Can Simulation Predict NCLEX-RN Success?

Published:December 02, 2022DOI:


      • A relationship between simulation performance and NCLEX-RN success was identified.
      • Simulation may allow for earlier identification of at-risk students.
      • Early identification of at-risk students can be a benefit to nurse educators.


      Undergraduate nursing programs frequently utilize computer-based predictor exams to identify whether students have high or low chances in achieving licensure. This study examines the relationship between undergraduate nursing student simulation performance and NCLEX-RN success. Data from a baccalaureate graduating class of 58 nursing students who completed multiple, high-fidelity simulation experiences 12-20 months prior to NCLEX-RN testing was assessed. In an Obstetric clinical course, students completed five simulations and were evaluated using the Creighton Competency Evaluation Instrument. Logistic regression was completed to identify significant relationships between student simulation performance and NCLEX-RN outcomes. Three of the five simulation experiences were statistically significant (p < .05) in predicting NCLEX-RN success. The results of this study indicate that simulation performance may be another method of predicting NCLEX-RN success. Implementation of this finding may provide means for early identification of at-risk students, allowing for targeted remediation interventions to best prepare them for later success on licensure examination.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Clinical Simulation In Nursing
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Bristol T.
        NCLEX-RN in every laboratory and simulation: technology can help.
        Teaching and Learning in Nursing. 2018; 13: 268-270
        • Curl E.D.
        • Smith S.
        • Chisholm L.
        • McGee L.A.
        • Das K.
        Effectiveness of integrated simulation and clinical experiences compared to traditional clinical experiences for nursing students.
        Nursing Education Perspectives. 2016; 37: 72-77
        • DeBourgh G.
        • Prion S.
        Using simulation to teach prelicensure nursing students to minimize patient risk and harm.
        Clinical Simulation in Nursing. 2011; 7: e47-e56
        • Doyle C.S.
        • Harper J.R.
        • Burke M.S.
        • Eiswirth E.
        Development of an associate degree program national council licensure exam for registered nurses preparation course to enhance student success.
        Teaching and Learning in Nursing. 2019; 14: 179-182
        • Gates M.G.
        • Parr M.B.
        • Hughen J.E.
        Enhancing nursing knowledge using high-fidelity simulation.
        Journal of Nursing Education. 2012; 51: 9-15
        • Havrilla E.
        • Zbegner D.
        • Victor J.
        Exploring predictors of NCLEX-RN success: One school's search for excellence.
        Journal of Nursing Education. 2018; 57: 1-3
        • Powell-Laney S.
        • Keen C.
        • Hall K.
        The use of human patient simulators to enhance clinical decision-making of nursing students.
        Education for Health (Abingdon). 2012; 25: 11-15
        • Rudolph J.W.
        • Simon R.
        • Dufresne R.L.
        • Raemer D.B.
        There's no such thing as “nonjudgmental” debriefing: A theory and method for debriefing with good judgment.
        Simulation in Healthcare. 2006; 1 (PMID19088574): 49-55
        • Sherrill K.J.
        Clinical judgment and next generation NCLEX - A positive direction for nursing.
        Education! Teaching and Learning in Nursing. 2020; 15: 82-85
        • Spurlock D.R.
        • Hunt L.A.
        A study of the usefulness of the HESI Exit Exam in predicting NCLEX-RN failure.
        Journal of Nursing Education. 2008; 47: 157-166
        • Strickland H.P.
        • March A.L.
        Longitudinal impact of a targeted simulation experience on high-stakes examination outcomes.
        Clinical Simulation in Nursing. 2015; 11: 341-347
        • Todd M.
        • Manz J.A.
        • Hawkins K.S.
        • Parsons M.E.
        • Hercinger M.
        The development of a quantitative evaluation tool for simulation in nursing education.
        International Journal of Nursing Education Scholarship. 2008; 5
        • Victor J.
        • Chavez L.S.
        • Podlesney C.
        Do predictor exams really predict readiness for professional nursing practice?.
        Clinical Simulation in Nursing. 2021; 50: 48-54
        • Young A.
        • Wilson P.
        Predicting NCLEX-RN success: The seventh validity study of the HESI Exit Exam.
        CIN: Computers, Informatics, Nursing. 2012; 30: 55-60
        • Zehler A.
        • Cole B.
        • Arter S.
        Hyflex simulation: A case study of a creative approach to unprecedented circumstances.
        Clinical Simulation in Nursing. 2021; 60: 64-68