Journal of Nursing Education

The Response of Higher Education to the Shortage of Nursing School Applicants

Laurie M Grubbs, RN, MSN, ARNP

Abstract

Introduction

Recent figures from the National League for Nursing's 1985 annual survey on nursing education programs revealed a shortage of applicants across the country (Rosenfeld, 1987). In response to this shortage, there has been some concern raised regarding admission standards for schools of nursing. Concern has focused on the notion that "...some institutions will try to attract anyone who is warm and breathing into their opening class" (Hodgkinson, 1985, p. 23). Lowering educational standards to keep up enrollments will only add to the existing shortage of nursing school applicants. The profession must recognize that recruitment will be positively rather than negatively affected by increasing educational standards for admission. Nursing must recruit bright, capable students. Filling enrollment vacancies with less qualified students will not be helpful because these individuals cannot deliver the highly sophisticated and complex care necessary in modern health-care settings. As Fralic (1987, p. 210) stated, "Today's patients, more than any other population in history, need professional nurses who can promptly detect and obviate complications, plan and initiate appropriate interventions and guide them through their episode of illness. ..in the shortest period of time with the best clinical outcomes." It would be more beneficial to the nursing profession to graduate fewer students who are well educated and trained than large numbers of poorly educated students.

Rosenfeld, in a recent NLN survey on recruitment and retention, stated that a shrinking applicant pool for basic nursing programs is resulting in lower admission standards (Rosenfeld, 1987). She expressed concern that for some programs the only choice is to either lower standards to stay in business or close. It was not clear in the survey, however, what the present admission standards were and how much they had been lowered. It is the purpose of this article to examine these questions.

Procedure

A mail survey of 150 randomly selected NLN accredited BSN programs in the United States was taken. Schools were asked about current grade point average (GPA) admission requirements; any changes in requirements over the past 5 years; prerequisite courses for admission to the school of nursing; frequency with which required nursing courses were being offered within the school of nursing; recruiting strategies; changes in enrollment in the past 5 years; and availability of RN to BSN programs.

The response rate was 98 schools (65% ) consisting of 66 public institutions and 32 private institutions. Forty-five of the responding schools had a current enrollment of fewer than 150 students; 27 had an enrollment between 150 and 300; and 26 had more than 300.

Results

GPA Requirements

Overall GPA requirements ranged from 2.0 to 3.0, with 2.5 being the mode (52%). Twenty-seven percent of the schools required a 2.0 and 2% required a 3.0 (both of these were small private schools). The remaining 21% required GPAs that fell within the 2.0 and 3.0 range. Forty-two percent had a separate GPA requirement for the science courses, which again ranged from 2.0 to 3.0. The mode (68% ) was a 2.0 in this instance with 24% requiring a 2.5 and 4% requiring a 3.0 (Figure).

Sixteen percent of the schools had changed their GPA admission requirements in the past 5 years. Despite decreased enrollments, 10% had raised rather than lowered both their science and overall GPA requirements to bring them up to at least a 2.3 and, in most cases, a 2.5. The most frequent reason given for raising requirements was that students admitted with GPAs below 2.5 were more likely to be unsuccessful in the program. Other reasons cited included a desire to upgrade the quality of the students admitted, a change in the educational…

Introduction

Recent figures from the National League for Nursing's 1985 annual survey on nursing education programs revealed a shortage of applicants across the country (Rosenfeld, 1987). In response to this shortage, there has been some concern raised regarding admission standards for schools of nursing. Concern has focused on the notion that "...some institutions will try to attract anyone who is warm and breathing into their opening class" (Hodgkinson, 1985, p. 23). Lowering educational standards to keep up enrollments will only add to the existing shortage of nursing school applicants. The profession must recognize that recruitment will be positively rather than negatively affected by increasing educational standards for admission. Nursing must recruit bright, capable students. Filling enrollment vacancies with less qualified students will not be helpful because these individuals cannot deliver the highly sophisticated and complex care necessary in modern health-care settings. As Fralic (1987, p. 210) stated, "Today's patients, more than any other population in history, need professional nurses who can promptly detect and obviate complications, plan and initiate appropriate interventions and guide them through their episode of illness. ..in the shortest period of time with the best clinical outcomes." It would be more beneficial to the nursing profession to graduate fewer students who are well educated and trained than large numbers of poorly educated students.

