A comparison of two nursing program exit exams that predict first-time NCLEX-RN outcome

Area of Science:

• Nursing Education
• Health Professions Assessment

Background:

• Baccalaureate nursing programs utilize exit examinations to assess student preparedness for licensure.
• Predictive accuracy of these exams for NCLEX-RN success is crucial for program evaluation and student support.

Purpose of the Study:

• To compare the predictive accuracy of two standardized nursing exit examinations: the Health Education Systems, Inc, Exit Exam and the Assessment Technologies Institute's RN Comprehensive Predictor.
• To determine which examination is a better predictor of success on the RN licensure examination (NCLEX-RN).

Main Methods:

• Retrospective descriptive correlational study design.
• Logistic regression analyses were used to assess the predictive accuracy of both examinations administered to senior baccalaureate nursing students.
• Key metrics evaluated included odds ratio, sensitivity, specificity, and overall accuracy.

Main Results:

• Both the Health Education Systems, Inc, Exit Exam and the RN Comprehensive Predictor were statistically significant but weak predictors of NCLEX-RN success.
• The RN Comprehensive Predictor demonstrated a slightly better odds ratio compared to the Health Education Systems, Inc, Exit Exam.
• Both examinations exhibited similar sensitivity, specificity, and overall accuracy in predicting licensure examination outcomes.

Conclusions:

• While both reviewed exit examinations have limited predictive power for NCLEX-RN success, the RN Comprehensive Predictor showed marginally superior performance.
• Given its inclusion in an existing review program and slightly better predictive value, the nursing faculty opted to exclusively use the RN Comprehensive Predictor for NCLEX-RN preparation.