Value-Added of HESI Exam as a Predictor of Timely First-Time RN Licensure

Abstract

The purpose of this research was to determine the extent to which HESI tests scores improve the prediction of timely first-time nursing licensure beyond prediction based only on academic performance in the nursing curriculum. Licensure in less than 140 days post-graduation was the dependent variable used as the operational definition for first-time NCLEX-RN success. Logistic regression was used to estimate the value-added of the HESI as a predictor after controlling for measures of academic performance in the nursing curriculum (GPA in nursing courses and the presence of D or F grades in nursing-relevant courses). HESI exit exam scores substantially improved the prediction of timely licensure. Nurse educators who seek cost-effective interventions for remediation benefit from using both HESI exit scores and data on academic performance in the nursing curriculum to better identify students who are a risk of failure to achieve timely first-time licensure.

Laying the Groundwork for NCLEX Success

“…The document further recommended faculty consider policies including multiple data sources to make decisions about students' competence to graduate. As indicated above, the studies investigating the accuracy of NCLEX predictor examinations have yielded mixed results, 5,6,[9][10][11][12][13] yet many schools use predictive tests as a sole indicator for progression to graduation. Spurlock and Hunt 5 found the HESI predictor examination was only ''fair'' in its prediction of students passing the NCLEX examination.…”

Examining the relationships between NCLEX-RN performance and nursing student factors, including undergraduate nursing program performance: A systematic review

“…This is in contrast with a preponderance of findings that higher nursing GPAs are highly correlated with NCLEX-RN success. [5,7,[9][10][11][12] Consistent with this, Romeo [2] found nursing GPAs to be the most significant predictor for NCLEX-RN success, while Giddens & Gloeckner [13] found program GPSs have a large effect size (p ≤ .001) on NCLEX-RN performance. Haas, Nugent and Rule [3] found nursing GPAs to be significant in prediction to the point that those that were successful on the NCLEX-RN had nursing program GPAs that were 0.3 points higher than those that failed, however the GPA point score at which this difference occurred was not provided.…”

“…The HESI was also a component of a model that predicted NCLEX-RN success along with nursing GPA and failing grades. [12] Studies examining the association between Nursing Entrance Test (NET) results and NCLEX-RN success also show contradictory evidence. Tipton, Pulliam, Beckworth, Illich, Griffin, and Tibbitt [11] found that a high overall NET score did not significantly predict a pass on the NCLEX-RN.…”

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

“…The exit exam is more comprehensive and is designed to be administered at or near the completion of an academic program. 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).…”

“…Every test item is then categorized by several subject areas and each subject area provides subset scores. The HESI Predictability Model, a proprietary mathematical model, is used to calculate the scores for both HESI exams (Lavandera et al, 2011;Morrison et al, 2008). Test items are individually weighted based on the level of difficulty, which Morrison et al (2008) indicates "is determined by dividing the number of correct responses to the item by the total number of responses to that item, thereby deriving a percentage of correct responses to the item" (p. 222).…”