2023 NCLEX REPORT

Florida Center for Nursing
Headquartered at University of South Florida College of Nursing
12901 Bruce B. Downs Blvd., MDC 22
Tampa, FL 33612

Report Citation Information:
Florida Center for Nursing (2024). 2023 NCLEX Report.

This report was prepared by Rayna M. Letourneau, PhD, RN, Executive Director, Florida Center for Nursing.

If you require this report in an alternate format, please contact us at  FLCenterforNursing@usf.edu.

Acknowledgements

The Florida Center for Nursing would like to thank the following individuals and organizations for their contributions to the development of this report:

Abigail Carden, MPH, CPH
Data Engineer | Florida Center for Nursing

Alec Jimenez
Data Engineer | Florida Center for Nursing

College of Nursing
University of South Florida

Sherri Sutton-Johnson, DrPH, MSN/Ed, CCHW, CSM
Education Unit Director | Florida Board of Nursing

Serina McGlockton
Government Operations Consultant, Nursing Education | Florida Board of Nursing

Shu-chuan Kao, PhD
Senior Manager, Measurement & Testing | National Council of State Boards of Nursing

Hong Qian, PhD, PMP
Exam Development Manager, Examinations | National Council of State Boards of Nursing

Executive Summary

Consistent with Florida Statute §464.0195(5), the FCN shall annually report data related to the National Council Licensure Examination (NCLEX). Summary data for Florida’s test-takers’ performance on National Council of State Boards of Nursing’s two licensure examinations, the NCLEX-RN and NCLEX-PN, are provided.

Key findings

Florida ranks third in U.S. population. However, in 2023, Florida produced the greatest number of NCLEX-RN test takers in the nation. 18,178 (9.75%) of the nation’s 186,350 first-time, U.S.-educated NCLEX-RN test takers were from Florida.

Florida’s 2023 NCLEX-RN pass rate was 76.75%, below the national average of 88.56%. Florida’s 2023 NCLEX-PN pass rate was 74.87%, below the national average of 86.67%.

There has been a gap between the national pass rates and Florida’s pass rates over the past decade. The gap between the national pass rate and Florida’s NCLEX-RN pass rate was greatest in 2020 and Florida’s NCLEX-PN pass rate was greatest in 2021. Since 2020 and 2021, the gap between the national pass rate and the NCLEX-RN and NCLEX-PN has decreased, respectively.

Florida’s first-time pass rates increased from 2022 to 2023, however Florida’s performance is still lower than the U.S. average. Florida’s NCLEX-RN pass rates ranked 52 of 55 jurisdictions. Florida’s NCLEX-PN pass rates ranked 52 out of 54 jurisdictions.

Lastly, the number of Florida’s test-takers taking the NCLEX in places other than Florida has decreased from 14% (n = 3,212) in 2021 to 5.5% (n = 1,171) in 2023.

Table of Contents

Introduction

The Florida Center for Nursing (FCN) was established in Florida Statute in 2001. The purpose of the FCN is to address issues related to Florida’s nurse supply and demand. Consistent with Florida Statute §464.0195(5), the FCN shall annually report data related to the National Council Licensure Examination (NCLEX).

The Florida Center for Nursing’s 2023 NCLEX Report provides information about Florida’s NCLEX pass rates. Evaluation of NCLEX pass rates is a critical step in overall evaluation of the State’s nursing workforce as newly licensed nurses are often employed to fill vacant nursing positions. Graduates who fail the NCLEX cannot enter the workforce as nurses. A consistent inability for employers to fill vacant nursing positions may result in decreased access to quality and safe nursing care for the people and visitors of Florida.

Background and Significance

Several steps must be completed before a new nurse can earn a license to practice. These steps include graduating from an approved prelicensure nursing education program, meeting the requirements of the Florida State Board of Nursing (FBON), and passing the National Council Licensure Examination (NCLEX).

The National Council of State Boards of Nursing (NCSBN) develops the NCLEX to test the competency of nursing program graduates in the United States and Canada. The NCLEX is a variable-length, valid and reliable computerized adaptive test to measure nursing competence. The passing standards for the NCLEX-RN and NCLEX-PN reflect the amount of nursing knowledge, skills, and attitudes required to practice competently at the entry level of the profession. The number of candidates passing the NCLEX (“pass rate”) can indicate the number of new nurses entering the nursing workforce.

