Close
About
FAQ
Home
Collections
Login
USC Login
Register
0
Selected
Invert selection
Deselect all
Deselect all
Click here to refresh results
Click here to refresh results
USC
/
Digital Library
/
University of Southern California Dissertations and Theses
/
Achievement and retention of first-semester nursing students: The effects of a study skills course
(USC Thesis Other)
Achievement and retention of first-semester nursing students: The effects of a study skills course
PDF
Download
Share
Open document
Flip pages
Contact Us
Contact Us
Copy asset link
Request this asset
Transcript (if available)
Content
ACHIEVEMENT AND RETENTION OF FIRST-SEMESTER NURSING
STUDENTS: THE EFFECTS OF A STUDY SKILLS COURSE
by
Lisa Marie Wiswell
A Dissertation Presented to the
FACULTY OF THE ROSSIER SCHOOL OF EDUCATION
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF EDUCATION
December 2005
Copyright 2005 Lisa Marie Wiswell
UMI Number: 3219856
3219856
2006
Copyright 2005 by
Wiswell, Lisa Marie
UMI Microform
Copyright
All rights reserved. This microform edition is protected against
unauthorized copying under Title 17, United States Code.
ProQuest Information and Learning Company
300 North Zeeb Road
P.O. Box 1346
Ann Arbor, MI 48106-1346
All rights reserved.
by ProQuest Information and Learning Company.
ii
ACKNOWLEDGMENTS
I would like to thank the following individuals for their support and
encouragement in making this venture possible.
Dr. Linda Serra Hagedorn, my chairperson. Thank you for being willing to
take on a student in an unconventional way and for making it possible for me to
complete my degree despite living in a different time zone.
Dr. Melora Sundt and Dr. Maurice Hitchcock, my committee members. Thank
you for time and energy on my behalf in helping me to complete this project.
Dr. Robert Wiswell and Sue Ann Wiswell, my in-laws and extended
committee members. Thank you for your support, encouragement, and many hours
spent helping me through this process. I would not have been able to do it without
you.
Kim and Laura Bergeson, my parents. Thank you for a lifetime of supporting,
encouraging, and loving me.
Grant, my wonderful husband and best friend. Thank you for believing in me,
always supporting me, and not ever letting me give up. Your sacrifice and
encouragement has made this dream attainable.
iii
TABLE OF CONTENTS
Acknowledgements ................................................................................................... ii
List of Tables............................................................................................................. v
List of Figures........................................................................................................... vi
Abstract.................................................................................................................... vii
CHAPTER 1. THE PROBLEM AND ITS UNDERLYING FRAMEWORK ......... 1
Background of the Problem....................................................................................... 3
Statement of the Problem .......................................................................................... 5
Purpose of the Study.................................................................................................. 5
Research Questions ................................................................................................... 5
Significance of the Problem ...................................................................................... 7
Methodology.............................................................................................................. 8
Assumptions .............................................................................................................. 9
Limitations................................................................................................................. 9
Delimitations ............................................................................................................. 9
Definition of Terms ................................................................................................. 10
Organization of the Study........................................................................................ 13
CHAPTER 2. REVIEW OF THE LITERATURE.................................................. 15
Literature Review .................................................................................................... 15
Theoretical Framework of College Student Retention....................................... 16
Nontraditional College Student Retention Theories........................................... 23
Structure of Nursing Education, Students and Curriculum ................................ 30
Nursing Student Retention ................................................................................. 38
Study Skills in Higher Education ....................................................................... 48
Effects of Study Skills on Student Success ........................................................ 55
Conclusions ............................................................................................................. 62
Implications ............................................................................................................. 65
CHAPTER 3. RESEARCH METHODOLOGY..................................................... 68
Research Questions ................................................................................................. 69
Research Design ...................................................................................................... 69
Population and Sample ....................................................................................... 71
Instrumentation................................................................................................... 72
Data Collection................................................................................................... 74
Data Analysis...................................................................................................... 75
iv
CHAPTER 4. FINDINGS ....................................................................................... 77
Findings ................................................................................................................... 77
Summary.................................................................................................................. 95
CHAPTER 5. DISCUSSION .................................................................................. 97
Conclusions ............................................................................................................. 97
Relationship of Findings to Previous Literature.................................................... 101
Limitations............................................................................................................. 102
Recommendations and Implications...................................................................... 103
References ............................................................................................................. 108
Appendices ............................................................................................................ 118
A. Study Skills Course for Nursing Students Questionnaire: Students
Who Took the Study Skills Course............................................................. 118
B. Study Skills Course for Nursing Students Questionnaire: Students
Who Did Not Take the Study Skills Course ............................................... 122
v
LIST OF TABLES
Table 1. Total Group, Study Skills Group, No Study Skills Group Mean
Comparisons (Mean ± Standard Deviations; T-test)................................... 78
Table 2. Group Comparisons ANOVA for Subsets 1-4 Based Upon Cumulative
Grade Point Average (Includes Bonferroni Post Hoc Comparisons) ......... 81
Table 3. Reenrollment Spring 2005......................................................................... 82
Table 4. Total Group Correlation Matrix ............................................................... 83
Table 5. Responses of Study Skills Course Participants to Questionnaire ............. 87
Table 6. Responses of Non-Participants in Study Skills Course to Questionnaire . 91
vi
LIST OF FIGURES
Figure 1. High School GPA vs. Fall 2004 GPA Graph.......................................... 84
Figure 2. Prerequisite Chemistry Grade vs. Fall 2004 GPA Graph ...................... 85
Figure 3. Microbiology Grade vs. Fall 2004 GPA Graph ..................................... 85
Figure 4. Anatomy and Physiology Grade vs. Fall 2004 GPA Graph ................... 86
Figure 5. PEE Verbal Score vs. Fall 2004 GPA Graph ......................................... 86
Figure 6. Bar Graph Group Response to Study Skills Statement 1B...................... 89
Figure 7. Bar Graph Group Response to Study Skills Statement 4C...................... 90
Figure 8. Bar Graph Group Response to Study Skills Statement 11 ...................... 90
Figure 9. Bar Graph Group Responses to Study Skills Non-participants
Statement 1H ............................................................................................... 93
Figure 10. Bar Graph Group Responses to Study Skills Non-participants
Statement 4E................................................................................................ 94
Figure 11. Bar Graph Group Responses to Study Skills Non-participants
Statement 5 .................................................................................................. 94
vii
ABSTRACT
The purpose of this retrospective, two-group comparison study was to: 1)
examine the relationship between students who completed a study skills course before
the first semester of an associate degree nursing program and academic achievement
and retention, 2) to examine the impact of the study skills course on students with the
highest and lowest grade point averages who voluntarily enrolled in the course
compared to students with the highest and lowest grade point averages who did not
take the study skills course, and 3) to identify students’ perceptions of the value of a
study skills course on subsequent semester performance.
Before Fall semester 2004, students entering an associate degree registered
nursing program (N=61) were given the option of attending a one-week study skills
course for nursing students. Nineteen students enrolled in the study skills course that
included topics such as time management, memorization strategies and test-taking.
Transcript and admission data was gathered on the total group of entering students in
the spring 2005 semester. Also during that semester, questionnaires were administered
to assess students’ perceptions and satisfaction with the course.
Statistical analysis indicated there were very few and insignificant academic
differences between students who did and did not take the study skills course. There
was not a significant difference in the subsequent academic performance of students
who took the study skills course, as measured by grade point average, number of units
taken, or retention. Variables other than the study skills course were evaluated for their
correlation to academic success in the first semester of nursing courses. The
viii
Microbiology grade, General Anatomy and Physiology grade, and the
verbal section of the Pre-entrance Exam were all significantly correlated to the fall
2004 grade point average.
The main conclusion reached at the end of this study was that although
students report they perceive benefit to the study skills course and feel it should be
continued and offered to future nursing students, there is no evidence that it
significantly impacts academic performance or improves retention for those who take
it compared to those who do not.
1
CHAPTER 1
THE PROBLEM AND ITS UNDERLYING FRAMEWORK
There is a growing shortage of registered nurses that is expected to
progressively worsen. By the year 2020, it is projected that there will be 20 percent
fewer nurses than are needed to care for the aging population (Buerhaus, Staiger &
Auerbach, 2000). The shortage is attributable to several factors. First, is the aging of
the registered nurse workforce and the emergence of alternative job opportunities. The
proportion of registered nurses under the age of 30 has declined from 25 percent in
1980 to nine percent in 2000. The decline in new, young entrants coupled with an
accelerating retirement rate for older nurses will produce a national supply of nurses
that by 2020 will be older and no larger than the supply in 2005 (National Center for
Health Workforce Analysis, 2002). Not only are registered nurses being added to the
workforce at a declining rate but they are leaving and giving up their licenses at a
faster rate than ever. Between 1996 and 2000 the loss of nurses from the licensed pool
increased six fold to nearly 175,000 (National Center for Health Workforce Analysis,
2002).
Another factor in the nursing shortage is the emergence of alternative job
opportunities and the declines in relative earnings. The number of licensed registered
nurses not employed in nursing grew by 52,000 to over 490,000 between 1996 and
2000 (U.S. Department of Health and Human Services, 2001). Although actual
earnings for registered nurses have increased steadily from 1983 to 2000, the amount
available after adjusting for inflation has been relatively flat since 1991. To illustrate,
2
in 1983, the average elementary school teacher earned about $4,400 more than the
average registered nurse. In 2000, elementary school teachers earned about $13,600
more (National Center for Health Workforce Analysis, 2002).
The third significant factor in the nursing shortage is the decrease in the
number of applicants and graduates of nursing schools, including a decrease in the
percentage of college freshmen who choose nursing as a career. The number of
registered nurse graduates fell 26 percent from 1995 to 2000 (National Council of
State Boards of Nursing, 2000), and due to declining enrollments, the number of
graduates is not expected to increase in the short term. In addition, several traditional
universities nationwide have phased out their baccalaureate nursing programs because
of budgetary cuts and the desire to allocate resources to the universities other
nationally ranked programs (Ray, 2004).
The future of nursing depends on recruiting and retaining qualified applicants
to nursing schools, issues which concern the majority of nursing programs. The
National League for Nursing Center for Research in Nursing Education and
Community Health (1997) reported declining enrollment and graduation in diploma,
associate degree, and baccalaureate registered nursing programs. Despite the National
League for Nursing Accreditation Commission (NLNAC) set standard of an 80
percent nursing student retention rate (NLNAC, 1996), many schools of nursing loose
half or more of the students who start their programs (Buerhaus, Staiger & Auerbach,
2000). The high attrition rates are impacted by changes over the last 25 years in the
types of students who choose the nursing profession. Nursing students are more likely
3
to be older and out of high school for several years, as well as have family and
employment responsibilities (Jeffreys, 1998). The high school academic performance
and level of preparedness for people choosing nursing has also declined (Staiger,
Auerbach, & Buerhaus, 2000).
Nurse educators are faced with the challenge of attracting qualified applicants
to nursing programs, and providing the resources that will facilitate success in the
program so the students will graduate and become competent members of the nursing
profession.
This study examines one retention strategy, a study skills course, that is offered
on a voluntary basis to associate degree nursing students at a public Midwestern
technical college before they enter their first-semester of nursing courses to evaluate
it’s effectiveness in improving participants academic achievement and retention.
Background of the Problem
Nursing programs strive to implement the most effective strategies to attract
qualified applicants to enter nursing school and then to retain these students to
graduation. Knowing that most nursing students fit the description of a nontraditional
student, and are therefore at risk for attrition due to academic and environmental
factors, some nursing programs have implemented retention programs that include all
students. Other programs define characteristics of at-risk students, and make a
retention program a mandatory part of their curriculum. Retention programs include
things such as tutoring, study groups, study skills instruction, mentors, workshops,
4
career advisement, and faculty instruction on supporting diverse students (Jeffreys,
2201; Lockie & Burke, Symes, Tart, Travis, & Tooms, 2002).
The effects of these retention programs appear to be generally positive,
although it is difficult to determine which aspects of the program provide the most
benefit. For instance, an enrichment program study results found that students who
voluntarily participated had higher pass rates and lower withdrawal rates than students
who did not participate. Other retention programs required participation by students
who were identified as at-risk for academic failure. Evaluation of these programs
found that students who participated were more successful in terms of grade point
average and graduation rates than at-risk students who did not participate (Lockie &
Burke, 1999; Symes, Tart, Travis & Tooms, 2002).
Student satisfaction questionnaires indicate that the overwhelming majority of
students who participate in retention programs feel satisfied with them and view them
as being greatly supportive (Jeffreys, 2001). Students also perceive that personal study
skills and faculty advisement are the most supportive academic variables (Jeffreys,
1998). Generally, research on the effects of college study skills courses on grade point
averages, number of credits earned, an attrition rates have reported moderately
positive effects (Connelly, DuBois, & Staley, 1998; Tuckman, 2003).
Teaching study skills and personal contact with faculty are strategies that can
be used within a formal retention program or informally as integrated components of a
nursing program. To date, the literature does not include any studies on the impact of
an independent study skills course offered on a voluntary basis to nursing students.
5
Statement of the Problem
Nursing programs focus on strategies to retain students admitted to registered
nursing programs; however the effectiveness of these strategies on improving
academic performance and retention frequently remains uncertain. It is also undecided
whether all types of students benefit academically from participating in a study skills
course and whether voluntary enrollment is an effective method of administering the
course. While student satisfaction with retention programs is reportedly high, there is
little understanding of how students perceive an independent study skills course
impacts their academic performance in the following semester.
Purpose of the Study
The purpose of this study was to examine the relationship between students
who completed a study skills course before the first semester of an associate degree
nursing program and academic achievement and retention. Its purpose was also to
examine the impact of the study skills course on students with the highest and lowest
grade point averages who voluntarily enrolled in the course compared to students with
the highest and lowest grade point averages who did not take the study skills course.
The third purpose was to identify students’ perceptions of the value of a study skills
course on subsequent semester performance.
Research Questions
1. Does participation in a study skills course before the first semester of a
nursing program influence subsequent grades, units taken, and re-
6
enrollment in the following semester in those who took the course
compared to those who did not?
2. How do students with the highest and lowest grade point averages
benefit from voluntarily enrolling in a study skills course compared to
the students with the highest and lowest grade point averages who
choose not to enroll in the study skills course?
3. Is there perceived value to the participants of taking a study skills
course?
Hypotheses
1. Hypothesis: Students who take the study skills course will have a
higher grade point average in the first semester of nursing courses,
enroll in more credits, and have a higher re-enrollment rate than those
who do not take the study skills course.
2. Hypothesis: Students with the lowest grade point averages who take the
study skills course will have a significant increase in grade point
average in the semester following the study skills course when
compared with students with low grade point averages who do not take
the course. Students with high grade point averages who take the study
skills course will not have a significant difference in subsequent
semester grade point average than students with high grade point
averages who did not take the course.
7
3. Students who take a study skills course will perceive moderate value in
the course as it relates to their subsequent semester coursework.
Significance of the Problem
A national nursing shortage currently exists and is expected to intensify as the
aging population increases and the need for health care grows. The shortage is a
problem that affects many groups of people, including nurses, hospital administrators,
the allied health professions, legislators, nurse educators, and the general public who
access health care. When working in an understaffed environment, nurses take on
more patients, have less time to spend with each patient, experience more stress and
fatigue, make more errors, and may eventually leave the profession due to “burn-out”
(Buerhaus, Donelman, Ulrich, Norman, & Dittus, 2005). Hospital administrators must
find ways to fill vacancies for nursing positions and maintain high quality patient care;
other health professionals also make accommodations in their work when nurses are
understaffed. However, the shortage of registered nurses is most detrimental to
individuals seeking health care. With an inadequate supply of nurses, access to health
care is diminished, patients are cared for more by nurses’ aides or other unlicensed
personnel, and the quality of care patients receive is reduced. In fact, a report released
by the Joint Commission on Accreditation of Healthcare Organizations (2002)
examined over 1600 hospital reports of patient deaths and injuries since 1996 and
found that low nursing staff levels were a contributing factor in 24 percent of the
cases.
8
A contributing factor to the nursing shortage is the insufficient number of
qualified students who are recruited and retained at nursing colleges and universities.
Another limiting factor to the preparation of more registered nurses is the shortage of
nursing faculty, clinical and classroom space, and budgetary constraints (American
Association of Colleges of Nursing, 2004-2005). In order to reduce attrition among
nursing students and prepare more nurses to enter the workforce, nursing educators
must know which strategies improve retention rates. Only those strategies that are the
most beneficial to students should merit the limited resources of nursing programs. If
more schools of nursing implemented and evaluated retention strategies and
disseminated their findings, the challenge of how to retain nursing students could be
better understood and managed, resulting in more graduates and employed registered
nurses.
Methodology
A quantitative retrospective two group comparison design was used in this
study. Demographic and academic data was obtained from the technical college’s
student database system on associate degree nursing students who enrolled in at least
one or more of the first-semester foundational nursing courses in Fall 2004 (N=61).
Data was also collected from a course evaluation questionnaire that was administered
to this same group of students during the spring 2005. The questionnaires included
further demographic data, such as number of hours worked per week and number of
dependent children, as well as statements to evaluate why students did or did not take
the class and the perceived value or benefit taking the course had during the
9
subsequent semester. Descriptive statistics were performed for all variables as well as
Pearson correlations between variables. T-tests were performed to evaluate group
differences between those that completed the study skills course and those that did not.
Assumptions
For this study, the following assumptions were made:
1. The data will be accurately recorded and analyzed.
2. The subjects responded to the questionnaires to the best of their ability.
3. The subjects are a representative sample of associate degree nursing students
enrolled at a Midwestern technical college.
4. Students who received credit for the study skills course attended the course.
Limitations
The following limitations to this study should be recognized:
1. Academic achievement and retention may be affected by variables other than the
study skills course.
2. Students who completed the study skills course may have obtained study skills
elsewhere.
3. This study is limited to the number of students in one entering nursing class, the
availability of student data, and voluntarily participation in the questionnaire.
Delimitations
Delimitations to this study are present. This study will confine itself to
surveying and collecting data on Associate Degree Nursing Students at a Midwestern
technical college who enrolled in one or more of the following first-semester nursing
10
courses during the fall 2004 semester: Nursing Fundamentals, Nursing Skills, Nursing
Pharmacology, and Introduction to Clinical Nursing. Therefore, findings are not
generalizable to all nursing students at this institution or to the general population of
nursing students. This study focuses on the differences in grade point average,
number of credits enrolled, and re-enrollment of first-semester nursing students who
did and who did not complete a study skills course, the effectiveness of a voluntary
selection process for enrollment as determined by the impact of the study skills course
on students with high and low grade point averages, and students’ perceived value of
the study skills course.
Definition of Terms
Academic Variables: Scholastic elements that influence how a student will interact
with the institution: study habits, academic advising, absenteeism, major
certainty, and course availability (Bean & Metzner, 1985).
Associate Degree Nurse: A Registered Nurse who has completed an Associate degree
in nursing from an accredited college and is prepared for staff positions in
hospitals and other inpatient facilities (National Council of State Boards of
Nursing, 2003).
At-risk College Student: A college student who is at-risk for academic failure based on
academic difficulty or a cumulative grade point average at or below 2.0 on a 4-
point scale (Luckie & Smethhurst, 1998).
Baccalaureate Degree Nurse: A Registered Nurse who has completed a Bachelor’s
degree in the science of nursing by an accredited college or university and is
11
prepared for positions in inpatient, outpatient and community health settings
(National League for Nursing, 2003).
College Integration: A student’s experience and involvement in the academic and
social systems of the college that determine a traditional college student’s
decision to persist or drop out (Tinto, 1975).
Community College: A two-year educational institution, typically government funded,
that offers courses to fit the needs of the local community, including
occupational, adult, general education, and liberal arts transfer courses
(Summers, 2003).
Curriculum: Planned educational experiences or courses related to a specific area of
study (Print, 1993).
Diploma Nursing Program: A small and declining hospital based Registered Nurse
training that prepares nurses for staff positions in hospitals (Nelson, 2002).
Distance Learning: Education in which the learners and instructors are in physically
separate locations and communicate through video, audio, Internet and satellite
technologies (O’Brien & Renner, 2000).
Environmental Variables: The elements in one’s surroundings that influence how a
student will interact with the institution: finances, hours of employment,
outside encouragement, family responsibilities, and opportunity to transfer
(Bean & Metzner, 1985).
12
Faculty Support: Behaviors instructors exhibit, such as listening, being approachable,
and helping outside of class that positively influence student’s ability to
succeed academically (Shelton, 2003).
