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High-Stakes Testing in Nursing Education: A Review of the Literature

Hunsicker, Jamie, MSN, MS, RN; Chitwood, Tara, MSN, RN, CCRN

doi: 10.1097/NNE.0000000000000475
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In an aim to improve first-time NCLEX-RN pass rates, some nursing programs have instituted high-stakes testing. This literature review investigated nursing faculty understanding of and student experiences with high-stakes testing. High-stakes testing is an assessment used to make decisions about student progression or completion of a nursing program. The literature revealed both negative and positive consequences associated with high-stakes testing. Literature from state boards of nursing and professional nursing organizations was also reviewed for recommendations.

Author Affiliations: Assistant Professor of Nursing (Ms Hunsicker), Ohio Northern University, Ada; Assistant Professor of Nursing (Mrs Chitwood), Jefferson College of Health Sciences, Roanoke, Virginia.

The authors declare no conflicts of interest.

Correspondence: Ms Hunsicker, Ohio Northern University, 525 S Main St, Ada, OH, 45810 (

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

Accepted for publication: September 20, 2017

Published ahead of print: November 11, 2017

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