Examine relationship between prerequisite biological course grades and grades in the beginning and advanced medical-surgical nursing courses
ADN students from two programs in 2009 and 2010 (N = 200)
Records-based correlational study
Paired sample t tests and correlation
DVs: grades in beginning and advanced medical-surgical nursing courses and nursing GPA
IVs: anatomy grade; pathophysiology grade; pre-requisite science GPA
Grade in pathophysiology was positively correlated with grades in the beginning (p < .001) and advanced (p < .01) medical-surgical nursing courses.
Grade in anatomy was positively correlated with grades in the advanced (p < .01) medical-surgical nursing course.
No significant relationships were found between the pathophysiology grade, anatomy grade, or the pre-requisite science GPA and the nursing GPA.
|Benn & Pacquiao (2010)|
Examine relationship between demographic factors and academic background to retention and graduation among minority students in an ADN program
One cohort of ADN students from an urban program (N = 76)
Secondary quantitative analysis of student records
Correlation, chi-square, student t test, ANOVA
DVs: program success or failure; graduation GPA
IVs: US or foreign HS education; citizenship status; program completion time; number of courses repeated; race/ethnicity; language spoken; Nursing Entrance Test (NET) scores in reading and math, GPA in prerequisite courses
More white than non-white students graduated: X2 (1, N = 76) = 6.14, p=.013.
Language nor location of HS was significantly related to graduation.
NET math and reading scores did not differ significantly between those who did and did not complete the program.
A positive correlation was found between NET math score and graduation GPA (p < .01).
Examine relationships between HESI A2 scores and program success
Three cohorts of ADN students admitted to a program between 2008 and 2010 (N = 263)
Discriminant function analysis
DVs: success (grade of ≥76%) or failure in Nursing 1, 2, 3, 4
IVs: HESI A2 composite, biology, chemistry, math, reading comprehension, and critical thinking scores
Mean HESI A2 biology scores were over 10 points higher for those who passed Nursing 1.
HESI A2 composite, biology, and chemistry scores were positively correlated with final scores in Nursing 1 and 2 for most cohorts (p < .01). HESI A2 reading comprehension and math scores were inconsistently significant among cohorts.
HESI A2 composite and biology scores predicted those who passed or failed Nursing 1, 2, 3, and 4, properly categorizing 64.7% – 87.8% of students.
|Chen & Vogles (2013)|
Examine the relationship between HESI A2 scores and success in first semester nursing courses
Students admitted to one ADN program between 2008 and 2011 (N = 508)
Correlational curriculum evaluation
Correlation, t test
DVs: grades and success or failure in three first semester nursing courses
IVs: HESI A2 composite, basic math, reading comprehension, vocabulary and general knowledge, grammar, and anatomy and physiology scores
HESI A2 composite and all five component scores were significantly higher for those who completed all three first-semester courses (p < .01) than those who did not complete one or more courses.
Significant positive correlations (p < .01) were reported between HESI A2 composite and component scores and grades in all three first semester nursing courses with one exception: HESI reading comprehension score and Pharmacology grade.
Gain insight on attrition from the perspective of ADN students
Nurses who left their ADN program for one or more semesters and were successful when they returned (N = 7)
Four axial categories identified: caring (as a motivator to be a nurse), courage, control, and adaptation. They formed the core category of psychic strength.
Students enter ADN programs with different levels of psychic strength which is weakened due to the challenges and stress of nursing school. Most adapt and regain homeostasis. Challenges and adaptation are cyclic and can lead to personal growth. Those not able to adapt felt powerless and anxious. This can lead to loss of courage to continue in school.
Examine the relationship between various NET sections and sub-sections and student success
Students admitted to an ADN program between 2001 and 2007 (N = 305); half admitted before NET implementation (n = 150) and half after (n = 155)
Chi-square tests, two sample independent t test, ANOVA, Z test
DVs: program success or failure
IVs: NET composite, math, reading, writing, test taking skills, and scientific reading comprehension scores; admission group (before or after NET)
Mean NET composite and scientific reading scores were significantly higher for those who passed the program (p = .04 and p = .03, respectively). The other scores were not significantly different between those who passed or failed.
Difference in the proportion of students who graduated before and after NET implementation was not significant (p = .42).
Identify ADN admission criteria that predict program completion
Students admitted to an urban ADN program starting August 2001 who had graduated, withdrawn, or failed by June 2009 (N = 1350)
Retrospective quantitative data analysis
Logistic regression, discriminant analysis, stepwise regression
DVs: program success or failure
IVs: grades in English, math, and science courses; HS diploma or GED; developmental courses taken (yes/no); HS GPA; college GPA; institution's weighted admission score; gender; ethnicity; age
Regression model of the independent variables was statistically significant for predicting program completion with 85% success (r2 = .1333; p < .0001).
