The HESI exit examination as a predictor of employment success

The study was designed to determine the validity of indicators of competency used to predict success for new graduate registered nurses in the acute care setting. Employment of new graduate nurses is a challenge for hospitals. The assessment process requires an investment of time and dollars. The best candidates need to be selected for available positions.

The study was conducted at an 888-bed hospital located in southwestern United States. One hundred and eight nurses employed in acute care within three months of graduation beginning June 1999 and ending January 2003 participated. Five instruments were used to gather data for the study: Health Education Systems Incorporated Exit Examination (HESI E2); NCLEX-RN; initial competency assessment; medication test; and 90-day performance appraisal.

Data were collected with the permission of the nurses. A descriptive, correlational design was used to determine the validity of the HESI E 2; NCLEX-RN outcomes; initial competency assessment scores, medication test scores and 90-day performance appraisal scores in predicting success of new graduate nurses in the workplace.

Predictive validity of the HESI E2 in forecasting NCLEX-RN outcomes for the study was 100%. Positive correlations were obtained on HESI E2 scores, initial competency assessment scores (r = 0.26, p = 0.01), and medication test ( r = 0.22, p = 0.05) scores. There was no relationship between HESI E2 scores and 90-day performance appraisals.

HESI E2 was effective in predicting success for new graduate nurses. Further study is needed to clarify nursing management issues related to the adoption of policies that require the use of nursing competency indicators to assist managers with employment decisions.