Rosenfeld, in a recent NLN survey on recruitment and retention, stated that a shrinking applicant pool for basic nursing programs is resulting in lower admission standards (Rosenfeld, 1987). She expressed concern that for some programs the only choice is to either lower standards to stay in business or close. It was not clear in the survey, however, what the present admission standards were and how much they had been lowered. It is the purpose of this article to examine these questions.

Procedure

A mail survey of 150 randomly selected NLN accredited BSN programs in the United States was taken. Schools were asked about current grade point average (GPA) admission requirements; any changes in requirements over the past 5 years; prerequisite courses for admission to the school of nursing; frequency with which required nursing courses were being offered within the school of nursing; recruiting strategies; changes in enrollment in the past 5 years; and availability of RN to BSN programs.

The response rate was 98 schools (65% ) consisting of 66 public institutions and 32 private institutions. Forty-five of the responding schools had a current enrollment of fewer than 150 students; 27 had an enrollment between 150 and 300; and 26 had more than 300.

Results

GPA Requirements

Overall GPA requirements ranged from 2.0 to 3.0, with 2.5 being the mode (52%). Twenty-seven percent of the schools required a 2.0 and 2% required a 3.0 (both of these were small private schools). The remaining 21% required GPAs that fell within the 2.0 and 3.0 range. Forty-two percent had a separate GPA requirement for the science courses, which again ranged from 2.0 to 3.0. The mode (68% ) was a 2.0 in this instance with 24% requiring a 2.5 and 4% requiring a 3.0 (Figure).

Sixteen percent of the schools had changed their GPA admission requirements in the past 5 years. Despite decreased enrollments, 10% had raised rather than lowered both their science and overall GPA requirements to bring them up to at least a 2.3 and, in most cases, a 2.5. The most frequent reason given for raising requirements was that students admitted with GPAs below 2.5 were more likely to be unsuccessful in the program. Other reasons cited included a desire to upgrade the quality of the students admitted, a change in the educational philosophy of the program, and, in two instances, an increase in qualified applicants. An additional 5% of the schools noted that they had plans to raise requirements in the near future due to the lack of success of students with GPAs below 2.5 and also because of the need for the students to have a strong science background.

FIGUREGPA ADMISSION REQUIREMENT

FIGURE

GPA ADMISSION REQUIREMENT

A closer look at the nine schools that reported raising admission requirements showed only one report of an increase in the quality of applicants due to the more stringent requirements. However, the actual number of students enrolled had decreased by 25% in the past 5 years. Two schools had already experienced an increase in the number of qualified applicants prior to the raising of their requirements. The raising was only a result of having a larger qualified applicant pool to choose from, which allowed the schools to make their requirements more stringent. One of these two schools stated that they would decrease their admission standards back to their original GPA if the number of qualified applicants began to fall. None of the schools reported an increase in total enrollment as a result of increasing the GPA requirements.

The remaining &7t of schools who changed their GPA admission requirements had lowered their science as well as their overall requirements. The most frequent reason given for lowering requirements was a decrease in qualified applicants (50Vf). Other reasons were falling admissions, change in recruitment goals, a desire to bring admission requirements in line with other schools, and a decision to reflect the actual versus desired GPA of many students who had been admitted in the past three years. One school reported that although it had not yet altered its requirements, they would be lowered in the future if admissions fell.

It is interesting to note that nine of the 10 schools that had raised their requirements experienced a decline in enrollment over the past five years ranging from W/t to SO'/r . Apparently this decline did not affect their decision to retain the higher standard.

It is known that the posted GPA admission requirements do not always reflect the actual GPAs of those students being admitted to the program. However. 84V( of the schools reported admitting fewer than five provisional students in a year and 14<# reported admitting fewer than 10.

Prerequisites

In addition to the institutional basic study requirements, the prerequisite courses of admission did not vary significantly among responding schools. The responses were consistently high for requirements of organic and inorganic chemistry; microbiology; general psychology and sociology; nutrition, growth, and development; and anatomy and physiology. Also listed as prerequisites but required by less than 6% of the schools were pharmacology, pathophysiology, statistics, anthropology, ethics, logic, philosophy, cell biology, physics, biochemistry, developmental psychology, abnormal psychology, computer literacy, college writing, and communications. There were a small number of programs that admitted directly from high school and therefore required no prior college courses.

