A Nightingale College nurse leader's TEDx talk, named a TED Editor's Pick, argues that nursing schools' first-time NCLEX pass rate requirements penalize programs without evidence linking the metric to patient safety or graduate competence.
Salt Lake City, Utah — July 20, 2026
A TEDx talk by Nightingale College nurse leader and regulatory strategist Blake Wm. Halladay, RN, has been named a TED Editor’s Pick, a distinction reserved for timely, research-backed talks representing “ideas worth spreading.” In his talk, “We need more nurses. Here’s how to train them,”show below, Halladay challenges a policy that allows nursing programs to be sanctioned or shut down, not because their graduates fail the national licensing exam (NCLEX), but because too many needed more than one attempt to pass.
The policy in question allows state boards to sanction or shut down nursing programs when too many graduates need more than one attempt to pass the National Council Licensure Examination (NCLEX), the exam required for RN licensure, regardless of whether those graduates ultimately pass and go on to practice safely.
Halladay reviewed nursing education laws across all 50 states and U.S. territories and found 26 different formulas for what counts as an acceptable first-time pass rate, with no consistent evidence tying the metric to school quality or patient outcomes.
"Every medication, every intervention we give as nurses has to be based on evidence that it works and that it's safe," Halladay said during the talk. "But the regulations governing nursing education itself are often based on nothing more than opinion."
The Evidence Halladay Cites
Halladay pointed to two sources in particular:
Candelaria Nava's Path to Licensure
Nightingale College cites the example of Candelaria "Candy" Nava who passed the NCLEX on her sixth attempt. Bilingual and working full time serving Spanish-speaking clients through most of her nursing education, Nava said she needed additional coaching to succeed on the exam.
"I was so anxious and depressed, and I knew that wasn't helping," Nava said. "I had to fix that first. Once I did, everything else fell into place."
Nava said she rebuilt her exam preparation around daily practice questions, visual study tools and a consistent routine, even when progress was slow. She learned she had passed while at the airport waiting for her sister's flight.
"I started jumping," she said. "I told her, 'I did it.' I felt like it was finally my time."
Nava was offered an RN position immediately after passing and now works as an RN serving the Hispanic community in Logan, Utah.
A Workforce Under Pressure
Nava's experience reflects a broader pattern, according to Halladay: NCSBN data show first-attempt NCLEX performance correlates with socioeconomic stability, language background and access to test-preparation resources, not long-term clinical competence.
The nursing shortage, meanwhile, continues to widen. More than 193,100 open RN positions need to be filled yearly. A projected 8% nursing shortage is expected through 2028, with the demand for licensed practical nurses exceeding supply through 2038. Contributing to that shortage, a record-breaking 93,000 qualified nursing applications were turned away in 2025, a figure driven in part by enrollment caps schools impose to protect first-time pass rates.
Pass-Rate Policy and Proposed Reform
Halladay says that NCSBN has updated its own guidance to encourage state boards to track multiyear performance trends rather than penalize single-year fluctuations. National accreditors CCNE, CNEA and ACEN have adopted three-year rolling averages, though many state regulators have not.
Halladay is calling on state boards of nursing to adopt NCSBN's multiyear approach and on policymakers to follow the National Academy of Medicine's recommendation to move away from first-time pass rate as a standalone quality measure.
"We have a nursing shortage crisis in this country," Halladay said. "It is time to build a system that unleashes the nursing workforce we so desperately need."
Halladay's full talk can be seen below: