Association between academic and non-academic variables and academic success of diploma nursing students in Pakistan

Factors Associated With Undergraduate Nursing Students' Academic and Clinical Performance: A Mixed-Methods Study

Background

There is conflicting and limited information regarding factors that influence undergraduate nursing students' academic and clinical performance prior to entry to practice.

Objective

To identify factors influencing the academic and clinical performance of undergraduate nursing students throughout the course.

Design

Mixed methods study utilizing a retrospective cohort and a qualitative study.

Setting

Monash University, Melbourne, Australia.

Participants

Longitudinal existing data of nursing undergraduate students who commenced in 2017 (n = 176) and 2018 (n = 76), and two focus groups with final year nursing students were analyzed.

Methods

Retrospective students' records were used to determine the students' academic and clinical performance using the weighted average mark (WAM) of the theoretical and clinical components of the curriculum, separately. The WAM considered the year level of each unit and was scored out of 100. Multivariate linear regression was used to determine predictor factors of academic and clinical performance. Variables include entry cohort (with no previous nursing qualification vs. diploma of nursing), admission category (domestic vs. international), campus (metropolitan vs. outer metropolitan), and secondary school (year 12) results. Two focus group discussions were conducted and thematically analyzed.

Results

More than two-thirds of the students were aged 18–20 years and mainly female. Almost 20% of the participants were international students. Students with higher secondary school (year 12) results and studying at the outer metropolitan campus achieved a higher academic performance while international students had significantly lower academic performance compared to domestic students. Students with a previous diploma of enrolled nursing and international students had lower clinical performance. Students identified that a comprehensive orientation, interactive curriculum, formal and informal support structure, and educator qualities influenced their academic and/or clinical performance.

Conclusions

A supportive educational environment with an interactive curriculum may enhance students' academic and clinical performance and readiness for practice. Furthermore, targeted interventions for international students, those with lower secondary school (year 12) results, and those with a former diploma of nursing may be required to increase academic and clinical performance.

Predictors of nursing students' academic performance in the National Autonomous University of Mexico, 2010-2019: A retrospective study

BACKGROUND

The available literature suggests that diverse factors, including sociodemographic, academic, psychological, and occupational, can have impacts on nursing students' academic performance. Therefore, it follows that the institutional environment can mediate on these influences.

OBJECTIVE

Based on a 10-years student performance follow-up information reservoir, to analyze the relationships between student performance and a set of sociodemographic and academic characteristics of students enrolled in the programs of Bachelor of Nursing (LE), and Bachelor of Nursing and Obstetrics (LEO), in the National School of Nursing and Obstetrics (ENEO) of the National Autonomous University of Mexico (UNAM).

METHODOLOGY

The registers (n = 3984) from the Academic Control Integral System of the ENEO-UNAM were used. The students' main sociodemographic and academic characteristics were described, and multiple-regression models were estimated in order to identify predictors of school performance.

RESULTS

Sustained increments in the enrolment of LE and LEO students during the study period. Changes were noticed regarding the sex distribution and the enrolment age. More students chose the LE program during this period. School performance was higher among female students, among students in their last semesters, and among students who had been granted a scholarship. In contrast, students who had previously failed a subject performed lower.

CONCLUSION

The identified school performance predictors suggest the need to strengthen institutional policies aimed at promoting the achievement of academic excellence so that graduate students become better prepared to enter the labor markets and address the nursing demands of society.

Basic science course grades predict success in the Israel mandatory nursing certification test among students enrolled in a second career program

BACKGROUND

With the constant urgent need to meet the demands of the future workforce, nursing education institutes are under increasing pressure to graduate more quality students. One way to achieve higher numbers of graduates would be to identify factors that predict nursing students' academic success. No reports of such predictors were found for students in accelerated programs for non-nursing Bachelor's degree graduates.

OBJECTIVES

This study was designed to examine the relationships between demographic characteristics, course grades in basic science and medical-surgical courses, and the final scores achieved by students in the Israel mandatory RN certification test.

DESIGN, SETTINGS, AND PARTICIPANTS

164 students, enrolled in four courses of a second career in nursing program (accelerated program) in an academic nursing school in central Israel, participated in this retrospective study.

