I don't think people fail on the diving portion of the nitrox cert... It's mostly the math/knowledge reviews as far as PADI is concerned...
In a practical sense, you really don't have to do a dive to understand how to use nitrox, or obviously to breathe it. You just inhale.
However, on our nitrox checkout dives, we were given assistance with using the analyzer to analyze our mix. My wife, who isn't as technically inclined as I am, and needed help with the mix analysis at first.
There are important things to learn about nitrox, like MOD, and understanding the PPO2, and what it can do to your body. Everyone is different. Someone can have an adverse reaction at only 1.2 ppo2, whereas someone else can deal with 1.6 (not recommended).
I know that PADI requires the dives for the cert. Is it a way to help the dive shop make some more money? Who knows?
There is nothing wrong with being cautious and/or overly safe, when you ARE taking your life in your own hands every time you dive.