FNP Pass Rates Drop AGAIN for the 5th Consecutive Year

Pass rates on the certification exams for family nurse practitioners (FNPs) decreased for the fifth consecutive year in 2023, marking a 13% drop since 2018. The ANCC had a stable  pass rate of 86% for the FNP exam in 2023 and the AANPCB had a 73% pass rate in 2023. Most FNP students 67% (17,362)  chose to take the  AANPCB exam  while 33 %  (8,530) took the ANCC exam. The 2022  FNP AANPCB exam pass rate was 74% and the 2022 FNP ANCC exam pass rate was  86%.

What is Behind This Downward Trend?

NP education specialists and faculty consultants point to several factors contributing to this decline:

• Changing academic delivery models
• Varying admission requirements
• Preceptor challenges
• Increased patient complexity

These issues, while significant, can be addressed to produce better-prepared NP graduates. This article outlines strategies to improve exam success.

FNP Certification Exams: Facts and Figures

FNP candidates can choose between two certification exams: one from the American Academy of Nurse Practitioners Certification Board (AANPCB) and one from the American Nurses Credentialing Center (ANCC). Despite similar construction and content, AANPCB pass rates declined 13% between 2018 and 2023, whereas ANCC pass rates saw only a 1% decrease.

Academic Contributors to Declining FNP Exam Scores

Experts cite several academic factors influencing declining scores:

1. Covid-19 Stressors: The pandemic significantly impacted student performance, contributing to a 10% drop in AANPCB pass rates in 2022.
2. Rapid Increase in FNP Programs: The surge in FNP programs has led to varying admission requirements and education delivery models, including more online programs. Hybrid programs have shown better outcomes than solely online programs.
3. Preceptor Challenges: Many students must find their own preceptors, leading to inconsistent clinical experiences. Strong relationships between preceptors and faculty are crucial for student success.

Preparation Contributors to Declining FNP Scores

Preparation issues also play a role:

1. Inadequate Exposure to Exam-Style Questions: Students often lack practice with questions that develop critical thinking skills essential for exams and clinical practice.
2. Weak Knowledge in Professional Issues: Topics like scope of practice are often under-emphasized.
3. Reliance on Preceptor Experiences: Students may answer questions based on clinical experiences rather than evidence-based guidelines.
4. Increased Patient Complexity: Graduates face higher-level exam questions due to more complex patient presentations.
5. Burnout: Balancing academic programs with work and family responsibilities contributes to burnout, affecting performance.

Strategies to Improve Student Performance

For Students:

1. Practice Exam-Style Questions: Develop a systematic approach to answering questions accurately and efficiently.
2. Focus on Common Primary Care Conditions: Study the conditions most frequently managed in primary care and those posing serious safety issues.
3. Use Comprehensive Review Courses: Select review formats that match your learning style and cover essential exam material.
4. Master Foundational Information: Build a strong understanding of common patient presentations and more complex conditions.
5. Prioritize Self-Care: Ensure adequate sleep, healthy food, exercise, and relaxation activities.

For Faculty:

1. Raise Admission Standards: Ensure students are well-suited for NP programs.
2. Early Exam Preparation: Start preparing students for certification exams from their first theory or clinical course.
3. Incorporate Diverse Learning Tools: Use study questions, case studies, review courses, and simulation in the curriculum.
4. Implement Continuous Remediation: Provide ongoing remediation to address knowledge gaps.
5. Evaluate Proficiency in Key Domains: Ensure students are proficient in assessment, diagnosis, planning, and evaluation, using methods like the Objective Structured Clinical Examination (OSCE).

By addressing these factors, both students and faculty can work together to improve FNP certification exam success and better prepare future nurse practitioners for clinical practice.