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The AANP FNP Pass Rate is Down to 75%. Here’s What to Know to Decrease Your Anxiety and Pass the Exam

In the last year, the AANP FNP pass rate declined from 85% in 2021 to 75% in 2022. Understandably, we’ve seen an increase in anxiety around this exam and some questions from students wondering why the pass rate dropped nearly 10%.

Here at SMNP Reviews, we know that anxiety is one of the greatest obstacles on your journey to becoming a real deal NP. We also know that boosting confidence and knowledge is your best antidote for exam stress.

To help you feel more confident about passing your AANP FNP exam, I sat down with Sarah Michelle to really dig into the root of the declining AANP FNP pass rate and explore the resources you can use to make sure you pass. Sarah shared her insightful viewpoints based on her experiences as an educator and a nurse practitioner. Her personal journey, starting as a tutor and growing into a nurse practitioner, has given her a unique and understanding perspective on the challenges students face, especially when it comes to exam anxiety.

We’ll uncover Sarah’s tried-and-true strategies for exam success, discuss the impact of anxiety on exam performance, and learn about how SMNP Reviews can guide you towards exam success and beyond. Check it out!

Declining AANP FNP Pass Rate: What to Know to Decrease Anxiety and Pass the Exam


Hi Sarah! Thanks for joining me today. Before we jump into the topic of the interview, can you first tell us a little about yourself and SMNP Reviews?

Sarah Michelle:

Sure thing. I’ve been an educator for as long as I can remember. When I was in nursing school, I started tutoring other nursing students and that was kind of my first “toe in the door” that teaching was something I like to do.

And not only was it something I like to do, it was something I love to do. At the time, I was working a full time job and tutoring on the side and by the end of the semester that I started tutoring, I went from tutoring two students to 40. I made it my new full-time job even though it was still a side hustle, and I continued doing that even when I became a nurse.

After I became a nurse, there’s all these opportunities to go back to school. And I was like, well, I know I want to teach in a more formal setting someday. So I’ll just go ahead and I’ll get my master’s in nursing education, kind of figure out what I’m doing with my life. So I did that. And right around that time, my employer was paying for school and they announced that they weren’t going to be paying for school any longer.

And I just thought, well, if I ever want to be a nurse practitioner, this is the time, because it’ll be free! So I decided to sign up for nurse practitioner school, and I told my husband, “Even if I never use this degree, it’s going to make me a better teacher someday. So I’m just going to do it anyway and it’ll give me more opportunities and I’ll have more flexibility in the future, but I don’t really know if I’m going to use it or not.”

Fast forward to when I graduated from nurse practitioner school, and I felt like I literally did every review out there, just none of it “hit” for me. What I was looking for was confidence in the knowledge I already had, and what I found doing review courses is I was just more overwhelmed than when I started.

And so, I took my board exam, and I passed it in less than an hour. It was no big deal at all, and I was so mad at myself. It’s like, why did I do all this torture? I did five review courses. I’m pulling my hair out over this exam. I studied and studied and studied. But really, what I needed was just the confidence building and tips for how to manage my own anxiety. Because that was really what I was up against. If I can manage my anxiety, I was good to pass the test.

So that’s how SMMP started. I was like, well, I’m just going to make a little three-hour review course. I’ll throw it on Facebook and we’ll see if my friends like it. My friends loved it. And then they shared it and shared it and shared it.

And now, obviously, it’s evolved past me at this point. But I’ve been teaching for a long time and it is by far my favorite thing that I do.

Why Is the AANP FNP Pass Rate Declining?


Amazing. Perfect. No notes.

So, I want to move on to the topic of the interview, which is the AANP FNP pass rate. The pass rate dropped from 85% in 2021 to 75% in 2022, which is a huge drop. Can you speak more to what you might think is contributing to the drop if you have any insights? Is it COVID? Is it anxiety related?

Sarah Michelle:

Well, you gotta think right now it’s 2023, so we’re in our first round of true COVID graduates. Most nurse practitioner programs are about three to five years, so we’re hitting that time zone of people that were entering into school right as everything was shifting so fast. Obviously there were a lot of obstacles and barriers to how education would continue, but I can’t say that online education is the only thing that’s led to a decrease in pass rates because online education has been around for a long time, especially in the graduate school space.

