David Peruski, RN, Ed.D. September 28, 2017 Nursing Program Readiness, Impact on Completion and NCLEX-RN Pass Rates: Dissertation Findings David Peruski, RN, Ed.D. September 28, 2017

Significance of Understanding This Topic Aligns with Completion Agenda Provides Opportunity to Review Impact of Developmental Education/Curriculum Help Understand Attrition and Impact Student Perspective Programmatic Workforce Minorities & Men Identify Interventions that may Positively Impact Completion Identify ways to improve completion rates Higher education leads to better opportunities for employment/Self-Improvement Student motivation Poor study behaviors Competing demands Nursing programs have varying rates of completion at times exceeding 50% Retention is important-nursing shortage looming

Models Persistence to Completion Models Commonalities Tinto Karp & Bork Jensen Demetriou & Schmitz-Sciborski Commonalities Academic Preparation Academic Engagement Social Integration/Engagement Seeking Assistance Understanding College/Expectations External Support Balancing Multiple Roles Lack of effective study skills Working in excess of 20 hours per week

Considerations Other Considerations Leading to Persistence/Retention Underprepared Greater risk for not completing Developmental education Focused on raising student’s aptitude Also seen as a deterrent Other Considerations Leading to Persistence/Retention Faculty Interaction Finances Attitude-Self Efficacy, Optimism, Goal Setting Identifying With Others Minorities/Men

Identified Challenges Selection processes into nursing programs Open versus selective Improving the number of minorities in nursing First generation Lower socioeconomic status

Making a Difference Persistence & Retention No one approach seems to make a difference Some Impact on Attrition GPAs Standardized Exams Prerequisite course work

Nursing Programs No more than one failure Attrition is Problematic Courses specific to nursing Not usually transferable to other programs Costly May drop out of college Incurred debt and not employable Measure of Quality Cohorts with empty seats High attrition/Low Completion versus Low Attrition/High Completion Have to maintain acceptable NCLEX rates

Approaches Bailey, Jaggars & Jenkins (2015) Eliminate barriers Strong advising Clear pathway Placement into college-level courses in an accelerated manner Eliminate barriers Support college completion Who completes Traditional, more affluent, residential, full-time Who struggles low income, part-time, commuter

Research Design Sample=453 students Fall 2011-Winter 2014 Registered Nurse Program Full-time Part-time Transition

Research Questions Do nursing students who enter college program-ready in reading, writing, and Math complete the nursing program at a significantly greater rate than students who are not program-ready in any area of reading, writing, or Math at the time they enter college? Do statistical differences in program completion exist among racial groups or by gender? Do nursing students who enter college program-ready in reading, writing, and Math pass the NCLEX-RN exam at a significantly greater rate than students who are not program-ready in any area of reading, writing, or Math at the time they enter college?

Findings 223 Students Program-Ready (49.23%) 230 Students Not Program-Ready (50.77%) 272 Completed 159 Program-Ready 71.30% 113 Not Program-Ready 49.13% Program Attrition 39.96%

Findings Program Readiness Program Completion FT 63% FT 54.4% PT 55% Transition 53% FT 54.4% PT 39.7% Transition 39.4% Program Readiness and Completion Appear to have a Relationship Program-Ready Students in All Program Tracks Completed at a Greater Percentage than Not Program-Ready Students

Findings Females 88% Males 12% Gender Female Completed 61.2% Males Completed 51.9% Larger percentage of program-ready males (25.9%) did not complete as compared to females (12.5%)

Findings Caucasians 85% Minorities 15% Race Caucasian Completed 61.2% Minorities Completed 53.6% Minorities represent a larger percentage of not program-ready students who both complete and do not complete

Findings 223 Students Program-Ready in all three areas (71.3% Completed) 398 Reading-ready students (55.2% Completed out of total sample) 340 Writing-ready students (49.7% Completed out of total sample) 292 Math-ready students (40.8% Completed out of total sample) 159 students completed that were program ready in all areas Math ready who completed was the lowest number at 185 Writing ready who completed was 225 Reading ready who completed 250 Math lowest completion because not really college ready only at elementary algebra level. COMPASS Reading-89 Writing-77 College Algebra-52

Percent of Program Ready Students who Completed and were: Math Ready 85.9% Writing Ready 70.6% Reading Ready 63.6% In this particular study students who were math ready and program ready had a very high success rate.

Findings NCLEX-RN Exam Pass Rates (First Attempt) FT 90.91% PT 90.63% Transition 88.68% Program-Ready 89.31% Not Program-Ready 92.04%

Analysis Program Readiness did statistically impact program completion Reading, Writing and Math preparedness had an impact on completion No statistical differences in completion between Male and Female or in Minorities and Caucasian NCLEX-RN Exam completed equally between program-ready and not program-ready

Conclusions Program-Readiness impacts completion positively Attrition is a concern Not program-ready students are as likely to complete as not Persistence & Completion Retention Models Grit/Intrinsic Motivation/Self-Efficacy Guided Pathways Minority student completion Male student completion NCLEX-RN pass rates are comparable among all groups Better academic prep, reading and writing may demonstrate ability to complete. Attrition Non-completers Twice as likely to be not program ready Minorities Role Models-Faculty, Representation to improve health practices May have motivation to complete and so even though underprepared they persist. Achieve a better life. Financial Support Males Lack of role models –social isolation Communication difficulties Men drawn to technical aspects does not equate to lack of caring Biases impact completion…asking men to do things that would not ask women…lift a patient, etc. FT students seem to have better completion rates Clearly defined academic plan Cohort groups have benefits of LCs such as satisfaction with classes and enhanced faculty/student relationships.

Recommendations Enhance Academic Preparedness Decrease Attrition Decrease Repeat Courses/Selective Admission Provide Advising and Orientation Evaluate Part-time Program Length on Completion Increase Support for Men and Minorities Evaluate Math Requirement Decrease Attrition Look at programs of similar size with lower attrition and see what steps they have taken to improve retention. Look for promising practices for students who are not program-ready but have the potential to impact completion. Decrease Repeat Courses/Selective Admission Grades, GPA, Intention to become a nurse all linked with completion. Limit retakes of course especially key courses that are linked with success like A&P to only two attempts. Selective admission criteria Impact on completion Have other colleges seen improvements in retention Important to assure equity to underrepresented groups. Advising/Orientation Required counseling and advising with faculty Mentoring opportunities, strengthen faculty/student interaction, passion Help understand rigors of nursing program, provide effective study habits Socialization Minorities and Men Focus Groups to gain opinions and ideas Evaluate Math Requirement Not at College Ready level Encouraging students to go onto get BSN need much higher level math Math-readiness and program completion the lowest Significance factor not significant at 0.01 level Evaluate students who have attained college level math scores and their completion rates

Further Research Program Completion and Prerequisite GPA Non-cognitive factors that impact completion Number of semesters enrolled in college and completion of the program Gateway GPA in A&P