Paper
Friday, 21 July 2006
This presentation is part of : Obtaining Evidence of Reliability and Validity for Computerized Examinations Used in Graduate and Undergraduate Nursing Programs
Reliability and Validity of the HESI Exit Exam: Research Findings from Six Years of Study
Ainslie Nibert, RN, PhD, Health Education Systems, Inc. (HESI), Houston, TX, USA, Anne Young, RN, EdD, College of Nursing, Texas Woman's University, Houston, TX, USA, and Carolyn Adamson, PhD, College of Nursing - Houston Center, Texas Woman's University, Houston, TX, USA.
Purpose: This presentation will describe research studies examining the accuracy of the Health Education Systems, Inc. (HESI) Exit Exam (E2) in predicting NCLEX-RN success for associate degree (ADN), baccalaureate degree (BSN), and diploma nursing students.
Design:  Descriptive, comparative designs employing chi squares were used to determine the accuracy of the E2 in predicting NCLEX-RN outcomes.
Population, Sample, Setting, Years: 
Responses of school administrators to questionnaires and their students’ aggregate E2 scores comprised the data.  The five previous studies examined 27,809 graduating RN students’ scores who took the E2 prior to graduation. Responses from 449 RN program directors who administered the E2 to 24,038 students in 2004 will be solicited Spring 2006 for a sixth study.
Concept or Variables Studied Together:  Predictive accuracy of the E2 and comparisons of student scores in five scoring intervals were made with their NCLEX-RN outcomes.
Methods: In five previous studies, the E2’s predictive accuracy was calculated, and chi square analyses detected differences among NCLEX-RN outcomes of students scoring in each of the five scoring intervals, among scores by program type, and across five years.  The sixth study employs the same methodology and will summarize self-reported demographics of the aggregate.
Findings:  The E2 was found to be 96.36% to 98.30% accurate in predicting NCLEX-RN success across five academic years, and will again be calculated in the sixth study. No significant differences were found in the predictive accuracy of the E2 by program type or among years studied. 
Conclusions:  The likelihood of NCLEX-RN failure increased as E2 scores decreased.  The E2 remains a highly accurate predictor of NCLEX-RN success.
Implications:  Establishing instrument reliability and validity is a continuous process essential for ensuring instrument quality; therefore, assessment of the E2’s accuracy in predicting NCLEX-RN success requires ongoing study.

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