Choosing a theoretical framework to guide HESI exit examination research

This article responds to issues raised in 2004 by Spurlock and Hanks, who interpreted data that were presented in four published studies describing the validity of the Health Education Systems, Inc. (HESI) Exit Examination. The argument for using classical testing theory as the preferred theoretical framework to a clinical disease detection model is advanced. While the Spurlock and Hanks article promotes a philosophical bias against the establishment of progression policies within schools of nursing, this article offers another assessment of the merits of detecting at-risk students so timely remediation can occur prior to administration of the National Council Licensure Examination for Registered Nurses (NCLEX-RN). From data presented in the four validity studies, the HESI Exit Examination was reported to be 96.36% to 98.30% accurate in predicting NCLEX-RN success, and those original findings are reaffirmed.