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Controversy over nursing exit exam

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tothepointeLVN, LVN

Specializes in Hospice / Ambulatory Clinic. Has 3 years experience.

I honestly don't get what the fuss is about. I have taken three HESI exams so far Entrance and term 1 and 2 exit exams. The HESI and the way the questions are asked were a lot easier than any questions we had in tests during class and a lot easier than any of the practice nclex. Most people did better on the HESI than they did overall in the class.

llg, PhD, RN

Specializes in Nursing Professional Development. Has 44 years experience.

The big underlying point of controversy in the use of the HESI test as an exit exam is that schools that do a really lousy job of educating the students are using the exam to "hide" the fact that their students are not prepared to pass the NCLEX when they finish their coursework. The schools are passing the students along (taking their money) and not teaching the students what they need to know to succeed in nursing.

Because most people look at the NCLEX pass rate as an indication of the quality of a school ... and many State Boards will actually close a school that does not maintain an acceptable pass rate ... the bad schools can't allow the students to take the NCLEX. So, they use the HESI to screen out those most likely to fail the NCLEX. thus maintaining an acceptable NCLEX pass rate and stay open.

So ... the students are the big losers. They pay money to the school that does not provide good education. At the end, they have "college credit," but no diploma and no endorsement to take the NCLEX. The school takes the money and has no need to improve the education provided because the NCLEX pass rate is acceptable.

It's happening at 2 schools in my area. A third school does't use HESI (I don't think), but gives frequent tests and works the students very hard. They definitely weed out people who are less likely to pass the NCLEX, but don't do a good job of providing education -- particularly on the clinical aspects of nursing. Lots of students either quit the program or flunk out -- but of course by then, the school has collected a lot of money from them.

It's a shame -- but it's not really illegal or anything. These schools are providing a gateway for people to enter the nursing profession -- but a gateway that only works for people who are good test-takers. These schools are not doing a good job of education, but they are providing a service to those who choose to go to their programs. If you can pass the classes (and the tests), they will endorse you to take the NCLEX. For someone who is a strong independent learner, it works.

But for students who need to be nurtured a bit and actively TAUGHT nursing, these programs do a lousy job. And if the students don't realize what they are signing up for when they enroll in such a program .... well ... as the old saying goes, "buyer beware." The attitude is: The students are adults who should research the program before investing their time and money. I don't like it and I am hoping that such schools start losing their NLN and/or AACN accreditations as it becomes more apparent what is actually happening.

Edited by llg

tothepointeLVN, LVN

Specializes in Hospice / Ambulatory Clinic. Has 3 years experience.

I can understand that. Well I guess I am grateful for the fact that my school despite being an expensive trade school teaches us critical thinking enough that the HESI is not an obstacle

Sensoria17

Specializes in LTC.

There were a lot of people in my class who should have been dropped but the instructors kept adjusting the grades so people could pass. Out of 44(day and evening classes) people, only 2 passed. Some people complained nonstop so they lowered the passing score to 750. That still only helped a handful of people. The rest of the class took it again last week and still it sounds like maybe 5 passed.

jollydogg_RN, ADN, BSN

Specializes in OR. Has 12 years experience.

I'm on my third attempt coming up here in mid April on the HESI. At our school, we take the first HESI attempt near the end of our third semester, and then one we just took last week, then the third attempt in mid April.

If we don't pass the third attempt, we can still walk and be pinned with our class (gee, I love fake graduation and pinning ceremonies), but our transcript has an "I" and we get like 2-3 more chances to pass it I think. Only then can we take the NCLEX.

I mean I guess we could have it rougher, since we actually still get to be "pinned" and "Graduate", and not flunk out altogether. We knew all along we were taking a HESI, but I dont think any of us grasped how much more different and HARDER the questions were. We felt fine doing NCLEX questions from various review courses, only to get our brains handed to us in the HESI.

Our first test, out of 60 some odd students, only 5 passed. Our second attempt, maybe another 5-8 passed. The rest of us are on our third try. A few students even dropped 120-140 points and the class average dropped a whole 70 points on the second version of the test!! I mean what does this tell you?

Before our second HESI, we cancelled a Friday class and had a "review" day.... which consisted of some test taking strategies on a power point we already knew, and looking at 20 questions and answering them, from a monotonous lecturer reading them also from a power point..... wow. I guess they did this to cover themselves so they could say they had done a review? NO remediation, NO practice HESIs in the difficulty and format, NOTHING.

You know that gut feeling they say nurses eventually develop when they KNOW something just isnt right? I mean I feel like I've already developed it for this situation. I don't consider myself a dumb student by any means. If all of our hard work over the past two years is going to be judged by a third party exam, shouldn't we be getting specific review for it? Can't they order review material from the company for us instead of hanging us out to dry?

Anyone else feel my pain? All I can do is study harder I suppose. It just doesn't seem right, especially with the nursing shortage. I feel like I should go to our interim director and discuss this, because I know a lot of the other students are in the same boat.

Any suggestions?

Bortaz, MSN, RN

Specializes in CDI Supervisor; Formerly NICU. Has 12 years experience.

