The predictive accuracy of HESI A2, MC and E2 exams on successive HESI exam scores and NCLEX-RN outcomes in an associate degree nursing program

The purpose of this study was to examine the predictive accuracy of standardized nursing exams produced by Health Education Systems, Inc., (HESI) used in an associate degree nursing program, and the National Council Licensure Examination for Registered Nurse (NCLEX-RN), provided by the National Council of State Boards ofNursing (NCSBN). Specifically, this study will determine the accuracy of student scores on three HESI exams in predicting success on each successive exam presented in the curriculum, beginning with the Admissions Assessment (A 2 ), followed by the Mid-Curricular (MC), concluding with the Exit Exam (E2), and ultimately determined by NCLEX-RN success. The study included 139 students who took the HESI A2 , MC, E2 and NCLEXRN from August, 2002 through October, 2004. The A2 is comprised of nine different exams. Seven of these exams are academically oriented, consisting of math, reading comprehension, grammar, vocabulary, chemistry, anatomy and physiology, and biology. Only the math and reading comprehension exams were administered to the

study population prior to admission into the nursing program. Scores on this exam were used as a component of the selection process. Faculty designated 850 as the benchmark score for the MC, administered half way through the curriculum, and the E2 , administered during the last semester of the curriculum. A descriptive longitudinal study design was used to examine the relationship of the scores of the HESI A2 to the MC, the MC to the P, and the P to the NCLEXRN. Data analysis revealed that the A2 Math and Reading Comprehension sub-exam scores were not predictive ofMC success with an accuracy rate of20.6%. The MC was extremely predictive at 100% in predicting £2 success. The E2 was highly predictive ofNCLEX-RN success at a rate of94.5%. A Chi-square Goodness of Fit calculation was used to analyze the exams and attrition from the program due to poor academic performance, but no statistically significant relationship between these variables was observed. Utilizing standardized nursing exams assists nursing schools in identifying students who are at-risk academically, and will likely require remediation to be successful.