For me personally, all of my classes were online, but it was the clinical portion that was in-person. And I feel like there’s definitely probably a gap that has occurred in my last three years in that clinical portion and people getting that hands-on experience. I know in the state of Kentucky, at least, simulation can replace up to 50% of your clinical time, and there is value in doing simulation.

I actually used to teach sim lab for a group of nursing students when I taught at a college in the midst of growing my business. There’s just something about being in-person and truly doing it hands on that you really get those critical thinking skills. You’re able to take the things you learn in lecture and then you actually go and apply it, and I think we’re just lacking some of that.

I think also pass rates are down because during the pandemic, people were very distracted from taking the exam. So they might say, like, “Oh, I finished school, but I’ve got this travel nurse contract I could do.” So we’ve got people that have lag time in between when they graduated and when they’re taking the test. I saw somebody in the Facebook group today who said they graduated two and a half years ago, and now they’re getting back around to taking the test.

So there’s not this tight timeline on if you have to test in this certain number of months. We actually had a student once who had graduated two decades ago, and she was so anxious after she failed the first time that she never came back to it until recently. I mean, she passed, but I do think we’ve got more “lag time students” just because life has been so chaotic and there’s been so many incentives in the nursing world. Healthcare is a business, and it’s been lucrative to be travel nurses or work extra shifts because people are needed so badly. 

So I think both of those things and then just making sure too, with the declining pass rates, that people are using prep sources. That is something new I’ve seen this year. We’ve kind of had an influx of people that are going to DIY [their prep plan] and just buy a Qbank then see what happens. But this is an exam that you absolutely have to prepare for, so I think that has been a gap too.

How Does This Compare to the ANCC FNP Pass Rate?


That makes total sense. I’m wondering about the difference between the AANP and ANCC pass rates, because I did see that the ANCC pass rate didn’t go down by that much.

Sarah Michelle:

Right, the ANCC pass rate is pretty high.


Yeah, I guess a decrease from 86.6%, 2021 to 85.9% in 2022, so not a huge change. So I am wondering if you think this is going to maybe make more people take the ANCC exam for example, instead of the AANP because of the declining pass rate on the AANP side.

Sarah Michelle:

In the nicest way possible, I always tell people this is the hill I’m going to die on because they perceive ANCC to be harder. So, a much smaller pool of people take ANCC versus AANP. But if you look at the data, like you just said, AANP pass rates are way below ANCC. 

And this has been a long-term thing the ANCC has been up against because the ANCC exam used to be 70% clinical content and 30% non-clinical. And by non-clinical, that’s like laws, regulations, ethical principles, those sorts of things that are not always things you get in school. So that felt very intimidating to students and students didn’t want to take that exam because of that. They have steered away from that, but they still have this reputation of being the harder exam because in the past when it was 30% non-clinical, ANCC did have lower pass rates than AANP.

So it’s a reputation thing that they’re up against, but I think like last year if you looked at the numbers, it was around 65-70% of the people who tested took AANP. So also with AANP pass rates being down, they’re getting a larger volume of people that are taking that exam too. So it’s a weird thing to try to tease apart.

Which Resources Can Help You Increase Your Chances of Passing?


Yeah, that makes total sense. You don’t need to jump ship right away just because the pass rates are lower, since there’s just a smaller group taking ANCC which skews the data.

So I do want to shift gears more into what you do and how SMNP’s courses can help students overcome these declining pass rates. I’m curious about the specific things that you offer for the AANP FNP certification exam. If there are certain resources that you have that you believe if students were able to use them would lead to them having a higher likelihood of passing the exam, even though the pass rate itself is going down.

Sarah Michelle:

Yeah, I think honestly what a lot of students need and they don’t even realize that they need until they’re in it. It’s just the accountability and structure of a study plan. So that’s why I love the live study group so much. You get everything that we offer all in one, but we literally tell you day one, log in, watch this one hour video. It’s going to be less than an hour per day. Do these questions. And if you can do that with us for four weeks, you’re going to be in a position to pass.