Frequency of Required Courses

The frequency with which required courses are offered during the year might make a program more attractive and accessible to students. Predictably, responses showed that the schools with enrollments greater than 150 offered courses more frequently than schools with enrollments of fewer than 150. Thirty-four percent offered required courses only one time per year. 26'/< offered required courses twice per year, and 13f/r offered courses three times per year. The remaining 277t varied in their frequency of course offerings from one to three times per year depending on the course and the enrollment.

In the past five years, 11 schools had increased the frequency with which courses were offered to increase flexibility for students, to better utilize specialty faculty, and to increase enrollment for spring and summer terms. A greater number of schools, 15. had decreased the frequency with which required courses were offered. Reasons offered included decreased enrollment, decreased faculty availability, budget constraints, change in curriculum, change in university policy regarding summer and evening courses, implementation of a policy admitting students only in the fall, and allowance of more time for faculty to pursue other endeavors.

Recruitment

When asked about time and money allocated for recruitment over the past five years. 85r/t had increased the amount of time and 67G/? had increased the amount of money spent on recruiting efforts. Strategies included formation of a task force: open houses; large mailouts; production of fliers, pamphlets, brochures, slide tapes. videos, and radio advertisements; recruitment displays; career days; increased travel to other colleges and to junior and senior high schools; faculty liaisons to high schools; and increased scholarships. Many schools had created a half-time or full-time position for a nurse recruiter. One school reported having its recruitment money cut by university mandate. Unfortunately, the enrollment for this program was down by 50% from the previous five years. Another school reported excellent results from putting its efforts into a retention program rather than solely a recruitment program.

Enrollment

When asked about change in enrollment over the past five years, twice as many schools reported a decrease in enrollment as those that reported an increase in enrollment. Twenty-five schools had a decrease of less than 25f/c , 27 schools had a decrease between 25% and 50%, and four schools had a decrease between 50% and 75%. The larger public schools seemed to experience a greater percentage drop in enrollment when compared with the smaller private schools.

RN to BSN Programs

It was interesting and encouraging to note that 61% of the schools had a separate or accelerated RN to BSN program that gave special consideration to the fact that these students were older, more experienced, adult learners. The schools reported a greater tendency to evaluate RNs individually rather than adhering rigidly to admission requirements as they did for generic students. All schools that had an RN to BSN program reported an increase in their number of RN students over the past five years. As more schools develop these accelerated programs, it is likely that an increase in RNs returning for a BSN will be seen.

Summary

This survey revealed that the majority of nursing schools responding, both public and private, required a 2.5 GPA for admission and that this standard had not been lowered in response to the nursing shortage. In general, responses indicated a belief that those students admitted with a GPA of less than 2.5 were not as likely to be successful in the program.

Although some research in higher education suggests that more stringent requirements tend to improve the status of the college and therefore improve the quality of the applicants, the results of this survey did not support this. However, those schools that had increased their admission standards had done so within the past five years and. therefore, the effects of these changes may not yet be realized.

The number, variety, and level of difficulty of prerequisite courses had remained constant and, in some cases, increased. Lowering the number and level of difficulty of prerequisite courses was not being done even with a decrease in the applicant pool.

Required nursing courses were being offered on a more frequent basis by some schools to attract more students by increasing flexibility within the program and to increase the number of times during the year that students can be admitted.

More time and money were being spent to improve the image of nursing and to recruit qualified students into the profession. Efforts were also being made to make it feasible for associate degree nurses to return for their bachelors degree in nursing.

The results of this survey were encouraging. Despite decreasing enrollments, the majority of schools surveyed were not lowering admission standards to increase their enrollments. In the long run, the reward for maintaining high educational standards will be high quality nurses. High quality nurses are needed by the profession to meet health-care demands in the future and to advance nursing as a profession.

References

  • Fralic. M. F. (April, 19871. Again so soon? Thoughts on the nursing shortage. Nursing and Health Care 8(4i. 209-210.
  • Hodgkinson, H. L. (1985). All one system: Demographics of education. Washington, DC: Institute for Educational Leadership.
  • Rosenfeld. P. (May. 1987). Nursing education in crisis: A look at recruitment and retention. Nursing and Health Care 8(5), 282-286.

10.3928/0148-4834-19890901-04

Sign up to receive

Journal E-contents