Award Date

December 2016

Degree Type


Degree Name

Doctor of Philosophy (PhD)



First Committee Member

Lori Candela

Second Committee Member

Carolyn Yucha

Third Committee Member

Reimund Serafica

Fourth Committee Member

Alice Corkill

Number of Pages



Every nursing program wants its graduates to pass the NCLEX-RN licensure examination the first time they take it. For those who fail, entry into practice is delayed until they can pass the NCLEX-RN. The nursing programs that graduated students who fail may experience a loss of reputation, decreased numbers of potential applicants, and, ultimately, state board of nursing sanctions. In an effort to determine which students are likely to be successful in taking the NCLEX-RN, many programs have turned to end-of-program predictor exams such as the Health Education System Inc. (HESI) exit examination (E2) (Lauer & Yoho, 2013; Nibert & Morrison, 2013; Reinhardt, Keller, Summers, & Schultz, 2012; Simon & Augustus, 2014). Students who score greater than 900 on the HESI E2 have a 96.36% to 99.16% probability of passing the NCLECX-RN on their first attempt (Adamson & Britt, 2009; Young & Willson, 2012; Zweighaft, 2013).

Nursing programs are very interested in identifying, and hopefully avoiding, barriers that may prevent their students’ academic success. Nearly all of the predictive literature that is available relates to academic barriers, such as GRE scores and prerequisite science grades, versus nonacademic barriers, such as stress, motivation, and competing work/family demands focus on the NCLEX-RN, not the HESI E2. Eddy and Epeneter (2002) suggest that nonacademic barriers, such as internal issues of anxiety and stress or external issues of family and financial demands are more important in predicting success but are much more challenging to study. Given the importance of nonacademic barriers and the 96.36% to 99.16% predictive accuracy of the first time scores on the HESI E2 to predict first time success on the NCLEX-RN, it is important that nurse educators also focus efforts on identifying nonacademic barriers. This descriptive, correlational study targeted graduating baccalaureate nursing students prior to their first attempt on the HESI E2. The study investigated the 15-item Internal and External Block Scale (IEBS) measuring nonacademic barriers, created by Arathuzik and Aber (1998), to determine whether there were statistically significant correlations between nonacademic barriers to success and performance on the end-of-program predictor exam HESI E2.

Fifty-nine baccalaureate nursing students participated in this study. No statistically significant correlations were found between any of the individual internal barriers or the individual external barriers and the performance on the HESI E2. In addition, there were no significant correlations found when analyzing the summary score representing the mean of all internal barriers or the summary score representing the mean of all external barriers, in relation to performance on the HESI E2. While this study provided no statistically significant findings related to nonacademic barriers to students’ performance on the HESI E2, nursing educators need to continue to investigate ways to assess and address nonacademic barriers to success. Further study, with a larger sample size, needs to be completed.

In addition, a future study that uses the IEBS near the beginning of the nursing education program may provide more relevant results. This study could evaluate correlations between IEBS results to a fundamental nursing course grade or a standardized subject matter final provided by a company such as Elsevier, which is similar to the HESI E2 used in this study. Periodically reassessing students throughout their nursing education could provide multiple opportunities for faculty to offer available resources for the students with nonacademic barriers.


End of program predictor exams; HESI E2; High stakes exams; NCLEX-RN; Nonacademic barriers


Educational Psychology | Nursing

File Format


Degree Grantor

University of Nevada, Las Vegas




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