What we’ve been up against this year are the “DIY people” that are just trying to do a Qbank and pass and they don’t realize like, “oh, hey, I really did need the structure to really buckle down and get this done.”

So I like the intensive nature of the live study groups because literally it’s one month of your life that you’ve already spent three to five years in school. There’s nothing else you can do until you pass this exam, so it’s a really big deal that you pass. You might as well set yourself up in the best way possible and have someone who’s done it before just say, “Hey, this is what you should do day-to-day, and if you do what we recommend, then you’re going to be successful in this thing.” It’s like a “we commit with you, you commit with us” sort of thing.

How Do You Gauge Performance During a Live Study Group?


I like that, “we commit with you, you commit with us.” 

So when it comes to people who participate in the live study group, for example, are there any ways for your team to assess, hey, this person might be at risk of not passing the exam this time around? 

Are there any ways that you can kind of gauge performance along the course of the study group? And if so, can you speak a little bit more about that? 

Sarah Michelle:

I think absolutely because our live study group today is unique in the fact that we are not a webinar format. So we are not lecturing to you in our live classes, like we are truly interacting with you. 

And I used to teach all of these classes myself, so it would become very obvious, like which students prepared for the live session and which students were unprepared. And we were able to identify that way.

Also, just scores on the practice questions all throughout. What we tend to see is we have a pre-diagnostic test in the beginning just for you to gauge where you’re at and then each week we recommend that you take another practice test and we like to see those scores go continually up.

But it becomes apparent with students when we assess, are their scores staying the same? Or are they even getting a little bit lower? Sometimes we see that when students get anxious in the middle of the program there’s a lot going on so we can target them that way.

And then lastly, I would say the easiest way for us to tell, because you know, a lot of study groups have gotten quite large, is we offer a one-on-one session so you can meet one-on-one with a nurse practitioner and they can tell you, “Okay, you were great at cardiac, but your respiratory knowledge needs a little bit of work. Here are five things that you could do to kind of beef up that knowledge base, or different strategies you could use.”

I like the one-on-one sessions too because they’re really great for identifying students who are abundantly anxious that are going to need a little bit of additional help to get over the hurdle of the exam. So I think one-on-ones by far are a wonderful resource too.

How Does Test Anxiety Affect Your AANP FNP Score?


Nice. And related to that, I know you mentioned before having some personal experience with test anxiety and the real effects that it can have on your actual score. Can you talk more about the reducing anxiety part of your course and how that differentiates you from other programs that might prepare people for AANP?

Sarah Michelle:

Yeah, I feel like it’s ingrained in everything that we do because right when you start the course there is an exam anxiety video and I just get on there and say like, preparing for the content knowledge is half the equation to passing this exam, but the other half of that equation is managing your anxiety because you can know all the content all day long, you’ve learned all this great stuff in school, but if you get to the exam and you’re so anxious that it turns to gibberish, you’re going to fail even if you prepared the right way.

And so I think a lot of what we do in the courses and especially in the live sessions is just reminding people like, “Oh, hey, I actually do know this stuff. I should be confident, I’ve spent three to five years in school at this point, and if I can pass nurse practitioner school, I can definitely pass this exam.”

People just need that gentle reminder. And some people are going to need a couple of additional strategies. I’m thinking of our students with ADHD, we often tell them every 20 questions, you should take a break. So just take a pause, take a mental break, you don’t even have to get up from your desk. Just little tips and tricks like that all along the way.

Another resource that we tell students to do, and it sounds silly, but it’s called a “brain dump sheet.” So when you get into your exam, you just dump down a bunch of things that you’re anxious about seeing on the exam, like maybe COPD treatments really trip you up.

So, right when your brain is fresh before you ever see a question, write down what those are, so when you do get flustered, if that were to come up, you can just come back to those. And a lot of simple tweaks can really go a long way on the anxiety front. The biggest thing is just building up confidence, but that feels like the hard part. Working with us though, we make that the easy part!

