HealthMay 17, 2024

Lippincott PassPoint exams, quizzes, and mastery level impact on NCLEX-RN pass rates

This study demonstrates the correlation between the use of Lippincott® PassPoint features and NCLEX-RN® pass rates among BSN students, analyzing data from PassPoint exams, quizzes, and mastery levels in relation to their NCLEX-RN outcomes. Participants, enrolled in a BSN program, had 12-month access to Lippincott PassPoint.

BSN: Study 3 - 1st cohort

Program: Study participants were enrolled in a BSN program in which students had 12-month access to Lippincott® PassPoint. PassPoint was used in a final semester NCLEX-RN® prep course to help identify where students needed help and to provide a more individualized experience to help them achieve first-time success on the NCLEX-RN.

Course Structure: PassPoint use was part of the students’ grade (~20%). Students used ATI during their program. They took two proctored tests (in a computer lab) and, following each, were required to remediate on weak areas using PassPoint. Students also took the HESI CAT and the HESI E2.

PassPoint Implementation: As part of their required coursework, students were assigned three question collection assignments and five ML quiz assignments with a target ML of 5. There were 12 PassPoint practice exams assigned — one per week for 12 weeks. Three practice exams had 75 questions, two 100 questions, two 150 questions, two 200 questions, and three 265 questions.

Lippincott® PassPoint usage and mastery

Overall Lippincott PassPoint quizzing usage and ML is shown in Table 20. Students answered an average of 1,560 questions, took an average of 107.6 quizzes, and achieved an average final quizzing ML of 4.3. There was little variance in ML but greater variance in usage, which shows some students were achieving target MLs with fewer questions than others. Given the large variance in question number, we also calculated the median number of questions answered (Mdn = 1,384) and number of quizzes (Mdn = 90).

Table 20: Overall Lippincott PassPoint usage and mastery (School C Study 1, N = 21)

Min  Max  M  SD Mdn 
Number of Quizzes 37
 316  107.6 67.5 90
Number of Questions 589
 3,024 1,560 682 1,384
Overall Quizzing ML 2.3
 5.5 4.3 .7 4.4

Students also took practice exams in Lippincott PassPoint throughout the program (see Table 21), with the overall final exam ML of 4.3 (SD = 7.2).

Table 21: Lippincott PassPoint Practice Exam usage and mastery (School C Study 1,  N = 21)

Min  Max  M  SD Mdn 
Number of Exams 11
 51  107.6 15.4 8.6
Number of Exam Questions 1,455
 4,845 1,560 2,105.5 684.2
Exam ML 5.6
 8 4.3 7.2 .7

Within the course, students were assigned 12 practice NCLEX-RN exams. Of the 21 students, 15 students took 12 or more practice exams (M = 15.43, SD = 8.58) and one student took 51.

Within Lippincott PassPoint correlations

A Pearson’s product-moment correlation was run to explore the relationship between the number of quiz questions answered in Lippincott PassPoint and overall ML. There was no significant correlation between the number of quiz questions students answered and their overall quizzing ML, r (21) = .328, p =.147.

HESI E2, course grades, and mastery level

There were no significant correlations between scores on the HESI E2 and ML either in quizzing or on practice exams. The average HESI E2 score was 870.9 (SD = 118.4), with a range from 614-1,081. The distribution of course grades is shown in Figure 1. The average grade in the course was a 3.7, and 10 students achieved an A. There were no significant correlations between grades, HESI E2 score, and ML.

NCLEX-RN outcome

Seventeen students passed the NCLEX-RN and four failed (81% pass rate). Given the difference in sample size, we ran a Mann-Whitney U test to compare ML, number of exams, and number of questions students actually answered on their NCLEX-RN exam. Even though usage and MLs were higher for the passing group than the failing group, they were not significantly so (see Table 22). In addition, we compared differences in HESI E2 score between the pass and fail groups. There were no significant differences for the HESI E2 score either, although those who passed did have a higher average score (897 vs. 756).

Table 22: Lippincott PassPoint Practice Exam usage and mastery by NCLEX-RN group (School C Study 1, N = 21)

Overall Quizzing ML Pass
 17  4.4 .6
 Fail  4  3.8  1.1
Number of Exams Pass
 17 7.3 .7
Fail   4  12.5  2.4
Exam ML Pass 17 7.3 .7
 Fail 4 6.9 .6
Number of Questions on NCLEX-RN Pass 17 91.7 49.6
Fail 4 265.0 0

There was, however, a significant difference in the median number of NCLEX-RN questions answered on the exam for the passing group (Mdn = 75) compared with the failing group (Mdn = 265), U (21) = 2.00, p = .001. Fourteen of the passing students did so on the minimum of 75 questions, although one of the passing group participants passed after 265 questions.


  • Students were assigned three question collection assignments, five ML assignments, and 12 practice exams.
  • Students answered a median of 1,384 practice quizzes.
  • Average quizzing ML was 4.3 (all students) and 4.4 for those who passed the NCLEX-RN.
  • Average practice exam ML was 7.2 (all students) and 7.3 for those who passed the NCLEX-RN.
  • Students took an average of 15 practice exams.
  • The cohort had an 81% NCLEX-RN pass rate.
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