NCLEX-RN readiness: HESI Exit Exam validity and nursing program policies

Predictors of attrition and program dismissal in a nursing major

BACKGROUND

Increasing the representation of nurses and other health professionals from minority populations is one way to address health disparities. The purpose of this study was to investigate nursing admission criteria that predicted first, second, third semester attrition and program dismissal.

METHOD

A retrospective secondary data analysis was conducted on existing student records spanning from 2016 to 2020 in one BSN program from a Hispanic-serving institution to gain an understanding about program attrition and dismissal. A total of n = 349 student records were included in the analysis.

RESULTS

Pre-nursing science GPA, pre-nursing college GPA, and reading ability were found significant predictors for attrition and dismissal, respectively.

CONCLUSIONS

Aptitudes in the sciences and in reading should be emphasized in pre-nursing to enhance student success in nursing. Findings from this study could inform administrators in postsecondary and in secondary education about establishing infrastructures for at-risk students to better prepare the latter for a nursing major.

Standardized Nursing Examination Remediation: A Program Evaluation

BACKGROUND

Nurse educators at a public university expanded their standardized examination program in Spring 2020 to include more specialty examinations, required remediation, and retesting for students who did not attain benchmark scores. This study conducted a remediation-focused program evaluation.

METHOD

A mixed-methods design was used. Aggregated deidentified Health Education Systems, Inc. (HESI) specialty examination scores (n = 907) were analyzed. Feedback from nursing students and recent alumni (n = 70) was collected using a Qualtrics survey.

RESULTS

For students scoring under benchmark, higher remediation time requirements led to greater increases in second-attempt specialty examination scores. More alumni than current students reported remediation was helpful (p = .029). Participants' perspectives regarding remediation barriers, helpful strategies, and motivating policies were identified. Five themes emerged from open-ended survey comments, adding depth to the quantitative findings.

CONCLUSION

Recommendations for standardized examination remediation strategies and policies are offered. [J Nurs Educ. 2023;62(9):519-522.].

Supporting student success on the practical nurse (PN) licensure exam: The Health Education Systems Incorporated (HESI) PN Exit Exam Study

BACKGROUND

Practical Nurses or Vocational Nurses (PNs/VNs) complete a 12-month certificate program and must successfully complete the National Council Licensure Exam for Practical Nurses (NCLEX-PN) prior to practice. While the scope of their practice is more circumscribed than the Registered Nurse (RN), they contribute significantly to healthcare throughout the U.S.A. Current research to support their learning and success is needed. Elsevier's Health Education Systems Incorporated (HESI) PN Exit Exam (E2) has been used to determine students' NCLEX-PN readiness for over 20 years. Given regular updates to the NCLEX test plan, ongoing research is needed to assess the E2's continued predictive validity and examine E2 program policies to enhance PN/VN student success.

OBJECTIVES

To examine the predictive validity of the E2 on NCLEX-PN first-time pass rates (NCLEX-PN FTPR) and determine which E2-related program policies are related to higher E2 scores and NCLEX-PN FTPR.

METHOD

Sixteen PN/VN program directors participated in the study, providing E2 program policy information and NCLEX-FTPR outcomes for 1371 students who took the E2 between 2018 and 2021.

RESULTS

Students passed the NCLEX-PN 96-98 % of the time when they scored 900 or higher on the E2 and passed 94 %-96 % of the time when they scored 850 or higher. Out of 16 programs, most required E2 test preparation (n = 13, 81.25 %) and allowed students more than one E2 attempt (n = 11; 68.75 %). Requiring minimum E2 scores and specific E2 test preparation were associated with higher NCLEX-PN pass rates, in each case mediated by higher E2 scores. Requiring remediation for students with low initial E2 scores led to higher E2 scores but not higher NCLEX-PN pass rates.

CONCLUSIONS

This study provides evidence for program policies and educational resources to support students' NCLEX-PN success. Setting an expected performance benchmark and requiring PN students to engage in E2 preparation prior to their first attempt are recommended strategies emerging from this study.