The Use of Discriminant Function Analysis to Predict Student Success on the NCLEX-RN

Promoting diversity through exploring and addressing "achievement/opportunity gap" in nursing education: A call to action

Promoting diversity, equity, inclusion, and belonging in nursing education is a contemporary issue. The purpose of this paper is to iterate a call to action for exploring and addressing achievement/opportunity gap in nursing education and propose strategies to address this gap in order to advance diversity, equity, inclusion, and belonging in educational institutions. Achievement/opportunity gap is an academic performance difference among students based on their socioeconomic status, age, race, ethnicity, and other demographic and sociocultural variables, and can lead to lack of career readiness among students. Four strategies are offered to address the achievement/opportunity gap in nursing education which includes a) explicit exploration of the gap to gather baseline information, b) taking an intersectional approach to examine differences in learning styles, beliefs, values, and learning needs of underrepresented and minority student populations, c) offering extensive co-designed preparatory programs to students who may be more prone to encounter this gap, and d) creating support communities for students to foster their academic performance.

Predictors of success in the registered nurse licensure exam for nursing graduates whose education was affected by the COVID-19 pandemic

The Coronavirus disease 2019 (COVID-19) pandemic has had an unprecedented impact on health-care education. However, the relationship between changes in nursing internships in Taiwan during the COVID-19 pandemic and outcome in the national registered nurse (RN) licensure exam for new nursing graduates is underexplored. The study was to explore the predictors of first-attempt success in the RN licensure exam in 2022. A retrospective review of secondary data was employed in this study. Adjusted binary logistic regression was used to analyze data. A convenience sample of 78 new graduates attempted the exam. Of these graduates, 87.2% passed the RN licensure exam. Age was the main predictor of exam success, followed by grand mean academic score and total alternative (nontraditional in-person) internship hours. Compared with those who failed the exam, the graduates who passed the exam were significantly more likely to be younger, have better academic performance, and have engaged in more alternative internship hours. Nursing faculties should consider implementing supportive strategies early for students who are underperforming or those who are older than their classmates on average to help them pass the RN exam on the first attempt. The optimal duration and long-term consequences of alternative nursing internships must be analyzed in further detail.

A Model for Student Success

BACKGROUND

Institutions may be experiencing an increasing number of applicants who are underprepared for nursing study, especially institutions with access missions. Early identification and intervention can mitigate risk of attrition and unsuccessful NCLEX-RN^® outcomes.

METHOD

An initial study of approximately 1,500 graduates from a multi-campus system led to the development of a comprehensive approach to student success. The model includes identifying nonacademic success factors through an early assessment survey, implementing a data-driven admissions matrix, changing progression policies, designing a new learning-relearning approach, and offering robust cocurricular student support.

RESULTS

NCLEX-RN pass rates and student persistence have improved in the 4 years since implementation, and graduation rates are stable.

CONCLUSION

Although improvements have been made, there is more work to do. African American students have not demonstrated overall improvements when compared to students of different racial and ethnic backgrounds. Further research is needed to test, design, and implement strategies to address social and race-related factors influencing persistence and success. [J Nurs Educ. 2022;61(2):101-104.].

Differences in Gender-related Profile Characteristics, Perceptions, and Outcomes of Accelerated Second Degree Nursing Students

BACKGROUND

The New Careers in Nursing (NCIN) program provided scholarships and other supports to accelerated degree students at 130 nursing schools and collected data from the scholars at three time-points.

PURPOSE

The NCIN database was analyzed to identify gender-based differences in scholars' profile characteristics, program experiences, and post-graduation outcomes.

METHOD

An adaptation of Jeffreys's Nursing Universal Retention and Success Model guided the analysis. Gender differences were assessed after multiplicity adjustments for false positive rates.

RESULTS

Differences based on gender were found for profile characteristics, student affective factors, academic factors, professional integration factors, environmental factors, as well as academic, psychological and NCIN program outcomes. Results suggest that males were influenced by economic factors more than females when choosing nursing as a career. They had fewer concerns about financial aspects associated with being a student again yet secured employment sooner after graduation than female scholars. They did not view support services as important as did female students. They expressed confidence in their leadership competence more than their female counterparts.

CONCLUSION

Efforts are needed to better understand and address the nuanced gender-based perceptions and needs of nursing students who are male.

Tailoring NCLEX-RN Indicator Assessments for Historically Black Colleges and Universities: Literature Review

A review of the literature was undertaken as the foundation for developing an assessment tool for Blacks/African Americans, other racial/ethnic minorities, and low-income students attending historically Black colleges and universities. Findings revealed a variety of academic and nonacademic indicators were used to evaluate likelihood of success. Course specific grades, grade point average (GPA), standardized comprehensive exams and standardized course specific exams were the most commonly used predictor variables that showed significant outcomes. Indicators more accurately predicted which students would pass NCLEX-RN rather than those who would fail. The type of pre-licensure program may influence best outcome indicators. Increased attention to and reporting of demographic information would increase the usefulness of findings in relation to developing a tailored assessment strategy for students enrolled in nursing programs at historically Black colleges and universities.