Lower grades in math (p = .0006) and two of three science courses (p = .0006; p = .0001), as well as GED (p < .0058) and age greater or less than the mean age of 32 (p < .0004), were significant in predicting program non-completion.
Examine common admission indicators for ability to predict success in the first semester of an ADN program
Students who started an ADN program in 2008 (N = 120)
Exploratory action research
Correlation and forward stepwise regression
DVs: Nursing Fundamentals and Health Assessment course grades; medication/math exam score; first semester ATI Fundamentals score
IVs: TEAS overall and English scores; last earned grades in science, math, and English on admission; age; gender
Fundamentals grade was significantly correlated with admission English (r = .322; p = .001), math (r = .224; p = .024), and science (r = .251; p = .009) grades; and TEAS English (r = .312; p = .002), math (r = .258; p = .009), science (r = .241; p = .016), and overall (r = .320; p = .001) scores.
Health Assessment grade was significantly correlated with admission English (r = .199; p = .047) and science (r = .346; p = .000) grades; and TEAS English (r = .331; p = .001), math (r = .231; p = .020), and overall (r = .283; p = .005) scores.
Medication/math score was significantly correlated with age (r = .230; p = .013) and TEAS science score (r = .231; p = .017).
ATI Fundamentals score was significantly correlated with TEAS English (r = .360; p = .0000), math (r = .284; p = .004), reading (r = .220; p = .024), science (r = .245; p = .015), and overall (r = .429; p = .000) scores.
Regression models for each of the four dependent variables explained 17.9% to 21.3% of the variance in outcomes. TEAS science, English, and overall scores; age; and admission grades in English and science were significant variables in one or more of the models.
Identify predictor factors to help nursing programs determine admission criteria
ADN students from two programs admitted between 2001 and 2003 (N = 218)
Retrospective descriptive correlational
ANOVA, logistic regression
DVs: program success or failure; nursing GPA, and NCLEX-RN success
IVs: ACT composite score; ACT math, reading, English, and science subscores; admission GPA; grades and anatomy and physiology I and II
Students who completed the program had higher mean ACT composite scores than non-completers (19.70 versus 18.85). ACT reading and English scores and grades in the biological courses were also higher.
Admission GPA, grades in anatomy and physiology I and II, ACT composite score, and ACT reading and math sub-scores accounted for 20% of the variance in nursing GPA F(8, 216) = 6.59, p < .001, R2 = .196).
Identify strategies to lower attrition and raise the NCLEX-RN pass rate in an ADN program
Quantitative: all students enrolled in an ADN program between 1999 and 2000 (N = 213);
Qualitative: 10 full-time faculty, 30 new graduates, and 45 directors of ADN programs
Correlation; narrative data coding
DVs: program completion; NCLEX-RN pass rate
IVs: prerequisite course grades; preadmission test components; demographic variables; HESI Exit Examination scores; nursing skills laboratory scores
Grades in Anatomy and Physiology II (r = .152) and Microbiology (r = .191) were significantly related to completion of the program.
Prerequisite course grades in English, Anatomy and Physiology I, Chemistry, and Psychology, age, gender, and race were not significantly related to completion of the program.
Themes for lowering attrition were presented for ADN directors (preadmission requirements, campus counselors, remediation, and faculty); faculty (prerequisites for program admission, mentoring for students, faculty needs), and students (student motivation, test-taking skills, NCLEX-RN review books during program, test reviews, study groups, and faculty contact for at-risk students).
Determine if HESI composite and sub-scores predict grades of C or higher in first semester of an ADN program
ADN students from one program (N = 133)
Chi-square, logistic regression
DVs: success or failure in first semester of the ADN program
IVs: HESI composite and subscores; age; gender; ethnicity; single parent; economic disadvantage; academic disadvantage
IVs were considered individually in statistical analyses. No significant relationships were found: HESI composite (χ2 (1, n = 86) = 1.09, p = .30), Reading Comprehension (χ2 (1, n = 131) = 0.52, p = .47), Vocabulary/General Knowledge (χ2 (1, n = 125) =.19, p = .66) Language (χ2 (1, n = 25) =.001, p = .97), Math (χ2 (1, n = 86) = 2.01, p = .16) scores; economic disadvantage (χ2 (1, n = 126) = .51, p = .48, phi = −.08); academic disadvantage (χ2 (1, n = 131) = .00, p = 1.00, phi = .03); single parent (χ2 (1, n = 123) = .03, p = .87, phi = .04).