Nontraditional College Student: A student who is older than 24, is a commuter, is a
part-time student, or is a combination of these three factors (Bean & Metzner,
1985).
Registered Nurse: A person who has graduated from an accredited nursing program
and has passed the standardized national license examination for registered
nurses (United States Department of Labor, 2004).
Retention Program: Planned activities designed to offer students academic and
psychological support in attempt to decrease attrition (Jeffreys, 2001).
Self-efficacy: The belief in one’s ability to perform a specific task or behavior
successfully (Bandura, 1997).
Strategy: A systematic plan designed to achieve a particular goal (Lucke &
Smethhurst, 1998).
Student Attrition: A college student’s leaving of the college without completing
degree requirements, regardless of the reason for leaving (Catalano & Eddy,
1993).
Student Retention: A student who is making satisfactory progress towards a personal
and/or educational objective consistent with the college's mission (Center for
the Study of College Student Retention, 2005).
13
Study Skills: Learnable strategies such as time management and memory
enhancement that can be applied to any specific college course to improve
academic success (Luckie & Smethhurst, 1998).
Traditional College Student: A student age 18-24 who resides on campus and attends
college full time (Bean & Metzner, 1985).
Organization of the Study
Chapter 1 of the study has presented the introduction, the background of the
problem, the statement of the problem, the purpose of the study, the questions to be
answered, the research hypotheses, the significance of the study, a brief description of
the methodology, the assumptions, limitations, delimitations, and the definitions of
terms.
Chapter 2 is a review of relevant literature. It addresses the following topics:
theoretical frameworks of traditional college student retention, theoretical frameworks
of nontraditional college student retention, the structure of nursing education,
registered nursing students and curriculums, nursing student retention, study skills in
higher education, and the effects of study skills on student success.
Chapter 3 presents the methodology used in the study, including the research
design; population and sampling procedure; and the instruments and their selection or
development, together with information on validity and reliability. Each of these
sections concludes with a rationale, including strengths and limitations of the design
elements. The chapter goes on to describe the procedures for data collection and the
plan for data analysis.
14
Chapter 4 presents the results of the study. Chapter 5 discusses and analyzes
the results, culminating in conclusions and recommendations.
15
CHAPTER 2
REVIEW OF THE LITERATURE
This literature review is organized into three major sections: 1) a review of
theoretical frameworks for traditional and nontraditional college student retention; 2) a
review of the structure of nursing education and nursing student retention; and 3) a
review of the purpose and effects of study skills courses on student success in higher
education.
Section 1
The theoretical framework for this study is based on the models researchers
have developed to identify and analyze the many variables that impact a student’s
decision to persist in college. This section will first present the findings from the most
influential work on traditional college student retention by Spady (1971), Tinto
(1975), Bean (1980), Pascarella and Terenzini (1980) and Astin (1975). Secondly, this
section will describe the alterations to the traditional frameworks proposed to be more
suitable for nontraditional college students.
Section 2
The literature addressing the topic of nursing education and nursing student
retention are the basis on which this section is organized. First, an overview of the
structure of nursing education will be provided, along with how the structure has
changed in the past 25 years. Secondly, a description of typical registered nursing
curriculums and students will be presented. Lastly, the problem of the national nursing
16
shortage and high nursing student attrition rates will be identified, followed by studies
that have investigated the variables that predict and influence nursing student attrition.
Section 3
This section is organized based on the literature addressing the purpose and
impact of study skills courses in higher education on student achievement and
retention. First, an overview of how and why study skills courses are taught will be
offered. Secondly, the types of students who enroll in the courses and the typical
curriculum will be described. Third, studies investigating the effects of study skills
courses on college student’s academic success will be reviewed.
Literature Review
Traditional College Student Retention Theories
American institutions of higher education deal with many issues associated
with providing educational opportunities for an increasingly diverse student
population. One specific challenge is retaining students to degree completion or
completion of other educational objectives (Summers, 2003). In the past most college
students fit the traditional description: age 18-24, resides on campus, and attends
college full time (Bean & Metzner, 1985). With the growth and access of community
colleges and an increased societal emphasis on the importance of higher education for
success, more and more students who do not fit the traditional student description are
attending college. A nontraditional student is older than 24, is a commuter, is a part-
time student, or is a combination of these three factors (Bean & Metzner, 1985).
Researchers have developed models for traditional and nontraditional college student
17
retention to identify and analyze the many variables that impact a student’s decision to
persist in college.
The theoretical frameworks used most extensively to describe traditional
college student retention originate from five sources. They include the work of Spady
(1971), Tinto (1975), Bean (1980), and Pascarella and Terenzini (1980), and Astin
(1975).
Spady’s Model of Student Attrition
Spady (1971) developed one of the earliest models of student attrition. He
adapted a theory of student departure from Durkeim’s (1953) theories of suicide and
departure from society. Durkeim (1953) described four types of suicide, one of which
he labeled egotistical. It occurred when people were unable to integrate socially and
normatively into their social environment. Spady (1971) perceived a similar process,
although not as severe, occurring in students who dropped out of college. Students
who did not feel compatible with the social system of college, did not share common
values with students, and did not interact socially with other students were more likely
to withdraw from the society of that institution.
Spady’s initial model (1970) formed the basis for his subsequent work. He
proposed that grade performance, intellectual development, normative congruence,
and friendship support influenced social integration. These five variables were then
linked to students’ decisions to persist or withdraw through assessing students’
satisfaction and longitudinal commitment. Spady (1971) applied this model in a
longitudinal study of 683 freshmen at the University of Chicago. Based on his findings
18
of this study, he revised his model in two ways. He included structural relations and
friendship support as a separate component, and he revised the relationship among the
components.
Tinto’s Model of Student Attrition
Building on the work of Spady (1971) and likewise connecting his theories to
Durkheim’s (1953) theories of suicide, Tinto (1975) completed his model of
traditional college student attrition to explain and predict the dropout process. He
adapted the main aspect of a social anthropological study by Van Gennep (1960) on
rites of passage in society to his college attrition model. Van Gennep (1960) identified
three stages of integration (separation, transition, and incorporation) an individual or
group pass through to move from one place or stage to another. Tinto (1987) proposed
college students experience these steps upon entering the new environment of higher
education.
Tinto’s (1975) model describes the practice of dropping out of college as a
longitudinal process of an individual’s integration in the academic and social systems
of the college (Tinto, 1975). Integration occurs when a student has experiences in
those systems and modifies academic goals and commitment to the college
accordingly. Essentially, the more a student is integrated into the college, the more
likely the student will persist. Conversely, the less integrated a student is, the less
likely the student will persist.
Tinto’s model (1975) seeks to explain dropout from institutions of higher
education, rather than from the system of higher education: hence it is an institutional
19
model rather than a systems model. Tinto’s student departure theory incorporated his
previous work with Cullen (Tinto & Cullen, 1973), resulting in a theoretical model
that includes pre-entry attributes--family background, individual attributes
(expectational and motivational attributes), and pre-college schooling, academic goals
and social commitment to the college, institutional experiences (grade performance,
intellectual development, peer-group interactions, faculty interactions), academic and
social integration, revised academic goals and social commitments to the college, and
the outcome (departure decision). In distinguishing between academic and social
domains, Tinto suggests a person may be able to achieve integration in one area
without the other; yet integration in both is critical in the dropout decision. A balance
between the two modes of integration is also important, as too much emphasis on
social activities at the expense of academic studies may lead to academic failure and
dismissal from the college.
Tinto’s (1975) concept of college integration provided a conceptual framework
for other researchers to develop empirical evidence on student persistence and
attrition. In fact, it is the most widely recognized and tested college departure model
(Summers, 2003; Metz, 2002). The research has had ambiguous results. It has
confirmed Tinto’s assertion that academic and social integration between the
individual student and the institution are good predictors of departure or persistence
(Nora, 1987; Nora & Rendon, 1990; Pascarella & Terenzini, 1980; Grosset, 1991).
Research has also shown that for the majority of college students (who are
nontraditional), social integration in not an important deciding factor of persistence or
20
withdrawal (Bean & Metzner, 1985, 1987; Stahl & Pavel, 1992; Benjamin & Hollings,
1995).
Bean’s Causal Model of Student Attrition
Bean (1980) acknowledged the contributions of Spady (1971) and Tinto (1975)
in the development of student attrition models; yet he found fault with the directional
causality and discreteness of the variables. Therefore, he developed a causal model of
student attrition adapted from a model of turnover in work organizations previously
developed by Price (1977). Bean (1980) assumed students leave institutions of higher
education for similar reasons that employees leave work organizations, namely,
satisfaction with the organization. Bean proposed that if students were more satisfied
with the organization (their institution of higher education) then they would have
greater institutional commitment and a greater likelihood of persisting in college. Bean
evaluated two types of variables, background and organizational determinants.
Background variables were previous academic performance, socioeconomic status,
state residency, distance to home, and hometown size. Organizational determinants
included routinization, integration, goal commitment, communication, distributive
justice, centralization, advisor, staff/faculty relationship, campus job, major, housing,
campus organizations, and opportunity for alternative roles. One of the most
significant indicators for employee satisfaction is pay; therefore, Bean used several
surrogate measures for pay to college students in the organizational determinants:
university grade point average, development and institutional quality, and practical
value in getting a job.
21
Bean (1980) tested his model on university freshmen (N=1,171) and concluded
the model and studies of turnover and work organizations are useful in analyzing the
process of student attrition. Results showed the organizational determinants accounted
for 21 percent of the variance in student attrition for females and 12 percent for males.
The study also showed that men and women left the university for different reasons;
yet institutional commitment was the most important variable in explaining attrition
for both.
In a follow-up study, Bean (1981) formed a new causal model that added
attitudinal variables (a subjective evaluation of perceived quality and satisfaction with
the institution) into the Bean model.
Pascarella and Terenzini’s Contribution to Student Attrition Models
Pascarella and Terenzini (1980) contributed to the growing body of knowledge
of student attrition theories and research with their work in predicting freshmen
persistence and voluntary dropout decisions. The purpose of their study was to
develop a multidimensional instrument to assess the major dimensions of the Tinto
(1975) model and to determine the validity of the instrument and thus the model.
Pascarella and Terenzini (1980) conducted a study with freshmen students (N=773) to
assess the various dimensions of social and academic integration and goal and
institution commitment Tinto (1975) described in his model. Five institutional
integration scales were assessed: peer group interactions, interactions with faculty,
faculty concern for student development and teaching, academic and intellectual
development, and institutional and goal commitments. The study controlled for pre-
22
college characteristics, some of which included sex, race, academic aptitude, and
parents’ level of formal education. Additionally, because Tinto suggested these
behaviors were potentially significant aspects of academic and social integration, the
study controlled for freshman year cumulative grade point average and extent of
involvement in extracurricular activities during the freshman year.
The results from the study supported the predictive validity of the major
dimensions of the Tinto (1975) model. Interestingly, there were strong correlations
with student-faculty relationships as measured by the interactions students had with
faculty and the faculty concern for students’ development and student persistence. In
fact, persisters’ average scores on these scales averaged approximately one standard
deviation higher than student who voluntarily departed at the end of their freshman
year. Likewise, in Pascarella and Terenzini’s previous study (1979) they reported the
impact of student-faculty relationships on freshman persistence to be the most
important when entering other measures of academic and social integration predictive
of withdrawal. Pascarella and Terenzini’s (1980) construction of a measure to assess
academic and social integration based on Tinto’s (1975) model and their findings
related to the significant impact of student-faculty relationships on retention (1979,
1980) contributed to and validated the work of previous researchers (Spady, 1971;
Tinto, 1975; and Bean, 1980) on traditional college student retention.
Astin and Institutional Responsibility
Another type of retention model focuses specifically on student involvement
and the institution’s responsibility to promote retention. Retention in these models is
23
influenced by policies and practices of the institution to encourage students to invest
energy into their academic experience (Astin, 1975, 1984; Billson & Brooks-Terry,
1987). Astin (1975, 1984) suggests that the institutions pedagogical approach is less
important than observing students’ behaviors for understanding student motivation and
the amount of time and energy they put into the learning process. In this model,
counselors, faculty, and student personnel workers are encouraged to focus on
increasing student involvement, as well as encouraging peer interactions and learning
teams among students. Similar to Astin (1975, 1984), Billson and Brooks-Terry
(1987) formulated a student retention model on the basis that improving institutional
supports and increasing student involvement will reduce attrition. The model includes
eight phases of a college student’s experience: outreach, recruitment/selection,
assessment, preparation, orientation, integration, maintenance, and separation. The
institution’s neglect to provide support services at any stage of a student’s college
career increases the risk of attrition. These theories place the responsibility for
retaining students on the institutions and their practices rather than on individual
students.
Nontraditional College Student Retention Theories
Many alterations to the traditional college student frameworks have been
proposed to be more suitable for nontraditional college student retention. The first and
most influential alteration was Bean and Metzner’ (1985) model of nontraditional
student attrition. At the time of this model's inception, research clearly showed an
increasing trend in the number of older, part-time, and commuter undergraduate
24
students (U. S. Department of Education, 1982). Furthermore, these nontraditional
students showed a higher rate of attrition from college than their traditional
counterparts (Astin, 1975). While there was a well-founded need for research on the
attrition of this group, there was not a theoretical model in existence to guide the
research.
Bean and Metzner Model
Bean and Metzner (1985) developed their model on a variety of behavioral
theories, models of student attrition, the fundamental difference between traditional
and nontraditional students, and the role of socialization to explain the attrition
process. After reviewing the literature on nontraditional students, Bean and Metzner
(1985) concluded that social integration plays a small role in nontraditional student
retention compared to the central role it plays in traditional student retention because
nontraditional students are not greatly influenced by the social environment of the
institution. Elements other than socialization in traditional college student retention
theories (individual background variables, the longitudinal process of dropping out,
and academic variables) were recognized and maintained in the nontraditional student
retention model. More specifically, the model indicates that a student’s decision to
persist or drop out is based on four sets of variables: (a) academic performance as
measured by grade point average, (b) intent to leave, influenced primarily by
psychological outcomes and academic variables, (c) background and defining
variables, primarily educational goals and high school performance, and (d)
25
environmental variables, which are expected to have a substantial direct effect on
dropout decisions (Bean & Metzner, 1985).
Two compensatory interaction effects are also included in the model. The first
is between environmental and academic variables. Environmental variables are
presumed to be more influential for nontraditional students than academic variables.
So, when academic variables are good but environmental variables are poor, students
are likely to drop out. When environmental support is good and academic support is
poor, students would be expected to persist. The second compensatory effect is
between academic and psychological outcomes. Students with high grade point
averages may still drop out if they perceive the psychological outcomes are negative;
yet students who perceive positive psychological outcomes from attending college will
persist despite low grade point averages. Therefore, for nontraditional students,
environmental support and positive psychological outcomes compensate for weak
academic support and success, but academic support and high academic achievement
will not compensate for weak environmental support and negative psychological
outcomes. In summation, while social integration variables have the most effect on the
traditional college student attrition process, external environmental variables have the
biggest effect on the nontraditional college student attrition process.
Metzner and Bean (1987) built upon their previous work by conducting a study
with freshmen at a commuter university to estimate their theoretical model. They used
the same four groups of variables that influence dropout decisions from their original
model, reporting that overall, the 26 total variables accounted for 29 percent of the
26
variance in dropout. The best predictors of dropout were grade point average and
intent to leave, followed by hours enrolled. Intent to leave was best predicted by the
psychological outcome variables, utility and satisfaction. Three environmental
variables, finances, outside encouragement, and opportunity to transfer, also had
significant effects on intent to leave.
The directed effects predicted between dropping out and environmental
variables were not found as anticipated. Yet, the effects of age (older students less
likely to intend to leave) and educational goals (higher goals less likely to leave) were
stronger than expected. They also found that background variables had an indirect
rather than direct effect on persistence and that goal commitment and stress were not
directly related to intent to leave or dropout. For the most part, Bean and Metzner’s
(1985) model was validated by the data; yet the unexpected findings from their study
suggested the model may need to be modified (Metzner & Bean, 1987).
Community College Retention Model
Stahl and Pavel (1992) supposed the Bean and Metzner (1985) model of
nontraditional student attrition would address community college attrition, as it
emphasizes the role of environmental variables. They collected data at an urban
community college on variables including age, gender, ethnicity, enrollment status,
educational goals, high school rank, academic variables, environmental variables,
grade point average, psychological outcomes, intent to leave, and outcome (departure
or persistence). Through exploratory factor analysis, these researchers found the
27
nontraditional student attrition model to be a weak fit with the community college data
they collected.
This led them to identify a new model, the Community College Retention
Model. This model eliminated background variables (age, ethnicity/race, and gender)
that cannot be changed by interaction with the college environment. According to this
model, the variables ultimately influencing retention for community college students
are: academic identity, academic commitment, academic interference, academic
achievement, satisfaction, and educational benefits. The relationship of many
measurement variables to latent constructs remained the same as the Bean and
Metzner (1985) model, however some variables measured latent constructs differently
such as: academic advisement, absenteeism, course availability, outside
encouragement, utility, goal commitment, and stress (Stahl & Pavel, 1992).
As part of the development of this model, the relative strength of the individual
variables in accounting for retention was also assessed. For instance, the paths from
academic commitment to educational benefits and to satisfaction were positive and
significant, as was expected from previous literature. Unexpectedly, there was a
significantly negative path to academic achievement and retention as high GPA’s,
certainty of major, and confidence have been linked with retention in other studies.
However, in community colleges, students with high academic achievement leave to
attain higher degrees (Stahl & Pavel, 1992).
28
Commuter Institutions and Retention
Another significant alteration to traditional college student retention theories is
the reconceptualization of Tinto’s (1975) model for nontraditional students who attend
a commuter institution. Pascarella, Duby, and Iverson (1983) tested the predictive
validity of Tinto’s (1975) model on freshmen at a large urban commuter institution to
determine whether or not the pattern of influences on student attrition in his Tinto’s
(1975) model were generalizable to a non-residential institution. The researchers also
wanted to extend Tinto’s (1975) model by adding the construct “instruction” which
Bean (1981) found had direct effects on persistence.
Findings from this study showed that aspects of Tinto’s (1975) model function
effectively in commuter institutions, such as the direct positive influence of academic
integration on student persistence. However, other aspects of Tinto’s model seemed to
conflict. For instance, social integration was shown to have a potentially negative
influence on student persistence in a commuter institution. Students with high levels of
social integration may realize the limited opportunities for increased socialization at
the commuter institution and be more likely to transfer to a residential campus. Also,
pre-college variables (e.g., sex, academic aptitude) had significant direct effects on
persistence in students in commuter institutions, compared to the indirect effects they
have on traditional students at a residential campus (Pascarella, Duby, & Iverson,
1983).
29
Tinto’s Modifications
Based on these and other findings, Tinto’s model was reconceptualized to give
it more explanatory power in a non-residential institution. In the revised model,
student pre-college characteristics not only influence interactions with the college
environment but they also have a direct, unmediated effect on persistence. Another
addition suggests that entering institutional commitment may have a direct effect on
academic integration, which then directly influences future institutional commitment.
A substantial departure from the original theory (Tinto, 1975) is the direct effect of
social integration, which is hypothesized to have either a non-significant or strongly
negative influence on attrition. Finally, the intention variable was added, since intent
to continue at the institution had the strongest direct effect of any single predictor on
freshmen year persistence/withdrawal decisions (Pascarella, Duby, & Iverson, 1983).
Tinto himself, made many alterations to his original theory to make it more
suitable for nontraditional students. In 1987, he published a book on the causes and
cures of student attrition. In this revision of his previous work, he described five major
theoretical foundations for developing and understanding the dynamic nature of
student persistence research. The foundations are: psychological, societal, economic,
organizational, and interaction factors. The inclusion of these areas supported the
previous findings of Metzner and Bean (1987) on nontraditional student retention, that
psychological and environmental variables are an essential component of a conceptual
model of student attrition that seeks to include the large number of nontraditional
students (Tinto, 1987).
30
Student Satisfaction and Retention
Another researcher criticized the integration models for not adequately
reflecting the complex and multileveled lives of modern college students (Benjamin,
1994). Instead, Benjamin (1994) proposed a model based on student satisfaction and
the quality of student life. This multidimensional construct involves interactions
between personal, interpersonal, social, and contextual factors and/or processes. The
eight indicators that influence a student’s subjective well-being are: satisfaction,
happiness, multiple life domains, short-term past, objective circumstances,
institutional circumstances, psychosocial factors, and meaning structures. Benjamin
tested this model with Hollings (1995) and found that involvement, or integration with
the institution, by itself to be an inadequate predictor of student persistence. They
found that competing demands of time and resources such as employers and parents
and other life problems such as health and finances, influence students’ abilities to
cope with the demands of college life and their decisions to persist or depart.