If you’re preparing for your AANP FNP exam right now and are looking for more ways to boost your confidence, check out this video on the SMNP Reviews YouTube channel about test-taking tips!

Do Declining Pass Rates Increase Test Anxiety?


Right. And especially with the pass rate declining, for example, do you think that could maybe heighten this anxiety and maybe make it worse going forward?

Sarah Michelle:

Definitely. Our Facebook study group is so anxious right now with these declining pass rates. I see it every day. People are posting about it all the time. They’re always asking other students in the group, “If you failed, could you reach out? Could you tell me why you failed?” They’re trying to get some sort of insight.

But what I like to remind people is kind of what we were just talking about. You and I can prepare the exact same way and get the exact same exam, but we could have two totally different exam experiences if I let my anxiety take over, and you didn’t. And so just reminding people, like, the only thing that you can control is your own preparation. 

And part of that preparation is going to be your anxiety management. So you just have to go in with that game plan in place. We can’t really rely on everybody else’s perceptions of the exam and all that. Because we also have to remember, even with a 75% pass rate, the majority are passing. So, the odds are in your favor, but it’s really hard to not be anxious when you see the pass rates go down year after year, which is what’s been happening with AANP.

What Happens If You Fail the AANP FNP Exam?


Great point. Also related to that, if you do have a student who fails the exam, for example, are there any support systems in place? Is there a resource where you reach out to them and say “Hey, you get X amount of access to our course after this?” Is there anything that you do for students who might fail the exam?

Sarah Michelle:

For our live study groups in particular, we do have a pass guarantee. So if you come to the live sessions, if you watch the videos, if you do the things you’re supposed to do and somehow fail, we truly do commit alongside you, so we would give you access again. We would let you back in the live study group again for free. 

And we oftentimes also do a free one-on-one with that student too. Can we assess what went awry on exam day? I’ll never forget one of the first one-on-ones that I did with a student who failed in the last study group. She was like, “I wasn’t anxious, but in the middle of the exam, I went in the bathroom, I threw up, I felt like I couldn’t breathe.” And I was like, “Well, you were having a panic attack. So, how can we better account for that next time?” So really trying to help them formulate a study plan that makes sense.

And we, for a long time, have offered a failing questionnaire. So even if you’re not a live study group student, we have a set of questions, like a little quiz that you can fill out and then give you feedback based on that. Like, did you only do 200 practice questions? Well, we recommend 1,000, those sorts of things to try to get people back on track. But a lot of it, unfortunately, is the anxiety.

What is the SMNP Reviews Pass Rate?


Right. Now, do you have a pass rate for people who go through your program, for example? Because I’m sure it’s not the same as the general pass rate. Does Sarah Michelle have a pass rate?

Sarah Michelle:

Yes. So for the live study groups in particular, it’s over 99% currently. So if you complete the program, you’re going to pass. But that’s just the big thing, is getting people to complete the program.

How Does Prep for AANP Differ from ANCC?


Excellent. I wanted to just throw in one extra question about if there’s anything specifically for the AANP exam?

Sarah Michelle:

So actually what we have something separate for is ANCC, because ANCC does have a little bit more non-clinical content. The AANP can ask a few questions pertaining to non-clinical content. So, really the prep is the same for both.

Sarah’s Advice for Your Upcoming AANP FNP Exam


Gotcha. Lastly, do you have any advice that you would give to anyone preparing for AANP?

Sarah Michelle:

Just to kind of sum everything up, I think people need to put in the time and dedication to pass these exams, and part of that is doing some sort of board prep. So whether that’s through us or not, just making sure that all the knowledge that you’ve learned in school, like you have that in check before you go take the exam.

The thought of people just taking exams on the fly or trying to cram into three days gives me so much anxiety. Like I can’t even possibly fathom. And so, even if you’re not doing the live study group, make sure you do have a solid study plan in place with whatever you’re doing. Because that’s going to be your ticket to success (and of course, your anxiety game plan too).


Thank you, Sarah!


Looking for more (free!) NP board prep content? Check out these other posts on the SMNP Reviews blog:

Or, check out these podcast episodes!