HESI Admission Assessment (A2) Examination Scores, Program Progression, and NCLEX-RN Success in Baccalaureate Nursing: An Exploratory Study of Dependable Academic Indicators of Success

doi:10.1016/j.profnurs.2014.01.007

Journal of Professional Nursing

Volume 30, Issue 5, September–October 2014, Pages 436-442

https://doi.org/10.1016/j.profnurs.2014.01.007 Get rights and content

In an effort to meet the demand for well-educated, high-quality nurses, schools of nursing seek to admit those candidates most likely to have both timely progression and first-time success on the National Council Licensure Examination for Registered Nurses (NCLEX-RN). Finding the right combination of academic indicators, which are most predictive of success, continues to be an ongoing challenge for entry-level baccalaureate nursing programs across the United States. This pilot study explored the relationship of a standardized admission examination, the Health Education Systems, Inc. (HESI) Admission Assessment (A²) Examination to preadmission grade point average (GPA), science GPA, and nursing GPA using a retrospective descriptive design. In addition, the predictive ability of the A² Examination, preadmission GPA, and science GPA related to timely progression and NCLEX-RN success were explored. In a sample of 89 students, no relationship was found between the A² Examination and preadmission GPA or science GPA. The A² Examination was correlated with nursing GPA and NCLEX-RN success but not with timely progression. Further studies are needed to explore the utility and predictive ability of standardized examinations such as the A² Examination and the contribution of such examinations to evidence-based admission decision making.

Section snippets

Academic Factors

Previous studies have cited academic factors as predictive in both progression and NCLEX-RN success. These included prenursing academic achievements, for example, high school rank, preadmission grade point average (GPA), nursing prerequisite/science GPA, achievement in individual science courses, SAT or ACT scores and scores on the Watson–Glaser Critical Thinking Appraisal (Beeson and Kissling, 2001, Seldomridge and DiBartolo, 2004, Waterhouse and Beeman, 2003). In their study, Seldomridge and

Design

An exploratory retrospective descriptive design was used to compare undergraduate nursing student predictors of first-time success on the NCLEX-RN and timely progression through the nursing program.

Sample and Setting

The population for this study was traditional undergraduate nursing students from a midsized public, accredited, baccalaureate nursing program located in a rural area of the mid-Atlantic during the period 2008–2010. Three cohorts were admitted to the nursing program for the fall semester in each

Sample Characteristics

Demographic characteristics of all students and the final sample (n = 89) can be seen in Table 1. Seventy-three (82%) of subjects completed the major, five (5.6%) were still in progress, and 11 (12.4%) withdrew, changed major, or were dismissed. The majority of the sample was female (93.3%, n = 83). Preadmission GPAs ranged from 2.78 to 4.0 with a mean GPA of 3.39 (SEM = .02, SD = 0.31). Scores on the A² Examination ranged from 66.3–93.94 (M = 84, SD = 0.32). Of those students who had taken the

Discussion

These findings suggest that although a significant relationship exists between preadmission GPA, science GPA, and timely progression through a nursing program, the role of the A² Examination as a predictor of timely progression is of no help, based on these data. Interestingly, the A² Examination was not significantly correlated with either the preadmission GPA or science GPA in our study. In contrast, Murray, Merriman, and Adamson (2008) found a strong correlation between A² Examination scores

Conclusion

The results of this study suggest that preadmission and science GPAs may be good predictors of timely progression in a nursing program. However, in our sample, the A² Examination was not correlated with preadmission GPA or science GPA and did not inform our nursing admissions process. Although the A² Examination correlated with nursing GPA, our data show that it had no predictive value regarding timely progression within the program. The low number of NCLEX-RN failures among participants makes