My school requires passage of the Exit Hesi as well, with a score of 850. In the 2 years that I have been in this NS, they've had a 20% pass rate on Exit Hesi.

Starting in 1st semester, we've had a mini-Hesi at the end of each semester, related to the subject matter taught in that semester (med-surge 1, pedi, mental, ob, etc). Fairly simple exams that were worth 10% of our course grade.

Now, in a graduating class of over 100, with many many "A" students that pass the mini's each semester with no problems, you'd think they'd prepared us for the Exit, right?

Apparently not, however, as I said: 20% pass rate on the first attempt in the last 2-4 graduating classes.

A week or two ago, our 4th level instructors informed us that we're still going to take the Hesi on exit, and 850 is still passing. However, starting with us, they are also going to administer the NLN Exit exam (which they've promised to meet with us for a bit of orientation to this exam), which is pass/fail.

Basically, we have to pass either the Hesi with 850, OR the NLN exam with "pass", in order to move on to practicum/preceptorship and then graduation/NCLEX.

NOT both. One or the other. Apparently, the NLN is much easier than the Hesi. I guess they got tired of trying to justify that 80% fail rate on Hesi.

As I've stated to them several times: If 10% - 20% of your class is failing, you can blame that on the students not studying or working hard enough or whatever. If 70% - 80% of your class is failing, you need to look at the instruction being given.

I'm pretty much an "A" student (damn you, OB) so far, with just 3-4 months to go. Here's hoping I can pass one of the two!

My school requires passage of the Exit Hesi as well, with a score of 850. In the 2 years that I have been in this NS, they've had a 20% pass rate on Exit Hesi.

Starting in 1st semester, we've had a mini-Hesi at the end of each semester, related to the subject matter taught in that semester (med-surge 1, pedi, mental, ob, etc). Fairly simple exams that were worth 10% of our course grade.

Now, in a graduating class of over 100, with many many "A" students that pass the mini's each semester with no problems, you'd think they'd prepared us for the Exit, right?

Apparently not, however, as I said: 20% pass rate on the first attempt in the last 2-4 graduating classes.

A week or two ago, our 4th level instructors informed us that we're still going to take the Hesi on exit, and 850 is still passing. However, starting with us, they are also going to administer the NLN Exit exam (which they've promised to meet with us for a bit of orientation to this exam), which is pass/fail.

Basically, we have to pass either the Hesi with 850, OR the NLN exam with "pass", in order to move on to practicum/preceptorship and then graduation/NCLEX.

NOT both. One or the other. Apparently, the NLN is much easier than the Hesi. I guess they got tired of trying to justify that 80% fail rate on Hesi.

As I've stated to them several times: If 10% - 20% of your class is failing, you can blame that on the students not studying or working hard enough or whatever. If 70% - 80% of your class is failing, you need to look at the instruction being given.

I'm pretty much an "A" student (damn you, OB) so far, with just 3-4 months to go. Here's hoping I can pass one of the two!

and they didnt like hearing it, did they!!....lol, but true, none the less

Bortaz, MSN, RN

Specializes in CDI Supervisor; Formerly NICU. Has 12 years experience.

No, they didn't. If looks could kill...

No, they didn't. If looks could kill...
:yeah:sometimes the truth hurts....however, someone with an educators background/education, would know this......and recognize the issue.

jollydogg_RN, ADN, BSN

Specializes in OR. Has 12 years experience.

I mean its just funny to me.. most of the instructors at our school are pushing 60. They keep saying "oh, this HESI will prepare you for the NCLEX, because the NCLEX is a lot harder"

did they even have such a thing as the HESI when they passed nursing school? I'm assuming not. How can they just sit there and lie right to our faces?

Mahage, LPN

Specializes in IMCU. Has 1 years experience.

I don't understand how anyone who can't pass the HESI could pass the NCLEX. I took it 3 times, entry, Associates, BSN and it was loads easier than NCLEX. But the real shocker is how on earth a school can get away with having such a low pass rate of the HESI and still stay in business? We had a small class 17 who were pinned together Summers Only class of 2007. All graduated and 100 % passed NCLEX. Regarding the HESI in my RN program, only 2 had to retake it and they passed on the second try. I really am naive I guess, but had no idea that schools would put students through so unprepared. I know that some may have stronger clinicals and weaker didactics but wow.....it is truely a rip off if they are using the HESI to make their NCLEX pass rate look good. I thought they were also being rated by how many of their entering students passed the course. Our instructors considered themselves as failing if we couldn't pass the course, yet the standards were very, very high. Most of Southern's classes have a 100 % pass rate for NCLEX. I saw the HESI as a practice test for NCLEX. We were also required to take a large number of NCLEX prep questions in computerized format every term. This was on our own time at the nursing computer lab. My program was 4 months every summer for 3 years. It was a 12 month accelerated RN program. They told us it would be like "taking a shower under a water hose "and that was the truth! It was extremely intense but we only had 4 who started with us and didn't finish with us. 2 transferred into Southern's traditional nursing program and 2 who left for family issues.

Nursing school is killer hard, so much to learn in so little time and such high stakes! Those schools sound horrible. I feel for the folks who have those programs as their only or only practical options.