METHODS

Socio-demographic data and the final grades for basic science courses (chemistry and biochemistry, microbiology, anatomy and physiology, pathology, and pharmacology), the major Medical-Surgical course, and the RN certification test, were collected from the institutional database and analyzed.

RESULTS

Positive correlations were found between the mandatory RN certification test score, and the final grades of all the studies except the pathology course and Medical-Surgical course. The final RN certification test score was predicted by the final grades, with anatomy and physiology (p < 0.001), and pharmacology (p < 0.003), explaining 40% of the variance of the dependent variable. There were no statistical effects of demographic variables.

CONCLUSIONS

Early evaluation and prediction of academic success for nursing students in the second career program may guide effective interventions designed to promote students' skills and improve their ability to complete the mandatory RN certification test successfully.

Academic failure and its predictors in Baccalaureate nursing students: A longitudinal study

AIMS AND OBJECTIVES

To describe the sociodemographic and academic characteristics of nursing students who report academic failure and to identify the determinants of academic failure (no degree on time) in a population of nursing students.

BACKGROUND

Although prior studies have shown that academic failure is influenced by multiple factors, the studies mentioned have mostly focused on specific single variables associated with academic failure, and they have reported inconsistent results.

DESIGN

A prospective follow-up study design was used in an Italian Baccalaureate Nursing Degree program. A total sample of 2,040 at baseline and a random subsample of 753 students were considered for academic failure determinants. The study followed the recommendations of STROBE (Strengthening the Reporting of Observational studies in Epidemiology).

METHODS

We included in the model academic background, self-efficacy, sociodemographic variables and self-efficacy in psychomotor skills and motivation. We used the Academic Nurse Self-Efficacy Scale (ANSEs), the Nursing Self-Efficacy in Psychomotor Skill Scale (NSE-PS) and the Motivation Nursing Students' Scale (MNSS) which have been validated on nursing students. For the assessment of predictors of academic failure, a two-stage hierarchical logistic regression analysis was performed.

RESULTS

Students who had academic failure were 69.4% of the sample. Predictors of academic failure were the secondary school certification grade, the university pre-admission test score; the academic self-efficacy, self-efficacy in psychomotor skills and clinical training examination grades were additional predictors.

CONCLUSIONS

The secondary school certification grade, the University pre-admission test score, low academic self-efficacy, low self-efficacy in psychomotor skills and low clinical training examination grades were predictors of academic failure in nursing students.

RELEVANCE TO CLINICAL PRACTICE

Our findings suggest that the universities could consider a cut-off in the pre-admission test score as a critical value for identifying students who are likely to fail. In addition, nursing faculty staff should consider strategies for developing self-efficacy and motivation.

Experiences of student nurses regarding the bursary system in KwaZulu-Natal province, South Africa

Background

During 2010, the South African nursing education system was restructured, changing student nurses from having supernumerary status to being bursary holders. Changes with the introduction of this new bursary system included institutional factors and benefits that could be removed from the students, potentially hampering students’ sense of belonging.

Aim

This study aimed to describe the experiences of students receiving bursaries in KwaZulu-Natal (KZN) province and to make recommendations for improving the system to bursary providers, educational institutions and practical settings based on these students’ experiences of the bursary system.

Setting

The experiences of student nurses regarding the bursary system are described within a specified setting comprising two nursing campuses in KZN.

Method

A qualitative study design was used and seven focus group interviews were conducted with purposively selected participants, representing the target population of first-, second- and third-year male and female nursing students registered for the Diploma in Nursing (General, Psychiatric, Community) and Midwifery.

Results

Two main themes and eight subthemes were identified. The findings indicated that some of the bursary system’s experiences were negative as opposed to students having supernumerary status. These experiences had negative socio-economic, psychological, clinical, academic and family impacts. Many concerns related to staff members’ attitudes, shortages of nurses and service demands during students’ clinical practice assignments.

Conclusions

The bursary system was not viewed as being beneficial to students as they did not receive all the benefits from being bursary holders. Support in clinical and academic areas was lacking as they were considered to be employees during their clinical assignments. There is an urgent need to review the bursary system.

