Regular readers of the Collaborative Momentum Consulting blog may remember the November 2020 story of Ashley, a high school dropout who wanted to be a nurse. A single mother of a small boy, Ashley had been working at low paying jobs when she was encouraged by a friend to complete a GED and take prerequisite courses necessary for a nursing degree. Grades in these courses, although not outstanding, were sufficient for admission to the nursing program. Ashley struggled her first year in the nursing program—making low C’s in all her nursing courses, although she performed well in during her clinical experience.
We all have had students like Ashley. We see potential in these students, but poor academic background and other psychosocial stressors create barriers for success. In Ashley’s case, at the beginning in her second year, her nursing program started a remediation program. Despite some initial resistance, Ashley participated in this remediation throughout the remainder of her program. She was able to make B’s in all her Senior Level courses, and even more importantly, she passed the NCLEX-RN and began a successful career in nursing.
Ashley’s story is not unique. Most of us have anecdotal evidence that struggling students’ performance improves after attending some sort of remediation program. A review of nursing literature for the last 20+ years, documents that student success programs enhance student retention (Jeffreys,1998; Symes, Tart, Travis, Tooms, 2002; Jacobs & Koehn, 2006; Firth, et.al.,2008; Cox, Davenport, & Phelen, 2015; Bonis, et.al, 2017, Quinn, et. al, 2018).
Although many of the remediation programs designed to prepare students for the NCLEX examination are instituted during the last year—sometimes even the last semester of a nursing program, Pence (2011 and) Jefferys (2012) both suggested that the first six weeks of the program were identified as a critical period for students to decide to stay in the program. In addition, my own experience, and likely yours as well, suggests that the first term of the program—and even the first year—is often fraught with difficulties for many students. As a result, developing and implementing a student success program in the early part of the curriculum will set students up for success. In our consulting work we have seen how this approach has reduced end-of-program stress and anxiety for both students and faculty.
Recommendations for Setting Students up for Success
Early intervention to prepare students for the rigors of a nursing program appears to be an important strategy to prevent student failure throughout the nursing program and reduce stress for all students, even those with excellent pre-nursing preparation. Here are some recommendations for implementing such initiatives.
- Faculty who are selected to teach the student success program should have demonstrated an ability to “connect” with students and a passion for assisting them with individual issues. They should also be comfortable teaching through discussion, learning activities, and guided reflection, rather that primarily lecturing.
- After faculty are prepared to effectively support students, a structured “student success” program early in the course of study should be implemented. The program should be open to all students entering the program.
- The student success program should be offered in 1-2 hour time periods over the first month. This gives students the opportunity to reflect on their previous study strategies and integrate these new concepts into their current behavior.
- The student success program should cover expectations of the nursing program, including the difference between nursing school and other previous academic endeavors. Study skills, time management, and wellness management should also be highlighted. Emphasis on the role test-taking plays in developing clinical judgment is a priority.
- The program should also include methods for students to use reflection to evaluate their own performance and plan strategies for improving their own performance as necessary.
- Faculty who are not presenting the material in the student success program, particularly those who will be responsible for ongoing remediation as students progress through the program, should be given a clear understanding of the objectives and activities of the student success program. This will not only allow them to be supportive of the program as a whole, but also provide them with strategies for individual remediation.
All nursing programs enroll students like the “Ashley” in this blog. The particulars of the story may be different, but the needs are the same. Had Ashley had such a student success initiative in the early days of her program, perhaps her first year in nursing school would have been easier and more successful. As we transition back to some level of normalcy in our work with students, let’s not forget the “Ashleys” in our classes. Effective remediation early and throughout the nursing program can help many of these students to be the nurses we so desperately need.
References and Recommended Readings
Bonis, S. Taft, L., Wendler, M.C. (2007) Strategies to promote success on the NCLEX RN: An evidence-based approach using the ACE Star model of knowledge transformation. Nursing Education Perspectives. 28(2) 82-87.
Crookes, K., Crookes, P., Walsh, K. (2013). Meaningful and engaging teaching techniques for student nurses: A literature review. Nurse Education in Practice, 13, 239e243.
Carr, S. M. (2011). NCLEX-RN pass rate peril: One school’s journey through curriculum revision, standardized testing, and attitudinal change. Nursing Education Perspectives, 32(6), 384–388.
Cox-Davenport, R. A., & Phelan, J. C. (2015). Laying the groundwork for NCLEX success: An exploration of adaptive quizzing as an examination preparation Method. CIN: Computers, Informatics, Nursing, 33(5), 208–215.
Day, L., Beard, K. V. (2019). Meaningful inclusion of diverse voices: The case for culturally responsive teaching in nursing education. Journal of Professional Nursing, 31, 277-281.
Everett, M. (2020) Sharing the Responsibility got Nursing Student Retention. Teaching and Learning in Nursing. 15 (2) April. 121-122.
Fontaine, K. (2014). Effects of a retention intervention program for associate degree nursing students. Nursing Education Perspectives, 35(2), 94-99.
Jacobs, P., & Koehn, M. L. (2006). Implementing a standardized testing program: Preparing students for the NCLEX-RN. Journal of Professional Nursing, 22(6), 373–379.
Frith, K. H., Sewell, J. P., & Clark, D. J. (2008). Best practices in NCLEX-RN readiness preparation for baccalaureate student success. Nurse Educator, 33(Supplement), 46S–53S.
Jeffreys, M. (1998). Predicting nontraditional student achievement and academic achievement. Nurse Educator. 23 (1) 42-48.
Jeffreys, M. (2015). Nursing Universal Retention and Success model: Overview and action ideas for optimizing outcomes. Nurse Education Today, 35(3), 425e431.
Lockie, N., & Burke, L. (1999). Partnership in learning for utmost success (PLUS): Evaluation of a retention program for at-risk nursing students. Journal of Nursing Education, 38(4), 188-192.
McEnroe-Petitte, D. (2011). Impact of faculty caring on student retention and success. Teaching and Learning in Nursing, 6(2), 80-83.
Onovo, (2019). Fundamentals of nursing practice and the culturally diverse ESL nursing students: The students’ perspectives for teaching and learning in nursing. Teaching and Learning in Nursing, 14, 238-245.
Quinn, BL, Smolinski, M., Bostain Peters,A., (2018). A review of Strategies to improve NCLEX rates. Teaching and Learning in Nursing. September 13 (1-9).
Sportsman, S. (2020) Student Remediation Programs Make Success Possible for Nursing Students. Collaborative Momentum Consulting Blog. November 16. http://collaborativemomentum.com/2020/11/16/strong-student-remediation-programs-make-success-possible-for-nursing-students/#more-16898.
Symes, L., Tart, K., Travis, L., & Toombs, M. (2002). Developing and retaining expert learners: The Student Success Program. Nurse Educator, 27(5), 227-231.
Tinnon, E. (2018). Reflective test review: The first step in student retention. Teaching and Learning in Nursing, 13(1), 31-34.