes both a learning experience and a source of meaningful performance data.
Elevate Healthcare’s (formerly CAE Healthcare) patient simulators are powered by Maestro, a simulation operating system with modeled physiology that enables realistic patient responses to learner interventions. Rather than rehearsing scripted sequences, students experience the clinical consequences of their decisions in real time, strengthening the clinical judgment skills the NGN is designed to assess.
Why Faculty Development Is Part of an Effective NCLEX Strategy
Faculty development is one of the most overlooked components of an effective NCLEX strategy. A program can invest in simulation equipment and question banks without fundamentally changing how faculty teach or how students develop clinical judgment. Faculty development helps close that gap by equipping educators to design learning experiences that build clinical reasoning, not just assess it.
The Elevate Learning Institute‘s Outcomes-Based Education Programs support this approach by helping educators strengthen the skills needed to develop clinical judgment. The Simulation and Clinical Readiness track focuses on designing, facilitating, evaluating, and debriefing simulation experiences that improve learning outcomes and prepare students for the clinical reasoning demands of the NGN.
Faculty who understand how to structure scenarios around clinical judgment frameworks and how to debrief in ways that surface reasoning processes produce learners who are better prepared, not just for the exam, but for the clinical environments they will enter afterward. Structured faculty development also creates consistency. When every faculty member in a program facilitates clinical judgment development with the same framework and the same quality of debrief, the program stops depending on individual faculty skill and creates a more consistent learning experience across the program.
How Programs Measure NCLEX Improvement and Document It for Accreditors
Accreditation bodies expect nursing programs to demonstrate more than strong NCLEX pass rates. They also expect evidence of performance trends, the interventions implemented to improve outcomes, and the results of those efforts. As a result, the ability to collect and analyze performance data becomes a strategic priority rather than simply an operational tool.
Simulation platforms such as LearningSpace help programs capture and analyze learner performance over time. Rather than evaluating a single simulation in isolation, educators can identify patterns across cohorts, determine where students consistently struggle, evaluate whether specific scenario types correlate with later exam performance, and measure the impact of curriculum changes over time.. That data gives program directors the evidence they need to demonstrate continuous quality improvement to accreditors, and to make the internal case for sustained investment in simulation infrastructure as part of the NCLEX improvement strategy.
A Measurable Path Forward
Declining NCLEX pass rates are a curriculum problem before they are a preparation problem. Programs that address the underlying clinical judgment through coordinated improvements across curriculum, assessment, faculty development, and simulation are building a more sustainable foundation for long term NCLEX success and practice readiness.
Elevate Healthcare gives nursing programs the connected tools to build that infrastructure. The Elevate Learning Institute equips faculty to design and facilitate the experiences that make simulation educationally effective, while LearningSpace generates the performance data that programs can show accreditors. Connect with a simulation expert today.