Predicting NCLEX-RN success: can it be simplified?

The purpose of this study was to compare a simple, easily calculated method for predicting student success on the nursing licensure exam (NCLEX-RN) with more statistically complex methods of prediction. The Risk Appraisal Instrument (RAI), designed by Barkley, Rhodes, and Dufour (1), does not require sophisticated statistical methods, and the authors suggest it may be adapted for use in other nursing programs. We modified the RAI to suit the University of Delaware nursing program, and retroactively applied the Delaware RAI (DRAI) formula to the records of 538 students who graduated from our undergraduate baccalaureate nursing program between 1995 and 1998. Nearly 61 percent of NCLEX-RN failures were correctly classified, and 72 percent were accurately classified overall. While this more simple prediction might be helpful as a predictor of risk, it does not approach the 76 percent to 92 percent correct prediction of failure in recently published studies using statistically more complex methods.