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Predictive Validity of Standardized Exit Exams for Next Generation NCLEX-PN Outcomes: A Multiprogram Analysis of Exam
Mamta Shah1, Ryan Baker, Michelle Shelly Bussard
1Author Affiliations: Elsevier Inc., Philadelphia, PA (Drs Shah and Lander); Playful Assessments LLC, Philadelphia, Pennsylvania (Dr Baker); Bowling Green State University, Bowling Green, Ohio (Dr Bussard); and Elsevier Inc., Gainesville, Florida (Dr Butts).
Background:
The 2023 Next Generation NCLEX-PN® (NGN-PN) introduced significant changes in content and methodology, necessitating revalidation of standardized exit exams as predictors of licensure success in practical nursing programs.
Purpose:
This multiprogram study examined the predictive validity of the HESI Exit Exam (E2) on first-time NGN-PN pass rates (FTPR) and the influence of institutional E2 policies on student outcomes.
Methods:
Data from 404 practical nursing students across 9 U.S. programs were analyzed alongside institutional E2 policies.
Results:
Achieving E2 benchmarks of ≥850 or ≥900 strongly predicted first-time pass NGN-PN rates (98.5%-98.8%), with passing students scoring nearly 190 points higher than failing peers. While no individual E2 policy was directly linked to passing the NGN-PN on the first attempt, policies such as requiring minimum scores, multiple attempts, practice testing, and structured remediation significantly increased benchmark score attainment.
Conclusion:
These results affirm E2 benchmarks as reliable predictors of NGN-PN readiness and highlight policy approaches that indirectly support licensure success. Incorporating evidence-based testing and remediation strategies may enhance student preparedness and strengthen program outcomes in the evolving NGN assessment landscape.
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