Reasons why students from diverse populations do not enter nursing, or are not successful in attaining a nursing degree, include inadequate academic preparation, poor study skills, lack of family support, financial stress, and feelings of being “marginalized” in class, study groups, and clinical sites because most of their fellow students and faculty are white (Fuller, & Mott-Smith, 2017; Graham, Phillips, Newman and Atz, 2016; Melillo, Dowling, Abdallah, Findeisen, & Knight, 2013). For these students, early intervention can improve retention rates. A multi-faceted approach to intervention programs has been shown to boost student success (Fitzpatrick, 2015; Fuller, & Mott-Smith, 2017; Harris, Rosenburg, O’Rourke, 2014).
Purpose: A baccalaureate nursing program entered into a community partnership with a Metropolitan School District (MSD) and public foundation to establish a success program for pre-nursing students. Pre-nursing students are applicants who wish to pursue a degree in nursing but do not fully meet academic requirements for direct admittance to the nursing program. The specific goals were: 1.) Recruit students from diverse backgrounds (as defined by race, gender, age and socioeconomic status) from inner city high schools to the nursing program; 2.) Retain 80% of the enrolled students through to the enrollment in nursing courses and 75% through graduation within six years; 3.) Partner with major healthcare providers to employ 80% of the students as State Tested Nursing Assistants (STNA); and 4.) Achieve an 80% satisfaction rating from programming evaluations.
Conceptual Framework: Vygotsky’s Social Development Theory was used to frame the study. Social constructivism is concerned with the importance of collaboration with others and views social interaction as the primary means by which learners construct new meanings (Vygotsky, 1998). The theory accounts for diversity of individuals in the process of learning.
Methods: A descriptive, exploratory design was used for the study. Nurse educators, with community funding and guidance, designed a success program that used strategies identified in the literature to support student development of critical thinking and reading, math competencies, study and test-taking skills, computer literacy, and medical terminology (Beauvais, Stewart, De Nisco, & Beauvais, 2013; Crooks, 2013; Dapremont, 2013, 2014; Latham, Singh, & Ringl, 2016). Emphasis was placed on time management, goal setting, communication skills, self-esteem and factors linked to student attrition such as financial need, social isolation, peer pressure, lack of role models, and family responsibilities. Data were collected from a convenience sample of 44 students. Descriptive statistics and t-tests were used to evaluate outcomes.
Results: Two cohorts were recruited for this program. Of the first cohort, 75% of the participants were from diverse backgrounds and 45% were recruited from the Metropolitan School District (MSD) or inner ring schools. Eighty-six percent of the second cohort were diverse and 75% percent of the students were recruited from the Metropolitan School District (MSD) or inner ring schools. GPA’s of the first cohort of students in the success program were significantly higher as compared to the cohort prior to the implementation of the success program (t [28] = 2.65, 16, p = 0.01). The GPA’s of the second cohort were also significantly higher (t [33] = 2.31, p = 0.01) as compared to the cohort prior to program implementation. There was found to be a large effect size (d = 1.2). One hundred percent of the students in the first cohort completed the STNA course and testing and were offered positions at local healthcare agencies. Seventy-three percent of the students from the first cohort remain at the college or in a nursing program; only one student has failed out of the nursing program. One hundred percent of the students in the second cohort remain in the program. Historically, retention rates for pre-nursing students at this college ranged from 10-26% through to sophomore year, with less than 5% of the students graduating with a degree in nursing. Student evaluations of the program are positive, ranging from 80% to 96%.
Conclusion: The inclusion of the student success program has demonstrated a positive impact on the retention and academic performance of diverse pre-nursing students in a baccalaureate nursing program. Further research is needed fully evaluate the impact of ongoing mentoring, advising and academic support on student graduation rates.