Structure of Registered Nursing Education
The current structure of registered nursing education in the United States is
founded on two essential components. The first is graduation from an accredited
nursing program; the second is passing the standardized national licensure
examination. Students may choose between three different educational tracks to
become a registered nurse: the Bachelor of Science in nursing (BSN), the associate
degree in nursing (ADN), and the diploma in nursing (United States Department of
Labor, 2004). With a degree or diploma in nursing, students are eligible to take the
31
National Council Licensure Examination-Registered Nurse (NCLEX-RN), an exam
that measures the minimum standard for nursing licensure and entry-level competence
to practice nursing (Yin & Burger, 2003).
The question of how to best prepare registered nurses is debated extensively.
The core issue is whether a BSN should be required for all registered nurses or
whether the ADN and diploma programs adequately prepare new nurses for various
health care settings. The few studies that compare outcomes of BSN and ADN
programs are mixed. Generally, the literature suggests that the differences between
programs do not affect nurses’ abilities to perform basic tasks in entry-level positions
(Karp, Jacobs, & Hughes, 2002).
Baccalaureate Degree Nursing Programs
BSN programs are offered by colleges and universities and take about four to
five years to complete. BSN programs became prevalent following World War II, and
by the 1950’s they moved nursing into the mainstream of higher education (National
League for Nursing, 2003). There are approximately 680 nursing programs currently
offering this degree. Baccalaureate degrees prepare nurses for positions in inpatient,
outpatient and community health settings (All Nursing Schools, 2004). Currently, 32
percent of America’s nurses have baccalaureate degrees (American Association of
Colleges of Nursing et al., 2001) The National Advisory Council on Nurse Education
and Practice (2001) recommends that by the year 2010, at least two-thirds of all
Registered Nurses have at least a BSN degree to meet the increasingly complex and
diverse health care needs of a growing and aging society.
32
More than 120 accelerated BSN programs are available for individuals with a
baccalaureate degree or higher in another field who want to pursue a career in nursing.
These programs last 12-18 months and are the fastest and most comprehensive route to
becoming a registered nurse for those who have already proven their ability to succeed
at the university senior-college level (American Association of Colleges of Nursing,
2004).
Another type of BSN program is available to diploma- and associate-degree-
registered nurses who want to broaden their scope of nursing practice and advance
their careers by obtaining a baccalaureate degree. There are more than 600 of these
programs available nationwide. Program length varies between one to two years
depending upon the program requirements and the student’s academic history
(American Association of Colleges of Nursing, 2004).
Associate Degree and Diploma Nursing Programs
The development of the ADN education began in 1958 as a project to alleviate
a nursing shortage by decreasing the length of the education process to two to three
years and placing the program in community/junior colleges (Hasse, 1990). The
number of programs has escalated from 7 to more than 880. According to the National
Center for Health Statistics, there has been a marked trend in the increase of ADN
graduates. In 1980 there were 36,034 ADN graduates and 24,994 BSN graduates; by
2003 ADN graduates increased to 47,423 and BSN graduates only increased to 26,630
(National Council of State Boards of Nursing, 2003). Currently, ADN graduates make
up the majority of registered nurse graduates each year (National Council of State
33
Boards of Nursing, 2003) who are prepared for staff positions in hospitals and other
inpatient facilities.
Due in part to being cost effective and accessible, the ADN seems to be the
preferred entry route by many nursing students, especially those with minority
backgrounds. A total of 21 percent of ADN graduates are from minority groups, and
10.7 percent are male. In comparison, in the total registered nursing population, 12.3
percent are minorities and 5.4 percent are male (U.S. Department of Health and
Human Services, 2001).
Diploma programs are provided in hospitals, last about three years, and prepare
nurses for staff positions in hospitals. There are only a small and declining number of
these programs still in existence. The process of phasing out diploma programs often
involves it’s merge with either associate or baccalaureate programs (Nelson, 2002). In
2003, only 2,565 students graduated from a diploma program nationwide (National
Council of State Boards of Nursing, 2003).
Change in the Structure of Registered Nursing Programs
The most significant change in the structure of nursing education in the past 25
years has been the shift from hospital-based diploma programs to associate and
bachelor’s programs in colleges and universities. The number of diploma programs
has dwindled from over 800 in the 1970’s to less than 100 currently (All Nursing
Schools, 2004). Between 1980 and 2000 the percentage of nurses who received their
education in diploma programs decreased from 60 percent to 30 percent of the
registered nurse population. During the same period, the percentage receiving
34
associate degrees increased from 19 percent to 40 percent and the percentage receiving
baccalaureate degrees increased from 17 percent to 29 percent (U.S. Department of
Health and Human Services, 2001). While some nursing leaders believe this trend has
separated nursing education from nursing service in a negative way (National League
for Nursing, 2003), others view this shift as an opportunity for nursing to break further
away from an apprenticeship model of education and move toward controlling the
educational experiences of the nursing profession (Nelson, 2002).
Another significant change in the structure of nursing education in the past 25
years has been the incorporation of computer and information technology into the
teaching and learning process (Carty & Rosefeld, 1998). The vast effects of computers
and information technology on higher education and the health care delivery system
have made their use inescapable, making computer literacy mandatory for nursing
students to succeed in school and in the workplace (Saranto & Leino-Kilpi, 1997). A
survey conducted by the American Association of Colleges of Nursing indicates that
most students own personal computers and participate in technology-mediated
communication as part of their nursing education (Potempa et al., 2001). Nursing
students use computers for a wide range of purposes such as word processing, e-
mailing instructors and classmates, researching topics for assignments, and accessing
and using hospital information systems in their clinical settings (Saranto & Leino-
Kilpi, 1997). Even the pen and paper format of the national licensure exam required
for all nursing students has been replaced with a computerized version (Yin & Burger,
2003).
35
Due to technological advancements, nursing programs have been able to
improve the quality and access of distance learning (O’Brien & Renner, 2000). This
development has increased access for many students who are unable to travel or
relocate to pursue a degree due to the demands of home life, child rearing, and
employment. For instance, registered nurses who want to obtain a baccalaureate
degree can participate in on-line degree completion programs that are flexible, cost-
effective, and easily accessible (O’Brien & Renner, 2000). Students in web-based
programs can interact with instructors and other students through e-mail, discussion
boards, teleconferencing, and chat rooms. Individual on-line courses, such as nursing
prerequisites, are also becoming increasingly available and popular with nursing
students in associate and baccalaureate programs who desire greater autonomy and
flexibility than a traditional classroom setting provides (Potempa et al., 2001). A
survey administered to all nursing schools belonging to the American Association of
College of Nursing found that 51 percent of the 365 schools who responded offered
web-based courses. The mean number of courses offered at these schools was 5.5
(Potempa et al., 2001).
Registered Nursing Curriculum
Registered nursing curriculums in programs throughout the United States are
designed and implemented independently. Yet, they all must be approved by their
respective state boards of nursing and receive accreditation from the National League
for Nursing Accreditation Commission, which is recognized by the U.S. Department
of Education for this purpose (National League for Nursing Accrediting Commission,
36
2004). Registered nursing education universally involves didactic instruction in
classroom settings, hands-on skills practice in a laboratory setting, and supervised
clinical experience in various health care settings such as hospitals, nursing care
facilities, public health departments, home health agencies, and ambulatory clinics
(U.S. Department of Labor, 2004).
Required prerequisite courses for associate and baccalaureate registered
nursing programs include anatomy, physiology, and microbiology. Other prerequisites
frequently required include: chemistry, nutrition, psychology, sociology, English,
human growth and development, and college algebra. Prerequisite classes are designed
to be completed in approximately one year of full-time study in associate degree
programs. In baccalaureate programs they are taken in conjunction with other general
education courses required by the university in the first two years of study (Coalition
for Nursing Careers in California, 2003).
Once admitted into the nursing program, students in an ADN and BSN
programs take theory, laboratory, and clinical courses in maternity nursing, psychiatric
nursing, medical surgical nursing, pediatric nursing, advanced adult medical surgical
nursing, and nursing pharmacology. These courses typically take two full-time
academic years to complete. In addition to these core courses, students in BSN
programs take courses in nursing research, nursing leadership, community health
nursing, statistics, nursing electives, and other upper level general education
requirements (U.S. Department of Labor, 2004).
37
Nursing Student Description
Nursing students provide striking examples of how college students have
drastically changed in the past 20 years. They are older than the traditional college-
aged student, commute to campus, have family responsibilities, are employed outside
of school, and are less academically prepared to meet the rigorous demands of higher
education than their counterparts 20 years ago (Jeffreys, 2001, 1998; Kelly, 1997;
Yoder & Saylor, 2002). Therefore, a typical nursing student would be a 30-year-old
White female who commutes to a community or junior college ADN program and
who has a family and a job outside of school. A person with this description is
typically considered a nontraditional student (Bean & Metzner, 1985): yet these
characteristics are not outliers in describing nursing students.
The average age of registered nurses at graduation from all of the basic
educational programs is 30.5 years (U.S. Department of Health and Human Services,
2001). A review of 2001 enrollment data showed that White students comprised 73
percent of students enrolled in baccalaureate registered nursing programs, Blacks 11.4
percent, Hispanics, 5.7 percent, Asians 5 percent, and Native Americans .6 percent
(American Association of Colleges of Nursing, 2002). Even though this data suggests
nursing students are more diverse than the current registered nurse population, which
is 88 percent, non-White nursing students are still underrepresented. The number of
male nursing students in on the rise: yet males make up only 5.4 percent of the
registered nursing workforce (U.S. Department of Health and Human Services, 2001).
The majority of registered nursing students attend a community or junior college. Of
38
2003 graduates, approximately 60 percent were from ADN programs, 35 percent were
from BSN programs, and less than one percent was from diploma programs (National
Council of State Boards of Nursing, 2003). Samples from current studies report that
the majority of registered nursing students are employed at least part time, with half
employed at least 20 hours per week. About half the number of students have
dependent children at home, some are caregivers for other family members, are
married, or have other family responsibilities (Shelton, 2003; Jeffreys, 2001, 1998)
Nursing Student Retention
It is estimated that only 59 percent of entry-level nursing students in associate
degree programs graduate (Buerhaus, Staiger, & Auerbach, 2000). Nursing student
retention is a challenge for nursing programs, students, and the nursing profession
(Wells, 2003). Each of these groups suffers negative consequences of high attrition.
Attrition is defined as “leaving college, regardless of reason, without completing
degree requirements” (Catalano & Eddy, 1993, p.53). Students must deal with the
psychological effect of failure and the financial setback of repaying student loans
(Sheffler, 1997). Colleges of nursing lose their investment in students who do not
graduate and tuition dollars are lost, as well. The nursing profession continues to lack
available nurses to meet the health care needs of society and fewer nurses in
preparation to fill future leadership positions (Wells, 2003). The decrease in qualified
applicants to nursing schools, high nursing school attrition rates, and an aging
registered nurse workforce have all contributed to the growing nursing shortage.
Unless these factors change significantly, it is projected that by 2020 there will be 20
39
percent fewer nurses than are required to care for the aging population (Buerhaus,
Staiger, & Auerbach, 2000).
In order to know how to best improve the retention rate of nursing students,
several studies have been conducted to identify the variables that predict and influence
attrition. These variables have been determined primarily through correlating
academic and retention outcomes such as grade point average, course completion,
subsequent enrollment, and graduation to other variables such as demographic
information, previous academic performance, student’s perceived self-efficacy,
perceived faculty support, student-reported perceptions on what influences their
academic success and retention, student satisfaction, and enrichment and retention
programs.
Demographic Variables
Student age and race are two demographic variables related to nursing student
success. Nursing students older than 22 years old performed significantly better
academically than their traditional college-aged peers (Houltram, 1996). In another
study, being a “mature” student, age 26 and above, was a significant predictor of
academic achievement (Kevern, Ricketts, & Webb, 1999). Racially diverse registered
nursing students have shown a significantly lower completion rate than their White
counterparts (Wilson, 2001; Jordan, 1996). Of students who fail to graduate from
baccalaureate and associate degree nursing programs, more than one-third are non-
Whites (Powell, 1992).
40
Previous Academic Performance
Previous academic performance has been evaluated as a predictor of success in
nursing school by several researchers. Houltram (1996) found that students who were
qualified at entry performed at an average level, while students who were unqualified
performed well below average. Yet, the relationship between entry qualifications and
academic performance was not statistically significant. Kevern, Rickets, and Webb
(1999) concluded that qualifications were significant predictors of academic
achievement after using a longitudinal sample approach to follow nursing students
throughout a diploma program. Other researchers (Brennan, Best & Small, 1996)
tracked the academic performance of students from high school to prerequisite college
courses to nursing school. They found that the students who fell behind in the first two
years of nursing school had significantly lower mean high school and prerequisite
course grades.
Findings from an integrative review of nursing research over a ten-year period
showed grade point averages in nursing and science courses as the greatest cognitive
predictors of student success and age and parental education as the greatest
demographic predictors (Campbell & Dickson, 1996).
A recent study evaluated the relationship of prerequisite science course
performance and tutoring services with academic performance of first semester
baccalaureate nursing students attending a state university (Potolsky, Cohen, & Saylor,
2003). A convenience sample was drawn from students enrolled in either the
Pathophysiology or Pharmacology course. The sample was taken from first semester
41
students since approximately 82.3 percent of attrition among baccalaureate nursing
students occurs in the first year of the program (Ehrenfeld, Rotenberg, Sharon, &
Bergman, 1997). Data was gathered by reviewing student records for prerequisite
science course grades and final Pathophysiology and Pharmacology grades, a sign-in
sheet for all tutorial sessions, and a survey instrument in which students evaluated the
tutoring services. This study found that there is a statistically significant association
between prerequisite science course grades and academic performance of first
semester nursing students. Study findings did not demonstrate a significant
relationship between open learning model tutoring and academic performance,
although positive student comments indicate that integrating these services may
reduce student attrition (Potolsky, Cohen, & Saylor, 2003).
Wilson (2001) conducted a study to predict student retention and academic
achievement in western United States associate degree nursing programs.
Questionnaires were administered to students in six ethnically diverse community
colleges to collect demographic data. Other instruments included a self-efficacy
strength test, a student perceptual appraisal, and an outcomes inventory form. The
study found that lower annual income, job hours over 20 per week, English not the
native language, birthplace outside the United States, and ethnicity non-Caucasian
were factors that correlated significantly with a greater risk for attrition (Wilson,
2001).
A large, urban, ethnically diverse community college found that its first
semester associate degree nursing students exhibited attrition rates as high as 29-35
42
percent, as indicated by academic failure and voluntary withdrawal (Sandiford &
Jackson, 2003). Instruments used to collect data from a convenience sample included a
demographic information form, a measure of an individuals need for achievement, and
a measure of a student’s basic skills found in college-level work. The purpose of this
data collection was to show the relationship of academic, socioeconomic, and
motivational variables to students’ attrition. The authors found that students assessed
at college language level had significantly (p<=.001) lower attrition rates than students
with below college language level. Students with a pre-semester grade point average
of 2.5 and above had significantly (p<=.001) lower attrition than students with a grade
point average between 2.49-2.00. The nonacademic variable assumed to affect the
passing rate of first semester students: hours planned to work weekly, financial
difficulty attending college, and achievement tendency, were not significant predictor
variables (Sandiford & Jackson, 2003).
Faculty Support
Faculty support is another variable on nursing student retention that
researchers have investigated. In one study three nurse educators interviewed 26
students who were at risk for academic failure at some point in nursing school
(Poorman, Webb, & Mastorovich, 2002). Students were asked about their academic
struggles and how their instructors either helped or hindered their progress and
subsequent retention. Patterns of faculty behavior emerged from the students’
experiences that hindered their academic progress, such as being uncaring, owning the
classroom (controlling in class), hovering over them in clinical experiences, and
43
favoring students. Instructor behaviors that helped struggling students to succeed were
initiating contact or approaching the students, being with them (giving them time and
attention), reviewing before and after exams, and offering encouragement and giving
praise (Poorman, Webb, & Mastorovich, 2002) .
In another study conducted to explore the relationship between nursing student
retention and faculty support (Shelton, 2003) students from nine associate degree
programs were categorized into three groups according to their persistence--students
who persisted throughout a nursing program without withdrawing, students who had
withdrawn voluntarily at some time during their program, and students who had been
required to withdraw because of academic failure. Students in each group were asked
to complete the Perceived Faculty Support Scale, a 5-point Likert scale consisting of
24 items designed to measure psychological and functional support they perceived
they received from their instructors while in nursing school. Psychological support
included such items as demonstrate respect for students, are approachable, listen to
students, and can be trusted. Functional support included providing feedback on
assignments, helping outside of class, and providing study guides and written
materials. Results showed that students who persisted perceived significantly greater
faculty support in terms of both psychological and functional support than the two
groups who withdrew voluntarily or failed academically.
Retention Programs
Various enrichment programs and retention programs have been implemented
to offer students academic and psychological support. Their effectiveness on
44
improving retention has been evaluated in several studies. An enrichment program at
an urban public university was designed to increase academic success, promote
positive psychological outcomes, and decrease attrition (Jeffreys, 2001). The program
activities included: orientation, mentors, tutors, study groups, career advisement and
guidance, workshops, networking, biannual newsletter, and transitional support. The
program services were offered at the beginning of the semester and were offered to all
nursing students in an associate degree program. The intervention group was the self
selected students who regularly participated in scheduled study groups led by peer
mentors/tutors. The control group was comprised of other students who did not attend
the groups. Demographic data was collected on the students in the intervention group,
and two instruments were administered. The Student Perception Appraisal surveyed
students on how restrictive or supportive select academic and environmental variables
were perceived to influence retention. A satisfaction questionnaire measured students’
general satisfaction with their nursing education and specifically the enrichment
program.
Results of the study showed that overall the students who participated in the
enrichment program had higher pass rates, lower failure rates, and lower withdrawal
rates than the control group. Responses from the satisfaction questionnaire were
overwhelmingly positive with 97 percent of the students indicating they were satisfied
with the college, nursing as a career, and overall enrichment services. The variables
students reported to restrict retention the most were nonacademic (environmental) and
included: family crisis, financial status, employment responsibilities, family financial
45
support, and family responsibilities. The variables students reported to be greatly
supportive to retention were the enrichment program, faculty advisement and
helpfulness, tutoring, family emotional support, transportation, and friends in class.
In a previous study conducted by the same researcher (Jeffreys, 1998), the
student perception appraisal tool was administered to nontraditional associate degree
nursing students in their first semester of nursing courses at an urban public college. A
nontraditional student met at least one of the criteria: age 25 or older, male, English as
a second language, ethnic or racial minority, had dependent children, or held a general
equivalency diploma. This tool assesses students’ perceptions of how restrictive or
supportive academic and environmental variables are on retention and academic
achievement. Only two academic variables were ranked among the most supportive
variables: personal study skills for academic achievement and faculty advisement for
retention. Environmental variables were perceived overall as most influential. Family
responsibilities, family crisis, and child care arrangements were perceived as the most
restrictive variables, while family emotional support and encouragement by friends in
and outside of class were viewed as greatly supportive (Jeffreys, 1998).
Another purpose of Jeffrey’s (1998) study was to determine the relationship of
self-efficacy on academic achievement and retention among nontraditional students.
Respondents were asked to rate their degree of confidence for achieving educational
tasks such as grade performance, attendance and study skills, as well as their perceived
ability to learn select nursing tasks. There was not a significant correlation between
reported levels of self-efficacy and retention or achievement. When combined with
46
select academic and environmental variables, self-efficacy accounted for a moderate
amount of variance (r
2
=.38) in predicting academic achievement (Jeffreys, 1998).
Another evaluation of a retention program was conducted to determine if at-
risk baccalaureate nursing students at a private urban university who participated in
the program were more successful in terms of persistence, cumulative grade point
average, graduation rates, and licensure pass rates than at risk students equivalent on
almost all demographic and academic measures studied who did not participate in the
program over a three-year period (Luckie & Burke, 1999). The retention program,
titled Partnership in Learning for Utmost Success (PLUS) included a comprehensive
assessment plan, a series of six one-hour academic courses in nursing with the first
facilitating successful learning strategies, faculty development to increase sensitivity
to diverse needs of multicultural students, and partnerships for learning (a positive
environment that stimulates active learning, formation of study groups, mentoring, and
the use of resources in the nursing computer lab). Students were required to enroll in
PLUS courses if in a semester their university cumulative grade point average was less
than 2.0 or if their nursing grade point average was less than 2.20. Other criteria that
identified students as at-risk but made enrollment voluntary were: repeated courses,
non-passing grades of D/F and W in supportive classes, placement on university or
nursing program probation, or recommendation by nursing academic advisors. The
study results indicated that the at risk participants were more successful in terms of
retention, cumulative grade point average, and graduation rates than the at-risk
students who did not participate. In fact, the attrition rate of PLUS participants was
47
only 9.9 percent compared to the attrition rate of 43.8 for non-PLUS participants
(p<.00001). This study shows the importance of developing connections and providing
support early in students’ academic careers. The majority of students at this university
are commuters; therefore, personal interactions with faculty, staff, and other students
are limited. It appears that the personal contact and encouragement offered by faculty
in PLUS courses and study sessions provided students the added resources and support
they needed to succeed (Lockie & Burke, 1999).