Examine how cognitive and noncognitive variables related to success in the ADN Nursing Fundamentals course
First semester ADN students from one program between 2001 and 2004 (N = 383)
DVs: success (grade of ≥80%) or failure in first semester Fundamentals course
IVs: college GPA, gender, race, age and five factors identified with factor analysis of multiple NET scores: reasoning, learning style, analytic, anxiety, commitment
Regression model was statistically significant X2(9, N = 383) = 33.10, p < .01), predicting student success with 99% accuracy but only 5.9% of failures.
All IVs were in regression model, but only the reasoning and analytic factors were individually significant (p < .01) with odds ratios of 1.58 and 1.80, respectively.
Examine ability of cumulative and/or pre-requisite GPA admission criteria for predicting timely ADN graduation
Student records from three ADN programs between 2003 and 2006 (N = 437)
Retrospective archived record review
ANOVA, correlation, logistic regression
DVs: timely graduation (with original cohort)
IVs: pre-admission cumulative GPA; pre-requisite course GPA; age; race/ethnicity
Average timely graduation rate for the three colleges in the study was 44%. Neither cumulative nor pre-requisite GPA predicted timely graduation (p = .830 and p = .643, respectively). This remained true after controlling for colleges, race, and age. The only significant factor was college (p < .0001).
Examine ADN student entry, progression, graduation, and licensure characteristics
ADN students entering their first clinical course during the 1997 1998 academic year (N = 112)
Correlation and t-tests
DVs: retention: ideal (graduation in four semesters), continuous (5+ semesters, no stopouts), and interim (5+ semesters, 1+ stopouts); Attrition: voluntary, involuntary, and first semester failure; Licensure: pass versus fail on first versus subsequent attempts
IVs: pre-nursing GPA, Anatomy and Physiology I grade, number of local credits, number of transfer credits, age, race/ethnicity, gender
Pre-nursing GPA, local credits, transfer credits, and Anatomy and Physiology I grades were not significantly different by retention or attrition category.
Program graduates were younger (t = 2.741; df = 110; p = .007) and had fewer transfer credits (t = 2.270; df = 110; p = .025) than nongraduates. Prenursing GPA was higher, although not significantly.
Women had more stopouts than men (27% versus 16%).
White students had the highest ideal retention rate (32.2%).
|Knauss & Willson (2013)|
Examine relationship between HESI A2 scores and grades in two first semester
ADN nursing courses ADN students entering one program in 2008 and 2009 (N = 157)
DVs: grades in Nursing 1 and Nursing 2
IVs: HESI A2 composite and component scores for math, reading comprehension, vocabulary/general knowledge, and grammar
HESI A2 composite score was positively correlated with final course grades in Nursing 1 and Nursing 2 (p < .01), accounting for 27% and 21% of the variance, respectively.
All HESI component scores were positively correlated with final course grades in Nursing 1 and Nursing 2 (p < .01) with the exception of the math and Nursing 2 (p < .05). Scores accounted for 4% to 14% of grade variance.
Identify admission criteria that indicate high likelihood for success in the first semester of an ADN program
First semester ADN students starting one program in 2013 (N = 78)
DVs: grade in first semester nursing course; success or failure in first semester
IVs: TEAS composite, reading, science, English, and math scores; prenursing GPA, and grades in Anatomy & Physiology
Significant positive correlations were found between the first semester nursing course grade and the TEAS composite (r = .455; p < .001), English (r = .329; p = .007), math (r = .279; p = .023), and science (r = .447; p < .001) scores and the prenursing GPA (r = .264; p = .032).
The regression model used only the TEAS composite and pre-nursing GPA due to multi-collinearity issues. It explained 22% of the variance in first semester nursing course grades. Only the TEAS composite was significant (p = .001).
Analyze pre- and postadmission criteria to predict ADN program and first-time NCLEX-RN success
Graduates and noncompleters from one ADN program between 1998 and 2005 (N = 404)
Stepwise backward linear regression, logistic regression, ANOVA
DVs: graduation or noncompletion; final ADN GPA; success or failure on first attempt at NCLEX-RN
IVs: preadmission criteria (HS GPA; HS rank; ACT composite and reading subject scores; number of applicable college credits and GPA from those classes); postadmission criteria (first-term nursing course GPA, second term grade nursing course GPA, and GPA for anatomy, physiology, and microbiology courses)
All pre- and post-admission criteria variables except number of previous college credits had a significant positive relationship to final ADN GPA at the p ≤ .001 level.