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Nursing schools strive for timely progression. The purpose of this pilot study was to use the Emergenetics Profile to determine if specific preferred ways of thinking and behaving support on-time progression.
Predictive, correlational design tested the relationship among Emergenetics Thinking Attributes, Behavioral Attributes, and on-time graduation. Thirty eight senior students participated.
Using multiple regression, the attributes of Structural thinking and Flexible behavior (p<.05) predicted on-time graduation.
Paying attention to the details and keeping on task, while remaining flexible to change will lead to success in nursing school.
Non-academic admission criterion of certified nursing assistant status for undergraduate nursing programs: A comparative case study
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Along with the general nursing shortage, the supply of qualified nurse educators for employment at many academic institutions is also inadequate (American Association of Colleges of Nursing, 2020). This factor has led to a limited number of available seats in undergraduate nursing programs, which results in program administrators and faculty striving to fill these seats with individuals who will complete the program and enter the workforce (Hinderer, Dibartolo, & Walsh, 2014; Strickland & Cheshire, 2017). The registered nurse workforce is currently experiencing shortages, with 20.6% of hospitals nationwide having more than a 10% vacancy rate (Sheffield, 2016).
The number of nursing program graduates does not meet the current demand for nurses. Program faculty relies on the predictive power of admission criteria to admit students who will be successful. Non-academic admission criteria, such as Certified Nursing Assistant (CNA) status, should be considered to complement academic criteria.
This study aimed to explore nursing students' perceptions and clinical faculty of the non-academic prerequisite of CNA status as an admission criterion. First-year students' preparedness for the clinical setting, self-confidence, and anxiety in clinical decision making (CDM) was considered.
A multi-methods comparative case study design was utilized. The setting was two undergraduate baccalaureate nursing programs. Nine faculty and 54 students participated in the study. The researcher collected data through interviews with the participants, observations, document analysis, field notes, and self-report on the Nursing Anxiety and Self-Confidence with Clinical Decision Making (NASC-CDM) scale.
Three themes emerged from the interview data: (a) student preparedness, (b) student learning, and (c) student program success. No statistically significant differences in student anxiety or self-confidence were found in the NASC-CDM scale.
The investigation of CNA status could be an essential aspect of the undergraduate nursing program admission process.
Systematic review: Predictors of students’ success in baccalaureate nursing programs
2020, Nurse Education in Practice
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The pre-admission science GPA has consistently been found to be a significant predictor of students' nursing GPA—that is, students with higher prerequisite science GPAs tend to have higher GPAs in their nursing courses (McClelland et al., 1992; Strickland and Cheshire, 2017; Wambuguh et al., 2016). These results are in agreement with other research findings in this review, which have reported that pre-admission science GPA is also a significant predictor of students’ timely progression in the nursing program (Hinderer et al., 2014) and program completion (Byrd et al., 1999; Elkins, 2015; Tartavoulle et al., 2018). Many nursing schools employ one or more standardized entrance exams as a means of assessing students' preparedness for the nursing program.
Nursing schools strive to select a diverse student population who are likely to succeed by ensuring timely student progression through the program and effective use of educational sources. The purpose of this systematic literature review is to explore the preadmission variables and selection criteria that predict student success in 4-year baccalaureate nursing programs in the U.S. Sixteen articles met the eligibility criteria, and six measures were used to define student success: (a) early academic success, particularly during the first and second year; (b) attrition; (c) timely completion of the program; (d) graduation; (e) performance in nursing courses; and (f) academic performance in other science courses. Typically, the core set of cognitive predictors used in the admission process in nursing schools were pre-nursing GPA, pre-nursing collegiate science GPA, and scores on standardized aptitude exams. This review suggests that it is challenging to isolate one single variable as the best predictor of student success; however, using a combination of variables can offer a reliable prediction method. More researchers should consider using a theoretical basis to guide their inquiry on this topic. Additionally, researchers should examine admission variables that are most relevant across programs.
Preadmission predictors for first semester course success in a baccalaureate nursing program