Factors influencing enrolled nursing students' academic performance at a selected private nursing education institution in KwaZulu-Natal

BACKGROUND

 The success of any educational institution is measured by its academic performance or how well students meet the standards set out. Currently, nursing students' academic failure is a phenomenon of growing international interest because of its economic impact and its negative effects on the availability of future nurses in different health care systems. Factors identified as influencing the academic performance of students include the socio-economic background of parents or guardians, lecturer-student relationships, academic support services, demographic factors, quality of nurse educators, availability of facilities in the school, the language of instruction and level of entry qualifications of students.

OBJECTIVES

 The purpose of this study was to describe the perceptions of enrolled student nurses on factors influencing their academic performance in a private nursing school in KwaZulu-Natal, South Africa.

METHOD

 Data were collected from 100 respondents using an adapted instrument related to the factors believed to influence students' academic performance.

RESULTS

 The results showed that parental involvement in education, good and supportive relationships between nurse educators and students, classroom computer technological gadgets, internet connection and adequate learning facilities were perceived as fostering better academic performance of students. In contrast, poor family background, use of English language for classroom instruction as well as negative peer group influences were leading to poor academic performance.

CONCLUSION

 Nursing institutions should, therefore, select students with higher-level entry qualifications, early identify at-risk students, recruit more qualified nurse educators and upgrade their facilities.

Student nurse selection and predictability of academic success: The Multiple Mini Interview project

BACKGROUND

With recent reports of public enquiries into failure to care, universities are under pressure to ensure that candidates selected for undergraduate nursing programmes demonstrate academic potential as well as characteristics and values such as compassion, empathy and integrity. The Multiple Mini Interview (MMI) was used in one university as a way of ensuring that candidates had the appropriate numeracy and literacy skills as well as a range of communication, empathy, decision-making and problem-solving skills as well as ethical insights and integrity, initiative and team-work.

OBJECTIVES

To ascertain whether there is evidence of bias in MMIs (gender, age, nationality and location of secondary education) and to determine the extent to which the MMI is predictive of academic success in nursing.

DESIGN

A longitudinal retrospective analysis of student demographics, MMI data and the assessment marks for years 1, 2 and 3.

SETTINGS

One university in southwest London.

PARTICIPANTS

One cohort of students who commenced their programme in September 2011, including students in all four fields of nursing (adult, child, mental health and learning disability).

METHODS

Inferential statistics and a Bayesian Multilevel Model.

RESULTS

MMI in conjunction with MMI numeracy test and MMI literacy test shows little or no bias in terms of ages, gender, nationality or location of secondary school education. Although MMI in conjunction with numeracy and literacy testing is predictive of academic success, it is only weakly predictive.

CONCLUSIONS

The MMI used in conjunction with literacy and numeracy testing appears to be a successful technique for selecting candidates for nursing. However, other selection methods such as psychological profiling or testing of emotional intelligence may add to the extent to which selection methods are predictive of academic success on nursing.

Males in Dietetics, What Can Be Learned from the Nursing Profession? A Narrative Review of the Literature

In Canada 95% of dietitians are female despite serving a sex-diverse population. Literature examining why there are so few male dietitians is limited. However, nursing, like dietetics, is female dominated but has a large body of literature examining sex diversity within the profession. Therefore, a narrative literature review was conducted to find articles that examined the following questions: (i) What are the barriers and motivating factors for prospective male nursing students? and (ii) What are the perceived sex-based challenges that male nursing students encounter during their education? A total of 38 articles were included in the final review and the results are presented under the following headings: barriers, motivators, and educational experiences both in the classroom and during clinical rotations. The review outlines the current state of knowledge regarding sex as it relates to nursing and how this information compares with the current dietetics literature. Conclusions and recommendations are drawn about what changes could be made in dietetic education immediately and how further research could provide insight towards reducing the barriers and facilitating easier access to dietetics education for males.

