Predicting NCLEX success with the HESI exit exam: Results from four years of study

The fourth annual validity study of the Health Education Systems, Inc. (HESI) Exit Exam (E²) was designed to examine not only the accuracy of the E² in predicting NCLEX success, but also the degree of risk for failure of the licensure exam associated with specific scoring intervals. A descriptive, correlational design was used to examine the data provided by schools of nursing regarding students' NCLEX outcomes in the academic year 1999–2000. As in the three previous studies, the E² was found to be a highly accurate predictor of NCLEX success (98.46%). Each scoring interval was significantly different from each of the other scoring intervals (P = .001). In fact, for the combined group of RN and PN students, the percentage of students who failed the NCLEX more than doubled with each successively lower scoring interval. Of the 2,059 RN students who scored in the A/B category, 35 (1.70%) failed the licensing exam; of the 1,014 students who scored in the C category, 60 (5.92%) failed; of the 980 students who scored in the D category, 106 (10.82%) failed, of the 1,324 students scoring in the E/F category, 314 (23.72%) failed, and of the 526 students scoring in the G/H category, 264 (50.19%) failed. These findings provide the information faculties need to make evidence-based decisions regarding students' risk for NCLEX failure. Additionally, frequency data were obtained from this survey regarding the use of the E² as a benchmark for progression and remediation, and these findings may also be useful to faculties that are considering establishment of such programs.

This study investigated use of the HESI Exit Exam (E²) as a benchmark for progression. Data obtained from 158 schools of nursing indicated that: (1) faculties are increasingly adopting policies that specify E² scores as benchmarks for progression; (2) a HESI score of 85 is the most frequently used benchmark; and (3) completion of a remediation course followed by mandatory re-testing is the strategy most frequently prescribed for those who fail to achieve designated benchmarks.