Promoting Retention and NCLEX-RN Success on the First Attempt: Roles of Remediation, Self-Confidence and Salutogenesis

Schools of nursing and nursing faculty are struggling with high attrition rates and low NCLEX-RN first time pass rates.  At the same time students are struggling with progressing and completing nursing programs while maintaining their own sense of self-worth. There is limited research addressing the association of positive factors that sustain nursing students in stressful situations, i.e., preparing for success on NCLEX. Student nurses who manage stress as a component of maturity and development become nurses who are able to monitor and moderate stress in their careers.

Salutogenesis is framed as a range of emotional responses occurring from health to disease (pathogenesis) throughout an individual’s lifespan. The theory of salutogenesis has been explicated as the capacity to survive stressful events while gaining enhanced psychological strength to face future stressful events. A sense of coherence (SOC) is one of the essential influences identified in individuals who managed to sustain a positive world view in spite of encountering extreme life stressors. In addition to the SOC the positive world model encompasses three main elements: (1) comprehensibility, (2) manageability, and (3) meaningfulness.

Comprehensibility, the core element of salutogenesis, is indicative of the mutual relationship an individual has in gaining a coherent understanding of structure within the individual’s environment, e.g., nursing school. The second element, manageability, encompasses implementing positive mechanisms and other coping resources to control that environment.  Meaningfulness, the third element, addresses the emotional and spiritual element that an individual may identify as valuable and worthy, for example the desire to become a nurse. 

The aims of this presentation are: (1) to explore coping strategies and resources that faculty may employ to assist nursing students who are dealing with stress, (2) to investigate the relationship between salutogenic factors (those facilitating adaptive coping) and perceived self-confidence among nursing students and, (3) to invite a call to action for research addressing these issues.  This presentation is a synthesis of the educational literature addressing Salutogenesis and identifying methods suitable to enhance remediation and promote self-confidence among nursing students preparing for NCLEX.