Full HESI curriculum integration — with a standardized remediation process — boosts Marshall University students’ NCLEX success

Students talking with doctor

At-A-Glance Facts

Marshall University College of Health Professions, School of Nursing, in Huntington, W.Va., offers associate, baccalaureate, and master’s degrees in nursing.

Marshall has integrated the complete suite of HESI Testing & Remediation products into its curriculum to achieve NCLEX passing rates in the 90s. Having an established policy for using HESI, including a detailed remediation plan, has been a key part of that success.


Marshall University has been successfully using HESI for 10 years. Much of that success-including an NCLEX pass rate consistently in the 90s -comes from integrating HESI into the nursing curriculum and having an established remediation process.

“We found that unless we made students remediate, too many didn’t do it, so their chances for success on NCLEX diminished,” says Susan Imes, RN, MSN, Assistant Professor at Marshall’s School of Nursing. Part of the difficulty was that remediation instructions varied considerably among individual instructors. “We needed to come up with a consistent remediation process.”

Remediation Requirement Includes Plan and Follow-up Tracking

Remediation-required for any student who scores below 900-became an important part of Marshall’s overall policy for using HESI. Originally, Marshall’s benchmark for requiring remediation was 850, but in 2009, the school raised it to 900 because students were not voluntarily remediating if they reached 850. “We have found that 97 percent of those who aren’t successful on NCLEX scored less than 850 on the HESI Exit Exam,” Imes adds.

Students receive a letter outlining the remediation plan, which begins with them reviewing their exam reports to see topics they missed. The plan states that students are “expected” to use available resources, such as Evolve, and to complete the remediation by a set date, usually 2 to 3 weeks. Those who don’t complete remediation receive a zero for the exam and cannot participate in the next HESI exam.

Students must complete and submit a Time Log that consists of topics and subtopics reviewed, key points, references used, and time spent studying the material. Expectations for remediation times vary according to test score and range from 2 hours for a score between 850 and 900 to at least 8 hours for a score less than 650. Imes says such specificity is needed because “for those who don’t have internal drive to take the time, we need to say, ‘you need to do this.”

Seniors who took the HESI Exit Exam, given in the first few weeks of the NCLEX review course, must also complete test questions from approved NCLEX prep books as part of their individual remediation study plan.

Marshall also offers Elsevier’s 3-day live NCLEX review course, which is based on overall class results, before students retake the Exit Exam at the end of the semester. Students who don’t reach the 900 benchmark on their second Exit Exam are encouraged to remediate using the Evolve Reach process and to consider an additional live review course before taking the NCLEX.

Establishing HESI Products Sequence Yields Positive Exam Scores

Remediation is just one part of Marshall’s overall HESI integration. The college has been using the full suite of HESI products since fall of 2009, and has fully incorporated them into its entire curriculum, including matching the test with the appropriate grade level. For example, sophomores take Specialty Exams and Practice Tests related to fundamentals, juniors take maternity and psychiatry exams and tests, and seniors take pharmacology and med/surg exams and tests.

Imes adds the school “has an established sequence for using HESI products in a course.” After the lecture, students are assigned a Case Study, which is graded pass or fail. Next, students take a Practice Test to help them prepare for the Specialty Exam. HESI exams cannot count for more than 10 percent of the grade for an entire course. If two exams are given, for example, each accounts for 5 percent.

HESI integration and remediation result in positive exam scores. “Students think the tests are too hard, but I get emails after they pass boards saying boards were easier and that they were glad they had HESI because it prepared them well.” says Imes. Marshall also receives positive reports from students during their exit interviews done at the end of the program. “They are glad they had HESI even though they may have been resistant when they were first exposed to it.”

HESI Advocate Promotes Success

Imes notes that Dr Madonna Combs, who is now professor emeritus, spearheaded the implementation of HESI and has been a driving force in its success. “It’s important to have an advocate for the program,” says Imes, who adds that Dr. Combs recommended the testing service to the faculty mainly because it was developed by a nurse and had documented validity and reliability.

“Dr. Combs made HESI at Marshall University what it is today-a well integrated, streamlined, successful program,” says Imes. “As the product line improved and expanded she made sure the faculty were educated and on board with the implementation.”

HESI Creates Customer Satisfaction

“With one product line, one package, HESI makes it much easier to make sense of everything,” says Imes. “The HESI suite provides the flexibility to use various assessment tools to build a program that improves learning and readiness for the NCLEX.” She concludes that the “single most important reason” for ongoing satisfaction with HESI is “the quality of their customer support team; the unwavering support for faculty and students is amazing.”