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.

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

BACKGROUND: The HESI® Exit Exam (E2) has been used to assess student readiness for the NCLEX-RN® examination for over two decades. PURPOSE: In this study, we examined the relationship between students' average E2 scores and their first time NCLEX-RN pass or fail outcomes to understand the validity of the E2 as a predictor of NCLEX-RN readiness. In addition, we examined the relationship between policies governing E2 use in programs and success on the NCLEX-RN. METHODS: Over 40 programs across the United States participated in the study, providing NCLEX-RN outcome information for 3686 students that took the E2 in 2018-2019 and information about policies. RESULTS: Students who achieved an average E2 score of 850 and above had a NCLEX-RN first-time pass rate (FTPR) of 96.33%. The NCLEX-RN FTPR was 97.29% for students whose average E2 score was 900 and above. Policies such as test preparation requirements and remediation for the E2 were associated with statistically significantly higher student NCLEX-RN FTPR. CONCLUSION: This study builds upon past evidence about the validity of the E2 and extends research in new directions by demonstrating the role of specific E2 policies in supporting students' success on the NCLEX-RN.