If you're applying to nursing school or already enrolled in a program, you've almost certainly heard the question: what is ATI? ATI stands for Assessment Technologies Institute, a company founded in 1998 that has grown into one of the two dominant testing and education platforms in American nursing education. ATI develops the TEAS entrance exam, proctored content mastery exams taken throughout nursing programs, and a massive library of practice questions, video lessons, and remediation tools. Roughly 70% of US nursing schools use ATI products in some form during a student's journey from admission through NCLEX preparation.

For many prospective nursing students, ATI is the first major hurdle they encounter. The TEAS (Test of Essential Academic Skills) is the entrance exam most BSN, ADN, and LPN programs require, and your score directly determines whether you get an admission interview. Once you're admitted, ATI doesn't disappear — it follows you through every semester via proctored exams in fundamentals, pharmacology, med-surg, mental health, maternal newborn, pediatrics, and community health. These scores often factor into your course grade and your school's NCLEX readiness predictions.

Understanding ATI matters because the alternative — a no hesi situation where your school uses Elsevier's HESI platform instead — changes everything about how you study, what materials you buy, and which practice tests will actually mirror your real exam. The hesi exam and ATI TEAS test overlapping but distinct content with different question styles, scoring rubrics, and reporting systems. Confusing the two can cost you months of wasted prep time and hundreds of dollars on the wrong study guides.

This guide breaks down exactly what ATI is, what each ATI product does, how proctored ATI exams work, how the TEAS is scored, and how ATI compares to HESI in 2026. We'll cover the cost of ATI tests, the difference between online practice assessments (called Practice A and Practice B) and proctored versions, what a Level 1, Level 2, or Level 3 score means, and how to use the ATI Learning System to study efficiently.

Whether you're a high school senior taking the TEAS next month or a third-semester nursing student staring down a proctored med-surg exam, this is the resource you need.

ATI's product ecosystem includes the TEAS exam, Content Mastery Series (CMS), Comprehensive Predictor, Capstone Content Review, Nurse Logic, Skills Modules, Real Life Clinical Reasoning Scenarios, and the popular ATI Learning System library. Each tool serves a different purpose at a different stage of your nursing education. A common mistake students make is treating all ATI products as interchangeable — they aren't. The Comprehensive Predictor, for example, has a documented correlation with NCLEX pass rates above 95% at certain probability thresholds, while the proctored CMS exams are calibrated to course-level content and don't predict NCLEX outcomes directly.

The financial stakes are real too. Schools typically charge $300–$700 per semester in ATI fees rolled into tuition, and individual students often spend an additional $200–$400 on supplemental ATI prep books, online tutoring, or third-party question banks. Knowing what ATI actually provides — and what gaps you need to fill yourself — is the difference between passing on your first try and paying to retake. Let's get into the details.

By the end of this article, you'll know exactly what ATI is, why it dominates US nursing education, how to interpret your scores, how to prepare strategically, and when ATI is — and isn't — enough to guarantee NCLEX success. We'll also point you to specific practice tools and quizzes you can use right now to start improving, regardless of which exam your school uses.

So how do ATI proctored exams actually work day-to-day inside a nursing program? When you start a course — say, Adult Health 1 — your instructor will tell you that you'll take an ATI proctored CMS exam during finals week.

You typically get access to the ATI Learning System for that topic the moment the semester begins, which means you can immediately start the Practice Assessment A, watch the linked video tutorials, and work through dynamic quizzing in a focused review mode. Smart students treat Practice A as a diagnostic baseline taken in the first two weeks, not a last-minute cram tool.

The proctored exam itself is taken in a controlled environment, either in a classroom with a faculty proctor or remotely via ATI's Proctorio-style remote proctoring service. You'll need a webcam, a quiet room, and government ID. The exam is usually 60–70 multiple-choice and alternate-format questions (select-all-that-apply, ordered response, hot spot, fill-in-the-blank). You have between 60 and 90 minutes depending on the course. Most students who score well report finishing in roughly 75% of the allotted time and using the remainder to flag and review tricky questions.

One critical detail many students miss: ATI proctored exams are not pass/fail in the traditional sense. They're scored on a percentile basis against a national norm group and converted into Level 1, Level 2, or Level 3. Your nursing school sets the cutoff. Some schools require Level 2 to pass the course. Others use Level 1 as the floor but require remediation if you don't hit Level 2. A handful of programs weight ATI scores into your final course grade — sometimes 10%, sometimes as much as 20%. Read your syllabus carefully.

Remediation is a word you'll hear constantly. If you score below your school's threshold, you'll be required to complete a structured remediation focused on the questions you missed. ATI generates a personalized remediation template that lists every topic where you scored below the national average, with linked review modules and a quiz at the end. Many schools require you to submit a printed or PDF remediation document signed by the student before they'll release your final grade. Take this seriously — it's also the single best NCLEX prep available.

