Predictive accuracy of the Hesi exit exam on NCLEX-RN pass rates and effects of progression policies on nursing student exit exam scores

A descriptive retrospective research study was used to assess the predictive accuracy of the 2001-2002 Health Education Systems Incorporated (HESI) Exit Exam (E2) on licensure exams, student NCLEX performance associated with various HESI scoring intervals, and the effects of benchmarking and remediation policies on student performance. Also, by means of a t-test, student scores from schools using designated E2 benchmark scores for progression were compared with student scores from schools without such policies. ANOVA was used to evaluate differences in student performance based on ranges of a designated benchmark E2 score as a 1) requirement for graduation 2) capstone course final grade weight; and 3) requirement for remediation; and to examine differences based on program establishment of a single benchmark consequence or combination of two or three benchmarking consequences. The database sample consisted of 182 nursing schools with 9,695 students. E2 was 97.8% accurate in predicting NCLEX success. Significant differences (p<.0005) between scoring intervals indicated that NCLEX-RN failures increased as the scoring interval decreased. A significant difference existed between E2 scores of students enrolled in nursing programs with benchmark policies and those enrolled in programs without policies indicating that students perform better when consequences are attached than when there are no consequences (p < . 0005). When the E2 score was required for graduation, schools with a benchmark set at 80 and below had higher E2 scores than both the 85 (p < .0005) and 90 benchmark (p = .001 ). When E2 scores were calculated as part of the course grade, there were no differences between the three groups (1-5%, 6-10%, and 16-20%). When the E2 was required for remediation, schools with a benchmark of 90 had greater performance than the 85 (p = .001) or the 80 and below (p <.0005) benchmarks. Evaluation of student E2 performance based on number of consequences found that students having two(p <.0005) or three (p = .001) consequences scored higher on the E2 than students having only one consequence. These findings provide information faculties need to make decisions regarding use of E2 scores as a benchmark in progression policies.