Method. Data was collected using an archival design from the existing records of all students readmitted after dismissal, defined as leaving the nursing program at any time before completion, between fall 2009 and fall 2015. Students were tracked until either dismissed a second time or successful, defined as program completion. Variables of interest include GPA when dismissed; GPA upon readmission to the program; reason for dismissal- personal or academic, number of semesters completed before the first dismissal, number of semesters out; midcurricular and exit HESI scores, and NCLEX-RN examination scores for those who completed. Other variables of interest included the numbers of clinical failures, medication math failures, skills test failures, as well as attendance and conduct reports before the second dismissal.
Results. Of the 107 students for whom complete records were available, 46 were dismissed a second time and 61 completed the program. The semester a student was initially dismissed and reason for dismissal was significantly related to academic performance upon return. No student readmitted after being dismissed the first semester for academic reasons in either nursing or chemistry completed the program (X2 37.492 (7), p < 0.001), while every student readmitted for the final semester or readmitted after withdrawing for personal reasons completed the program. As students progressed through the second and third semesters, the percent of students completing the program increased, though the percent completing after return in the third semester was just over 50% (53.2%). Those who completed the program had significantly higher GPAs on readmission (t = 2.023, p = .05). Those students having to take coursework to raise more than 2 semesters of coursework to raise their GPA to meet readmission requirements had only a 10% chance of completing the program (X2 21.080 (4), p < 0.001), while those who were initially dismissed for conduct had a 12.1% chance of completing the program (X2 10.461, p =0.01). Students not completing the program had significantly more absences (M= .5, SD= 1.1) than those who completed (M= .18, SD= .5; t= 2.027, p= .045) and skills test failures, with those not completing the program having more failures (M= .41, SD= 1.1) than those who completed (M= .03, SD= .18; t= 2.641, p= .01). There was a significant difference between the type of student and program completion, with advanced standing students being more likely to complete (X2 4.075, p =.044). There were no differences in program completion rates by gender. There was no significant difference in program completion rates for those students (n = 21) who failed multiple courses in any one semester (X2 .228, p = .63). A 2-factor logistic regression model consisting of GPA upon reentry and initial semester dismissed was statistically significant (X2 100.5 (60), p =0.001), explaining 81.8% of the variance in program completion rates, correctly classified 88.8% of the students.
Discussion. This study revealed major implications to consider when evaluating readmission of policies. The fact that no student readmitted after academic dismissal the first semester did not complete the program was not surprising. Though program entrance criteria screen for academic ability, it may be that the student who is not successful this early in their schooling is not prepared or able to meet the academic demands of nursing school. The low completion rate for those students with a lower readmission GPA or who took additional coursework to raise their GPA is congruent with reports regarding the predictive value of GPA in the general college and nursing student populations. Implementing policies that lower the maximum time allowed for program completion would make it more difficult for students with low GPAs to be readmitted and reduce student’s financial burden associated with continuing to take additional coursework towards a degree which will likely not be realized.
Conclusion. The results of this study provide faculty and administrators with data that can be used to evaluate and develop readmission policies based on clearly defined criteria which measure a student’s ability to succeed, as well as develop and implement appropriate remediation programs, such as tutoring or mentoring, designed to provide students with resources to support retention and improve the completion rate of readmitted students. This analysis strongly supports the need for careful consideration regarding the timing of dismissal and the student’s GPA and conduct, when considering the readmission of students and their chance for successfully completing the nursing program.