Establishing progression policies with the HESI exit examination: a review of the evidence

Schools of nursing across the United States are seeking ways to ensure their pass rates on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) remain above acceptable levels. One way schools of nursing have been seeking to ensure adequate pass rates is by implementing progression policies. These policies prevent students from taking the NCLEX-RN by either preventing student graduation or withholding permission by the school for the student to take the examination. Many of these policies rely heavily, and sometimes solely, on the Health Education Systems, Incorporated (HESI) Exit Examination as a primary predictor of students' NCLEX-RN outcomes. While the HESI Exit Examination can be a useful tool as part of a school's assessment program, it is not able to accurately predict NCLEX-RN failure; therefore, educators are cautioned in using it as the sole predictor of NCLEX-RN outcomes. Schools would be well served by considering more of the evidence available on predictors of student NCLEX-RN outcomes when considering implementation of progression policies.