The NCLEX pass rate is often used as a measure of prelicensure nursing program effectiveness. Additionally, the NCLEX pass rates may influence important decisions about overall prelicensure nursing program quality, admission and progression policies, curricula, and teaching and learning practices. The purpose of this report is to provide data on Florida’s candidates’ performance for the NCLEX-RN and NCLEX-PN examinations for 2023 and trended over time that can be used for decision-making.

As newly licensed nurses enter practice, they are expected to make complex decisions regarding patient care. The NCSBN responded to the need to measure decision-making abilities and enhanced the NCLEX. On April 1, 2023, the NCSBN launched the Next Generation NCLEX (NGN), which uses real-world case studies to better measure nursing candidates’ clinical judgment and decision-making abilities.

Methodology

The NCLEX pass rate is considered the principal indicator of prelicensure nursing education quality. First-time pass rates were utilized for all data analysis in this report. This approach is consistent with the method used across the nation to compare results within and between jurisdictions.

NCLEX data is evaluated by a calendar year and not an academic year. The annual rates identified in this report reflect the results of first-time test-takers from January 1 through December 31 for each respective year, 2020-2023.

Annual NCLEX results are recorded by the NCSBN. When exams encounter delivery issues or require further investigation, the results are placed on hold and, as a result, are not available for inclusion in any reports, including the NCLEX Report 6 and the NCSBN statistical sheet. Additionally, Nursing Regulatory Bodies (NRBs) may void exams for various reasons, further contributing to the fluctuations in the total number of exams.

The statewide data were transferred from the NCSBN to the FBON then to the FCN on January 12, 2024. The data consisted of individualized, deidentified data. Variables included graduation date, education program, education program jurisdiction, exam series code (NCLEX-RN/NCLEX-PN), repeater (yes/no), grade (pass/fail), exam delivery date, and NCSBN jurisdiction (jurisdiction where test-taker tested).

The statistical sheet available at https://www.ncsbn.org/public-files/NCLEX_Stats_2023_Q4_PassRates.pdf utilized NCLEX data reconciled as of January 16, 2024. Once generated, this report is not updated to include additional exams released from score holds or to exclude exams voided by NRBs within the same reporting period.

National data containing quarterly numbers of test takers and number of first-attempt passed for each jurisdiction was reconciled by the NCSBN on January 16, 2024, then prepared and generated for the FCN on January 23, 2024. This data included any updates made in the NCSBN’s NCLEX database up to the evening of January 23, 2024.

The Florida Department of Health (DOH) Medical Quality Assurance (MQA) online search portal was utilized to determine the license status of Florida’s prelicensure nursing programs. Only programs that are approved, approved/probationary, or accredited are included in the DOH MQA online portal. Terminated or closed programs do not display. Listed below are the definitions of each license status per the DOH MQA website (https://mqa-internet.doh.state.fl.us/MQASearchServices/NursingPrograms).

APPROVED – A program for the pre-licensure education of professional or practical nurses that is conducted in the state at an educational institution and that is approved under Florida Statute §464.019. The term includes such a program placed on probationary status.

APPROVED / PROBATIONARY – The status of an approved program that is placed on such status pursuant to Florida Statute §464.019.

ACCREDITED – An “accredited” nursing education program, as defined by Florida Statute §464.003, is a program for the prelicensure education of professional or practical nurses that is conducted in the United States at an educational institution, whether in Florida, another state, or the District of Columbia, and that is accredited by a specialized nursing accrediting agency that is nationally recognized by the United States Secretary of Education to accredit nursing education programs. The specialized nursing accreditors are the Accreditation Commission for Education in Nursing (ACEN), Commission on Collegiate Nursing Education (CCNE) and the National League for Nursing Commission for Nursing Education Accreditation (NLN CNEA).

Nursing program licensure statuses as identified on the DOH MQA online search portal on January 16, 2024, were utilized for categorizing programs and data comparisons (see Appendix A and Appendix B).

All data in this report are presented in an aggregate format. Individualized program data can be found in Report 4 – Jurisdiction Program Summary of all First-Time Candidates Licensed in All Jurisdictions on the FBON website. The 2023 annual Report 4 for Florida’s RN programs can be found by accessing the following link. https://floridasnursing.gov/forms/2023%20RN%20Report%204%20–%20Jurisdiction%20Program%20Summary%20of%20all%20First-Time%20Candidates%20Licensed%20in%20All%20Jurisdictions%20%282%29.pdf.

