A Comparison of Two Nursing Program Exit Exams That Predict First-Time NCLEX-RN Outcome

Abstract

This retrospective descriptive correlational study compared the predictive accuracy of the Health Education Systems, Inc, Exit Exam (Elsevier) and Assessment Technologies Institute's RN Comprehensive Predictor, both of which were administered to nursing students in an upper-division baccalaureate nursing program during their final semester of study. Using logistic regression analyses, it was determined that the two examinations were statistically significant but weak predictors of success on the RN licensure examination. The RN Comprehensive Predictor had a slightly better odds ratio; however, both examinations had similar sensitivity, specificity, and overall accuracy. Because the RN Comprehensive Predictor was included in the Assessment Technologies Institute's Comprehensive Assessment and Review Program already being used by the BSN program, based on the results of this study, the nursing faculty decided to use only the RN Comprehensive Predictor during its NCLEX-RN preparation course.

Accuracy and completeness are required: A response to Dreher et al (2019)

“…Further, and perhaps more importantly, we strongly hold that any scholarly examination of research evidence done in support of advancing one's arguments must be inclusive of the relevant research evidence so as to avoid presenting an incomplete picture of the evidence by limiting the review to a single study. Numerous analyses conducted before and after Spurlock and Hunt using the same classification accuracy procedures have produced findings consistent with Spurlock and Hunt . In addition, Randolph examined the association between use of exit exams with a cut‐score (with corresponding consequences) and NCLEX pass rates and on‐time graduation rates among 89% ( n = 34) of Arizona's approved nursing programs.…”

“…First, Nibert and Young 6 wrote, "The HESI Exit Exam (E 2 ) is a secure, comprehensive examination that has demonstrated a high degree of accuracy in predicting NCLEX success as well as identifying those students at risk of failing the NCLEX. [29][30][31] " The papers cited by Nibert and Young 6 in the superscripted reference numbers are Lauchner et al, 5 Hanks et al, 14 and Newman, Britt, and Lauchner. 15 So, the HESI Exit Exam is not designed to test only for passing but rather, assumes a role in estimating both the probability of passing and the risk of failing the NCLEX-RN.…”

“…Dreher et al go on to erroneously describe the research questions in Spurlock and Hunt in noting, “this analysis seems unproductive given that the core research questions reported were whether or not certain HESI‐E 2 levels are associated with passing the NCLEX‐RN, not with failing the NCLEX‐RN” (p5). First, Nibert and Young wrote, “The HESI Exit Exam (E 2 ) is a secure, comprehensive examination that has demonstrated a high degree of accuracy in predicting NCLEX success as well as identifying those students at risk of failing the NCLEX in the superscripted reference numbers are Lauchner et al, Hanks et al, and Newman, Britt, and Lauchner .…”