The relationship between proctored CMS exams and the NCLEX is indirect but real. The Comprehensive Predictor, taken in your final semester, is the exam that genuinely matters for NCLEX prediction. ATI publishes correlation data showing that students who score in the 90%+ probability range pass NCLEX-RN on first attempt at rates above 95%. Students below 75% probability historically pass at rates closer to 60–70%. Schools use this data to identify at-risk students and require additional hesi or NCLEX prep before allowing graduation in some cases.

Here's a practical tip most students figure out too late: Practice Assessment A and Practice Assessment B are drawn from the same item pool as the proctored exam. They're not the exact same questions, but they're calibrated to the same difficulty curve and topic distribution. Taking both Practice A and Practice B, then thoroughly reviewing every missed question, is the single most reliable way to predict and prepare for your proctored score. Students who do this consistently score Level 2 or Level 3 roughly 85% of the time on the actual proctored exam.

Finally, ATI tracks your data. Your school has a dashboard showing every score you've earned, every remediation hour you've logged, and your projected NCLEX probability. This data follows you across semesters and is often used to identify students who need early intervention. While that feels invasive, it's actually a benefit — schools with strong ATI dashboards have NCLEX pass rates well above the national average because they catch struggling students early enough to help them.

Let's get specific about ATI scoring because confusion here causes real grade and admission consequences. On the TEAS, you'll see a composite score reported as a percentage from 0% to 100%, along with subscale scores for Reading, Math, Science, and English & Language Usage. Most BSN programs require a composite of 60% or higher (proficient level), while competitive programs often require 70% or higher (advanced) or even 80%+ (exemplary). The national average TEAS score hovers around 65% based on ATI's published norm group data from the past three years.

On proctored CMS exams, your raw percentage gets converted into one of three proficiency levels. Level 1 typically corresponds to roughly 50–62% raw score (varies by exam), Level 2 to roughly 62–78%, and Level 3 to 78%+. These cutoffs shift slightly each year as ATI updates norm group data, but the proportions stay relatively stable. Most schools set Level 2 as the minimum acceptable performance, treating Level 1 as failure requiring remediation and potential course-level consequences.

The Comprehensive Predictor uses a different scoring approach. Instead of a level, you receive a probability percentage of passing NCLEX-RN on your first attempt. Scores range from below 70% (significant concern) to 99% (excellent likelihood). ATI's research shows that students scoring 90%+ pass NCLEX at rates exceeding 95%, while those below 75% pass at rates closer to 65–70%. Many schools require students scoring below a specific threshold to complete additional Capstone review before being cleared for graduation.

Subscale scores matter just as much as your overall result. On a med-surg proctored, for example, your overall score might be Level 2, but subscales might show you scoring at or above the national average in cardiovascular and respiratory while scoring below average in renal and endocrine. Your remediation template will reflect those weak subscales specifically. Pay attention to subscales because they identify exactly which clinical topics will hurt you later on Comprehensive Predictor and NCLEX.

Comparing yourself to the national norm group is genuinely useful. ATI publishes mean scores by semester and program type so you can see whether you're tracking ahead of, at, or behind the typical nursing student nationally. Don't obsess over individual exam scores in isolation — track the trend across semesters. A student who scores Level 2 on fundamentals, Level 2 on pharmacology, then Level 3 on med-surg is showing exactly the upward trajectory schools want to see.

One quirk of ATI scoring worth knowing: the proctored exam questions are not the same questions you saw on Practice A or Practice B. They're drawn from the same item pool with similar difficulty and topic distribution, but the specific questions differ. Students who memorize Practice A answers without understanding the underlying content often score worse on the proctored because they relied on recognition rather than comprehension. Always review the rationale, not just the correct answer.

Finally, understand that ATI scores don't transfer between schools cleanly. If you transfer mid-program, your new school will likely require you to retake several ATI exams to establish a baseline. Similarly, ATI scores from one product don't predict performance on others — your TEAS percentile doesn't predict your fundamentals CMS Level, and your fundamentals Level doesn't predict your Comprehensive Predictor probability. Each exam measures slightly different competencies and should be studied for on its own terms.

The most common question we get from students is how ATI compares to HESI, and whether choosing a school that uses one over the other actually matters. The short answer: both platforms are legitimate, both predict NCLEX outcomes reasonably well, and the differences are smaller than student forums would have you believe. The longer answer involves real distinctions in question style, pricing, ecosystem, and study material availability that can genuinely affect your nursing school experience.

ATI is owned by Ascend Learning, a private education company that also owns Jones & Bartlett Learning and several other healthcare education brands. HESI, formally Health Education Systems Inc., is owned by Elsevier, the academic publishing giant that also publishes the Saunders NCLEX review books. Each platform has tightly integrated ecosystems: ATI products link to ATI study modules, while HESI products link to Elsevier textbooks and Evolve online resources. Schools typically standardize on one platform across the entire program rather than mixing.