After discovering a first semester failure rate in individual nursing courses to
be 35 percent for baccalaureate minority students, a unique retention program was
developed at Texas Women’s University - Houston Center called the Student Success
Plan (SSP) (Symes, Tart, Travis & Tooms, 2002). All students who received less than
55 percent on the Nurse Entrance Test were required to enter SSP. Students in the
program took a two-semester sequence of a three credit course on skills for success. In
addition, students for whom English is a second language were required to take 15
hours of accent modification. The SSP courses were designed to turn students into
expert learners through enhancing their study skills, test taking abilities, time and
stress management, written and oral communication, and critical thinking skills. Based
on Ertmer and Newby’s (1996) theory of the expert learner and the steps of the
nursing process, the SSP program taught students to assess, diagnose, plan,
implement, and evaluate their learning needs to become successful learners, students,
and future nurses. At the time of the program evaluation, retention rates had greatly
improved, as 32 of the 35 students remained in the nursing program (89 percent). As a
48
group, these retention rates are comparable to their classmates who were not identified
as academically vulnerable (Symes, Tart, Travis & Tooms, 2002).
Study Skills in Higher Education
Study skills in higher education are learnable strategies to help students learn
and succeed academically in college. Rather than attempting to improve student
aptitude in a particular academic subject, study skills courses attempt to teach students
how to manage their time, energy, effort, and ability to study most effectively. When
students learn and obtain the necessary general skills, values, and habits to succeed in
college they can apply them to any specific course and succeed (Luckie & Smethurst,
1998). Study skills commonly taught in higher educational settings include: setting
goals, motivation, learning styles, time management, concentration, methods to
enhance memory, note-taking, active reading skills, essay and objective test-taking
strategies, managing and avoiding test anxiety, critical thinking, writing papers,
communication, relationships, health, stress management, college essentials, and
principles of research. (Hooper, 2001; Luckie & Smethhurst, 1998; McWhorter, 2003;
Reynolds, 1996; Van Blerkom, 2003; Kiewra, 2002).
Purpose of Teaching Study Skills
Study skills courses are taught in higher education to improve grades and
increase retention. Currently only 50 percent of those who enrolled in college earned
baccalaureate degrees (U.S. Department of Education, 1999). Tinto’s (1993) work
shows that a considerable number of students leave college for reasons other than
academic difficulties. Yet, high attrition rates can be attributed in part to the
49
ineffective learning strategies college students employ in the classroom and while
studying (Kiewra, 1991; Pressley, Yokoi, Van Meter, Van Etten, & Freebern, 1997).
These deficient learning and study strategies affect students’ abilities to succeed in
college indirectly through their grade point averages and retention (Kern, Fagley, &
Miller, 1998).
Many students are not formally instructed on how to learn before entering
college. Instruction on learning strategies is rarely incorporated into primary or
secondary school curriculums (Applebee, 1984; Durkin, 1979). For instance, after
viewing more than 100 hours of reading and social studies instruction, Durkin did not
observe a single incidence of learning strategy instruction. Although many students
succeed in high school despite lacking effective study skills, academic tasks at the
college level require more independent learning and higher-level learning (Carson,
Chase, Gibson, & Hargrove, 1992). There are multiple ways in which college students
may be taught how to learn; completing a study skills course is one way by which
students can acquire effective learning strategies to succeed academically in college.
Study Skills for College Freshmen
The students who most commonly enroll in study skills courses in higher
education are first semester freshman. Nationally there is a high attrition rate of first-
year college students (American College Testing Program, 1992. In fact, the United
States Department of Education reported the national freshman-to-sophomore dropout
rate has risen to 26.9 percent (1999). The high attrition rate is partially attributable to
the high percentage of entering college students who are inadequately prepared for the
50
academic challenges of higher education. One-third of first-time freshmen entering
public or private two- and four-year colleges and universities are not fully prepared to
begin college work (Abraham, 1991) or meet the study demands placed on them (Nist
& Simpson, 2002). McCabe (2000) reported that 42% of first-time college-goers
enroll in remedial classes annually. Further evidence of this lack of preparedness is
reported by Simpson (1984) in a study of 395 college freshmen that suggests students
had little idea how to know if they were ready for a test, had one study strategy
regardless of the content, and could barely explain why a strategy would be important
to their own learning process. Study skills courses are one of a number of approaches
designed to meet the widespread need of assisting freshmen transition from high
school to college successfully and be retained to graduation.
For most freshmen, taking a study skills course would be beneficial and so it is
offered as an optional class. However, for freshman students who have been labeled
“at risk” for academic failure on the basis of their high school grade point averages,
SAT scores, or placement tests, this type of training may be crucial for their success
and therefore it is required (Forster, Swallow, Fodor, & Foulser, 1999). This
requirement is based on the premise that the student has the ability to succeed but is
lacking the motivation and skills necessary to achieve academic success. Hence, if the
academic behaviors that contribute to college achievement are acquired, despite past
poor performance, the student may succeed (Bender, 2001).
51
Study Skills for Students on Academic Probation
Another group of students who enroll in study skills courses are
undergraduates who are on academic probation (grade point average at or below 2.0
on a 4-point scale) or are having academic difficulty (Luckie & Smethhurst, 1998).
These students are generally required to enroll rather than enrolling by self selection.
This group of students includes those who did well in high school but struggled upon
encountering difficult college courses and those who did not do well in high school yet
desire to obtain postsecondary education.
Although the majority of students in study skills courses are college freshmen
and undergraduates on academic probation, there are a few other select groups for
which study skills courses have been directed to enhance academic performance. For
instance, instructors at Emory University have taught a study skills course for adults
planning to go back to school, a course for medical students, and a course for internal
medical residents (Luckie & Smethhurst, 1998). While it may seem that medical
students and residents have already demonstrated academic success by their current
positions, they can still learn how to more effectively manage their study time,
improve their grades, and have more time for out-of-school activities (Luckie &
Smethhurst, 1998).
Study Skills Curriculum
A typical study skills curriculum is typically designed in conjunction with one
of several commonly used textbooks (Ellis, 2002; Hopper, 2001; Van Blerkom, 2003)
on college study skills. Courses are founded on informational and generative models
52
of learning with an emphasis on self-regulated and strategic learning (Simpson, Hynd,
Nist, & Burrell, 1997).
A classic curriculum is intended to be implemented over the course of a
semester or quarter-long class that meets one to two times per week. The textbooks for
the course are purposefully designed to be inclusive of all resource materials so that
the instructor can concentrate on the students in the class rather than on supplementing
the text. The course is very interactive and encourages students to immediately
personally apply the concepts they are learning through activities such as journal
entries, list making, worksheets, making calendars, inventories, end of chapter review
quizzes, filling in charts, evaluating student examples, supplemental internet activities,
short writing assignments, and self-monitoring (Hooper, 2001; Luckie & Smethhurst,
1998; McWhorter, 2003; Reynolds, 1996; Van Blerkom, 2003; Kiewra, 2002).
As an introduction to the course, students are exposed to several ways they can
prepare to learn effectively. This instruction includes such things as the characteristics
of successful students, learning how to set goals, getting motivated to learn, using
learning styles to enhance performance, making the most of college resources, and
making the transition to learn (for student entering from the workforce) (Van Blerkom,
2003). After these initial topics are covered, a typical curriculum shifts to time
management--an overarching theme in learning and practicing effective study skills.
Principles covered in time management include: analyzing present use of time,
organizing study time, learning how to use scheduling and planning, using time-
management strategies to stay motivated, coping with procrastination, and
53
reevaluation of ones individual time plan (Hooper, 2001; Luckie & Smethhurst, 1998;
McWhorter, 2003; Reynolds, 1996; Van Blerkom, 2003; Kiewra, 2002).
Concentration and memory typically follow time management in a college
study skills curriculum. Students learn what concentration is, causes of poor
concentration, benefits of improved concentration, and strategies for improving
concentration. Students are also taught memory processes, why memory strategies are
necessary, and general and specific memory strategies such as recitation, mnemonics,
and making associations. Taking lecture and text notes and reading a textbook
commonly follow. This portion of the curriculum emphasizes why taking lecture and
text notes are advantageous, how to take lecture and text notes, what to include in the
notes, and how to review and edit notes. General strategies for reading college
textbooks, such as reading the chapter before the lecture, previewing the chapter
before reading it, and reviewing what was read are introduced in this section, as well
as how to become a critical reader and how to use a test reading/study system (Luckie
& Smethhurst, 1998; Van Blerkom, 2003).
After the students have learned to manage their time and study and learn
effectively, they are taught how to prepare for and take objective and essay tests. In
preparation for exams, students are encouraged to gather information before studying,
use active study strategies, use the five-day study plan, and self-evaluate level of
preparedness. Strategies for taking objective tests include how to reduce test anxiety,
general and specific strategies for answering true/false questions, multiple choice tests,
fill in questions and matching. Guidance on budgeting time during a test, following
54
directions, predicting test questions, guessing strategies, and learning from exams are
incorporated in this content. Students are taught to prepare for essay tests by gathering,
learning, and organizing information, and to predict the questions and write out their
answers. Knowing how to prepare for an essay tests lays the foundation for students
to successfully take the test by learning the factors that influence grading on essay
tests, strategies for gaining more points, and basic strategies for taking an essay test
(Hooper, 2001; Luckie & Smethhurst, 1998; McWhorter, 2003; Reynolds, 1996; Van
Blerkom, 2003; Kiewra, 2002).
Aside from these core elements of a study skills curriculum, there are
additional topics instructors may incorporate into their classes depending on their
individual preferences and needs of their students. They are: critical thinking, writing
papers, communication and relationships, health, stress management, college
essentials, and principles of research. A critical thinking curriculum consists of what
critical thinking is and why it is necessary, skills, qualities, and techniques of thinking
critically, the process of decision making, and distinguishing between fact and
opinion. Writing college-level papers is another topic that is included in some study
skills courses. It includes drafting and revising, how to use outlines, avoiding the most
common writing mistakes and plagiarism, and how to effectively use the library as a
resource ((Hooper, 2001; Luckie & Smethhurst, 1998; McWhorter, 2003; Reynolds,
1996; Van Blerkom, 2003; Kiewra, 2002).
Relationships, health and stress management are not generally classified as
technical study skills, yet they are components of students lives that have potential to
55
greatly influence their academic performance (Ellis, 2002). Topics such as
communicating, listening, conflict resolution, obtaining proper nutrition, sleep and
exercise, the effects of alcohol, tobacco, and drugs, signs of stress, and how to reduce
and cope with life’s stressors are covered (Ellis 2002; Hopper, 2001). College
essentials is an additional topic that includes information on how to use the student
handbook, a syllabus, how to calculate a grade point average, how to behave and act
responsibly in a higher educational setting, and it answers other frequently asked
questions a first-year college student may have (Hopper, 2001). Principles of research
introduce students to using resources in the library, databases, the internet, and how to
reference information they use. The curriculum used for various study skills courses
may vary greatly depending on what topics the instructor chooses to emphasize.
Effects of Study Skills Courses on Student Success
Multiple studies describe the effect of study skills courses on college students’
subsequent performance. The effectiveness of study skills courses have been measured
most commonly by test scores, grade point average’s, number of credits obtained and
retention data (Connelly, DuBois, & Staley, 1998). Some researchers have used
students’ self-assessment results to examine attitudinal and behavioral changes
(Higbee & Thomas, 1999; Wambach, 1993) while others have measured students’
behavioral differences as observed by their instructors (Bender, 2001). Current studies
on study skills courses are built on the work of Pintrich, McKeachie, and Lin (1987),
Weinstein and Underwood (1985), Dansereau and colleagues (1979), Biggs and Rinn
(1984), who have conducted extensive evaluations of study skills programs and have
56
collectively reported moderate effects on grade point average’s, number of credits
earned, and attrition rates (Connelly, DuBois, & Staley, 1998; Tuckman, 2003).
One state university began a College Skills Development Program to improve
academic success and increase the retention of freshmen students whose predicted
grade point average (based on high school grades and SAT scores) was less than 2.00
(Bender, 2001). Students met twice a week for a two-credit study skills class. The text
used covered study skills such as time management, memory techniques, reading
skills, note-taking, test-taking, critical thinking, and writing skills. In addition, an
orientation to college life topics such as self-responsibility, diversity, relationships,
health, and money were included. Three groups of first-semester freshmen were
included in the study. The first group attended the study skills course and tutorial
sessions for their major courses. The second group just attended the study skills
course, and the third group was a control group who did not enroll in study skills or
tutoring and had a GPA between 2.00 and 2.10. Likert-scaled questionnaires were
administered to math and English instructors who taught classes in which all three
groups of students were enrolled. Instructors indicated students’ current behaviors
considered to be related to better performance (motivation to succeed, class
attendance, and class participation) as well as how their behaviors had changed during
the semester.
The aforementioned study found that students who took the study skills course
and the tutoring had the largest increase in grade point average after the first semester
and were observed by their instructors as demonstrating significantly more behaviors
57
related to academic success when compared to the two other groups. The students who
only enrolled in the study skills course had significantly higher grade point averages
than the control group and demonstrated more positive behaviors as well. This study
showed that interventions for at-risk college students can be effective in improving
academic achievement and behaviors. While a study skills course alone appears to
make a significant difference, combining it with academic tutoring seems to be the
most effective way to improve grades and behavior (Bender, 2001).
Another large public college developed an educational psychology based study
skills course designed to teach learning and motivation strategies such as: taking
reasonable risk, taking responsibility for outcomes, searching the environment for
information, and using feedback (Tuckman, 2003). Within these strategies students
were taught how to manage their time and life stressors, learn effectively from lectures
and textbooks, prepare for examinations, and write papers. Half of the 226 students
who took the four and a half hours per week course over 10 weeks were freshmen, 22
percent were sophomores, 15 percent were juniors, and 12 percent were seniors. While
this course was an elective, advisors recommended it to students in need of academic
assistance. A comparison group was drawn from student records. Each student in the
course was matched with a non-course student on gender, ethnicity, rank, and prior
grade point average. In evaluating the outcomes of taking this course, researchers
found that students who took the course earned significantly higher grade point
averages in comparison to the matched group, both the term they took the course and
the term after taking the course. They were also more likely to return for the next year
58
of college than students in the matched group (Tuckman, 2003). With the recent
increase in computer-assisted education and online classes, some colleges are
beginning to evaluate the effectiveness of study skills courses administered on
computers. Few studies have evaluated web-based study skills courses; however, with
these technological advances more are likely to follow. For instance, randomly
assigned first-year college chemical engineering students were placed in a treatment
group using a study skills software program and a control group. Researchers
examined high school grade point average, first-term grade point average, student
goals, use of time, self assessments, and feedback. In looking at these criteria,
significant pre-treatment group differences were found to exist. So, although
improvements in students’ performance in the treatment group were observed, they
may be due to preexisting differences from the control group (Zinatelli, Dube, &
Jovanovic, 2003). Another web-based platform was evaluated for its effectiveness as
an instruction supplement for a student success course consisting of study skills and
learning strategies. Results suggest it is a useful supplement and worth employing to
assist students learn in this increasingly popular alternative method (Shafer, Lahner,
Calderone, Davis & Petrie, 2002).
In another study a university biology teacher modified the traditional broad-
based study skills curriculum to a specific course for freshmen and sophomore
students enrolled in an introductory-level zoology class (Belzer, Miller, & Shoemake,
2003). The supplemental study skills class, titled “Concepts” met once a week and was
taught by one of seven doctoral students. It was implemented when the course was
59
designated “high risk” by the institution, since only 60 percent of students who took
the course passed it. Unique in its approach, the study skills course focused on
teaching study skills and biological thought processes in the context of a General
Zoology lecture course. A comparative analysis found that the supplemental course
significantly improved students’ success in General Zoology, as measured by
decreased failure rates, positive learning strategies, and motivation. Learning study
skills was a critical component to the supplemental course; yet it is impossible to
separate its effect with the additional content knowledge and exposure students
received on a weekly basis. From this study, it appears that in a “high-risk” lecture
style class such as General Zoology, a supplemental course that teaches study skills in
relation to the course content improves student success.
Determined to expand on the growing body of research reporting moderate
effects of study skills courses on grade point average’s and attrition rates, community
college researchers conducted a structured interview study to discover the long term
outcomes associated with completion of a study skills course (Connelly, DuBois, &
Staley, 1998). This study contrasted high and low grade point average second semester
first-year students on five outcomes: use of non-study time; time management
analyses; self-report changes; adaptation to different general studying situations; and
studying behaviors as measured by marked texts, notes, and self-reported review
tactics. While lacking a control group, the significance of this pilot study lies in its
methodology rather than results. However, the results suggest that the study skills
60
course had a moderate effect on future academic performance and strategy usage
among this group of participants.
A classroom study was conducted to evaluate the effectiveness of a study skills
course, as well as to investigate the roles of teaching and assessing study skills by the
instructor or researcher (Oakerson, 1993). Participants in the state university study
skills course were freshmen level students who had been identified as “at risk” for
academic failure by their advisors. The Learning and Study Strategies Inventory
(LASSI) was used to measure pre and post performance on the designated study skills.
Students scoring below the 75
th
percentile on the LASSI can significantly benefit from
study skills instruction (Mealey, 1988). The LASSI identifies 10 study areas which
were used as topics of instruction in the course. They are: attitude, motivation, time
management, anxiety, concentration, information processing, selecting main ideas,
support techniques, self testing, and test strategies. Differences between the pre and
post test scores were found to be statistically significant for six of the LASSI
categories: anxiety, information processing, selecting main ideas, use of support
techniques, self testing and review, test strategies and preparing for tests. Additionally,
higher scores on the test strategies section were significantly correlated to a higher
cumulate grade point average at the end of the course. The findings from this study
support specific concepts, skills, and strategies that can be emphasized in study skills
courses to maximize its benefit to students.
A small liberal arts college presented a study skills course to a group of at-risk
first-year freshmen and transfer students (Forster, Swallow, Fodor, & Foulser, 1999).
61
Freshmen students either had an ACT score of 15 or less, low high school GPA’s or
were in the bottom half of their class. Transfer students who participated had a college
GPA of 2.0 or less. Multiple small sections were offered that met for 90 minutes twice
a week for 15 weeks. Instructional methods and contents were representative of a
typical study skills curriculum. Students were taught various study techniques and
were actively engaged in the learning process through discussion and personal
application of the techniques. The Learning and Skills Inventory (LASSI) was used as
an assessment and teaching tool and was administered pre and post course. In addition,
a 31-item questionnaire was administered as a pretest to assess students’ knowledge of
the college’s academic support resources. In the post-test several open-ended and
Likert-type questions were added. The same tests were also administered to general
admission first-year students as a control group. The study skills class had a positive
impact on the majority of the participants as shown by high student satisfaction (95
percent reported they would recommend the class to other students), improvements in
study skills used as measured by LASSI (which did not occur in the control group),
improved knowledge of college resources, and an improvement in grades and
retention (compared to previous at-risk cohorts). The open- ended questions indicated
students were pleased with the effects of the class. One student wrote, “When entering
this course I didn’t really know what I was doing in college. I thought it would just be
something to do before I got kicked out; however, now I know I can do well in
college. I know what my priorities are and how to accomplish them.” Due to the
overall beneficial results this class had on those students who participated, this college
62
is developing a seminar that would be required for all first-year students (Forster,
Swallow, Fodor, & Foulser, 1999).
Interestingly, results from this study also showed that students least affected by
the course were those with low motivation, as measured by LASSI. A similar finding
on the importance of motivation was also identified as a discriminating factor for
student achievement by Albaili (1997). When 168 undergraduates took the LASSI to
examine differences between low-, average-, and high-achieving students at a
university, motivation was the most powerful factor out of the numerous learning and
study strategies separating the students.