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This analysis supports that higher grades in previous courses and specifically, prerequisite science courses, and higher scores on the TEAS test predict success in first semester nursing courses (Liu, Codd, & Mills, 2018). Studies support that preadmission GPA is a significant predictor of first semester (Kowitlawakul et al., 2013) and overall nursing program success (Hinderer et al., 2014; Manieri et al., 2015; Timer & Clauson, 2011). Others found that prerequisite science GPA is significantly associated with positive course outcomes in first semester nursing students (Hinderer et al., 2014; Kowitlawakul et al., 2013; Mthimunye et al., 2018; Murray et al., 2008; Wambuguh et al., 2016) and nursing program success (Van Hofwegen et al., 2019).
Identifying students' who are able to complete a rigorous course of study, graduate on time, and pass the NCLEX-RN© is a principle role of nursing program admissions teams.
To examine which preadmission factors predict students' success in the first semester of a baccalaureate nursing program.
Undergraduate students' data from the academic years 2013 to 2017 were analyzed (N = 927). Bivariate and multiple regression analyses were used to examine potential predictors of first semester course success, and scores on standardized NCLEX preparation exams.
Preadmission cumulative GPA (OR = 3.82, 95% CI = 1.43–10.16) and prerequisite science GPA (OR = 2.57, 95% CI = 1.14–5.78) predicted success in the pathopharmacology course. Preadmission cumulative GPA (OR = 6.53, 95% CI = 1.59–26.85) and TEAS composite score (OR = 1.15, 95% CI = 1.09–1.22) predicted success in the health assessment course. Preadmission cumulative GPA (OR = 3.42, 95% CI = 1.18–9.92) and TEAS composite score (OR = 1.05, 95% CI = 1.01–1.10) predicted success in the foundations course. Higher preadmission cumulative GPA (B = 14.19, p < 0.01), prerequisite science GPA (B = 12.62, p < 0.01), and TEAS composite score (B = 0.48, p < 0.01) predicted a higher pathopharmacology-KAPLAN, Inc. test scores. Higher preadmission cumulative GPA (B = 62.52, p < 0.01), prerequisite science GPA (B = 61.18, p < 0.01), and TEAS composite score (B = 4.76, p < 0.01) predicted a higher fundamentals-HESI test scores.
Preadmission cumulative GPA, prerequisite science GPA, and TEAS composite score were significant predictors of success in first semester courses and performance on standardized tests.
Nurse educators’ use of lecture and active learning
2019, Teaching and Learning in Nursing
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Active learning strategies may improve some student learning outcomes, but does using active learning strategies support new graduate success on the nursing licensure examination? Most literature regarding forecasting graduate success on the National Council Licensure Examination (NCLEX) is tied to traditional markers including predictor examinations and course grades (Hinderer, Dibartolo, & Walsh, 2014; Johnson, Sanderson, Wang, & Parker, 2017). As a starting point, we conducted a survey to explore how educators perceive the extent of their use of lecture versus active learning in the classroom in prelicensure nursing programs.
The results of numerous studies suggest that by using active learning strategies educators can improve student learning outcomes. We asked 536 nurse educators teaching in prelicensure programs to estimate the extent that they integrate active learning strategies into their courses. There were no relationships identified between the estimated extent of active learning use and program National Council Licensure Examination pass rates.
Instituting Evidence-Based Changes to Improve First-Time NCLEX-RN® Pass Rates
2018, Journal of Nursing Regulation
First-time National Council Licensure Examination-Registered Nurse (i.e., NCLEX-RN®) pass rates are important criterion in evaluating the effectiveness of prelicensure nursing programs. This article describes one baccalaureate nursing program’s approach in developing and implementing comprehensive, evidence-based strategies to effectively halt a 3-year decline in the program’s annual first-time pass rates. Strategies included revisions in student policies related to admission, progression, and graduation; a comprehensive curriculum revision; and faculty development. These data-driven strategies improved first-time NCLEX-RN pass rates from 64.86% to 94.29% over 3 years—a dramatic 45% increase.

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Original ArticleHESI Admission Assessment (A2) Examination Scores, Program Progression, and NCLEX-RN Success in Baccalaureate Nursing: An Exploratory Study of Dependable Academic Indicators of Success

Section snippets

Academic Factors

Design

Sample and Setting

Sample Characteristics

Discussion

Conclusion

Journal of Professional Nursing

Journal of Professional Nursing

Nurse Education Today

Journal of Professional Nursing

Journal of Professional Nursing

Nurse Education Today

Nurse Education Today

Journal of Professional Nursing

Journal of Professional Nursing

A closer look at academic probation and attrition: What courses are predictive of nursing student success?

Nurse Education Today

A review of intervention studies to promote NCLEX-RN success of baccalaureate students

Nurse Educator

Original Article
HESI Admission Assessment (A²) Examination Scores, Program Progression, and NCLEX-RN Success in Baccalaureate Nursing: An Exploratory Study of Dependable Academic Indicators of Success