The 2023 annual Report 4 for Florida’s PN programs can be found by accessing the following link. https://floridasnursing.gov/forms/2023%20PN%20Report%204%20–%20Jurisdiction%20Program%20Summary%20of%20all%20First-Time%20Candidates%20Licensed%20in%20All%20Jurisdictions%20%282%29.pdf.

In addition to statewide findings, the FCN deems it critical to evaluate NCLEX data at the regional level. The FCN divides the state into 8 geographic regions:

East Central Region consists of Brevard, Flagler, Lake, Orange, Osceola, Seminole, Sumter, and Volusia Counties.

North Central Region consists of Alachua, Bradford, Citrus, Columbia, Dixie, Gadsden, Gilchrist, Hamilton, Jefferson, Lafayette, Leon, Levy, Madison, Marion, Suwanee, Taylor, Union, and Wakulla Counties.

Northeast Region consists of Baker, Clay, Duval, Nassau, Putnam, and St. Johns Counties.

Northwest Region consists of Bay, Calhoun, Escambia, Franklin, Gulf, Holmes, Jackson, Liberty, Okaloosa, Santa Rosa, Walton, and Washington Counties.

South Region consists of Broward, Miami-Dade, and Monroe Counties.

Southeast Region consists of Indian River, Martin, Okeechobee, Palm Beach, and St. Lucie Counties.

Southwest Region consists of Charlotte, Collier, Glades, Hendry, and Lee Counties.

West Central Region consists of Desoto, Hardee, Hernando, Highlands, Hillsborough, Manatee, Pasco, Pinellas, Polk, and Sarasota Counties.

Findings

In 2023, Florida produced the greatest number of NCLEX-RN test takers in the nation. 18,178 (9.75%) of the nation’s 186,350 first-time, U.S.-educated NCLEX-RN test takers were from Florida. Additionally, 3,251 (6.84%) of the nation’s 47,552 first-time, U.S.-educated NCLEX-PN test takers were from Florida. In total, Florida yielded 21,429 (9.16%) of the nation’s 233,902 first-time, U.S.-educated NCLEX test takers in 2023.

The following tables demonstrate the distribution of first-time, U.S.-educated NCLEX test takers over each quarter of 2023.

Florida’s 2023 first-time NCLEX-RN pass rate was 76.75%, below the national average of 88.56%. On April 1, 2023, the NCSBN launched the Next Generation NCLEX (NGN), which uses real-world case studies to better measure nursing candidates’ clinical judgment and decision-making abilities. Quarters 2, 3, and 4 results were based on the NGN.

Florida’s 2023 NCLEX-PN pass rate was 74.87%, below the national average of 86.67%. On April 1, 2023, the NCSBN launched the Next Generation NCLEX (NGN), which uses real-world case studies to better measure nursing candidates’ clinical judgment and decision-making abilities. Quarters 2, 3, and 4 results were based on the NGN.

Florida’s pass rates falling below the national average has been a consistent trend over the past 4 years for both NCLEX-RN and NCLEX-PN rates.

There has been a gap between the national pass rates and Florida’s pass rates over the past decade. The gap between the national pass rate and Florida’s NCLEX-RN pass rate was greatest in 2020 when there was a 17.74 percentage point difference. The gap between the national pass rate and Florida’s NCLEX-PN pass rate was greatest in 2021 when there was a 17.05 percentage point difference. Since 2020 and 2021, the gap between the national pass rate and the NCLEX-RN and NCLEX-PN has decreased to 11.81 and 11.80 percentage points, respectively.

Comparison of jurisdictions and pass rates.

When compared to other jurisdictions, Florida’s NCLEX-RN pass rates ranked 52 of 55 and Florida’s NCLEX-PN pass rates ranked 52 out of 54. Florida had the most NCLEX-RN test takers and the second-highest number of NCLEX-PN test takers of all jurisdictions. The following tables provide the complete rank ordering of U.S. jurisdictions for NCLEX-RN and NCLEX-PN pass rates.

Comparison of pass rates and program license status.

Prelicensure nursing education programs with nursing specialty accreditation had higher pass rates each year from 2020 through 2023.

Comparison of pass rates and institutional characteristics.

Pass rates for public, private nonprofit, and private for-profit institutions were trended over time. The following tables compare pass rates for Florida’s public and private institutions from 2020 through 2023.

From 2020 through 2022, private for-profit institutions had the greatest number of NCLEX-RN test takers but lower NCLEX-RN pass rates than private nonprofit and public institutions.