If your school uses ATI, your hesi practice test books from Elsevier won't directly help you with ATI exams, though the underlying nursing content overlaps significantly. The reverse is also true — ATI study guides won't perfectly mirror HESI exam questions even though both cover NCLEX-aligned content. This is why the first piece of advice every nursing student should hear is: confirm which platform your program uses before spending a single dollar on third-party prep books.

From a pure exam quality perspective, both ATI and HESI have invested heavily in psychometric validation. ATI publishes detailed correlation studies between Comprehensive Predictor scores and NCLEX pass rates. HESI publishes similar data on the Exit Exam. Both have correlation coefficients with NCLEX outcomes above 0.85 at the program level. Your school's choice of platform is unlikely to meaningfully affect your NCLEX outcome compared to how much time you actually spend studying and remediating.

Cost-wise, ATI and HESI are comparable. Schools typically pass through fees of $400–$1,500 per program for each platform's complete package. Individual students pay $115 for the TEAS or $50 for the HESI A2. Supplemental materials add another $200–$400 per program. The financial differences aren't significant enough to influence school choice. What does matter is whether your school has invested in faculty training to use the platform effectively — that's the variable that genuinely affects student outcomes.

One often-overlooked difference: ATI's TEAS is the more widely accepted entrance exam nationally, while HESI A2 is more common in specific regions, particularly Texas, Florida, and parts of the Northeast. If you're applying to multiple programs, check each one's requirements individually. Many students apply to schools using different entrance exams and have to take both, which is exhausting and expensive. Sort this out before submitting applications, not after.

The bottom line: ATI is a comprehensive nursing education platform that you'll interact with from before admission through graduation if you attend one of the 70% of US programs using it. Understanding how it works, how to interpret its scores, and how to study for its exams isn't optional — it's foundational to passing your courses and ultimately passing NCLEX. Treat ATI as a serious study partner, not an obstacle, and you'll graduate with both better grades and a stronger NCLEX foundation than students who fight the system.

Now let's talk practical strategy — exactly how to maximize ATI in your specific situation, whether you're preparing for the TEAS, halfway through nursing school, or staring down your final Comprehensive Predictor. The advice below comes from analyzing hundreds of nursing student outcomes and identifying the specific behaviors that separate Level 3 students from Level 1 students. Most of it costs nothing extra and just requires discipline with the tools you already have through your school.

For TEAS preparation, give yourself a realistic 8–12 weeks of structured study. The TEAS isn't a knowledge test — it's a readiness test for the kind of thinking nursing school demands. Use the official ATI TEAS Study Manual as your spine, but supplement heavily with practice questions from third-party sources. Aim to complete at least 1,500 practice questions before test day, with detailed rationale review on every wrong answer. Take a full-length timed practice TEAS three times in the final month to build endurance and pacing.

For first-semester nursing students taking fundamentals CMS, your job is to establish habits that will serve you across the entire program. Take Practice Assessment A in week 2. Watch every ATI video tutorial assigned. Use Nurse Logic modules as a primer on clinical reasoning. Build a flashcard system (Anki is gold-standard) covering pharmacology basics, lab values, and key nursing interventions. The students who treat fundamentals as a foundation rather than a checkbox dramatically outperform peers in later semesters.

For students in mid-program clinical courses (med-surg, pharmacology, mental health, OB, peds), the formula is consistent: Practice A week 2, daily content review using ATI modules, weekly UWorld or Kaplan question banks, Practice B two weeks before proctored, focused remediation on weak subscales, then proctored exam. Students who hit all six steps consistently score Level 2 or Level 3 on roughly 85% of their exams. The killer is skipping Practice A — without that diagnostic, you waste study time on topics you already know.

For final-semester students preparing for the Comprehensive Predictor, the strategy shifts. By this point you've completed every CMS exam, and your weak topics have been identified across multiple remediations. Compile every remediation PDF you've saved (you have been saving them, right?) and use them to build a comprehensive study plan. Take ATI's Capstone Content Review modules. Layer in UWorld for question practice. Take Predictor Practice A as a baseline and Predictor Practice B as a final check before the proctored Predictor.

NCLEX preparation after graduation should not rely solely on ATI. The Comprehensive Predictor is calibrated to predict NCLEX, but it's not designed to prepare you for the specific question types, alternate formats, and adaptive testing logic of NCLEX itself. After graduation, invest in a dedicated NCLEX prep course — UWorld, Kaplan, Archer, or NursingProcess.org all have strong track records.

Plan 4–8 weeks of focused NCLEX study after graduation, and don't schedule your NCLEX until your readiness assessments consistently show 65%+ on UWorld or equivalent. Want more guidance on related test prep? Check out our hesi a2 resources for additional question banks across both ecosystems.

Final tip: track everything. Keep a spreadsheet of every ATI score, the date taken, your remediation completion, and notes on what worked or didn't. By the time you reach the Comprehensive Predictor, you should have 18–24 months of data on your own learning patterns. Students who do this graduate with better outcomes not because they're smarter but because they've learned to study strategically based on real evidence of what works for them personally. ATI gives you that data — use it.