How well does pre-service education prepare midwives for practice: competence assessment of midwifery students at the point of graduation in Ethiopia

BACKGROUND

Midwifery support and care led by midwives is the most appropriate strategy to improve maternal and newborn health. The Government of Ethiopia has recently improved the availability of midwives by scaling up pre-service education. However, the extent to which graduating students acquire core competencies for safe and effective practice is not known. The purpose of this study was to evaluate the quality of midwifery education by assessing the competence of graduating midwifery students.

METHODS

We conducted a cross-sectional study to assess the competence of students who completed basic midwifery education in Ethiopia in 2013. We interviewed students to obtain their perceptions of the sufficiency and quality of teachers and educational resources and processes. We assessed achievement of essential midwifery competencies through direct observation, using a 10-station Objective Structured Clinical Examination (OSCE). We calculated average percentage scores of performance for each station and an average summary score for all stations. Chi-square test, independent sample t test, and linear regression analysis were used to assess the statistical significance of differences and associations.

RESULTS

We assessed 484 graduating students from 25 public training institutions. Majority of students rated the learning environment unfavorably on 8 out of 10 questions. Only 32 % of students managed 20 or more births during training, and just 6 % managed 40 or more births. Students' overall average competence score was 51.8 %; scores ranged from 32.2 % for manual vacuum aspiration to 69.4 % for active management of the third stage of labor. Male gender, reporting sufficient clinical experience, and managing greater numbers of births during training were significant predictors of higher competence scores.

CONCLUSIONS

The quality of pre-service midwifery education needs to be improved, including strengthening of the learning environment and quality assurance systems. In-service training and mentoring to fill competence gaps of new graduates is also essential.

Social accountability and nursing education in South Africa

BACKGROUND

There is global emphasis on transforming health workforce education in support of universal health coverage.

OBJECTIVE

This paper uses a social accountability framework, specifically the World Health Organization's six building blocks for transformative education, to explore key informants' perspectives on nursing education in South Africa.

METHODS

Using a snowballing sampling technique, 44 key informants were selected purposively on the basis of their expertise or knowledge of the research area. Semi-structured interviews were conducted with the key informants after informed consent had been obtained. The interviews were analysed using template analysis.

RESULTS

South Africa has strategic plans on human resources for health and nursing education, training, and practice and has a well-established system of regulation and accreditation of nursing education through the South African Nursing Council (SANC). Key informants criticised the following: the lack of national staffing norms; sub-optimal governance by both the SANC and the Department of Health; outdated curricula that are unresponsive to population and health system needs; lack of preparedness of nurse educators; and the unsuitability of the majority of nursing students. These problems are exacerbated by a perceived lack of prioritisation of nursing, resource constraints in both the nursing education institutions and the health training facilities, and general implementation inertia.

CONCLUSION

Social accountability, which is an essential component of transformative education, necessitates that attention be paid to the issues of governance, responsive curricula, educator preparedness, and appropriate student recruitment and selection.

The 'bioscience problem' for nursing students: an integrative review of published evaluations of Year 1 bioscience, and proposed directions for curriculum development

BACKGROUND

The difficulties that nursing students have in learning human biosciences have given cause for concern for over 20 years but the problem remains.

OBJECTIVE

To conduct an integrative review of published primary research into the 'bioscience problem', evaluate their outcomes, and provide a contemporary analysis of potential directions for curriculum planners.

REVIEW METHODS

A systematic search of electronic databases CINAHL, Medline, British Nursing Index and Google Scholar was conducted for empirical research studies, published between 1990 and 2013, designed to either predict performance of students in bioscience assessments in Year 1 of their studies or identify in-course curriculum delivery issues.

RESULTS

The search generated nineteen papers that met inclusion criteria. Twelve papers involved predictive factors for bioscience attainment and seven surveyed student views on curriculum issues. Four others that surveyed reflections of later-year students or qualified nurses on Year 1 outcomes were also retained for additional context. Prediction based on pre-admission academic achievement was not reliable. Student factors including age at entry, self-efficacy in science, and having appropriate study skills in particular appear to be confounding factors. In-course influences such as teaching strategy or lecturer skills are also inconsistent and likely to represent confounders operating at local, institutional level.

