Fayetteville State University moved up nursing test’s use

By Corey G. JohnsonStaff writer
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A test employed as an exit exam for Fayetteville State University’s nursing program was originally planned for use in the fall, after the graduation of the first class of nurses, according to documents obtained from the university.
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Instead, the test was given to seniors in the nursing program this spring, and 25 of the 32 failed to graduate when they did not pass the test.
FSU officials have said they administered the test to assess student preparation, not to predict the pass rate for the national licensure exam the students were to take after graduation. And officials have said that the test — developed by Health Education Systems Inc. — was given only after students had been well-informed of the plan to use it.
But according to a 23-page nursing department evaluation plan, the test was intended to “enhance NCLEX-RN (National Council Licensure Examination for Registered Nurses) pass rates.” And the document indicates that the plan was to start using the test “fall 2007 and ongoing.”
It is unclear exactly when the decision was made to use the exam or why it was given during the spring semester instead of the fall. University officials have declined to comment on the specifics of the decision.
Prior warnings
Former FSU nursing faculty members said in recent interviews that a state consultant warned them in 2004 not to implement a standardized exit exam because of their potential to spawn legal disputes. And student handbooks and catalogs from 2004 to 2006 do not mention an exit exam requirement.
But sometime after the summer 2006 arrival of Dr. Willar White-Parson as department chairwoman, the school chose to institute such an HESI exit examination for its first graduating class.
During an honors research class that began in January, the students learned that 80 percent of their final grade would hinge on whether they scored at least 850 on the HESI test. Students complained about the short notice and the lack of test preparation materials. Students also questioned why they were told they must pass the class in order to graduate in light of earlier FSU documents that stated that the class was not required for a degree.
Since the students were not permitted to graduate, some have retained a lawyer to handle their dispute with the school. The students have not filed a lawsuit.
Meanwhile, the State Board of Nursing has delayed granting full approval to FSU’s program. According to a letter sent to the university May 21, the nursing board’s staff concluded that the department is not in compliance with rules requiring clear communication of standards and graduation requirements.
The letter does not specifically mention the requirement that students pass the HESI exam to graduate. The board gave FSU until Aug. 1 to confirm whether the problems have been addressed. FSU had not responded to the board directive as of Wednesday, a board spokesman said.
Published studies
If — as the nursing department planning document suggests — FSU officials wanted to use the HESI exam as a predictor of success on the licensure test, they could have been putting too much stock in it.
Two studies published in 2004 and 2006 in the Journal of Nursing Education found that the HESI exam was not a good predictor of who would fail the licensure exam.
The studies — using HESI’s data — found that the lower a student scored on the test, the less accurate the instrument was in predicting performance on the national licensure exam. In one example, 2,978 out of 3,073 students passed the licensure exam despite failing to obtain the HESI cutoff score.
Darrell Spurlock Jr., a nursing professor at Mount Carmel College of Nursing, was one of the study authors.
“There is literally no strong research that shows whether these exams improve a school’s pass rate,” Spurlock said. “If this (HESI) was a pill you wouldn’t be allowed to take it.”
Officials at Elsevier, the parent company to HESI, could not be reached for comment.
HESI researchers have published articles arguing that Spurlock used an inappropriate theory to analyze HESI data.