Predictors of NCLEX-RN success in a baccalaureate nursing program as a foundation for remediation

This study evaluated students' demographic and nursing program variables and standardized test scores to determine whether significant differences existed between students who successfully completed the National Council Licensure Examination for Registered Nurses (NCLEX-RN) and those who were unsuccessful. In addition, the predictive accuracy of two standardized examinations, the Mosby AssessTest and the Health Education Systems, Incorporated (HESI) Exit Examination were compared. Two cohorts of graduating senior nursing students were studied (1999 cohort N = 121; 2000 cohort N = 103). Demographic and nursing program variables were obtained from student records. The Undergraduate Studies Committee provided standardized test scores (Mosby AssessTest in 1999; HESI Exit Examination in 2000). Only two program variables were consistently associated with success on the NCLEX-RN--final course grade for a didactic, senior-level medical-surgical nursing course and cumulative program grade point average. Scores on both standardized tests were significantly different in students who were successful on the NCLEX-RN and those who were not. The HESI Exit Examination demonstrated greater sensitivity, specificity, positive and negative predictive value, and test efficiency, compared with the Mosby AssessTest. Use of program variables and students' standardized test scores may allow faculty to identify students at risk for failing the NCLEX-RN and to provide structured remediation so these students may be successful on the licensing examination and begin their nursing careers.