Predictability associated with exit examinations: a literature review

The aims of this review are to study the accuracy of commercial examinations for predicting NCLEX-RN® success to determine whether there are significant differences in scores for graduates who pass the NCLEX-RN on their first attempt compared with those who do not and to discuss the implications of the findings in relation to progression policies. The most widely reported relationships between standardized test scores and NCLEX-RN success are associated with the Health Education Systems, Inc. (HESI) Exit Examination. In studies conducted over 4 consecutive years with a total of 17,432 students, HESI was found to be 96.4% to 98.3% accurate in predicting NCLEX-RN success for the highest scoring students. When HESI Exit Examination scores are used in logistic regression models, they are useful only in predicting NCLEX-RN success, not failure. These findings are consistent with reports regarding other computerized examinations. There is mixed evidence that these progression policies result in increased NCLEX-RN pass rates.