Predicting NCLEX success with the HESI Exit Exam: fourth annual validity study

The fourth annual validity study of the Health Education Systems, Inc. (HESI) Exit Exam was designed to examine not only the accuracy of the examination in predicting NCLEX success but also the degree of risk for failure of the licensure examination associated with specific scoring intervals. A descriptive comparative design was used to examine the data provided by schools of nursing regarding students' NCLEX outcomes in the 1999-2000 academic year. As in the 3 previous studies, the examination was found to be a highly accurate predictor of NCLEX success (98.46%). Each scoring interval was significantly different from each of the other scoring intervals (P = .001). In fact, for the combined group of registered nurse and practical nurse students, the percentage of students who failed the NCLEX more than doubled with each successively lower scoring interval. These findings provide the information faculties needed to make evidence-based decisions regarding students' risks for NCLEX failure. Additionally, frequency data were obtained from this survey regarding the use of the examination as a benchmark for progression and remediation, and these findings may also be useful to faculties that are considering establishing such programs.