Conclusions
In order to reduce the growing national nursing shortage and meet the societal
demand for nursing care, nursing programs need to improve nursing student retention
rates, thereby producing a higher number of entry level nurses to enter the workforce.
Theoretical frameworks for college student retention provide a basis on which specific
academic specialties, such as nursing, continue to study the variables that influence
attrition. The most influential theoretical contributions to understanding the traditional
college student attrition process emphasize the importance of social and academic
integration in student departure/persistence outcomes (Spady, 1971; Tinto, 1975;
Bean, 1980; Pascarella & Terenzini, 1980). Nontraditional student retention models
emphasize the importance of academic and environmental variables on students’
departure decisions (Bean & Metzner, 1985, 1987; Pascarella, Duby, & Iverson, 1983;
Benjamin, 1994). The majority of nursing students are nontraditional students,
63
therefore, academic and environmental variables effecting nursing students should be
emphasized in the research. Despite an increased understanding of the attrition process
through these frameworks, there is a need for continued study and modification of the
models, as well as application of the knowledge gained to decrease attrition in all
college students.
Research shows the majority of nursing students are being trained in associate
and baccalaureate degree nursing programs. Professional advisory councils
recommend the majority of registered nurses to be baccalaureate prepared by 2010.
Access to nursing programs is improving with the incorporation of distance-learning,
which appears to be a growing trend, yet high attrition rates continue to persist.
Research has shown the effects of several variables on nursing student
retention. Evidence suggests that age, ethnicity, and previous academic performance,
especially prerequisite science course grades, have an impact on retention (Potolsky,
Cohen, & Saylor, 2003; Wilson, 2001; Houltram, 1996). Faculty as advisors, role
models, and sources of support enhance nursing student retention (Shelton, 2003).
Nursing students perceive that environmental factors have a greater influence than
academic factors on their ability to succeed (Jeffreys, 1998, 2001). At-risk participants
in retention programs are more likely to graduate than similar non-participants (Lockie
& Burke, 1999; Hesser, Pond, Lewis, & Abbott, 1996). While results from these
studies have given nursing leaders and educators some evidence to guide their
retention strategies, the need for more research remains to guide them in selecting
proper students to begin nursing programs, adequately supporting the students they
64
admit, and graduating their students to enter the workforce (Buerhaus, Staiger, &
Auerbach, 2000).
In an effort to increase the academic performance and retention of college
students, study skills courses are taught in higher education settings. First-year college
students make up the majority of students who take study skills courses, while transfer
students, students at risk for academic failure, and even high achieving students who
want to improve have benefited from applying the course content. Each study skills
course differs based on the instructors’ and institutions’ purposes; yet the basic topics
of time management, memory strategies, and test-taking strategies are the foundation
for most curriculums. Each of the studies evaluating study skills programs differs
significantly from the others. There have been relatively few well-controlled studies
on the differences that study skills courses make in student outcomes. Overall,
evidence suggests that they are beneficial to students’ performance, even if in a
modest way, in particular to those who lack the essential, effective learning and
management strategies to meet the rigorous requirements of college courses.
In summary, theoretical frameworks for nontraditional college student
retention suggest nursing educators focus on the academic and environmental
variables that impact student’s decision to persist in a nursing program. Effective
study skills courses could potentially influence some of these variables. While some
nursing retention programs incorporate study skills, the direct impact of a study skills
course on nursing students has yet to be identified.
65
Implications
It is the goal of every nursing school to graduate competent and professional
registered nurses. In order to do this, it is essential for nursing educators to find
effective ways of retaining the students who have chosen the nursing profession.
Nursing educators can begin by understanding and applying nontraditional college
student retention theories that emphasize the importance of academic and
environmental variables on student’s decision to persist with their educational goals.
For instance, nursing programs can be supportive of the struggles many nursing
student face (such as employment, financial concerns, and dependent children at
home) by offering more flexibility. Evening and weekend courses and opportunities
for distance learning enable students to plan courses around work schedules and home
responsibilities. Nursing programs can develop strategies to support students
academically who face barriers to success, such as inadequate preparation for the
rigors of nursing school. Nursing programs may incorporate mentoring programs,
tutoring services, remediation courses, teach computer skills, and/or offer general
study skills courses.
Nursing admissions counselors could also use this information to ensure
interested students are aware of the academic rigor of the nursing program and are
adequately prepared. Knowing that environmental factors contribute to a student’s
decision to persist, an admissions counselor may be better able to help a student decide
if he or she is able to adjust other areas of life in order to accommodate the time and
energy that is essential to academic success.
66
One of the reasons for the high attrition rate in nursing programs may be
related to the types of students who are admitted. Perhaps many community college
“open-door” policies contribute to the attrition problem by the admittance of
unprepared students. Based on the current research, nursing programs could modify
admissions criteria to include prerequisite science course grades, achievement testing,
and college grade point average. Another implication of the literature is the need for
faculty to give effective and personal support to students. Students benefit from both
functional and psychological support. Knowing the impact faculty members can have,
they could be trained and informed on how meet the needs of their students in
seemingly small and ordinary ways. Another way nursing programs can increase
retention is through the use of enrichment and retention programs. Nursing programs
can utilize and promote supportive resources available on campus, as well as initiate
their own system for mentoring and supporting students.
Nursing program administrators and faculty realize that students leave nursing
programs for reasons other than academic difficulties. However, because some
attrition can be attributed in part to ineffective learning strategies and study skills,
study skills courses can be utilized during the first year of college to remedy these
deficits and improve academic performance. While taking a study skills class may be
beneficial for most first-year college students, for those at higher risk for academic
failure (based on previous grades or placement exam scores) a study skills class may
be crucial to their success. Therefore, nursing programs may offer a study skills course
67
to students who wish to enroll voluntarily for their own benefit as well as make the
course mandatory for those who have been identified as “at-risk.”
Since student achievement is determined by so many factors, it is difficult for
researchers to identify how a student’s study skills or lack of them truly influence their
learning, grades, and retention. Perhaps the biggest difference in academic outcomes
could be found in the effects of study skills courses on students who have the capacity
and motivation to succeed yet are inhibited by ineffective learning and management
strategies.
Further research is needed to further explore the causes of nursing student
retention among nontraditional students and the ways in which nursing programs can
best support students. Predictive indicators of success need to be identified as well.
Increased knowledge on the specific content taught in study skills courses and
pedagological styles that are most effective would benefit course instructors and
coordinators. Additional research could also be directed on the effects of study skills
courses on academic achievement, especially as it relates to specific fields, such as
nursing.
68
CHAPTER 3
RESEARCH METHODOLOGY
This study used a quantitative, retrospective, quasi-experimental, two-group
comparison design. Academic and demographic data were collected from a database
on associate degree nursing students who began the program in Fall 2004. Responses
from a student satisfaction and evaluation questionnaire of the study skills course were
also collected. The purpose of this study was to examine the relationship between
students who completed a study skills course before the first semester of an associate
degree nursing program and academic achievement and retention. Its purpose was also
to examine the impact of the study skills course on students with the highest and
lowest grade point averages who voluntarily enrolled in the course compared to
students with the highest and lowest grade point averages who did not take the study
skills course. The third purpose was to identify students’ perceptions of the value of a
study skills course on subsequent semester performance. This chapter includes the
research questions, the hypotheses, and a description of the research methodology.
The latter includes the sampling procedure and population, instrumentation, and
procedures for data collection and analysis.
The purpose of this study was to examine the relationship between students
who completed a study skills course before the first semester of an associate degree
nursing program and academic achievement and retention. Its purpose was also to
examine the impact of the study skills course on students with the highest and lowest
69
grade point averages who voluntarily enrolled in the course compared to students with
the highest and lowest grade point averages who did not take the study skills course.
The third purpose was to identify students’ perceptions of the value of a study skills
course on subsequent semester performance.
Research Questions
1. Does participation in a study skills course before the first semester of a
nursing program influence subsequent grades, units taken, and re-
enrollment in the following semester in those who took the course
compared to those who did not?
2. How do students with the highest and lowest grade point averages
benefit from voluntarily enrolling in a study skills course compared to
the students with the highest and lowest grade point averages who
choose not to enroll in the study skills course?
3. Is there perceived value to the participants of taking a study skills
course?
Research Design
This study uses a quantitative, retrospective, quasi-experimental, cross-
sectional, two - group comparison design. This type of design was chosen because the
purpose of the study is to evaluate the effectiveness and impact that a study skills
course had on nursing students’ academic achievement in the subsequent semester.
Students self-reported perceptions of the study skills course are important to
70
understanding why students decide to take or not take the voluntarily course and how
valuable they perceive it to be in their subsequent coursework.
To begin this study, course rosters were obtained for lists of student who
enrolled in the one-week study skills course for nursing students before the fall
semester 2004 from the college’s computerized data base system. Class rosters were
obtained from the four foundational nursing courses students take during the first
semester of a nursing program: nursing fundamentals (introduction of the nursing
process as a framework for caring for people with common health alterations such as
comfort, elimination, mobility, etc.), nursing skills (“hands-on” clinical skills and
physical assessment skills done in a laboratory setting), nursing pharmacology
(components of medication administration, drug classifications, and their effects on
the body), and introduction to clinical nursing (application of the nursing process and
performing basic nursing skills to meet the needs of diverse clients). Individual student
transcripts were obtained and divided into two sections, one for those that took the
study skills course before enrolling in one or more of the nursing courses listed above
and one for those that did not. Data collected from the transcripts included courses
taken, courses currently enrolled, declared program of study, and cumulative and
semester grade point averages. The nursing admissions counselor was contacted in
order to obtain student data located on admissions records, such as pre-entrance exam
scores, standardized achievement test scores, the prerequisite chemistry grades, and
high school grade point averages. The questionnaires that students in this sample
completed were obtained from the associate dean of nursing. These were administered
71
during the spring semester 2005 by faculty instructors during clinical course time
under the direction of the nursing administration.
The most significant dependent variables in this study were re-enrollment in
the spring 2005 and the fall 2004 semester grade point average. Other dependent
variables included in the study are: age, gender, race, number of credits graded,
withdrawn, incomplete, and for credit only in fall semester 2004, high school grade
point average, cumulative college grade point average prior to fall semester 2004,
number of college credits graded prior to fall semester 2004, prerequisite chemistry
grade, college microbiology grade, college anatomy and physiology grade, pre-
entrance exam score, COMPASS achievement test score, and ACT and AST score
achievement test scores. The independent variable in this study is whether students did
or did not take the study skills course.
Population and Sample
The population of interest in this study is associate degree nursing students
currently enrolled in first-semester foundational nursing coursework. The
nonrandomized sample (N=61) for this study is all associate degree nursing students at
a public Midwestern technical college who enrolled in at least one of four (above-
mentioned) first-semester nursing courses during the fall semester 2004. The sample
will then be divided into two subgroups, those that took the study skills course the
week before the fall 2004 semester (N=19) and those that did not (N=42). The sample
consists of students who attend a state supported technical college that draws its
student population from the local rural community.
72
Instrumentation
The instruments used to collect data in this study are: class rosters, student
transcripts, admission data (National League for Nursing pre-entrance exam scores,
standardized achievement scores (COMPASS, ACT, AST), high school grade point
averages, prerequisite chemistry course grades, and a course evaluation and
satisfaction questionnaire administered in two distinct versions (one for students who
voluntarily chose to enroll in the study skills course and one for those that chose not to
enroll). Additionally, the study skills course is an instrument in this study.
The class rosters and student transcripts were obtained from a database system.
It is a database available on campus computers to faculty and staff of the college. The
database system was developed approximately 25 years ago by a computer
programmer employed by the college to record all data related to student and course
management.
Admissions data is stored in individual folders in the nursing admissions
counselor’s office. It includes the NLN pre-entrance exam, high school grade point
averages, prerequisite chemistry course grades, and placement and achievement tests
(COMPASS, ASSET, and ACT). The NLN pre-entrance exam is a standardized
entrance exam for potential nursing students seeking admittance into nursing schools
nationwide. It is one way in which nursing schools may evaluate an applicants
potential to succeed in their program. The test consists of three main areas: verbal
skill, mathematics, and science. Individual scores are reported compared to the group
norm and nursing schools decide what scores are acceptable for their own admission
73
purposes (National League for Nursing, 2005). The NLN has established validity and
reliability for the exam.
The COMPASS, ASSET, and ACT assessments are distributed by ACT, Inc.,
who has established validity and reliability for each test (ACT, 2005). COMPASS and
ASSET are both placement assessments for post-secondary education courses.
COMPASS is a computerized test that assesses English composition, reading,
mathematics, and English as a second language. ASSET is a paper and pencil test that
provides immediate score reports for students in reading and mathematics and is often
used as part of a Student Success Seminar (ACT, 2005). The ACT is an achievement
assessment of a persons English, Mathematics, Reading, and Science skills. It is used
as an indicator or a student’s preparedness for college level coursework.
The questionnaire that was previously administered has not been evaluated for
reliability and validity. It has face validity since it is assessing student’s perceptions of
their experience. It was written by a nursing faculty member and administered under
the direction of the dean of the school of nursing for quality improvement. It was
based on assessing the value of topics covered in the study skills course and a generic
course evaluation form of an unknown origin commonly used for students to evaluate
many different courses in the technical college. The two versions of the questionnaire
are included in Appendix A and B.
The study skills course being evaluated for its effectiveness was offered to
nursing students beginning the nursing program. It was taught on the main campus of
the Midwestern technical college at the Academic Success Center by one of the
74
centers instructors. It was broadcast via ITV to three satellite campuses in the local
surrounding area. It was held on a Monday, Tuesday, Wednesday, and Thursday from
9 a.m. to 11 a.m. each day during the week before the fall semester courses began. The
cost was $19.20. The course was an abbreviated version of a semester long two-credit
course offered by the college titled Student Success. The topics covered in the course
were: time management, learning styles, concentration, technical reading, scanning
reading, active listening, note-taking, memory strategies, and objective and essay test
preparation. The subjects were taught from topic specific packets of information and
worksheets put together by the instructor.
The course began after administrators in the nursing program requested it, in
an attempt to better prepare students for the academic rigor or nursing coursework.
The first study skills course for nursing students was offered before the fall 2001
semester and has been held continuously before the fall and winter semesters since
then. The course is open to any nursing students who wish to enroll, with a maximum
enrollment of 20 students per section. It is advertised through posted fliers in the
nursing department as well as in an information packet sent by mail to students’
residences. Students who wish to enroll in the course register by phone or in person
through the college. Students are not graded in the class, but do receive 0.20 credits.
Data Collection
Institutional Review Board (IRB) approval at the University of Southern
California was obtained prior to data collection. As there is not an IRB at the college
where the study took place, written permission from a college administrator to collect
75
the data was obtained. Academic and demographic data and questionnaire data was
stored in an Excel spreadsheet and analyzed and stored in SPSS Statistical Program
Version 11.5. After the data was collected (from the computer database, the
admissions committee, and the Dean of Nursing’s questionnaires) and entered, it was
saved without names or identifiable identification numbers to protect students’
anonymity. Students received a chronological number from 1-61 in the computerized
saved data file. Any hard copies of identifiable data were shredded.
The tools used in this study included student transcripts, admission data for
entrance into the nursing program, demographic data obtained from the questionnaire,
and the course evaluation component of the questionnaire ( which was produced by the
college for administrative purposes of gathering student perceptions and feedback on
the study skills course).
Data Analysis
All data was entered into SPSS statistical programming version 11.5 for
analysis. There were three stages to the analysis of this study.
Stage 1A
The first stage of the analysis was descriptive. In this stage the mean, standard
deviation, range and variance were determined for each variable to note the normal
distribution of the data. A description of the two subgroups, those who did and did not
participate in the study skills course will be included.
76
Stage 1B
The second part of this stage correlated variables related to academic
preparation to success in the nursing program. Success was defined by college grade
point average in courses completed prior to entering the nursing program and in the
first semester of nursing courses.
Stage 2
The second stage compared the pre and post variables of the two groups,
students who did and did not take the study skills course. Standard t-tests were used
for mean comparisons on variables exhibiting normal distribution with interval level
of measurement. For variables in which the data were not normally distributed or the
sample size was prohibitive, nonparametric comparisons were applied. The sample
was also subdivided into groups based upon prior academic achievement.
Comparisons of the subgroups are included.
Stage 3
The third stage was to describe why some students did or did not take the study
skills course. The questionnaires were analyzed for factors that most heavily
influenced students’ decisions to take or not take the course. For students who took the
course, the perceived value of the study skills course was elucidated based on their
responses from the course evaluation.
77
CHAPTER 4
FINDINGS
There were 61 students who enrolled in at least one of the four fundamental
courses for first semester nursing students during the fall 2004 semester. Transcript
and admission data was obtained on all of the students. Demographic data and
students responses to the study skills course were obtained on students who
participated in the study skills questionnaire. Of the 61 beginning nursing students, 19
voluntarily took the study skills course the week before classes began, while 42
students did not. Eighteen students who took the study skills course also completed the
satisfaction and evaluation questionnaire, while 31 students who did not take the
course completed the questionnaire. For the total group, the questionnaire completion
rate was 80 percent. However, in the study skills group there was a 95 percent
response rate.
Sample Descriptions
A description of the total sample is described in Table 1, as well as the two
subgroups, those who participated in the study skills and those who did not.
Table one results have different sample sizes depending on the variable. The large
reduction in sample size for some variables is related to program requirements. For
instance, this program did not require the CPASS, ACT, and AST exams for
admission; hence many of the students did not take them. These numbers will be used
indicators of success in the program, but the results should be accepted with caution
78
because of the small sample sizes. Another difference in sample size is evident
between specific class grades. All students had a Chemistry grade recorded since it is a
prerequisite to entering the program. Many, but not all students had a Microbiology
grade and a General Anatomy and Physiology grade recorded, as the program
encourages students to take them before entering the nursing program, but also allows
them to be taken concurrently with nursing courses.
Table 1. Total Group, Study Skills Group, No Study Skills Group Mean Comparisons
(Mean ± Standard Deviations; T-test)
Total Sample Study Skills Group No Study Skills Group
Variable Mean ±SD N Mean ±SD N Mean ±SD N
Fall 2004 Semester
GPA
2.72 ±80 57 2.79 ±0.71 18 2.68 ±0.84 39
Units Graded Fall
2004
7.67 ±2.50 57 7.28 ±1.53 18 7.85 ±2.84 39
Cumulative GPA
before Fall 2004
3.25 ±0.58 56 3.34 ±0.58 17 3.21 ±0.58 39
Age 34.3 ±8.95 61 37.58 ± 8.93 19 32.9 ±8.67
a
42
High School GPA 2.88 ±0.66 34 2.55 ±0.75 12 3.06 ±0.54
a
22
Microbiology grade 3.24 ±0.85 34 3.67 ±0.50 9 3.08 ±0.91
b
25
Anatomy/ Physiology
grade
2.63 ±1.05 49 2.79 ±1.12 14 2.57 ±1.04 35
Chemistry grade 3.16 ±0.80 61 3.21 ±0.86 19 3.14 ±0.78 42
PEE verbal 75.5 ±18.2 51 79.2 ±17.9 18 73.5 ±18.4 33
PEE numerical 75.1 ±20.0 51 78.3 ±14.84 18 73.3 ±22.3 33
PEE science 81.0 ±13.2 51 83.3 ±12.8 18 79.7 ±13.4 33
CPASS reading 87.3 ±9.15 12 85.00 ±8.68 4 88.5 ±9.73 8
CPASS writing 87.6 ±7.92 13 92.33 ±4.73 3 86.2 ±8.31 10
CPASS numerical 66.0 ±20.8 14 62.0 ±20.12 4 67.6 ±21.9 10
ACT reading 23.0 ±4.58 11 22.00 1 23.1 ±4.82 10
ACT writing 20.2 ±3.29 11 19.00 1 20.4 ±3.44 10
ACT numerical 21.1 ±4.40 11 20.00 1 21.3 ±4.62 10
AST reading 46.3 ±4.62 16 49.00 ±2.71 4 45.4 ±4.85 12
AST writing 47.3 ±3.69 16 46.75 ±3.59 4 47.5 ±3.85 12
AST numerical 44.2 ±6.77 16 46.40 ±6.47 5 43.2 ±6.97 11
a
P < .05
b
P < .10
79
A description of the demographic data was performed to determine
characteristics of the total group, as well as any differences between students who
chose to take the study skills course and those who did not. Three male students and
16 female students enrolled in the study skills course. Six male students and 36 female
students did not, making the group total comprising of 9 male and 52 female students.
