Leading Change in Admission and Progression Requirements to Promote Retention in a Pre-Licensure BSN Program

Saturday, 7 November 2015

Deborah A. Greenawald, PhD, MSN, RN, CNE
Alvernia University, Reading, PA, USA
Zane Wolf, PhD, RN, FAAN
School of Nursing, Lasalle University, Philadelphia, PA, USA
Suzanne Prevost, PhD, RN, FAAN
College of Nursing, University of Alabama, Tuscaloosa, AL, USA

This change project was implemented as part of the Experienced Nurse Faculty Leadership Academy (ENFLA) by Deborah A. Greenawald (Scholar), in collaboration with Zane R. Wolf (ENFLA Mentor) and Suzanne Prevost (ENFLA Faculty), and with additional support from Sigma Theta Tau International/Chamberlain College of Nursing Center for Excellence in Nursing Education.

Introduction: Each year across the United States, students compete for a limited number of seats in pre-licensure BSN programs. With the increasing costs associated with nursing education and college in general, it is important to attempt to admit only students who have the best chance for success in the intended nursing major, and then to monitor their performance closely in foundational courses to determine their continuing ability to be academically and clinically successful in subsequent semesters. By “casting a wide net” with less stringent admission and progression guidelines for nursing students, many are academically unsuccessful after  initial semester/s or lower level nursing courses, negatively impacting retention within the nursing major and, in many cases, overall attrition at a university. Although many admission and screening strategies are being utilized by baccalaureate nursing programs around the U.S., there have not been any singularly definitive indicators of potential nursing student success identified in the literature. Although the factors which influence nursing student success are complex, one approach to increasing overall retention in a nursing program is to examine current admissions guidelines and progression policies and relate them to historic patterns of nursing student retention and success.

Purpose: The purpose of this project is to closely examine the historic patterns of retention and progression within the Nursing major for students admitted to the pre-licensure BSN program of a small, Catholic, Franciscan university as either traditional or transfer students, with a goal of making changes to existing policies and guidelines to better support increased student retention and progression from the time of initial admission to the university to graduation. To support a student’s academic and clinical learning in nursing, better screening must be done at the time of application and admission to only admit those with the greatest chance for success. By better controlling the quality of students admitted to the Nursing program and thereafter more closely monitoring their progression, using (proposed) stricter guidelines than those currently in place, it is hoped that retention in the program will increase and that a greater number of students who are initially admitted will progress to graduation with a BSN and, ultimately, success on the NCLEX-RN licensure exam.

Methods:  Existing data on nursing student admission and retention at the university were reviewed, noting patterns among students who were unsuccessful in the nursing major. The researcher met with key members of the Admissions Department and Nursing faculty, including on-going discussions with the Chair of Nursing, who shared considerable data on student retention, and the Dean of the College of Professional Programs, whose support would be necessary to move the final proposal through administrative channels. Evidence from the current literature regarding best-practices for admission standards and progression guidelines related to nursing student success was reviewed, with consideration of the university’s mission and values as proposed changes were being considered. An initial list of eight potential changes to current policies and procedures was developed and presented to the Nursing faculty for review and comment. Specifically, changes were proposed to admission GPA and SAT scores, the number of science courses which can be repeat/deleted for a passing grade (minimum “C”), the number of times a student may withdraw from a nursing course without receiving a grade, and the “advanced placement” for transfer students who hold a LPN license. Additionally, a recommendation was made that the university no longer distinguish between “Nursing” and “Pre-Nursing” students (the latter group being those who had some marginal qualifications related to high school GPA or SAT/ACT scores during the admission process), but rather, categorize all students initially admitted to the Nursing program as “Pre-Nursing” until they have successfully completed the foundational science courses prior to beginning the first required nursing course. Faculty input resulted in some minor changes to the initial proposal after which the plan was endorsed by consensus and moved along for further approval through faculty governance.

Results: Over the course of a semester, the proposed changes to nursing student admission and progression guidelines received approval from all necessary individuals and committees and are scheduled for implementation beginning in Academic Year 2015-2016. The impact of the changes on overall nursing student retention and successful program completion will not be able to be assessed for several years. However, on-going research will track the data on admission, retention, and successful program completion for students in the traditional pre-licensure BSN Program in order to document the outcomes of this change project. 

Conclusions: Leading change is challenging in most situations, but in the environment of higher education, nursing faculty and leaders may be particularly challenged by institutional structures and processes over which they do not have much control. Building relationships with colleagues outside of the Nursing Department is necessary to persuade others in positions of authority why proposed changes are necessary to support nursing student success. Understanding the perspectives of Admissions Department staff, the Registrar, the Marketing Department, and faculty from other disciplines who sit on key committees is an essential step when trying to influence others to support changes to student recruiting/admissions and academic eligibility for progression. This change project represents an important shift in the manner in which student success is supported at this university, by interceding at the initial step of student admission and then more strictly controlling progression, so that those students who reach the upper levels of the Nursing curriculum will have the optimal chance to be successful in BSN completion and passing the NCLEX-RN.