Developing a Prelicensure Exam for Canada: An International Collaboration

Nine previously conducted studies indicate that Elsevier's HESI Exit Exam (E2) is 96.36%–99.16% accurate in predicting success on the National Council Licensure Examination for Registered Nurses. No similar standardized exam is available in Canada to predict Canadian Registered Nurse Examination (CRNE) success. Like the E2, such an exam could be used to evaluate Canadian nursing students' preparedness for the CRNE, and scores on the numerous subject matter categories could be used to guide students' remediation efforts so that, ultimately, they are successful on their first attempt at taking the CRNE. The international collaboration between a HESI test construction expert and a nursing faculty member from Canada, who served as the content expert, resulted in the development of a 180-item, multiple-choice/single-answer prelicensure exam (PLE) that was pilot tested with Canadian nursing students (N = 175). Item analysis data obtained from this pilot testing were used to develop a 160-item PLE, which includes an additional 20 pilot test items. The estimated reliability of this exam is 0.91, and it exhibits congruent validity with the CRNE because the PLE test blueprint mimics the CRNE test blueprint.