The remainder of the demographic information was obtained through the 49
completed surveys (18 in study skills group, 31 not in study skills). Ninety six percent
of the total group identified themselves as Caucasian. Seventy-two percent of the
students in the study skills course were married, with the remainder being separated or
divorced. Forty-eight percent of student who did not take the study skills course were
married, 32 percent were single, and 19 percent were separated or divorced. Eighty-
eight percent of the students who took the study skills course and 68 percent of those
that did not had at least one dependent child at home. In the total group, 71 percent of
students had one or more dependent children at home.
In the total group, 49 percent of students reported that their financial resources
were adequate, 43 percent reported they were less or much less than adequate, and 8
percent reported they were more than adequate. Eighty percent of the total group of
students reported working in employment outside of school; twenty nine percent
worked 20 hours a week or less and 51 percent worked 21 hours or more a week. All
of the 49 students had obtained a high school diploma or GED, two students had an
associate degree, and 10 students had a baccalaureate degree. Of the students who took
the study skills course, 11 percent have mothers and fathers who had an associate
80
degree or higher. Of the students that did not take the study skills course, 32 percent
have mothers with an associate degree or higher and 19 percent have fathers with an
associate degree or higher. When asked what level of nursing education students
eventually intended to achieve, 72 percent of students who took the study skills class
reported associate degree, compared to 33 percent of students who did not take the
study skills class.
Test of Group Differences
An independent-samples T-test was performed to ascertain if there were
differences between the study skills participants and the non-participants on specific
variables. The results revealed significant group differences for age, high school GPA,
and Microbiology grade (see Table 1). The study skills group was significantly older,
had a lower high school GPA, and performed better in the Microbiology course.
Test of Sub Group Differences
In order to test the hypothesis that the less academic qualified participants
would benefit most from the study skills class, the total sample was divided into equal
groups (n=8) based upon cumulative college grade point averages. Study skill
participant high academic achievers (subset 1) had a mean cumulative GPA of 3.79 ±
0.25. The study skill low academic achievers (subset 2) had a mean cumulative GPA
of 2.85 ± 0.44. The non-study skills participants of high- (subset 3) and low- (subset
4) achievers had GPA means of 3.89 ± 0.08 and 2.41 ± 0.57, respectively. The results
of the ANOVA testing the difference between these subsets are presented in table two .
81
Table 2. Group Comparisons ANOVA for Subsets 1-4 Based Upon Cumulative Grade
Point Average (Includes Bonferroni Post Hoc Comparisons)
Variable Subset Mean ± SD N F-value Significance
Age 1 40.75 ±10.32 8 6.688 .002
2 34.25 ±6.90 8
3 37.50 ±7.83 8
4 24.50 ±4.50 8
Fall 2004 GPA 1 3.13 ±0.48 7 2.482 .083
2 2.27 ±0.667 8
3 2.92 ±1.18 8
4 2.06 ±0.95 7
High School GPA 1 2.82 ±0.72 4 1.205 .344
2 2.48 ±0.67 6
3 3.27 ±0.70 4
4 3.03 ±0.58 4
# Credits Graded Fall 1 7.14 ±1.46 7 .787 .515
2 7.13 ±1.64 8
3 8.25 ±1.83 8
4 8.43 ±2.07 7
# Previous credits 1 23.62 ± 17.85 8 1.529 .229
2 35.87 ±26.23 8
3 26.87 ±11.05 8
4 40.62 ±12.80 8
Micro Grade 1 3.80 ±0.45 5 3.33 .050
2 3.33 ±0.58 3
3 4.00 ±0.00 5
4 2.40 ±1.51 5
Anat/Phys Grade 1 3.66 ±0.52 6 4.09 .019
2 2.00 ± 1.00 7
3 3.33 ±1.63 6
4 2.00 ±1.00 7
Chemistry Grade 1 3.13 ±0.84 8 .131 .941
2 3.25 ±0.89 8
3 3.28 ±0.74 8
4 3.25 ±0.71 8
PEE Verbal 1 82.75 ±13.66 8 .513 .667
2 73.14 ±23.87 7
3 75.0 ±19.5 6
4 68.8 ±29.1 6
PEE Numerical 1 76.00 ±16.67 8 .225 .878
2 81.86 ±13.73 7
3 82.00 ±27.36 6
4 75.83 ±16.93 6
PEE Science 1 83.63 ±11.03 8 .103 .958
2 85.00 ±16.58 7
3 86.00 ±14.99 6
4 81.67 ±15.46 6
82
The results indicate that the high achievers, irrespective of study skills
participation, were significantly older that the non-participant lower academic
achievers. The results also indicate that the Microbiology grade was a significant
discriminator between the high academic achievers and the low achiever subsets. The
study skills high group had a significantly higher General Anatomy and Physiology
grade than did either low achieving subset. None of the other subset comparisons
yielded significant differences. These results support the position that there were very
little academic differences between those who do or do not take the study skill class
and in their subsequent semester academic performance.
Another important question relates to the impact of participation in the study
skills class versus non-participation with regard to subsequent reenrollment. The
following table provides this information.
Table 3. Reenrollment Spring 2005
Reenrollment Spring
2005
No reenrollment Spring
2005
Total Group 56 (92%) 5 (8%)
Student in Study Skills 18 (95%) 1 (5%)
Student not in Study Skills 38 (89.5%) 4 (9.5%)
The reenrollment from the first semester of nursing courses to the second
semester was high; 92 percent reenrolled. The chi-square statistic evaluating the
frequency of reenrollment yielded a
2
=0.0087. This was not significantly significant.
This suggests that there were no differences in the expected versus observed frequency
of non-reenrollment between the two groups (degrees of freedom = 1). Of the five
students from the total group who did not reenroll, one student was in subset one (high
83
achieving study skills participant), two were from subset four (low achieving no study
skills), and two were from the no study skills group, neither subset.
Relationships and Correlations
A Pearson correlation matrix shows the correlations between variables. Table
four illustrates those with significant correlations. The interaction among these
variables may be a valuable way of reducing redundancy in student screening for
admission into the nursing program and choosing admission criteria most predictive of
success in the nursing program.
Table 4. Total Group Correlation Matrix
Cum
GPA
Fall
GPA
Micro
Grade
A&P
Grade
PEE
Ver
PEE
Sc i
ACT
Writ
ACT
Num
AST
Read
AST
Num
Cum
GPA
--- .501
(**)
.831
(**)
.529
(**)
--- --- --- --- --- ---
Fall
GPA
.501
(**)
--- .651
(**)
.743
(**)
.381
(**)
--- --- --- --- ---
Micro
Grade
.831
(**)
.651
(**)
--- .756
(**)
.469
(*)
.451
(*)
--- --- --- .709
(*)
A&P
Grade
.529
(**)
.743
(**)
.756
(**)
--- .344
(*)
.311
(*)
--- --- --- ---
PEE
Verbal
--- .381
(**)
.469
(*)
.344
(*)
--- .403
(**)
.767
(*)
.748
(*)
.773
(*)
.786
(**)
PEE
Sci
--- --- .451
(*)
.311
(*)
.403
(**)
--- --- --- --- ---
ACT
Writ
--- --- --- --- .767
(*)
--- --- --- --- ---
ACT
Num
--- --- --- --- .748
(*)
--- --- --- --- ---
AST
Read
--- --- --- --- .773
(**)
--- --- --- --- ---
AST
Num
--- --- .709
(*)
--- .786
(**)
--- --- --- --- ---
** Correlation is significant at the 0.01 level (2-tailed)
* Correlation is significant at the 0.05 level (2-tailed)
--- Non-significant relationship
84
The variables high school grade point average and Chemistry grade are not
included in the correlation matrix because they did not significantly correlate with any
of the other variables (Figures 1 and 2). Similarly, the CPASS tests and some sections
of the other assessment tests were not included since they were not significantly
correlated to other variables. The three variables that were significantly associated
with student GPA in the first semester of nursing courses were the Microbiology
grade, the General Anatomy and Physiology grade, and the PEE verbal score (Figures
3-5).
Figure 1. High School GPA vs. Fall 2004 GPA
High School GPA vs Semester GPA
0.50
1.00
1.50
2.00
2.50
3.00
3.50
4.00
0.50 1.50 2.50 3.50
Semester GPA
High School GPA
r=.262
y = 0.373 + 1.49
85
Figure 2. Prerequisite Chemistry Grade vs. Fall 2004 GPA
Chemistry Grade vs Semester GPA
1.0
1.5
2.0
2.5
3.0
3.5
4.0
1.00 1.50 2.00 2.50 3.00 3.50 4.00
Semester GPA
High School Chemistry
Grade
Figure 3. Microbiology Grade vs. Fall 2004 GPA
Microbiology Grade vs Semester GPA
0.50
1.00
1.50
2.00
2.50
3.00
3.50
4.00
4.50
1.00 1.50 2.00 2.50 3.00 3.50 4.00
Semester GPA
Microbiology Grade
r=.054
y = 0.052 + 2.155
R=0.651
y = -0.051 + 2.796
86
Figure 4. Anatomy and Physiology Grade vs. Fall 2004 GPA
General Anatomy and Physiology Grade vs
Semester GPA
1.00
1.50
2.00
2.50
3.00
3.50
4.00
1.00 1.50 2.00 2.50 3.00 3.50 4.00
Semester GPA
Anatomy and
Physiology Grade
Figure 5. PEE Verbal Score vs. Fall 2004 GPA
PEE Verbal Score vs Semester GPA
10
30
50
70
90
110
1.00 1.50 2.00 2.50 3.00 3.50 4.00
Semester GPA
PEE Verbal Score
r=.381
y = 0.016 + 1.517
r=.743
y = 0.097 + 2.53
87
Results of Questionnaires
Students responded to given statements on the questionnaire on a scale from
one to five. One indicated “strongly agree”, two was “agree”, three was “neither agree
nor disagree”, four was “disagree”, and five was “strongly disagree”.
Table 5. Responses of Study Skills Course Participants to Questionnaire
Statements N Mean Std. Dev.
1. I enrolled in the study skills class because
a. I didn’t do well in high school. 18 4.11 1.1
b. I thought it would help me do well in
nursing school.
18 1.39 0.5
c. I had a friend taking it. 17 3.94 1.1
d. it was at a convenient time and location. 18 3.00 0.9
e. it was offered at a reasonable price. 17 2.29 1.2
f. I was having academic difficulties in
college courses.
18 3.94 1.3
g. it was required as part of my student
success plan.
17 3.94 1.1
2. I thought taking the study skills class
would
a. help me get a higher grade point average. 18 2.06 0.7
b. help me find students to study with. 17 3.65 0.9
c. help me study more effectively. 18 1.50 0.5
d. give me tips on succeeding in nursing
school.
17 1.35 0.5
3. I feel taking the study skills course
helped me
a. with my time management skills. 18 2.22 0.6
b. to learn what my learning styles are. 18 2.00 0.5
c. be able to concentrate better. 18 2.50 0.7
d. be a better listener in class. 17 2.24 0.4
e. be a better note-taker. 18 2.27 0.8
f. to memorize things. 18 2.55 0.8
g. to prepare for and take multiple choice
tests.
18 2.39 0.8
h. to prepare for and take essay tests. 18 2.50 0.7
88
Table 5: Continued.
Statements N Mean Std. Dev.
4. The study skills class would have been
better if
a. it lasted throughout the semester. 17 3.29 1.0
b. it lasted only one day. 17 3.17 1.0
c. it had more content related specifically to
nursing.
18 1.88 0.8
d. it included tutoring sessions during the
semester.
17 2.88 1.0
5. I am currently using the things I learned
in the study skills course in my nursing
classes.
18 2.11 0.8
6. The study skills instructor was an
effective teacher.
18 2.11 0.7
7. The resource materials (worksheets,
paper packets) helped me learn the course
content.
18 2.0 0.7
8. The subject matter in the study skills
course was presented in a logical,
organized sequence.
18 1.94 0.5
9. I would have liked to take this course
on-line.
18 3.44 1.2
10. Overall, the study skills course offered to
nursing students is beneficial.
18 2.17 0.8
11. I would recommend the study skills
course for other students starting the
nursing program.
18 2.0 0.8
Factors such as having friends in the study skills course, poor high school
performance, and academic difficulties in college courses were reasons student
enrolled in the study skills course. By far, students strongly consented they took the
89
course because they thought it would help them do well in nursing school (Figure 6).
They also thought it would help them study more effectively, help them get a higher
GPA, and give them tips on succeeding in nursing school. Overall, students reported
that each of the skills taught in the study skills course were beneficial. Students felt
that the study skills course would have been better if it had more content related
specifically to nursing (Figure 7). They agreed that the instructor, materials, and
method of presentation were effective; and would not necessarily have preferred an
on-line version. They agreed that the overall course is beneficial and that they would
recommend to other students starting the nursing program (Figure 8). The figures are
based upon responses on the Likert-scale ranging from “one” (strongly agree with
statement) to “five” (strongly disagree with statement).
Figure 6. Group Response to Study Skills Statement 1B: “I enrolled in the study skills
course because I thought it would help me do well in nursing school.”
Question 1B
2.00 1.50 1.00
12
10
8
6
4
2
0
Std. Dev = .49
Mean = 1.35
N = 17.00
90
Figure 7. Group Response to Study Skills Statement 4C: “The study skills class would
have been better if it had more content related specifically to nursing.”
Question 4C
3.00 2.50 2.00 1.50 1.00
8
6
4
2
0
Std. Dev = .78
Mean = 1.88
N = 17.00
Figure 8. Group Response to Study Skills Statement 11: “I would recommend the study
skills course for other students starting the nursing program.”
Question 11
4.0 3.0 2.0 1.0
10
8
6
4
2
0
Std. Dev = .87
Mean = 2.0
N = 17.00
91
Table 6. Responses of Non-Participants in Study Skills Course to Questionnaire
Statements N Mean Std. Dev.
1. I chose not to take the study skills class
because
a. I did well in high school. 30 2.26 1.1
b. I didn’t think it would help me do better
in nursing school.
30 3.16 1.0
c. none of my friends were taking it. 30 3.96 0.7
d. the time and location were inconvenient. 29 2.62 1.1
e. it cost too much. 30 3.46 0.9
f. I got good grades in my college classes. 30 2.8 0.9
g. it was not required. 30 2.5 0.9
h. I didn’t have time. 29 1.96 0.9
i. I didn’t know about it. 29 3.41 1.2
j. I have taken a study skills class before. 29 3.68 1.2
k. I already have adequate study skills. 29 2.79 0.9
2. I thought taking the study skills class
would
a. help me get a higher grade point average. 30 2.76 0.9
b. help me find students to study with. 30 3.13 0.8
c. help me study more effectively. 31 2.25 0.8
d. give me tips on succeeding in nursing
school.
31 2.16 0.8
3. I feel taking a study skills course would
help me
a. with my time management skills. 31 2.12 0.7
b. to learn what my learning styles are. 31 2.25 0.6
c. to be able to concentrate better. 31 2.54 0.7
d. be a better listener in class. 31 2.48 0.8
e. be a better note-taker. 31 2.29 0.8
f. to memorize things. 31 2.32 0.6
g. to prepare for and take multiple choice
tests.
31 2.19 0.7
h. to prepare for and take essay tests. 31 2.32 0.6
92
Table 6: Continued.
Statements N Mean Std. Dev.
4. I would have taken the study skills class
if
a. it lasted throughout the semester. 30 3.63 0.9
b. it lasted only one day. 30 2.40 1.1
c. it had more content related specifically to
nursing.
31 2.38 1.1
d. it included tutoring sessions during the
semester.
31 2.61 0.9
e. I was having academic difficulty. 31 2.06 0.6
f. there wasn’t a fee. 31 2.25 0.8
g. it was offered on-line. 31 2.64 0.9
h. I had an advisor or instructor personally
recommend it.
31 2.74 1.0
i. I thought the study skills instructor was a
really good teacher.
31 2.45 0.8
5. The one-week study skills course should
continue to be offered to nursing students.
31 1.93 0.6
Students who did not participate in the study skills course reported not taking
the course due to lack of time (Figure 9) and feeling that they had performed well in
high school. The reasons that least impacted their decision not to enroll were friends
taking the course, the cost, and taking a study skills course previously. Students agreed
that they thought taking the course would give them tips on succeeding in nursing
school and study more effectively. Students also reported that they felt taking the
study skills course would help them with the various topics taught in the class.
6. I would recommend the study skills
course for other students starting the
nursing program.
31 2.25 0.8
93
Students reported that they would not have likely taken the course had it lasted
throughout the semester, but agreed they would have taken it if they were having
academic difficulty (Figure 10), there wasn’t a fee, if it lasted only a day, if it had
content related more specifically to nursing, and if they thought the instructor was a
really good teacher. Students agreed that the study skills course should be continued to
be offered to nursing students (Figure 11) and that they would recommend it to other
students starting the nursing program.
Figure 9. Group Responses to Study Skills Non-participants Statement 1H: “I chose
not to take the study skills class because I didn’t have time.”
Question 1H
5.0 4.0 3.0 2.0 1.0
30
20
10
0
Std. Dev = .78
Mean = 2.0
N = 29.00
94
Figure 10. Group Responses to Study Skills Non-participants Statement 4E: “I would
have taken the study skills class if I was having academic difficulty.”
Question 4E
3.00 2.50 2.00 1.50 1.00
20
10
0
Std. Dev = .63
Mean = 2.06
N = 31.00
Figure 11. Group Responses to Study Skills Non-participants Statement 5: “The one-
week study skills course should continue to be offered to nursing students.”
Question 5
4.0 3.0 2.0 1.0
30
20
10
0
Std. Dev = .68
Mean = 1.9
N = 31.00
95
Summary
Results indicated that nursing students who take a voluntary one-week study
skills course prior to beginning an associate degree registered nursing program do not
have a significantly higher GPA, retention rate, or take a significantly different
number of units in the first semester of nursing courses. Results revealed that students
who take the study skills course are significantly older, have a lower high school GPA,
and perform better in the Microbiology course. Further results indicated there are very
few and insignificant academic differences between students who do and do not take
the study skills course and in their academic performance in the semester following
the course.
Three variables significantly correlated to nursing student’s performance in the
first semester of nursing courses: Microbiology grade, General Anatomy and
Physiology grade, and PEE verbal score. High school GPA and the prerequisite
Chemistry course do not correlate to student’s academic performance in nursing
courses.
Students who took the study skills course perceived that it helped them with
skills taught in the course (i.e. time management, learning styles, note-taking, etc.).
They primarily enrolled in the course because they thought it would help them do well
in nursing school. They were satisfied with the course presentation and overall,
reported the course was beneficial. Students who chose not to take the study skills
course also perceived benefit to taking it and think it should be continued to be
96
offered. They didn’t take it themselves because they reported doing well in high
school and not having enough time.
97
CHAPTER 5
DISCUSSION
The purpose of this study was to examine the relationship between students
who completed a study skills course before the first semester of an associate degree
nursing program and academic achievement and retention, to examine the impact of
the study skills course on students with the highest and lowest grade point averages
who voluntarily enrolled in the course compared to students with the highest and
lowest grade point averages who did not take the study skills course, and to identify
students’ perceptions of the value of a study skills course on subsequent semester
performance.
This chapter is structured into four sections. First, the conclusions of the study
will be presented. Second, the relationship between the findings of this study and
previous literature will be discussed. Third, limitations of the study will be presented.
Lastly, recommendations and implications for nursing educators and administrators as
well as for future studies will be offered.
Conclusions
Based on the analysis and results presented in this study four conclusions were
reached.
Conclusion 1. There is no evidence that voluntary participation in a study
skills course leads first semester nursing students to greater academic success in the
subsequent semester than those who do not take the course.
98
Students who enrolled in the study skills course ranged from low to high
academic performers. Due to the diversity of the students’ abilities and past
performances, it is likely that their subsequent performance in nursing school was
related to factors other than the impact of the study skills course (such as their
previously established patterns of academic performance). The lack of successful
impact of the course may also be related to the content of the course, the presentation
of the material, and/or the instructor’s teaching style. It may also be related to the lack
of retention and application of the skills and concepts presented, especially
considering the course lasted only over the course of one week.
This finding is of importance to nursing program administrators who strive to
allocate resources to programs that are the most beneficial to students, with the desired
result of improved student retention and satisfaction with their educational experience.
This outcome is also of significance to the educators in the academic resource center
who design and carry out the curriculum for the course, specifically designed to meet
the needs of nursing students.
Conclusion 2. Voluntary enrollment in a study skills course does not
significantly impact students with lower GPA’s to increase their GPA’s in the
following semester.