Mahage

Edited by Mahage

hypocaffeinemia, BSN, RN

Specializes in Critical Care.

Heh. My school even has two HESI test days on the official calendar: One for all of us to take it, and a second day for all of us who failed the first time to retake it. The fact they're preparing ahead for a significant chunk of the class to fail it says a lot.

BabyLady, BSN, RN

Specializes in NICU, Post-partum.

The big underlying point of controversy in the use of the HESI test as an exit exam is that schools that do a really lousy job of educating the students are using the exam to "hide" the fact that their students are not prepared to pass the NCLEX when they finish their coursework. The schools are passing the students along (taking their money) and not teaching the students what they need to know to succeed in nursing..

:yeah::bow::yeah::bow:

Amen to that.

The purpose of the accrediting the nursing program is to discourage substandard nursing programs.

It's just a way to skew the numbers...if you have 20 students that finish, and only 10 pass the HESI and those same 10 pass the NCLEX...a school can claim a 100% pass rate on the NCLEX.

You would think that the BON's would have a SERIOUS problem with that.

jollydogg_RN, ADN, BSN

Specializes in OR. Has 12 years experience.

Well, I have no problem with the HESI.... as long as it would be put to good use... as in remediation for what your areas of weakness are that are determined after taking the test.

Dont the schools pay money for the HESI exams? And if so, can they not provide the extra remediation tools by the same company to those who are so obviously lacking in the knowledge that we supposedly "need" to pass the NCLEX?

Something isnt right.... this is my first time in nursing school. I've studied the material the instructors assign, I do my extra questions, I've been reading from a Saunders book more recently, and yet still, people who are in my same situation, are on try number 3 for the HESI.

Does this mean I'm not meant to go into the nursing profession? Am I applying what I've learned? This is the first time facing these exams, and the professors are just saying "study harder". Clearly something is NOT working.

Mahage, LPN

Specializes in IMCU. Has 1 years experience.

Well, I have no problem with the HESI.... as long as it would be put to good use... as in remediation for what your areas of weakness are that are determined after taking the test.

Dont the schools pay money for the HESI exams? And if so, can they not provide the extra remediation tools by the same company to those who are so obviously lacking in the knowledge that we supposedly "need" to pass the NCLEX?

Something isnt right.... this is my first time in nursing school. I've studied the material the instructors assign, I do my extra questions, I've been reading from a Saunders book more recently, and yet still, people who are in my same situation, are on try number 3 for the HESI.

Does this mean I'm not meant to go into the nursing profession? Am I applying what I've learned? This is the first time facing these exams, and the professors are just saying "study harder". Clearly something is NOT working.

Does the school not provide some tutoring? We had a tutoring program called ASAP. We met with the ASAP tutor on a regualr basis as a group and individual sessions. I didn't always do the group tutoring but did in my weakest areas. This was for our actual classes, but she met with us prior to HESI, then we had special NCLEX sessions.

Sounds like you are doing all you can, unless these services are offered and you aren't taking them up on the offer. Also you might consider forming a study group if a tutoring group is not available.

Good luck,

Mahage

jollydogg_RN, ADN, BSN

Specializes in OR. Has 12 years experience.

Ha. Our school doesn't offer tutoring. They keep saying stuff as in "if you get below an 80 on a certain test you have to come for tutoring" but they never go through with it. I would be shocked and amazed if they ever offered any real tutoring.

Apparently we haven't had anything other than an interim dean of nursing in the past 6-8 years because we can't keep a dean for more than a couple of years at most. I don't know what this means or what this says about our nursing program. We have a new interim dean, and she seems fairly nice. She helped me get some information I wanted to know and actually followed up with me on it several days later, which is more than I could probably say about some of our instructors.

Do you think talking to the new interim director about this would do anything? I mean I guess it couldn't hurt to try? The thing is, is that I don't want to come off as seeming like I'm acting I'm more than something I'm not. I am just genuinely concerned about what I should be doing so that I can pass this HESI next time.

Mahage, LPN

Specializes in IMCU. Has 1 years experience.

Ha. Our school doesn't offer tutoring. They keep saying stuff as in "if you get below an 80 on a certain test you have to come for tutoring" but they never go through with it. I would be shocked and amazed if they ever offered any real tutoring.

Apparently we haven't had anything other than an interim dean of nursing in the past 6-8 years because we can't keep a dean for more than a couple of years at most. I don't know what this means or what this says about our nursing program. We have a new interim dean, and she seems fairly nice. She helped me get some information I wanted to know and actually followed up with me on it several days later, which is more than I could probably say about some of our instructors.

Do you think talking to the new interim director about this would do anything? I mean I guess it couldn't hurt to try? The thing is, is that I don't want to come off as seeming like I'm acting I'm more than something I'm not. I am just genuinely concerned about what I should be doing so that I can pass this HESI next time.

I would definately make my concerns known. You are only going to be giving her information that she needs to do her job. Try forming a study group with some of the better students. Not the ones who are really floundering, but the ones who are sincere and motivated and try to get someone in there that is having a bit of an easier time. This doesn't take away your schools repsonsibilities, but it can help.

Mahage

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