“The HESI Exit Exam is highly predictive of success on the ARRT (American Registry of Radiologic Technologists) exam,” says Lisa Aberle, MSRS, BS, RT(R), (CV), Assistant Professor of Radiography and Director of the Radiography Program at Heartland Community College in Normal, Illinois. “Faculty members can feel confident that students who score at the recommended level will pass the exam.”
Solving a Challenge
In 2008, Aberle faced a challenge when she became director of the radiography program. The content specifications for the ARRT exam had changed to focus more on digital imaging than film. The change reflected current practice, but it, along with a few other factors, led to a decline of pass rates from 100 percent in previous years to 89 percent in 2009.
Aberle turned to the HESI Radiography Exit Exam for help. “Our goal was to use HESI to determine where our curriculum was weak and to address those issues,” she says. The ARRT exam is split into five sections, and students had experienced the biggest drop in the section on equipment operations and quality control. “The HESI Exit Exam divided that section into three subsections, which is how the registry does it,” she says. “Our students were scoring poorly in two of the three.”
Once Aberle pinpointed the problem, she and her team revised the curriculum to address those two subsections: physics and imaging equipment. “We added extra review exercises and stepped up efforts to ensure students understood the content when we taught it.”
Aberle says she also “wanted to use HESI as a predictor as to who would pass the registry exam.” Faculty could then work with students at risk, encouraging them to complete remediation.
It took time for everything to fall into place, but by 2012, efforts had paid off with a return to 100 percent pass rate. The average score that year was 86, much higher than the required 75. What’s more, students scored an average of 8.1 for the equipment operations and quality control section, compared to 7.3 in 2010, meeting Aberle’s goal of higher than 7.5.
Giving Students Confidence
Aberle says a key benefit of the HESI Exit Exam is that “it identifies students who are going to have difficulty with the exam.” Although 700 is an acceptable score, and 750 is recommended, Aberle prefers her students to score 750 or higher. “All of the students who scored in that range have passed the exam,” she says.
That kind of data has a positive effect on students. “I can say that, ‘historically this score is very reflective of what you will get on the registry exam,’ and that dials back their anxiety,” Aberle says. Although students tell her the HESI Exit Exam is “very difficult,” Aberle sees that as a positive, not a negative. “I’d rather have them over-prepared so when they take the actual exam they feel confident because it’s easier than the HESI.” Graduates have confirmed with her that they found the registry exam easier.
Faculty meet with students who don’t achieve the desired score to let them know their concerns. They then review the student’s HESI Exit Exam report to identify areas of weakness. “We let them know what they should work on to improve their knowledge and recommend they go through the remediation,” Aberle says. Although not required, she finds that the recommendation is enough to spur students to complete remediation. Aberle also gives students other exercises and testing that she has developed, and adds that with remediation, “Students can focus on the specific items they are having difficulty with instead of taking an overall exam over and over again.”
Writing Test Questions
In addition to using HESI Exit Exam in the Heartland Community College Radiography Program, Aberle has been writing test questions since 2010. She says the experience gives her insight into the process: “I can see first-hand the rigorous process of creation and evaluation that each question goes through.”
HESI Exit Exams are created based on the ARRT content specifications. There are 180 questions that count toward the student’s score and 20 pilot questions. The pilot status enables Elsevier and Aberle see how a question is performing with students at different schools before it’s added to the main test.
“Once a question has 100 uses, we have a good idea if it’s a good question or not,” Aberle says. “If it is, it’s elevated to nonpilot status; if it’s not, it’s removed and replaced with another pilot question.” She adds that every quarter, Elsevier staff and she “review the exam as a whole to make sure it’s not too easy or too hard and that the statistics associated with the whole exam are still good.”
Aberle points out another benefit of writing test questions: “As I create exams for my own students, it makes me better able to write questions that are clear so the students know what I am looking for.”
The test development is a “very rigorous process,” she sums up, “which is why I feel confident that if students score well they will pass the registry exam because so much work goes into the product.”
Planning for the Future
Aberle plans to expand the use of the HESI Radiography Exit Exam, which students currently take at the start of the final semester. “I would like to require a second exam right before they graduate,” she says. “This would give students an opportunity to see different questions and to confirm that the last semester has paid off.” She also plans to require students to complete remediation.
In the meantime, Aberle and her students are enjoying the benefits of the Exit Exam. “A lot of work goes into making it as much like the ARRT registry exam as possible,” she says. “It’s a very good way for students to see how they would do on a proctored exam.”
Aberle says she believes in HESI because “I know how much work goes into the product and how much it’s desired to have a good product for students. I am a big fan.”