Significant differences were reported between those who graduated and passed the NCLEX-RN on the first attempt and those who never graduated for the following variables at the p < .005 level: HS GPA, HS rank, ACT composite, previous college credits, previous college GPA, and grade in Microbiology.
Regression models using pre- and postadmission criteria predicted 92% of the variance in final ADN program GPA. Previous college GPA was a significant pre-admission variable (p < .001).
|Murray, Merriman, & Adamson. (2008)|
Examine the ability of the HESI A2 examination for predicting ADN and BSN success
Students from one ADN (N = 217) and one BSN program (N = 69)
Bivariate regression and t-test
DVs: program completion or noncompletion; Nursing course grades
IV: HESI A2 composite score
The A2 scores for ADN students were significantly positively correlated (r = 0.253 to 0.442; p = .05 to .01) with grades in eight of the nine nursing program courses. A2 scores for BSN students were positively correlated with grades in 10 of 20 courses.
Mean A2 scores of those who completed the ADN program were significantly higher than those who did not (75.98 and 70.44, respectively; p < .001).
Identify variables that predict ADN success in first semester Fundamentals of Nursing course
80% of ADN students from two programs (N = 117)
Chi-square, logistic regression
DV: grade in Fundamentals course
IVs: self-rated scores on General Self-efficacy and J.B. Rotter's Locus of Control scales and competency with computers; demographic factors (age, gender, marital/family status, employment status, prenursing GPA) and grade in Anatomy and Physiology I
Success versus failure in Fundamentals did not vary by gender (p < .532), marital status (p < .889), or number of children under 18 (p < .058).
Significant positive correlations were found between Fundamentals grade and Anatomy and Physiology I grade (r =.637; p < .001), pre-nursing GPA (r = .657; p < .001), and self-efficacy (r = .219; p = .027).
Working 20 hours or more per week was negatively associated with success in Fundamentals (X2(1, N = 17) =6.11, p = .013).
Logistic regression was used to predict success in Fundamentals with the IVs of self-efficacy, locus of control, Anatomy and Physiology 1 grade, and computer competency. Anatomy and Physiology 1 grade (OR = 3.870, 95% CI (1.959, 7.647), p < .001) and computer competency (OR = 3.388, 95% CI (1.016, 11.296), p = .047) were significant.
Determine the relationship between EI, motivation, demographic variables, and nursing student retention
First-year students from nine ADN programs in fall 2009 (N = 390) in fall 2009; pregnant students excluded; participation rate of 67.6%
Quantitative, descriptive nonexperimental
Regression analysis and independent sample t tests
DV: first-semester retention
IVs: motivation (MSLQ score); EI (AES score); age; gender; race/ethnicity; ADN school; readmission status
The relationship between first semester retention and several MLSQ mean subscale scores was significant: extrinsic motivation (p = .043), task value (p = .048), time and study (p = .048), effort regulation (p = .040), control of learning beliefs (p = .060), test anxiety (p = .093), critical thinking (p = .077), and peer learning (p = .067).
Mean age did not differ significantly between those retained versus not retained (p = .915).
Hierarchal logistic regression indicated race/ethnicity (p < .001) and the ADN school (p = .022) were predictors of first semester retention. Mean AES and MSLQ were not significant predictors.
Identify admission factors associated with ADN program and NCLEX-RN success
Students from one multi-campus ADN program admitted between 1990 and 1995 (N = 572)
DVs: success (graduation with original cohort and first-time NCLEX-RN success; program completion
IVs: 27 admission variables, categorized into three clusters: academic, policy, personal and experiential factors, and campus entry and exit locations
None of the 27 IVs were statistically significant in predicting success. Students who failed or left the program were not included in this sample.
Among noncompleters, first semester clinical had the highest attrition rate (651%), decreasing to 164% as semesters progressed.
Attrition among students exempted from meeting the math requirement was 219% higher than for those who met it.
Noncompleters were younger, had fewer years since HS, were more likely to have no health care experience and repeated science courses, and had lower admission GPAs and standardized admission test scores. They received admission requirement waivers four times the rate of completers.
Examine preadmission academic factors for ability to predict ADN program completion and NCLEX-RN success
ADN students admitted to one program between 2005 and 2007 (N = 294)
Backward stepwise logistic regression
DVs: program completion, NCLEX-RN exam success
IVs: TEAS reading, math, science, and English scores; ACT reading, math, science, and English scores; cumulative admission GPA; prerequisite admission college GPA; HS GPA; support course credits taken at admission; general education, health-related, and science support course GPAs; LPN licensure; student type (traditional or nontraditional), gender, race/ethnicity, year of HS graduation
TEAS science score (p = .003), science GPA (p < .001), and student type (p = .023) were significant predictors of program completion.
