Do no harm: progression policies and high-stakes testing in nursing education

Many schools of nursing are adopting progression policies to ensure that school licensure pass rates remain above acceptable levels. These policies prevent students who are predicted to fail the licensure examination from taking the examination, usually by preventing graduation from or completion of the nursing program. Progression policies frequently rely on a single test score from a predictive exit examination, such as the Health Education Systems, Inc. (HESI) Exit Examination, as a measure of whether students are likely to pass or fail the licensure examination and, therefore, whether they are permitted to graduate from the nursing program. In this article, questions about the HESI Exit Examination's test-use validity are explored. Best practices in testing and assessment require faculty to perform a more comprehensive assessment of students' abilities and to not rely on one predictor alone when making important educational decisions. Recommendations and suggestions are provided to guide faculty in decision making about progression policies.