A Transitioning Program and Low NCLEX Pass Rates
In the semesters leading up to fall 2022, South Plains College faced a steep decline in NCLEX-RN pass rates — dropping to 50%. The nursing program was undergoing significant change, with new faculty members acclimating to their roles and the college shifting between instructional platforms. According to longtime faculty member Jan Buxkemper, who was called back from retirement to teach an NCLEX prep course, these transitions disrupted consistency in the program and left students without the structure they needed. “I think that had a big role in why scores were so low,” Buxkemper said. “We were changing the platforms that we were using during that time period, too.”
At the same time, students were struggling to keep up with the evolving demands of the new NCLEX. Adding Next Generation NCLEX (NGN) questions — designed to assess clinical judgment — proved difficult for many. “There were a lot of changes with our testing system,” Buxkemper explained, “and the instructors [were] learning how to utilize that correctly, as well as the challenges of the new NGN-style questions.”
During a faculty meeting focused on shifting students' mindset about the NCLEX, faculty member Jessica Williams coined “One & Done.” Buxkemper adopted this phrase as the new class mantra, incorporating the “One & Done” mindset into the NCLEX Prep Course. “Take the NCLEX once and pass,” she told students. “Get those initials behind your name instead of worrying about taking the NCLEX again.” But achieving that required a shift — not just in strategy, but in student engagement. She needed a solution to build competence and confidence, one practice question at a time.
Building a Data-Driven NCLEX Prep Strategy With UWorld
To tackle the challenges her students faced, Buxkemper made UWorld the foundation of her prep course starting in the spring of 2023. While the resource had been available previously, students hadn’t fully engaged with it. That changed when weekly UWorld assignments became a core part of their grade. “It was students finding out that UWorld wasn’t an option — and that they were going to have to do it — that really shifted things,” Buxkemper explained.
Each week, students were assigned 150 UWorld questions with no time limit, allowing them to take an open-book approach if needed. “They have a week to do it,” she said. “They can look up the answers to questions in resources … The whole goal is to be confident as well as competent when they walk in to take the NCLEX.”
But the practice didn’t stop there. Buxkemper layered in a second assignment — nicknamed the “laundry list.” For every missed question, students had to write out why the correct answer was right and why their chosen answer was incorrect using UWorld’s detailed rationales as a reference. This exercise pushed students to reflect on their reasoning and develop stronger test-taking habits. “Many students have said, ‘I changed my answer and then got it wrong when I originally had the right answer,’” Buxkemper said. “It’s a good learning tool as well … I tell them, ‘Be confident in your answer — most of the time, your first answer is correct.’”
To further support learning, Buxkemper used UWorld’s reporting features to monitor class-wide and individual performance. She frequently referenced the time data and class averages to help students reframe their perception of workload. “If I tell them, ‘The average time the class took was 3 hours and 40 minutes out of 7 days,’ I can say, ‘If you do even 25 questions every night, you’ll be fine.’”
Students also received points for each assignment, and those scoring below 80% were encouraged to take advantage of their 6 available “retake” opportunities. Most improved significantly on the second attempt of an assignment — some scoring as high as 98% or 99% — and Buxkemper reinforced their growth by reviewing missed content in class. She regularly used UWorld’s reporting tools to identify weak content areas on a class level and incorporated those questions into live classroom discussions. “[Students] have to read the question and walk the class through it,” she said. “It reinforces their knowledge when they go up and go through it with their classmates.”
The data wasn’t just for students. Buxkemper also used performance trends to inform instruction across the program. “I give the instructors their student data from UWorld,” she said. “I show them where there are weak areas so they know — maybe these are areas they need to change what they’re doing instructionally or enhance in those areas.”
By embedding UWorld into weekly assignments, facilitating student self-remediation, and using real-time data to close learning gaps, South Plains transformed UWorld from a supplemental tool into a comprehensive solution — and students quickly saw the difference.
Transformational Outcomes: From Transition Challenges to Top Scores
Since fully integrating UWorld into its NCLEX prep curriculum, South Plains College has seen a dramatic turnaround in both pass rates and student confidence. Before the change, only half of students were passing the NCLEX. “We were at 50%,” Jan Buxkemper recalled. “We had so many more low performers before we started our new approach.”
In the year following UWorld’s structured implementation, results improved sharply. The December 2023 cohort achieved a 100% NCLEX pass rate with a 96% pass rate for the calendar year. The momentum continued the following year, with pass rates holding strong in May 2024 and in December of that same year. “It’s just proven that UWorld has been very beneficial to us,” Buxkemper said.
These quantitative gains were accompanied by noticeable improvements in students’ mindset and NCLEX readiness. Many students entered the program with significant test anxiety and uncertainty about their ability to pass. Weekly exposure to UWorld’s rigorous practice questions — and the consistent feedback they received from the platform’s detailed rationales — helped change that. “So many students have test anxiety,” Buxkemper said. “I have seen that when they use UWorld, students become more confident.”
That boost in confidence came not just from practice but from seeing their own progress over time. UWorld’s self-assessments played a key role in this transformation. Buxkemper administered one at the start of the semester and another at the end, using UWorld’s reports to track growth and guide students in targeted self-remediation. “They could see how much they’d improved,” she said. “Some students went from low to borderline to very high, allowing them to go into the NCLEX confident. It felt like practice.”
Many students echoed this sentiment. “I’ve had so many students say, ‘UWorld really helped me. It felt like when I went in to take the NCLEX, I was taking another UWorld exam,’” Buxkemper shared. That familiarity — paired with increased competence — made a measurable difference.
Even student enrollment, which had declined alongside pass rates, began to rebound. “Our classes had gotten down to 30 students,” Buxkemper said. “Last fall, we were back up to 58.” As confidence and outcomes improved, more students began to trust the program again, and instructors across the department took note.
Overall, UWorld’s impact extended far beyond performance metrics. It gave students structure, accountability, and a reliable way to close learning gaps. More importantly, it equipped them with the tools — and mindset — they needed to pass the NCLEX the first time.
Sustaining Success Through Structure and Support
Following the turnaround in NCLEX pass rates, Jan Buxkemper and her colleagues at South Plains College have no plans to scale back their use of UWorld. Instead, they’re focused on building on their momentum by maintaining the strategies that have worked — and exploring new ways to expand UWorld’s role across the curriculum. “We’ll continue to do what we’re already doing because obviously it’s been successful,” Buxkemper said. “We’ll probably utilize UWorld’s lectures just to reinforce those subject areas.”
UWorld’s adaptability is a key reason the faculty believes it can remain a long-term NCLEX prep solution. “There’s just so many things I could say about the reporting data,” Buxkemper said. “I’ve used it to reinforce concepts with the students and encourage them to identify overall weaknesses.” She also appreciates the platform’s depth, variety of question types, and ability to support self-directed learning.
For educators considering UWorld, Buxkemper’s advice is simple: use it fully, use it consistently, and use the data to guide instruction. For Buxkemper, that means keeping students focused, confident, and ready to be “one and done” on exam day. “We’re allowing students to take those steps to grow,” she said. “And most of the time, they see their grade go up by the end of the semester. They see that they’re ready [for the NCLEX].”
