Quality of instruction, clinical experience, realistic practice opportunities, the way the exams are written.. There are a LOT of things, but since I know my school I will say this. It has one of the highest pass rates in this states for the size of school. We have quality instructors with years of experience and a passion for educating future nurses. We also have clear guidelines of what is expected of us in terms of conduct etc. We have a big lab area where students can learn and practice skills, and we have great clinical sites where we get to see and do a variety of things. The exams are also NCLEX style questions and timed, and they are not easy. Student effort is a big part of it too, but without the opportunities to learn in multiple ways no amount of effort will truly prepare the student for life as an RN and to pass boards.
Some programs have very high NCLEX pass rates, and I believe this has a direct correlation with pass/fail rates. If a RN program is easier, then this is often reflected in lower school NCLEX rates. In my program usually about 1/4 does not make it through the first semester. After the first semester the retention rate is much higher. The program is hard, but my school has had a 97-100% pass rate for quite some time, while others in my state are at 70%.
Some students have too many outside commitments that interfere with the time that our program demands. Our instructors recommend only working very part time at the most. Those of us with families and children have great support systems. While some lack the drive, for the most part we all have had a long road just to get this far and are working our tails off.
Most states publish the NCLEX pass/fail rates by school and the data is pretty interesting.
I had quality instructors at my school, but my school doesn't have great passing rates. I believe that has to do with the quality of students that come through the doors. I felt my school was extremely easy, but I noticed all too often, my fellow students were failing the tests. One course per month is what I had. Some of my classmates really should not have been in that type of nursing program. They should have gone at a slower pace which really would have benefited their learning needs and probably the nclex results.