Cited by 20Cultural Competency in Health CareMedical Education and AdmissionsTeacher Education and Assessments

Diversity in nursing and challenges with the NCLEX-RN

Muirhead, Lisa, Cimiotti, Jeannie P., Hayes, Rose, Haynes-Ferere, Angela, Martyn, Kristy, Owen, Melissa, McCauley, Linda·2022·Nursing Outlook

Abstract

High-stakes, standardized testing has historically impeded education/career attainment for members of underrepresented minority groups and people needing testing accommodations. This study was to understand how high-stakes, standardized testing, particularly the NCLEX-RN, impacts diversity, equity, and inclusion (DEI) in nursing. This study explored the history, context, perspectives surrounding standardized testing, with a focus on the NCLEX-RN. The authors consider content, form, and delivery of testing, including accommodations. They identify available data and data collection gaps relevant to DEI and the NCLEX-RN. No nursing organization published the national data necessary to evaluate/refine the NCLEX-RN from a DEI perspective. Preliminary nursing studies and data from other professions indicated disparities in testing outcomes. Nursing must determine if prospective nurses are experiencing disparities in testing outcomes. The authors highlight opportunities to advance DEI through improved data collection, reformed licensure processes, and the reframing of standardized testing as one of many tools to determine competency.

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Crossref · 10.1016/j.outlook.2022.06.003

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44 of 44 references verified0 citation errors · 0 not checkable

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  • Another area of research that we have identified in the international literature that is not well represented in our review is related to bias, discrimination, and racism within the context of complaints, investigation, and disciplinary processes.

    “Another area of research that we have identified in the international literature that is not well represented in our review is related to bias, discrimination, and racism within the context of complaints, investigation, and disciplinary processes [192,235–246].”

    From Nursing regulation in Canada: Insights from a scoping review (2025) · cites this paper as [243]

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Authors
Muirhead, L., Cimiotti, J. P., Hayes, R., Haynes-Ferere, A., Martyn, K., Owen, M., & McCauley, L.
Affiliations
Emory University (US)
Corresponding author
Hayes, Rose
Venue
Nursing Outlook
Publisher
Elsevier BV
Published
2022-09
Volume
70
Issue
5
Pages
762-771
ISSN
0029-6554 (ISSN-L)
OpenAlex
W4289755351
Cited by
20
References
44
Citations by year
2026: 2 · 2025: 7 · 2024: 4 · 2023: 6 · 2022: 1
FWCI
6.48
Type
journal article
Language
en
Open access
closed
Locations
  • Nursing Outlook (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Sociology and Political Science › Cultural Competency in Health Care
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Medical Education and Admissions
  • Social Sciences › Education › Teacher Education and Assessments
Keywords
NCLEX-RN, standardized testing, nursing licensure, diversity, equity, and inclusion, test accommodations, high-stakes testing, nursing workforce diversity, competency assessment
MeSH terms
Education, Nursing, Baccalaureate, Educational Measurement, Humans, Licensure, Licensure, Nursing, Prospective Studies, Students, Nursing

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