Study skills courses, by design, are offered to assist students obtain the
necessary skills to succeed in college. Students who already have higher GPA’s are
not the primary population these classes are geared toward, as these students already
demonstrate successful application of these skills (through their GPA’s). Therefore, it
99
is the students who have not demonstrated academic success who could supposedly
benefit the most from learning and applying study skills. Unfortunately, the results
from this study show that the only significant difference found among high and low
achieving students who did and did not take the class was that students with higher
GPA’s who enrolled in the study skills course have significantly higher GPA’s than
students with lower GPA’s who do not take the course. It appears that the students
who could be benefiting the most, those with lower GPA’s, are not experiencing any
significant improvement in GPA over similar students who do not take the study skills
course.
Nursing administrators would find this conclusion significant in their decision
to continue offering the study skills course on a voluntary basis each semester. These
findings are also important for other researchers who might explore why students with
lower GPA’s do not experience a significant improvement in GPA after taking the
study skills course, as this is the group in which improvement would be most
anticipated.
Conclusion 3. Students who did and did not enroll in a study skills course
before their first semester of nursing courses reported perceived positive value in the
course and agreed that the course should be continued to be offered for other nursing
students.
Students perceived positive psychological gains of taking the course were
widely agreed upon, even by students who did not take the course. While objective
measurements of subsequent performance did not indicate the course had a significant
100
impact on the students, the subjective measurements indicated it was beneficial. It is
not surprising that the strongest response for students not taking the course was not
having enough time, considering the demographics for the Fall 2004 class indicate
these students fit the description of nontraditional college students who are older, have
families, and employment outside of school. However, students who chose to take the
course despite similar competing demands for their time reported they felt st rongly
enough that the course would help them succeed in nursing school that they made the
time to attend.
The comprehensive impact that the study skills course had on students who
enrolled is difficult to determine. Small differences were seen in academic
measurements between the groups who did and did not enroll, but they were not
significant. However, the overwhelming response from participants in the course
showed that students felt their subsequent semester performance was enhanced having
taken it. Student satisfaction with the course and perceived benefit would be important
for nursing administrators and the course instructors to consider in planning for future
course offerings.
Conclusion 4. First semester nursing GPA was significantly related to
cumulative college GPA, grades in Microbiology and General Anatomy and
Physiology, and the Pre-entrance Exam Verbal score.
In the process of collecting data on students to determine differences between
the groups who did and did not take the study skills course, additional factors were
discovered that were significantly related to students’ first semester performance in
101
nursing school. Students’ cumulative college GPA was related to their first semester
nursing GPA; however high school GPA was not.
Grades in two science courses, Microbiology and General Anatomy and
Physiology, were significantly related; yet Chemistry grade was not. This was an
interesting finding since the Chemistry grade is a prerequisite for admission into the
program; yet it lacks predictive value to success in the program. The other two science
courses are not mandatory for admission but can be taken concurrently with nursing
courses after admission or taken before (depending on student preferences). Student
grades in these courses correlate to success in the nursing program.
The nursing college recently implemented the use of the NLN Pre-entrance
exam as other criteria for admittance to the program. In the Fall 2004 class, only the
verbal portion of this exam was significantly related to students’ GPA in the first
semester of the nursing program, while the mathematics and science sections did not.
This information is significant to nursing administrators who determine
admission criteria into nursing programs flooded with applicants, yet struggle to retain
students through to graduation.
Relationship of Findings to Previous Literature
The effect of an individual study skills course for nursing students has not been
previously tested. The effects of study skills courses on college student success have
been conducted primarily on college freshmen. The effects have been measured most
commonly by test scores, GPA’s, number of credits obtained, and retention data
(Connelly, DuBois, & Staley, 1998; Tuckman, 2003) and collectively have reported
102
moderate effects on these outcomes. This association has not been found specifically
with nursing students.
Some nursing programs have conducted studies evaluating comprehensive
retention programs that include components overlapping topics taught in study skills.
The results of these program evaluations show students who participate have better
academic outcomes compared to similar students who don’t participate (Luckie &
Burke, 1999; Jeffreys, 2001; Symes, Tart, Travis, & Tooms, 2002). However, the
impact of a study skills course independent of a retention program in nursing has not
been previously reported in the literature.
Limitations
The first limitation to this study was that academic achievement and retention
may be affected by variables other than the study skills course. In the semester after
taking the study skills course, students’ level of success may have been related to other
academic or environmental variables, such as faculty advisement or a family crisis
rather than taking the study skills course. There are numerous and varied influences on
an individual student’s ability to succeed in a given semester; all of these influences
are not easily identifiable, nor their effects distinguishable.
The second limitation to this study was the possibility that students who
completed the study skills course may have obtained study skills elsewhere; therefore
their subsequent academic performance may be influenced on previously acquired
study skills rather than those they gained from the class. Students may have taken
previous study skills courses, had teachers who incorporated these skills and concepts
103
into other classes, or be self-taught. Likewise, students who did not take the study
skills course might have obtained the skills taught in the course by other means and
used them in the first semester of the nursing program. It is difficult to separate the
direct influence of the study skills course content from an individual’s prior
knowledge and experience; however adding a pre-test and post-test to future sessions
of the study skills courses would yield some of this information.
Lastly, this study was conducted at only one institution with students from one
entering nursing class. Therefore, it is not generalizable to students at other nursing
schools; every nursing school has a unique curriculum, student demographics, and
inherent culture. In addition, this study was limited by the availability of data on the
students in the entering class, which was not comprehensive and identical for every
student and every variable. Student perceptions of the study skills class were limited to
students who voluntarily participated in the questionnaire. Students may have hurried
through the questionnaires without giving much thought to their responses and/or
given socially desirable responses.
Recommendations and Implications
There are several recommendations that can be made based on the findings of
this study. First, nursing administrators at the college where this study was conducted
might consider reevaluating the purpose and goals of the study skills course and
whether or not they are being met the way the course is currently offered and
conducted. If the intent of the study skills course is to provide psychological support
to all nursing students who are interested in taking the course, it may be considered
104
successful in its current form. However, if the intent of the course is to raise students
subsequent GPA’s and improve retention rates, then the course structure may need
altering. For instance, the course could be made mandatory for all entering students
with a GPA below 2.5. The course could also be expanded to include other retention
strategies such as faculty mentoring, study groups, and a semester-long course (rather
than a week). An expansion of the course would involve the allocation of additional
resources; yet it may produce the results of improved retention and GPA more
effectively than the current class being offered. Continuing the course as it is could be
an ineffective way of utilizing valuable resources if it is not fulfilling its purpose to
improve student achievement.
Another recommendation for nursing administrators is to reevaluate the
admission criteria for entrance into the nursing program. Admission criterion is used
as a way to determine adequate preparation and to predict success in a program of
study. At this institution the only course grade that is a prerequisite for admission is
Chemistry and only a C grade or higher is necessary to complete admission
requirements. This study found no significant correlation between the chemistry grade
and achievement in the first semester of nursing; however, there was a significant
relationship between grades in Microbiology and General Anatomy and Physiology
grades and achievement in nursing courses. So, perhaps a B grade in these two courses
could be made prerequisite requirements.
Nursing administrators would likely meet resistance implementing this change
from students and institution administration, as the technical college endorses an
105
“open-door” policy for all of its programs. This has consistently been a challenge for
the nursing school which has repeatedly admitted under-prepared students who have
merely waited on a list for admittance. Many students then fail nursing courses and
drop from the program. The end result is low retention, discouraged students, and
fewer nurses entering the workforce. If students capable of achieving B grades in the
two science courses were admitted, they would likely be better academically prepared
to handle the rigors of college nursing education. Changing this policy of admissions
criteria could potentially have a greater impact on retention than offering a study skills
course once students have been admitted. Perhaps the study skills course could be
offered to pre-nursing students, who could learn and apply the principles in
prerequisite courses before starting the nursing program.
Further studies on the impact of study skills courses on nursing student
retention and achievement should be conducted. Replicating the study with a larger
sample size at multiple colleges of nursing over multiple semesters is recommended to
further support or refute the conclusions drawn from this study.
Further research should also be conducted to determine students’ knowledge
and application of study skills and concepts when they begin the study skills course. A
pre-test could be administered at the beginning of the course, as well as a post-test at
the end of the course to measure knowledge expansion. A follow-up questionnaire
could also be obtained several months after the course to assess which concepts and
skills students retain and utilize. The findings from this research could answer the
106
question, “Is subsequent academic performance related to previously acquired study
skills or those skills they learned by taking the class?”
Another area for future research is further examination of the admission
criteria most predictive of students’ success in nursing school. It appeared that one
section (verbal) of the NLN Pre-entrance Exam (PEE) was significantly associated
with first-semester nursing GPA from this study. However, it is surprising that the
science and mathematical sections were not. These relationships need to be further
examined however, since there is the possibility that first semester nursing courses are
not science or mathematically based and that these components of the exam may
correlate to success in courses further into the nursing curriculum. Since this was a
relatively small sample at one institution, further studies on the predictive value of the
PEE could be conducted on a larger scale. Further studies could also be conducted to
explore why two science course grades were significantly associated with GPA, but
one was not. Further investigation on the relationship of high school GPA and nursing
GPA would be beneficial. In the sample group in this study, the average-aged student
had been out of high school for over 10 years. Older students returning to school, such
as these, are likely to be more motivated in college than in high school. However,
larger studies could be conducted at nursing schools with their respective student
demographics to assess if high school GPA has predictive value on success in the
nursing program and whether it should be considered an admissions criterion.
Further research could also be conducted to evaluate the impact of students’
perceived self efficacy in their ability to succeed in nursing school and their decision
107
to enroll in the study skills course. Students’ self efficacy could be measured before
and after taking the study skills course to determine whether the psychological support
received in the course enhanced their belief in their ability to persist through the rigors
of nursing school. Researchers could also assess which components of the study skills
course correlate with the most gain in self efficacy. Factors such as student’s age and
length of time out of school could be examined in relation to perceived self efficacy.
This group of older students may not be identified as “at-risk” academically based on
their grade point averages or standardized test scores, but may be “at-risk” for
dropping out due to low self efficacy in their ability to compete with younger students
and succeed at the college level.
A final area for further research is examining the efficacy of various study
skills course curriculums. It would be beneficial for nursing program administrators
and educators to know and implement the aspects of a study skills curriculum that are
most beneficial to student success. The design of study skills course curriculums such
as the intensity of instruction, topics taught, teaching methods, length of course,
placement of course in the nursing program curriculum, and concurrent participation
in mentoring, tutoring, and other retention programs could all be further investigated.
The knowledge gained from these multiple areas of research could be used to
guide curriculum development and strategic planning in nursing programs seeking to
maximize the positive outcomes a study skills course has the potential to produce.
108
REFERENCES
Abraham, A. (1991). They came to college? A remedial/developmental profile of first-
time freshmen in SREB states. Issues in Higher Education, 25, SREB.
ACT, Inc. (2005). Information for Life’s Transitions. Retrieved May 8, 2005 from
http://act.org.
ACT Institutional Data File (1992). Iowa City, IA: American College Testing
Program.
Albaili, M. A. (1997). Differences among low-, average-, and high-achieving college
students on learning and study strategies. Educational Psychology, 17, 171-
177.
All Nursing Schools (2004). Entry-level nursing programs. Retrieved December 30,
2004, from http://www.allnursingschools.com/faqs/programs.php
American Association of Colleges of Nursing, 2002. 2001-2002 Enrollment and
graduations in baccalaureate and graduate programs in nursing, American
Association of Colleges of Nursing, Washington, DC.
American Association of Colleges of Nursing, 2004. Fact sheet: Accelerated
baccalaureate and master’s degrees in nursing, Degree Completion programs
for registered nurses. Retrieved on December 31, 2004, from http://www
aacn.nche.edu/Media/Factsheets/DegreeCompletionProg.htm
American Association of Colleges of Nursing, 2004-2005. Enro llment and
graduations in baccalaureate and graduate programs in nursing. Retrieved on
October 3, 2005 from http://www.aacn.nche.edu/IDS/datarep.htm
American Association of Colleges of Nursing, American Nurses Association,
American Organization of Nurse Executives, & National League for Nursing.
(2001). Strategies to reverse the new nursing shortage. A policy statement
from Tri-Council members. Retrieved on November 15, 2004, from
http://www.nursingworld.org/pressrel/2001/sta0205.htm.
Applebee, A. N. (1984). Contexts for learning to write. Norwood, NJ : Ablex.
Astin, A. W. (1975). Preventing students from dropping out. San Francisco: Jossey -
Bass.
109
Astin, A. W. (1984). Student involvement: A developmental theory for higher
education. Journal of College Student Personnel, 25, 297-308.
Bandura, A. (1997). Self - efficacy: The exercise of control. New York: W. H. Freeman
Bean, J. P. (1980). Dropouts and turnovers: The synthesis and test of a causal model of
student attrition. Research in Higher Education, 12, 155-87.
Bean, J. P. (1981). The synthesis of a theoretical model of student attrition. Paper
presented at the annual meeting of the American Education Research
Association, Los Angeles, CA.
Bean, J. P. & Metzner, B. S. (1985). A conceptual model of nontraditional
undergraduate student attrition. Review of Educational Research, 55, 485-540.
Belzer, S., Miller, M., Shoemake, S. (2003). Concepts in biology: A supplemental
study skills course designed to improve introductory students’ skills for
learning biology. American Biology Teacher, 65, 30-40.
Bender, D. S. (2001). Effects of study skills programs on the academic behaviors of
college students. Journal of College Reading and Learning, 31, 209-216.
Benjamin, M. (1994). The quality of student life: Toward a coherent
conceptualization. Social Indicators Research, 31, 205-264.
Benjamin, M., & Hollings, A. E. (1995). Toward a theory of student satisfaction: An
exploratory study of the “Quality of Life.” Journal of College Student
Development, 36, 574-586.
Biggs, J. B. & Rihn, B. (1984). The effects of intervention on deep and surface
approaches to learning. In J. Kirby (Ed.), Cognitive Strategies and educational
performance. New York: Academic Press.
Billson, J. M. & Brooks, T. M. (1987). A student retention model for higher education.
College and University, 62, 290-305.
Brennan, A. L., Best, D. G., & Small, S. P. (1996). Tracking student progress in a
baccalaureate nursing program: Academic indicators. Canadian Journal of
Nursing Research, 28, 85-97.
Buerhaus, P. I., Staiger, D. O. & Auerbach, D. I. (2000). Implications of an aging
registered nursing workforce. Journal of the American Medical Association,
283, 2948-2954.
110
Buerhaus, P. I., Donelman, K., Ulrich, B., Norman, L., & Dittus, R. (2005). Six-part
series on the state of the RN workforce in the United States. Nursing
Economics, Retrieved on October 3, 2005 from www.nursingeconomics.net
Campbell, A. R. & Dickson, C. J. (1996). Predicting student success: a 10-year review
using integrative review and meta analysis. Journal of Professional Nursing,
12, 47-59.
Carson, J. G., Chase, J. D., Gibson, S. U., & Hargrove, M. F. (1992). Literacy
demands of the undergraduate curriculum. Reading Research Instruction, 31,
25-50.
Carty, B. & Rosenfeld, P. (1998). Computer technology to information technology:
Findings from a national study of nursing education. Computers in Nursing,
16, 259-265.
Catalano, J. T. & Eddy, J. P. (1993). Student retention: Crisis in nursing higher
education. College Student Affairs Journal, 12, 53-39.
Center for the Study of College Student Retention, (2005). Retention Definitions.
Retrieved on May 8, 2005, from
http://www.cscsr.org/retention_issues_definitions.htm.
Coalition for Nursing Careers in California, (2003). A win for California nursing
students and faculty. Retrieved on December 31, 2004, from
http://cncc.org/featured_stories/ca_students_win.httm
Connelly, K. P., DuBois, N. F., & Staley, R. (1998). Structured interview study of the
long-term effects of a college study skills course: Traces and self-report
measures. Paper presented at the meeting of the Annual American Educational
Research Association Meeting, San Diego, CA.
Dansereau, D. F., Collins, K. W., McDonald, B. A., Holley, C. D., Garland, J.,
Diekhoff, G., & Evans, S. H. (1979). Development and evaluation of a learning
strategy training program. Journal of Educational Psychology, 71, 623-659.
Durkeim, E. (1953). Sociology and philosophy. Glencoe, IL: Free Press.
Durkin, D. (1979). What classroom observations reveal about reading comprehension
instruction. Research Quarterly, 14, 481-538.
Ehrenfeld, M., Rotenberg, A., Sharon, R., & Bergman, R. (1997). Reasons for student
attrition on nursing courses: A study. Nursing Standard, 11, 34-38.
111
Ellis, D. (2002). Becoming a master student (10
th
ed). New York: Houghton Mifflin
Company.
Ertmer, P. A. & Newby, T. J. (1996). The expert learner: Strategic, self-regulated, and
reflective. Instructional Science, 24, 1-24.
Forster, B., Swallow, C., Fodor, J. H., & Foulser, J. E. (1999). Effects of a college
study skills course on at-risk first-year students. NASPA Journal, 36, 120-132.
Grosset, J. M. (1991). Patterns of integration, commitment, and student characteristics
and retention among younger and older students. Research in Higher
Education, 23, 159-178.
Hasse, P. T. (1990). The origins and rise of associate degree nursing education.
Durham, NC: Duke University Press.
Hesser, A., Pond, E. F., Lewis, L., & Abbott, B. (1996). Evaluation of a
supplementary retention program for African-American baccalaureate students.
Journal of Nursing Education, 35, 304-309.
Higbee, J. L. & Thomas, P. V. (1999). Affective and cognitive factors related to
mathematics achievement. Journal of Developmental Education, 23, 8-16.
Hopper, C. H. (2001). Practicing college study skills: Strategies for success (2
nd
ed.).
New York: Houghton Mifflin Company.
Houltram, B. (1996). Entry age, entry mode and academic performance on a Project
2000 Common Foundation Programme. Journal of Advanced Nursing, 23,
1089-1097.
Jeffreys, M. R. (1998). Predicting nontraditional student retention and academic
achievement. Nurse Educator, 23, 42-48.
Jeffreys, M. R. (2001). Evaluating enrichment program study groups: academic
outcomes, psychological outcomes, and variables influencing retention. Nurse
Educator, 26, 142-149.
Joint Commission on Accreditation of Healthcare Organizations, (2002). Health care
at the crossroads: Srategies for addressing the evolving nursing crisis.
Retrieved on October 3, 2005 from www.jcaho.org
Jordan, J. (1996). Rethinking race and attrition in nursing programs: A hermeneutic
inquiry. Journal of Professional Nursing, 12, 382-390.
112
Karp, M. M., Jacobs, J., & Hughes, K. L. (2002). Credentials, curriculum, and access:
The debate over nurse preparation. Washington, DC: American Association of
Community Colleges.
Kelly, E. (1997). Development of strategies to identify the learning needs of
baccalaureate nursing students. Journal of Nursing Education, 36, 156-162.
Kern, C. W., Fagley, N. S., & Miller, P. M. (1998). Correlates of college retention and
GPA: Learning and study strategies, testwiseness, attitudes, and ACT. Journal
of College Counseling, 1, 26-34.
Kevern, J., Ricketts, C., & Webb, C. (1999). Preregistration diploma students: A
quantitative study of entry characteristics and course outcomes. Journal of
Advanced Nursing, 30, 785-795.
Kiewra, K. A. (2002). How classroom teachers can help students learn and teach them
how to learn. Theory Into Practice, 41, 71-80.
Kiewra, K. A. (1991). Aids to lecture learning. Educational Psychologist, 26, 37-54.
Lockie, N. M. & Burke, L. J. (1999). Partnership in learning for utmost success
(PLUS): Evaluation of a retention program for at-risk nursing students. Journal
of Nursing Education, 38, 188-192.
Luckie, W. R. & Smethhurst, W. (1998). Study power: Study skills to improve your
learning and your grades. Brookline, MA: Brookline Books.
McCabe, R. H. (2000). No one to waste: A report to public decision-makers and
community college leaders. Washington, D.C.: Community College Press.
McWhorter, K. T. (2003). Study and critical thinking skills in college (5
th
ed). United
States: Longman.
Mealy, D. L. (1988). Test review: Learning and study strategies (LASSI). Journal of
Reading, 28, 382-385.
Metz, G. W. (2002, October). Challenges and changes to Tinto’s persistence theory.
Paper presented at the annual meeting of the Midwestern Educational Research
Association, Columbus, OH.
Metzner, B. S. & Bean, J. P. (1987). The estimation of a conceptual model on
nontraditional undergraduate student attrition. Research in Higher Education,
27, 15-38.
