A Study of the Usefulness of the HESI Exit Exam in Predicting NCLEX-RN Failure

Abstract

Schools of nursing across the country are implementing progression policies that prohibit students from graduating or from taking the nursing licensure examination, sometimes based solely on a single predictive test score. In addition, little empirical evidence exists that supports progression policies as effective in increasing a school's NCLEX-RN pass rates. This article reports on a study conducted when one school did not achieve the results they expected after implementing a progression policy. With use of logistic regression, diagnostic indexes, and other methods, reasons for the disparity between expected and observed NCLEX-RN pass rates were examined. Results revealed that the Health Education Systems, Inc. (HESI) Exit Exam was not able to accurately predict NCLEX-RN outcomes for graduates and, further, that progression policies that allow retest after retest so as to achieve a minimum score on the HESI Exit Exam are not supported empirically. Conclusions and suggestions for schools using or considering progression policies are provided.

Longitudinal Impact of a Targeted Simulation Experience on High-Stakes Examination Outcomes

“…Additionally, many nursing programs require a predetermined score on the exit examination as a condition for graduation from the program. This secures the right to take the NCLEX-RN Ò ; thus, these tests are considered high-stakes (Spurlock & Hunt, 2008).…”

Impact of Adaptive Quizzing as a Practice and Remediation Strategy to Prepare for the NCLEX-RN

“…Some schools go further and implement "high-stakes" testing policies which preclude students This focus on prediction is problematic for several reasons; First of all, while there is evidence that students scoring above a certain threshold are likely to pass the NCLEX-RN [13], there is little or no predictive information about the students who are below the threshold. Furthermore, high-stakes tests do not identify those students at-risk of failing the NCLEX-RN-which is a much more useful piece of information when considering the need for remediation [10] [11]. Finally, the information from predictive tests often comes when students are close to graduation and so the potential impact on student learning is limited.…”

Using Case Studies and Videotaped Vignettes to Facilitate the Development of Critical Thinking Skills in New Graduate Nurses

“…It is longer, with 150 multiple choice items (Lavandera et al, 2011;Morrison et al 2008). The exit exam is frequently used by nursing programs as a predictor of student preparedness for the National Council Licensure Examination (NCLEX) for registered nurses (Morrison et al, 2008;Spurlock & Hunt, 2008).…”

“…It is often used for progression policies and as a predictor of students' NCLEX outcomes. Spurlock and Hunt (2008) (Insight Assessment, 2011;Sullivan-Mann, Perron, & Fellner, 2009). The overall KR-20 for the HSRT was 0.77 to 0.83 (Maneval, et al 2012;Panns, Sermeus, Hieweg, & Van der Schans, 2010 students' critical thinking scores using the HSRT.…”

“…Spurlock and Hunt (2008) and Staib (2003) (Ennis & Weir, 1985) uses written essays to evaluate a given argument and the Cornell Critical Thinking Tests (CCTT), which are designed to measure a wide range of critical thinking abilities. A major limitation of both the Ennis-Weir and the CCTT is that they have not been used in nursing research.…”