Standardize Predictive Testing: Practices, Policies, and NCLEX-RN Outcomes
Langford, Rae W.
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Purpose: A major indicator of nursing programs' effectiveness is the pass rate on national licensure examinations among first-time candidates. Twenty years of evidence supports use of standardized examinations for undergraduate end of program assessment to facilitate knowledge development, ensure competence of new graduates, and demonstrate organizational and curriculum effectiveness. While re-validation of standardize exams is an ongoing process, little is known about the effectiveness of remediation practices of nursing educational programs in regards to progression policies, remediation practices and re-testing with parallel exam versions. The aims of this study were to investigate continued accuracy of a predictive exit exam, testing and remediation policies and practices, and to determine the outcomes of repeat testing. Methods: Deans and directors of nursing schools that administered Elsevier HESI™ Exit Exam (E2) students during the 2010 academic year responded. Data were collected regarding students' national nursing licensure examination outcomes and the schools' remediation and re-testing strategies and policies. Results: A random stratified sample of 5438 student records was obtained, 3084 were from Associate Degree (AD) and 2354 were from Baccalaureate Degree (BD) programs. NCLEX outcomes were known for all but 316 (5.8%) students. The re-validation accuracy of the E2 for NCLEX-RN success was 98.26% for students scoring 900 and above. As E2 scores decreased failure rates increased. Seventy-three (74%) of the 98 schools had exit policies, the most frequent established benchmark score was 90%, and 74% of schools counted the standardized exam as part of course grades. More than 60% of the student remediation strategies were student self-directed, including review based on testing reports. Conclusion: A national United States sample of BD and AD nursing programs has found that electronic standardized end of program assessments are highly accurate at predicting licensure success. Faculty's implementation strategies, policy development, and methods for remediation will be discussed.