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Measuring Competency Levels with Health Education Systems, Inc Exams in Schools of Nursing

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Measuring competency levels with Health Education Systems, Inc Exams in Schools of Nursing

Research critique

Title and Facts

The article that I have chosen to critique is an article that was written by S. Morrison, C. Adamson, A. Nibert, and S. Hsia for who are all PhD, RN licensed. The article is entitled "HESI Exams: An Overview of Reliability and Validity." The title of this article is appropriate and descriptive in that this article addresses the means of measuring the reliability and validity of the Health Education Systems, Inc (HESI) Exams. This article evaluates two HESI exams. These exams are HESI specialty exams and HESI exit exams. The authors tell us within the article why the specialty exam was developed and how it is used. The specialty exam assesses the student's comprehension and ability to relate concepts within particular content areas. Facilities consider the scores from these exams and use them as a replacement for teacher-made final exams. The HESI specialty exams consist of 50-items. The authors speak about midcurricular exams which are custom exams given to students to evaluate several nursing courses consisting of 100-test items as well as making them a valuable tool as an exit exam at the end of the first half of the curriculum. The article goes on to explain the reason the exit exam was developed which is to evaluate students' preparedness for the licensing exam to identify the strengths and weaknesses of the students and the possible need for remediation before they are to take the licensure exam. The exit exam is a 150-item comprehensive exam given towards the end of the curriculum. There are different versions of this exit exam for the RN and the PN students to take. There are currently four versions for RN students and two versions available for PN students. The exit exams have shown to reveal a high degree of accurateness in predicting outcomes of the students that sit for the NCLEX-RN and NCLEX-PN exams. These exams also give a based organization that can be used for program strength, weakness, development and modification. The National League for Nursing Accrediting Commission (NLNAC) and the Commission on Collegiate Nursing Education (CCNE) call for schools of nursing to exhibit a systematic program evaluation. For this reason the schools of nursing have started using these exams more and more in recent years. According to HESI database records (Morrison et al., 2004) the number of schools of nursing using HESI exams increased from 85 in December 1999 to 565 in December 2003, an increase of 565% in 4 years.


The purpose of this article is to explain the methods used to ascertain reliability and validity for these exams, the existing reliability result for HESI specialty exams and HESI exit exams, and the existing validity information in support of HESI specialty and HESI exit exams. The conceptual framework used in developing the HESI exams is grounded in classical test and critical thinking theory. The creation, administration, and interpretation of tests are accomplished through educational and psychological measurement processes (Morrison et al., 2004).

Theoretical Framework

The critical thinking portion of the exam was based on Paul's Critical Thinking Theory (1993) and Blooms Critical Taxonomy (1956). In the article Morrison et al., 2004, makes mention that Crocker and Algina stated that measurement of psychological attributes occurs when quantitative values are assigned to the sample of behaviors obtained from administering a test.

Literature Review

In reviewing the literature it is appropriate, inclusive, informative and up-to-date. There are detailed explanations of the different types of HESI exams, what each one is used for, what the exams are going to prove. However, in the title HESI should have been spelled out initially to give the average reader some incite of what the article was going to be discussing. The authors were detailed and concise in telling us (the reader) about the reliability of the HESI test. I commend the authors for stating up front that the validity of the study is going to be a continued progression that will call for a need of supplementary approaches to ascertain validity beyond those described in the classical test theory evidence of validity will be proven when available.

Ethical Considerations

The ethical consideration in this as stated in the article will be to protect those participates who take the HESI exams, NCLEX-RN, and NCLEX-PN and grant permission to let them gain assess to their results to analyze. In reference to informed consent, it is stated that the researchers plan to obtain permission for use of test scores to be reviewed and analyzed. However, as far as the questionnaire given to the nurse educators evaluating the HESI exam it is not clear if this is an anonymous questionnaire or if the evaluator will be identified.


In observing and classifying similar behaviors of the test taker, the test designer was able to draw assumptions about the psychological constructs that contribute to their makeup. The test designer was also able to recognize associations among psychological constructs and practical consequences, as a result predicting test-taking behaviors, for example accomplishment in nursing practice. The test designer must identify the observations on behalf of the constructs that describe these behaviors initially in order to make these predictions. Syllabi from nursing programs across the United States are used by nurses to play a role in the revision and design along with NCLEX test blueprints provided by



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