Repeat Testing with the HESI Exit Examination: Performance of ADN and BSN Nursing Students

Young, Anne

Saturday, 29 October 2011: 3:55 PM

Anne Young, RN, EdD
Rae W. Langford, RN, EdD
College of Nursing, Texas Woman's University, Houston, TX

Learning Objective 1: describe the outcomes of repeat testing using the HESI Exit Exam for associate degree and baccalaureate nursing students.

Learning Objective 2: evaluate nursing program policies regarding Exit Exam retesting in light of benchmarking requirements and potential NCLEX-RN success.

Purpose: To ensure NCLEX-RN licensure success, nursing faculties have moved to exit testing using standardized examinations. In an effort to promote student success, some schools require remediation for low scoring students followed by repeated exit examinations using a parallel test version derived from the same test pool of questions. The purpose of this study was to (1) evaluate student HESI™ Exit Examination (E²) scores on successive tests and (2) examine NCLEX-RN success potential with retesting.

Methods: Paul’s (1993) critical thinking theory served as a theoretical framework. Data were extracted from the 2009-2010 Elsevier Exit Exam data base containing responses from an electronic survey sent to a stratified random sample of Associate Degree, Baccalaureate, and Diploma program directors. Fifty eight program directors (42%) returned the survey – representing 25 BSN, 29 ADN, and 4 Diploma programs for a total sample of 3,435 students

Results: Student E²performance significantly improved with repeated testing. For the 921 students taking the initial E²and repeating the exam once, mean scores significantly increased from 780.79 (SD=82.59) to 843 (SD=110.79) (t=19.037, df=920, p = .000). The 285 students taking the original E²and then repeating parallel examinations twice for a total of three tests experienced significant scoring increases. Initial test means were 758.95 (SD=88.84) rising to 785.11 (SD=78.58) on the second testing, and again increasing to 821.34 (SD=98.71) [Willks’ Lambda=.704, F (2, 283) = 59.53, p = .000, multivariate partial eta squared = .296]. As E²scores increased, there was a greater likelihood of NCLEX-RN success particularly for second time test takers scoring 850 or greater.

Conclusions: Repeat testing has the potential to guide for remediation efforts followed by retesting. Higher scores on retesting predict greater NCLEX-RN success. Further research is needed regarding additional factors that improve student performance on repeat testing.

See more of: Testing, Exams and Transition to Practice
See more of: Oral Paper & Poster: Science Sessions