CONCLUSIONS

The integrative review approach enabled analysis of incongruencies between studies that have been a barrier to curriculum development. Sound admissions criteria based on pre-university academic performance show promise in resolving the 'bioscience problem' but will likely be contingent on innovative support early in Year 1 for study skills and the fundamentals of human bioscience, plus attention to local quality assurance for curriculum delivery.

The influence of critical thinking skills on performance and progression in a pre-registration nursing program

BACKGROUND

The importance of developing critical thinking skills in preregistration nursing students is recognized worldwide. Yet, there has been limited exploration of how students' critical thinking skill scores on entry to pre-registration nursing education influence their academic and clinical performance and progression.

AIM

The aim of this study was to: i) describe entry and exit critical thinking scores of nursing students enrolled in a three year bachelor of nursing program in Australia in comparison to norm scores; ii) explore entry critical thinking scores in relation to demographic characteristics, students' performance and progression.

METHOD

This longitudinal correlational study used the Health Sciences Reasoning Test (HSRT) to measure critical thinking skills in a sample (n=134) of students, at entry and exit (three years later). A one sample t-test was used to determine if differences existed between matched student critical thinking scores between entry and exit points. Academic performance, clinical performance and progression data were collected and correlations with entry critical thinking scores were examined.

RESULTS

There was a significant relationship between critical thinking scores, academic performance and students' risk of failing, especially in the first semester of study. Critical thinking scores were predictive of program completion within three years. The increase in critical thinking scores from entry to exit was significant for the 28 students measured. In comparison to norm scores, entry level critical thinking scores were significantly lower, but exit scores were comparable. Critical thinking scores had no significant relationship to clinical performance.

CONCLUSION

Entry critical thinking scores significantly correlate to academic performance and predict students risk of course failure and ability to complete a nursing degree in three years. Students' critical thinking scores are an important determinant of their success and as such can inform curriculum development and selection strategies.

Gender differences in the academic and clinical performances of undergraduate nursing students: a systematic review

OBJECTIVES

Nursing is often regarded as a female-dominated profession. Many nursing curricula are received by mainly female students. It is uncertain how male students behave in this environment of nursing education in hospitals and universities. This article aimed to review gender differences in the academic and clinical performances of undergraduate nursing students.

DESIGN

A systematic review was assessed and different themes were extracted by inductive approach.

DATA SOURCES

A search strategy was carried out for the period 2006-2011 utilising six computerised databases: Academic Search Premier, CINAHL, ERIC, MEDLINE, ScienceDirect, and the Wiley Online Library.

REVIEW METHODS

Research studies were included and screened by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. All articles in English that met our aim were selected and relevant results were abstracted and thematised.

RESULTS

Fifty-five articles were included. Five themes were generated from the literatures, including the differences of academic, clinical, psychological, nursing profession identity and health concept between male and female nursing students.

CONCLUSIONS

Both genders performed similarly in different aspects. Most studies revealed that the clinical placement satisfaction of male students was similar to that of female, despite the negative experiences the former faced during obstetric placement. Further research is needed to examine the gender differences in studying and make changes in the nursing curricula to accommodate with male students.

Factors influencing nursing students' academic and clinical performance and attrition: an integrative literature review

Predicted workforce shortages have resulted in government initiatives to increase student numbers in preregistration nursing education. In tandem schools of nursing need to ensure students' progress and complete. The aim of this review was to identify factors that influence preregistration nursing students' academic performance, clinical performance and attrition. An integrative review of both quantitative and qualitative literature was conducted using validated appraisal checklists. The review included studies published from 1999 to 2011 in the databases: MEDLINE, CINAHL, Proquest nursing, Proquest Education (via Proquest 5000), ERIC, Journals@Ovid, PsychINFO and ScienceDirect. Studies were categorised according to their impact on academic progression, clinical progression and attrition. Forty four studies were found; most used quantitative methodologies. The review identified that few studies explored factors that impact on students' clinical performance. The four categories that potentially impact on nursing students' academic performance and attrition were: demographic, academic, cognitive and personality/behavioural factors. The challenge for universities committed to students' success is to develop strategies aimed at addressing these factors that are appropriate to specific contexts and student cohorts.