SALISBURY — Catawba College received its first three-year average for how many of its nursing students passed the national licensure exam on their first attempt, and it’s the lowest in the state by a one-point margin.

Data from the N.C. Board of Nursing says Catawba’s three-year average for pass rates was 66%. Mars Hill University narrowly cleared Catawba with a 67% pass rate on the first attempt. Because of its scores Catawba is one of five on a warning status by the Board of Nursing.

There are 34 programs in North Carolina conveying bachelor degrees in nursing.

But Catawba College says there is more to the story than the first-attempt pass rate and that it’s taking steps to improve the statistic.

The program received state approval in 2017 and got off to a strong start when its first students sat for the exam in 2019 with an 88% pass rate on the first attempt, but the pass rate dropped significantly in subsequent years, with a first-attempt pass rate of 64% in 2020 and 47% in 2021.

Catawba was one of many programs in the state that saw a drop in first-attempt pass rates during the pandemic, but a handful also saw improvement or maintained their rates. Sixteen programs had three-year pass rates of at least 90%.

Catawba College says its program has never been stronger. It has an overall pass rate of 97% after students who did not pass on the first attempt sat for the test a second time. All of its students have nailed down job offers before graduating, the college says.

Catawba Provost Constance Rogers-Lowery said the second-attempt pass rate means only a single Catawba student has not passed the exam.

“However, we take very seriously the importance of improving the first-time pass rate and are working diligently to strengthen our program and improve that statistic,” Rogers-Lowery said in an emailed statement.

Amy Fitzhugh, chief legal officer for the Board of Nursing, said she couldn’t verify a statement from the Catawba College that it is “fairly common” for new pre-licensure programs to be monitored for improvement while they develop their programs.

“The education consultants do a good job of staying in contact with the programs, identifying which issues might be in place, provide resources and consultation with them to identify what some of the deficiencies might be,” Fitzhugh said.

Fitzhugh said consulting is effective at getting programs removed from warning status.

The college also began implementing improvements after its drop in pass rate in 2020.

Catawba says it’s implementing a litany of new measures to bring up the pass rate, including more selective requirements to be admitted to the program. Starting in 2022, students have to maintain at least a 3.0 GPA to be admitted to the program — up from a 2.5 GPA for previous cohorts.

The college also recruited more faculty, added a “boot camp” program, added more test preparation, adjusted courses based on exam data and added an exam for junior nursing students they must pass to advance.

Catawba’s program also is increasing its admission score requirement and its weighted exam averages to at least 80 points because it found students perform better on the licensure exam with an exam average of 80 or higher.

“Our action plan illustrates measures for immediate improvement for the 2022 cohort and maintaining the improvements going forward,” Catawba College said in an emailed statement.

Department Chair Valerie Rakes said the class which will graduate in May is the first with more stringent requirements.

The college says the COVID-19 pandemic impacted the program by limiting clinical time and shifting classes to remote.

Catawba said in March 2020 health care systems stopped clinicals due to the pandemic and resumed in a limited capacity in the fall. The college says the amount of clinical time has improved with the availability of vaccines and less hospital overload due to the disease.

Nursing students are required to complete 120 hours of “focused care client experience” in addition to clinical hours.

The college also said it has seen interest in the program increase despite being more selective. The college says faculty continue to meet after graduation until a student passes the exam. Students are more likely to pass the exam on the first attempt if they continue to meet with faculty after graduation, Catawba College said.