113
National Advisory Council on Nurse Education and Practice (2001). First report to the
secretary of health and human services and the congress. Retrieved December
31, 2004 from http://bhpr.hrsa.gov/nursing/nacnep/firstreport.htm
National Center for Health Workforce Analysis (2002). Projected supply, demand,
and shortages of registered nurses: 2000-2020. Retrieved May 20, 2005 from
http://bhpr.hrsa.gov/healthworkforce/reports/rnproject/report.htm
National Council of State Boards of Nursing, Inc. (2000). NCLEX results page.
Number of candidates taking the NCLEX-RN examination and percent
passing, 2000, by type of candidate. Retrieved December 30, 2004, from
http://www.ncsbn.org/research_stats/nclex.asp
National Council of State Boards of Nursing (2003). National council of state boards
of nursing research and statistical data. Retrieved November 15, 2004, from
http://www.noadn.org/adn_facts.htm
National League for Nursing (2003, August 22). Position statement: Innovation in
nursing education: A call to reform. Retrieved November 15, 2004, from
http://nln.org/aboutnln/PositionStatements/innovation.htm
National League for Nursing Accrediting Commission (2004). The work of NLNAC.
Retrieved November 15, 2004 from http://nlnac.org/home.htm
National League for Nursing Accrediting Commission. (1996). Criteria and guidelines
for the evaluation of associate degree programs in nursing (NLN Publication
No. 23-6983). New York: National League for Nursing.
National League for Nursing Center for Research in Nursing Education and
Community Health. (1997). Nursing data review 1997. New York: National
League for Nursing.
Nelson, M. A. (2002). Education for professional nursing practice: Looking backward
into the future. Online journal of issues in nursing, 7, Available:
http://nursingworld.org/ojin/topic18/tpc18_3.htm
Nist, S. L. & Simpson, M. (2002). College Studying. Reading Online, 5, April.
Nora, A. (1987). Determinants of retention among Chicano college students: A
structural model. Research in Higher Education, 26, 31-59.
Nora, A., & Rendon, L. I. (1990). Determinants of predisposition to transfer among
community college students: A structural model. Research in Higher
Education, 31, 235-255.
114
Oakerson, P. F. (1993, October). Teaching and assessing study skills: a classroom
study. Paper presented at the 23
rd
Annual Meeting of the Midwest Association
for Teachers of Educational Psychology, Anderson, IN.
Pascarella, E. T., Duby, P. B. & Iverson, B. K. (1983). A text and reconceptualization
of a theoretical model of college withdrawal in a commuter institution setting.
Sociology of Education, 56, 88-100.
Pascarella, E. T. & Terenzini, P. T. (1979). Interaction effects in Spady’s and Tinto’s
conceptual models of college dropout. Sociology of Education, 52, 197-210.
Pascarella, E. T. & Terenzini, P. T. (1980). Predicting freshman persistence and
volunta ry dropout decisions from a theoretical model. The Journal of Higher
Education, 51, 60-75.
Pintrich, P. R., Mckeachie, W. J., & Lin, Y. G. (1987). Teaching a course in learning
to learn. Teaching Psychology, 14, 81-86.
Poorman, S. G., Webb, C. A., & Mastorovich, M. L. (2002). Student’s stories: How
faculty help and hinder students at risk. Nurse Educator, 27, 126-131.
Potempa, K., Stanley, J., Davis, B., Miller, K., Hassett, M. R., & Pepicello, S. (2001).
Survey of distance technology use in AACN member schools. Journal of
Professional Nursing, 17, 7-13.
Potolsky, A., Cohen, J., & Saylor, C. (2003). Academic performance of nursing
students: Do prerequisite grades and tutoring make a difference? Nursing
Education Perspectives, 24, 246-250.
Powell, D. L. (1992). The recruitment and retention of African-American nurses: An
analysis of current data. Journal of the National Black Nurses Association, 6,
3-12.
Pressley, M., Yokoi, L., Van Meter, P., Van Etten, S., & Freebern, G. (1997). Some of
the reasons why preparing for exams is so hard: What can be done to make it
easier? Educational Psychology Review, 9, 1-38.
Price, J. L. (1977). The study of turnover. Ames: Iowa State University Press.
Print, M. (1993). Curriculum Development and Design. 2nd ed. St. Leonards, NSW:
Allen & Unwin.
Reynolds, J. A. (1996). Succeeding in college: Study skills and strategies. Needham
Heights, MA: Allyn & Bacon.
115
Sandiford, J. R. & Jackson, D. K. (2003, April). Predictors of first semester attrition
and their relation to retention of generic associate degree nursing students.
Paper presented at the Council for the Study of Community Colleges, Dallas,
TX.
Saranto, K., & Leino-Kilpi, H. (1997). Computer literacy in nursing: developing the
information technology syllabus in nursing education. Journal of Advanced
Nursing, 25, 377-385.
Sheffler, S. (1997). Strategies that facilitate academic success of nursing students in
HBCU’s. The ABNF Journal, 8, 113-115.
Shelton, E. N. (2003). Faculty support and student retention. Journal of Nursing
Education, 42, 68-76.
Simpson, M. L. (1984). The status of study strategy instruction: Implications for
classroom teachers. Journal of Reading, 28, 136-143.
Simpson, M. L., Hynd, C. R., Nist, S. L., & Burrell, K. I. (1997). College assistance
programs and practices. Educational Psychology Review, 9, 39-87.
Spady, W. G. (1970). Dropouts from higher education: An interdisciplinary review
and synthesis. Interchange, 1, 64-85.
Spady, W. G. (1971). Dropouts from higher education: Toward and empirical model.
Interchange, 2, 38-62.
Stahl, V. V. & Pavel, M. D. (1992). Assessing the Bean and Metzner model with
community college student data. U.S.; Arizona.
Staiger, D., Auerbach, D., & Buerhaus, P. (2000). Expanding career opportunities for
women and the declining interest in nursing as a career. Nursing Economics,
18, 230-236.
Summers, M. D. (2003). Attrition research at community colleges. Community
College Review, 30, 64-84.
Symes, L., Tart, K., Travis, L., & Toombs, M. S. (2002). Developing and retaining
expert learners: The student success program. Nurse Educator, 27, 227-231.
Tierney, W. G. (1992). An anthropological analysis of student participation in college.
Journal of Higher Education, 63, 603-618.
116
Tinto, V. (1975). Dropout from higher education: A theoretical synthesis of recent
research. Review of Educational Research, 45, 89-125.
Tinto, V. (1987). Leaving college: Rethinking the causes and cures of student attrition
(1st ed.). Chicago: The University of Chicago.
Tinto, V. (1993). Leaving college: Rethinking the causes and cures of student attrition
(2
nd
ed.). Chicago: The University of Chicago.
Tinto, V. & Cullen, J. (1973). Dropout in higher education. A review and theoretical
synthesis of recent research. New York: Teachers College.
Tuckman, B. W. (2003). The “Strategies-for-Achievement” approach for teaching
study skills. Annual conference of the American Psychological Association,
111
th
, Toronto, ON, Canada August 7-10, 2003.
U.S. Department of Education (1999). Student effort and academic progress.
Washington, DC: Government Printing Office.
U. S. Department of Education, National Center for Education Statistics. (1982). The
condition of education. Washington, DC: Author.
U.S. Department of Health and Human Services and Bureau of Health Resources and
Services Administration (2001). National sample survey of registered nurses
2000, U.S. Government Printing Office, Washington, D.C.
U.S. Department of Labor Bureau of Labor Statistics (2004). Occupational outlook
handbook: Registered Nurses. Retrieved November 15, 2004, from
http://stats.bls.gov/oco/ocos083.htm
Van Blerkom, D. L. (2003). College study skills: Becoming a strategic learner (4
th
ed.). Canada: Thomson Wadsworth.
Van Gennep, A. (1960). The rites of passage. Chicago: University of Chicago Press.
Wambach, C. A. (1993). Motivational themes and academic success of at-risk
freshmen. Journal of Developmental Education, 16, 8-12.
Weinstein, C. E., & Underwood, V. L. (1985). Learning strategies: The how of
learning. In J. W. Segal & R. Glaser (Vol. Eds.), Thinking and learning skills
(Vol. 1, pp. 315-327). Hillsdale, N.J.: Erlbaum.
Wells, M. I. (2003). An epidemiologic approach to addressing student attrition in
nursing programs. Journal of Professional Nursing, 19, 230-236.
117
Wilson, M. (2001). Predicting student retention and academic achievement in western
United States associate degree in nursing programs. Unpublished doctoral
dissertation, University of Southern California.
Yin T., & Burger, C. (2003). Predictors of NCLEX-RN success of associate degree
nursing graduates. Nurse Educator, 28, 232-236.
Zinatelli, M., Dube, M. A., & Jovanovic, R. (2003). Computer-based study skills
training: The role of technology in improving performance and retention.
Journal of College Student Retention, 4, 67-78.
118
APPENDIX A
STUDY SKILLS COURSE FOR NURSING STUENTS QUESTIONNAIRE:
STUDENTS WHO TOOK THE STUDY SKILLS COURSE
Study Skills Course for Nursing Students Questionnaire
The study skills course referred to in this questionnaire was the one-week (eight-hour)
course that was offered to nursing students at Western Wisconsin Technical College the week
prior to fall semester 2004.
Part 1: Students Who Took the Study Skills Course
Name (please print): ____________________________________ Your name will be kept
confidential.
Directions: Circle the answer for each question.
1. What is your race/ethnicity?
a. Asian/Asian-American c. Caucasian e. Native American
b. African American d. Hispanic/Latino f. Other _________
(Write in answer.)
2. What is your marital status?
a. Single c. Separated or Divorced
b. Married d. Widowed
3. How many dependent children do you have at home?
a. None c. 2 e. 4
b. 1 d. 3 f. 5 or more
4. How would you evaluate your financial resources?
a. Much less than adequate c. Adequate e. Much more than adequate
b. Less than adequate d. More than adequate
5. How have you financed your education? (Put the percentage of each source. The total of all
funding will equal 100%).
a. Loans ____ c. Scholarships _____ e. Family members _____
b. Grants ____ d. Self/own funding _____ f. Other ______________
119
6. On average how many hours per week do you spend in outside employment?
a. None c. 6-10 e. 16-20 g. 26-30
b.1-5 d. 11-15 f. 21-25 h. More than 30
7. What grades did you get in high school?
a. Mostly A’s c. Mostly C’s e. Mostly lower than D’s
b. Mostly B’s d. Mostly D’s
8. What is the highest level of education you have achieved?
a. Some high school c. Some college e. Bachelor’s Degree
b. GED or high school diploma d. Associate Degree f. Master’s Degree or
Doctorate
9. What is the highest level of education obtained by your mother?
a. Some high school or less c. Some college e. Bachelor’s Degree
b. GED or high school diploma d. Associate Degree f. Master’s Degree or
g. Don’t know Doctorate
10. What is the highest level of education obtained by your father?
a. Some high school or less c. Some college e. Bachelor’s Degree
b. GED or high school diploma d. Associate Degree f. Master’s Degree or
g. Don’t know Doctorate
11. What level of nursing education do you eventually intend to achieve?
a. Licensed Practical Nurse c. Bachelor’s in Nursing
b. Associate Degree RN d. Master’s or Doctorate in Nursing
120
Part 2
Instructions:
1. Do not write in the shaded areas.
2. On each row place an “X” in the box that best describes your answer.
Statements
Strongly
Agree
(1)
Agree
(2)
Neither
Agree
Nor
Disagree
(3)
Disagree
(4)
Strongly
Disagree
(5)
1. I enrolled in the study skills class because
a. I didn’t do well in high school.
b. I thought it would help me do well in
nursing school.
c. I had a friend taking it.
d. it was at a convenient time and location.
e. it was offered at a reasonable price.
f. I was having academic difficulties in college
courses.
g. it was required as part of my student success
plan.
2. I thought taking the study skills class would
a. help me get a higher grade point average.
b. help me find students to study with.
c. help me study more effectively.
d. give me tips on succeeding in nursing school.
3. I feel taking the study skills course helped me
a. with my time management skills.
b. to learn what my learning styles are.
c. be able to concentrate better.
d. be a better listener in class.
e. be a better note-taker.
f. to memorize things.
g. to prepare for and take multiple choice tests.
h. to prepare for and take essay tests.
121
Statements
Strongly
Agree
(1)
Agree
(2)
Neither
Agree
Nor
Disagree
(3)
Disagree
(4)
Strongly
Disagree
(5)
4. The study skills class would have been better if
a. it lasted throughout the semester.
b. it lasted only one day.
c. it had more content related specifically to
nursing.
d. it included tutoring sessions during the
semester.
5. I am currently using the things I learned in the
study skills course in my nursing classes.
6. The study skills instructor was an effective
teacher.
7. The resource materials (worksheets, paper
packets) helped me learn the course content.
8. The subject matter in the study skills course
was presented in a logical, organized sequence.
9. I would have liked to take this course on-line.
10. Overall, the study skills course offered to
nursing students is beneficial.
11. I would recommend the study skills course for
other students starting the nursing program.
12. How would you rate the study skills course on a scale of 1-10 (1 is low, 10 is
high)? _______
13. Please indicate any additional comments or suggestions you many have regarding
the study skills course for nursing students.
Thank you for your time to fill out the questionnaire!
122
APPENDIX B
STUDY SKILLS COURSE FOR NURSING STUDENTS QUESTIONNAIRE:
STUDENTS WHO DID NOT TAKE THE STUDY SKILLS COURSE
Study Skills Course for Nursing Students Questionnaire
The study skills course referred to in this questionnaire was the one-week (eight-hour)
course that was offered to nursing students at Western Wisconsin Technical College the week
prior to fall semester 2004.
Part 1: Students Who Did Not Take the Study Skills Course
Name (please print): ____________________________________ Your name will be kept
confidential.
Instructions: Circle the answer for each question.
1. What is your race/ethnicity?
a. Asian/Asian-American c. Caucasian e. Native American
b. African American d. Hispanic/Latino f. Other _________
(Write in answer.)
2. What is your marital status?
a. Single c. Separated or Divorced
b. Married d. Widowed
3. How many dependent children do you have at home?
c. None c. 2 e. 4
d. 1 d. 3 f. 5 or more
4. How would you evaluate your financial resources?
a. Much less than adequate c. Adequate e. Much more than adequate
b. Less than adequate d. More than adequate
5. How have you financed your education? (Put the percentage of each source. The total of all
funding will equal 100%).
a. Loans ____ c. Scholarships _____ e. Family members _____
b. Grants ____ d. Self/own funding ___ f. Other ______________
123
6. On average how many hours per week do you spend in outside employment?
a. None c. 6-10 e. 16-20 g. 26-30
b. 1-5 d. 11-15 f. 21-25 h. More than 30
7. What grades did you get in high school?
a. Mostly A’s c. Mostly C’s e. Mostly lower than D’s
b. Mostly B’s d. Mostly D’s
8. What is the highest level of education you have achieved?
a. Some high school c. Some college e. Bachelor’s Degree
b. GED or high school diploma d. Associate Degree f. Master’s Degree or
Doctorate
9. What is the highest level of education obtained by your mother?
a. Some high school or less c. Some college e. Bachelor’s Degree
b. GED or high school diploma d. Associate Degree f. Master’s Degree or
Doctorate
10. What is the highest level of education obtained by your father?
a. Some high school or less c. Some college e. Bachelor’s Degree
b. GED or high school diploma d. Associate Degree f. Master’s Degree or
g. Don’t know Doctorate
11. What level of nursing education do you eventually intend to achieve?
a. Licensed Practical Nurse c. Bachelor’s in Nursing
b. Associate Degree RN d. Master’s or Doctorate in Nursing
124
Part 2
Instructions:
1. Do not write in the shaded areas.
2. On each row place an “X” in the box that best describes your answer.
Statements
Strongly
Agree
(1)
Agree
(2)
Neither
Agree
Nor
Disagree
(3)
Disagree
(4)
Strongly
Disagree
(5)
1. I chose not to take the study skills class because
a. I did well in high school.
b. I didn’t think it would help me do better in
nursing school.
c. none of my friends were taking it.
d. the time and location were inconvenient.
e. it cost too much.
f. I got good grades in my college classes.
g. it was not required.
h. I didn’t have time.
i. I didn’t know about it.
j. I have taken a study skills class before.
k. I already have adequate study skills.
2. I thought taking the study skills class would
a. help me get a higher grade point average.
b. help me find students to study with.
c. help me study more effectively.
d. give me tips on succeeding in nursing school.
3. I feel taking a study skills course would help me
a. with my time management skills.
b. to learn what my learning styles are.
c. to be able to concentrate better.
d. be a better listener in class.
e. be a better note-taker.
f. to memorize things.
g. to prepare for and take multiple choice tests.
h. to prepare for and take essay tests.
125
Statements
Strongly
Agree
(1)
Agree
(2)
Neither
Agree
Nor
Disagree
(3)
Disagree
(4)
Strongly
Disagree
(5)
4. I would have taken the study skills class if
a. it lasted throughout the semester.
b. it lasted only one day.
c. it had more content related specifically to
nursing.
d. it included tutoring sessions during the
semester.
e. I was having academic difficulty.
f. there wasn’t a fee.
g. it was offered on-line.
h. I had an advisor or instructor personally
recommend it.
i. I thought the study skills instructor was a
really good teacher.
5. The one-week study skills course should
continue to be offered to nursing students.
6. I would recommend the study skills course for
other students starting the nursing program.
7. Please indicate any additional comments or suggestions you may have regarding
the study skills course for nursing students.
Thank you for your time to fill out the questionnaire!
Linked assets
University of Southern California Dissertations and Theses
Conceptually similar
PDF
Associate degree nursing students' perceptions of caring ability, parental care and nursing school climate: A quantitative and qualitative study of caring links among first semester nursing stud...
PDF
Examining the factors that predict the academic success of minority students in the remedial mathematics pipeline in an urban community college
PDF
Asian students in community colleges: A study of intersecting effects of student characteristics, construct models of retention, social reproduction and resulting variables as applied to the stud...
PDF
Community college students and achievement in mathematics: Predictors of success
PDF
Assessment of nursing college students' learning styles in Taiwan using the Myers -Briggs Type Indicator
PDF
Academic success and student-parents in the Los Angeles Community College District
PDF
Assessment of Taiwanese business students' learning styles using the Myers -Briggs Type Indicator
PDF
Fulfilling the mission to serve the underserved: A case study of a private, Catholic, urban college's two -year program
PDF
Academic, environmental and social integration variables that maximize transfer preparedness for Latino community college students: An application of academic success models to the study of Tran...
PDF
Implementation of literature circles in a rural high school English class: One teacher's journey of changing student attitudes toward reading
PDF
A study of the Navy College Program for Afloat College Education: Implications for teaching and learning among nontraditional college students
PDF
Community college students: The effect of parenthood and selected variables on degree -seeking aspirations
PDF
Factors influencing academic success of Chinese international students in Los Angeles community colleges
PDF
Evaluating the California Community Colleges Registry
PDF
International students: Patterns of success
PDF
Community college English courses: The road less traveled by community college students
PDF
Increasing graduate success on the CAT version of the NCLEX -RN
PDF
A study of the profile and leadership traits of vice presidents of instruction in the California community college system
PDF
Faculty mentoring in nurse anesthesia educational programs
PDF
A pilot study to investigate the relationship between student self -regulatory resource management strategies and academic achievement in a Web-based hybrid graduate nursing course
Asset Metadata
Creator
Wiswell, Lisa Marie
(author)
Core Title
Achievement and retention of first-semester nursing students: The effects of a study skills course
School
Rossier School of Education
Degree
Doctor of Education
Degree Program
Education
Publisher
University of Southern California
(original),
University of Southern California. Libraries
(digital)
Tag
education, community college,education, curriculum and instruction,Health Sciences, Education,OAI-PMH Harvest
Language
English
Contributor
Digitized by ProQuest
(provenance)
Advisor
Hagedorn, Linda Serra (
committee chair
), Hitchcock, Maurice (
committee member
), Sundt, Melora (
committee member
)
Permanent Link (DOI)
https://doi.org/10.25549/usctheses-c16-473637
Unique identifier
UC11341268
Identifier
3219856.pdf (filename),usctheses-c16-473637 (legacy record id)
Legacy Identifier
3219856.pdf
Dmrecord
473637
Document Type
Dissertation
Rights
Wiswell, Lisa Marie
Type
texts
Source
University of Southern California
(contributing entity),
University of Southern California Dissertations and Theses
(collection)
Access Conditions
The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the au...
Repository Name
University of Southern California Digital Library
Repository Location
USC Digital Library, University of Southern California, University Park Campus, Los Angeles, California 90089, USA
Tags
education, community college
education, curriculum and instruction
Health Sciences, Education