Paper
Friday, July 13, 2007
HESI Exit Exam: Predictive Value for Entry Level Competencies of Novice Registered Nurses
Rosemary Pine, RN, MSN, CDE, Center for Professiaonal Excellence, The Methodist Hospital, Houston, TX, USA
The purpose of this study was to determine if the HESI Exit Exam (E2), which is a highly accurate predictor of NCLEX-RN success, might also measure entry level competencies of novice nurses. The sample consisted of 108 new graduate nurses who took the E2 prior to graduation and were assigned to acute care and critical care units in a large, tertiary-care hospital. Five instruments were used to obtain the data for this study: (1) E2 scores obtained during the final semester or quarter of new graduates’ nursing school programs, (2) NCLEX-RN outcomes reported by the Texas Board of Nurse Examiners within the first three months of employment, (3) Performance Management Systems (PMS) competency evaluation scores, (4) Medication Administration Safety Test (MAST) scores, and (5) 90-Day Performance Appraisal scores. PMS scores ranged from 45.38 to 109.00 (highest possible score is 130) (M = 75.10; SD = 13.67; Mdn = 72.65). MAST scores ranged from 52.00 to 100.00 (highest possible score is 100) (M = 79.16; SD = 11.91; Mdn =77.00). The 90-Day Performance Appraisal scores ranged from 9.00 to 17.00 (highest possible score is 20) (M = 11.37; SD = 1.86; Mdn = 10.62). Based on a chi-square test of independence, the E² was significantly related to NCLEX-RN outcomes (c2(4) = 13.49, p <0.01). As E2 scores decreased, subjects risk for NCLEX-RN failure increased. These findings indicated that the E2 was not only an effective predictor of new graduates’ NCLEX-RN success, but was also as an effective measure novice nurses’ competencies, as measured by the PMS, MAST, and 90-Day Performance Appraisal. As such, E2 scores are potentially useful determinants of the new graduate nurses’ ability to assume entry-level positions within the practice setting.