Understanding the HESI Score: predicting NCLEX success and best practices for nursing exams

The HESI Score is used to describe performance on nursing Specialty and Exit Exams. The HESI predictability model (HPM), a proprietary mathematical model, is used to calculate each HESI Score (typical range from 0 to 1500). The HPM considers several factors, including the difficulty level of each test item and the performance by that student on all of the items. Research on predictive accuracy of the HESI exams has been conducted using this HESI Score and have found the HESI Score to be highly accurate in predicting NCLEX® success.  

How should the HESI score be interpreted? 

Overall HESI scores can be interpreted and used as always with a HESI score of 850 indicating an Acceptable level of Content Mastery and an NCLEX prediction of passing on first attempt of ≥ 96%. 

What is the HESI Conversion Score 

The HESI conversion score is a calculation based on the overall HESI score that should be interpreted as a more traditional score. This score is often necessary or desired for grade/ gradebook purposes and offers consistency in doing so. It is still, however, a reflection of student performance regarding mastery of content.  

Application of the Conversion Score 

Faculty have reported using the exam as 5% – 15% of the total course grade which seems to be a good balance between incentivizing the test takers to do their best work but not making the exam so important test takers are driven to collude to better their grade. 

Is HESI a reliable reflection of student performance? 

HESI scores are calculated based on each individual test taker’s performance and the difficulty of the items on each exam, ranging from 0 to 1500. Research has shown that students are significantly more likely to pass the NCLEX-RN or NCLEX-PN on their first attempt when they achieve the acceptable or recommended HESI benchmark (850 & 900 respectively).  

What is a recommended HESI score? 

Recent research found ≥ 97% of test takers who score at 850 or higher on the HESI RN exit exam will pass the NCLEX-RN on their first attempt, and ≥ 98% of those scoring 850 or higher on the HESI PN exit exam will pass the NCLEX-PN on their first attempt. 

Best Practices Common to RN & PN HESI Exit Exam Success 

• Require a minimum Exit Exam score (commonly 850) 

• Allow at least three E2 retake opportunities if the minimum score is not met 

• Use HESI remediation tools and content 

• Use of Supporting Elsevier resources such as Sherpath, Shadow Health, Practice Tests & Elsevier Adaptive Quizzing (EAQ) 

• Implement structured remediation learning plans based on student scores 

How are exam items calculated in the HESI score?

The NGN items as well as the multiple-choice multiple answer (MCMA) items are scored using partial credit. That item score is combined with the difficulty of that item in the proprietary HESI formula. Each item is weighted based on the number of Clinical Judgment it contains. For all traditional items and all NGN items within a case, this is a weight of 1 (or unweighted). For all Bowtie and Trend items, these can have a weight of between 1(like the items in a case) to 6 (covering all areas of the Clinical Judgment Measurement Model).