Each unit increase in TEAS science score increased the probability of program completion by a factor of 1.06. For each unit increase in science GPA, students were almost five times as likely to complete the program. Nontraditional students were more likely to complete the program than traditional students.
Explore factors that contribute to ADN program completion and NCLEX-RN success
Successful ADN graduates who passed the NCLEX-RN (N = 6) and professors (N = 3) from one ADN program
Semi-structured interviews; document analysis
Three themes emerged:
○ Factors related to either student qualities and skill sets (motivation; academic abilities such as critical thinking, test taking, and study skills; organization; prioritization of roles and responsibilities; the ability to manage life events and extreme stress; and health care experience);
○ Collaboration with others (support systems such as religion, finance, family, and friends; communication with faculty members; level of faculty involvement with students); and
○ Nursing curriculum (innovative teaching methods and carefully constructed course examinations; practice questions).
Prenursing academic factors were not cited as important for success. This was clarified in the final interviews. Due to the competitive admission process, success was attributed to other factors.
Identify factors ADN students perceive as contributing to academic success or failure
Successful ADN students from one program with lower than average entrance GPA and TEAS score (N = 10); Unsuccessful students with above average entrance GPA and TEAS score (N = 10)
Modified constant comparative method
Both groups received emotional support from their families, but successful students received more financial support.
Successful students took more college prep courses in high school and took full course loads when completing prerequisites.
Successful students described nursing courses as challenging and responded by studying more. Unsuccessful students perceived classes and exams as unnecessarily difficult, passing as beyond their control, and felt instructors wanted students to fail.
Partially test the Model of Nursing Student Retention
Nontraditional students from nine ADN programs (N = 458); three groups: persistently enrolled without withdrawing (n = 300), formerly enrolled and voluntarily withdrew (n = 83), formerly enrolled and withdrew for academic failure (n = 75)
Survey return rate was 96% for currently enrolled students and 42% for formerly enrolled students
Chi-square and ANOVA
DV: program status (persisted, withdrew voluntarily, failed academically)
IVs: background variables (age, gender, marital status, responsibility for dependent family members, adequacy of financial resources, number of hours of employment per week, prior education, expected level of education, parental education, HS GPA, and college GPA); internal psychological processes (academic self-efficacy measured as academic efficacy expectations with the Self-Efficacy for Self-Regulated Learning scale and academic outcome expectations with the Outcomes Expectations Questionnaire-ADN); and external supports (perceived faculty support measured with the Perceived Faculty Support scale
Background variables differed significantly between students who persisted and those who failed for financial concerns (p = .035), high school GPA (p = .005), and college GPA (p < .001). Differences between those who persisted and those who voluntarily withdrew were prior education (p = .010), expected education level (p = .018), and college GPA (p = .028).
Academic efficacy expectations, academic outcome expectations, age, dependents family members, and hours of employment per week were not significantly different among groups.
Students who persisted had significantly higher perceived faculty support than those who failed and those who voluntarily withdrew (p < .001 for both).
Examine the relationship between sociodemographic characteristics, dispositional factors, situational factors, and institutional factors on first semester ADN retention
ADN students from eight programs (N = 439)
Chi-square, factor analysis, correlation, ANOVA, binary logistic regression
DV: success in first semester
IVs: Sociodemographic characteristics of ethnicity, gender, related courses completed, course load, developmental courses taken, highest degree earned, parents college attendance, relationship status, children financially dependent, other family members financially dependent, and receiving financial aid; Institutional constructs of faculty, peers, and diversity and overall experience; Career values of autonomy, flexibility, caring, work style, and job characteristics; Situational constructs of work issues and financial concerns; Dispositional construct of confidence in ability; and other items of family encouragement, support of friends, and missing class due to family obligations.
Retained students were more likely to be white (p = .022), have completed related courses (p = .009), and taken fewer developmental courses (p = .018). They were less likely to have other family members financially dependent on them (p = .003).
Nonretained students were more likely to value job autonomy (p = .018) and flexibility (p =.001). Retained students were more confident in their ability (p = .008), had more family encouragement (p = .03) and support from friends (p = .02), and rarely missed class for family obligations (p = .04).
A model of the significant factors above explained 10.6% to 16.7% of the variance in retention. Most notable, nonretained students were over three times as likely to have family members financially dependent on them, over twice as likely to have incomplete related courses and have taken two or more remedial courses.