In 2023, Florida’s public programs (87.63%) produced the greatest number of NCLEX-RN test takers and had higher pass rates than private nonprofit programs (87.47%) and private for-profit programs (71.34%).

The NCLEX-RN pass rates for Florida’s private for-profit programs has increased from 2021 to 2023.

Comparison of pass rates and length of time from graduation to test taking.

Candidates that completed the NCLEX in the first month after graduation had the highest pass rates. Candidates that waited 2 months after graduation to test had lower pass rates than those that had a test date closer to their graduation date. The more time that passed from graduation to dates of test, the lower the pass rates. This finding has been consistent when evaluating data from 2020 through 2023.

Comparison of pass rates and testing state.

In 2023, the majority of Florida’s NCLEX test takers completed the NCLEX-RN or NCLEX-PN examination process in Florida, however 5.5% of test takers completed the examination process in a jurisdiction other than Florida. In comparison, in 2020 13.9% of test takers completed the examination process in a jurisdiction other than Florida.

Regional Findings

Of the 8 regions of Florida, the South region produced the most test takers in 2023, followed by the West Central, Southeast, and East Central regions.

In 2023, the Northeast region had the highest pass rate for all test takers, followed by the Northwest and West Central regions.

In 2023, the largest number of Florida’s first-time NCLEX-RN test takers were from the South region (n = 4,654). However, the Northeast region demonstrated the highest first-time NCLEX-RN pass rates.

When evaluating BSN prepared test-takers in 2023, the largest number of Florida’s first-time BSN prepared NCLEX-RN test takers were from the South region (n = 1,797). However, the Northwest and Northcentral regions demonstrated the highest first-time NCLEX-RN pass rates.

When evaluating associate degree prepared test-takers in 2023, the largest number of Florida’s first-time ADN prepared NCLEX-RN test takers were from the South region (n = 2,843). However, the Northeast region demonstrated the highest first-time NCLEX-RN pass rates.

From 2022 to 2023, NCLEX-RN pass rates increased in all regions of Florida.

In 2023, the largest number of Florida’s first-time NCLEX-PN test takers were from the South (n = 538) and West Central (n = 537) regions, However, the Northwest and Northeast regions demonstrated the highest first-time NCLEX-PN pass rates.

From 2022 to 2023, NCLEX-PN pass rates increased in all but one region of Florida.

Limitations

While the FCN aims to disseminate the most accurate information with the highest level of transparency, there are certain limitations that may impact the findings in this report.

The NCLEX ID and graduation date are self-reported variables provided by candidates at the time of their registration for the NCLEX exam. As this information is based on candidates’ self-disclosure, we do not have the means to verify its accuracy. Consequently, we maintain the candidates’ data as provided in our database without any alteration.

There is minor variability between the statistics published on the 2023 NCSBN statistic sheet (https://www.ncsbn.org/public-files/NCLEX_Stats_2023_Q4_PassRates.pdf), what is reported by the Florida Center for Nursing, and what may be reported by other state workforce centers across the U.S. This variability is due to the implementation of the score hold review process for the NCLEX exam. When exams encounter delivery issues or require further investigation, the results are placed on hold and, as a result, are not available for inclusion in any reports, including the NCLEX Report 6 and the NCSBN statistical sheet. Additionally, Nursing Regulatory Bodies (NRBs) may void exams for various reasons, further contributing to the fluctuations in the total number of exams. The statistical sheet available at https://www.ncsbn.org/public-files/NCLEX_Stats_2023_Q4_PassRates.pdf utilized the NCLEX data reconciled as of January 16, 2024. Once generated, this report is not updated to include additional exams released from score holds or to exclude exams voided by NRBs within the same reporting period. The Report 6 data files that were prepared for the FCN were generated on January 23, 2024. These files include any updates made in the NCSBN’s NCLEX database up to the evening of January 23, 2024.

Additional variation between the findings of the 2023 NCLEX Report and previously published reports by the FCN are the result of reclassification of codes.

With manual analyzation of data, there is a certain level of uncertainty and possible misclassification of institutional characteristics. The FCN strives for excellence and will continue to work with colleagues at the Florida Board of Nursing and Florida Department of Education to improve these processes.

Appendix A.

MQA export RN programs

Appendix B.

MQA export PN programs

Appendix C.

NCLEX statistics from NCSBN

Appendix D.

List of Abbreviations