The Relationship Between Socioeconomic Status (SES) and NCLEX-RN: Comparing SES Indicators in Mediated Logistic Regression

The main purpose of this study was to examine the relationship between socioeconomic status (SES), ACT test scores, and the National Council Licensure Examination-Registered Nurse (NCLEX-RN) through a mediated logistic regression model. ACT is often considered one of the strongest predictors of success on the NCLEX-RN. Data from nursing students (N = 1,176) at a large, Midwestern university were analyzed. The goal was to determine if the predictive power of ACT on the NCLEX-RN stems from the influence of SES on ACT. A significant indirect effect through the causal chain of Pell Grant eligibility (i.e., SES)→ACT→NCLEX-RN was found.

Examining the Association Between the NAPLEX, Pre-NAPLEX, and Pre- and Post-admission Factors

Objective. To examine the relationship between the NAPLEX and Pre-NAPLEX among pharmacy graduates, as well as determine effects of pre-pharmacy, pharmacy school, and demographic variables on NAPLEX performance. Methods. A retrospective review of pharmacy graduates' NAPLEX scores, Pre-NAPLEX scores, demographics, pre-pharmacy academic performance factors, and pharmacy school academic performance factors was performed. Bivariate (eg, ANOVA, independent samples t-test) and correlational analyses were conducted, as was stepwise linear regression to examine the significance of Pre-NAPLEX score and other factors as related to NAPLEX score. Results. One hundred fifty graduates were included, with the majority being female (60.7%) and white (72%). Mean NAPLEX score was 104.7. Mean Pre-NAPLEX score was 68.6. White students had significantly higher NAPLEX scores compared to Black/African American students. NAPLEX score was correlated to Pre-NAPLEX score, race/ethnicity, PCAT composite and section scores, undergraduate overall and science GPAs, pharmacy GPA, and on-time graduation. The regression model included pharmacy GPA and Pre-NAPLEX score. Conclusion. The findings provide evidence that, although pharmacy GPA is the most critical determinant, the Pre-NAPLEX score is also a significant predictor of NAPLEX score.

Evaluation of student factors associated with pre-NAPLEX scores

OBJECTIVE

To examine relationships among students' Pre-NAPLEX scores and prepharmacy, pharmacy school, and demographic variables to better understand factors that may contribute to Pre-NAPLEX performance.

METHODS

A retrospective review of pharmacy students' Pre-NAPLEX scores, demographics, prepharmacy factors, and pharmacy school factors was performed. Bivariate (eg, ANOVA) and correlational analyses and stepwise linear regression were conducted to examine the significance of various factors and their relationship to Pre-NAPLEX score.

RESULTS

168 students were included, with the majority being female (60.7%) and White (72%). Mean Pre-NAPLEX score was 68.95 ± 14.5. Non-Hispanic White students had significantly higher Pre-NAPLEX scores compared to minority students (p<0.001). Pre-NAPLEX score was correlated (p<0.001) to race/ethnicity (r=-0.341), PCAT score (r=0.272), and pharmacy school GPA (r=0.346). The regression model (adjusted R(2)=0.216; p<0.001) included pharmacy school GPA, academic probation, academic remediation, and PCAT composite.

CONCLUSION

This study highlighted that select demographic, prepharmacy, and pharmacy school factors were associated with Pre-NAPLEX outcomes. Such factors may assist colleges/schools of pharmacy in identifying students who may be at risk for poorer NAPLEX performance and may need greater preparation.

Risk assessment profile and strategies for success instrument: determining prelicensure nursing students' risk for academic success

The ultimate outcomes for succeeding in a collegiate prelicensure nursing program are earning a Bachelor of Science in Nursing degree and passing the NCLEX-RN®. The Risk Assessment Profile, Strategies for Success (RAPSS) is a criterion-based instrument that incorporates demographic and academic risk indicators. A convenience sample (N = 255) obtained retrospectively from student files was used to determine whether the RAPSS could be used to predict whether completers of a baccalaureate, prelicensure program will pass or fail the NCLEX-RN. Results indicate that the scale does discriminate between candidates who fail and pass, even with as few as three of the 13 items.

The use of selective admissions tools to predict students' success in an advanced standing baccalaureate nursing program

The judicious selection of nursing school applicants is important, and universities are increasingly incorporating non-academic criteria into their admission processes. We undertook a retrospective, correlational study of the predictive utility of an admissions process for nursing students' "in-program" success. The sample consisted of all 249 students admitted to a Canadian accelerated baccalaureate nursing program over a four-year study period. The students' arithmetic mean grade for six nursing courses (both theoretical and clinical) and their final grade point average (GPA) at graduation were the outcome measures of student success. The predictor variables included the applicants' demographic characteristics (e.g., age, gender, ethnic minority status, and previous educational attainment), their supplemental application materials and interview scores (assessing non-academic criteria), and their admission GPA. Linear regression was conducted on the outcome measures to determine whether the selection tools added information over that obtained through the use of admission GPA in predicting success. Although their admission GPAs were consistently predictive of the students' success, neither the supplemental application nor the interview scores had predictive utility. The variables consistently predictive of student success were age, ethnic minority status, and admission GPA, accounting for 26% of the variance in the selected nursing grades and 36% of the variance in GPA at graduation. The results provided little evidence to justify using the selective admissions tools.

At-risk Students

Early identification of students at risk of failing the National Council Licensure Examination for Registered Nurses allows nurse educators and students the opportunity to develop a remediation plan. The author describes one program's systematic review and exploration of the predictive ability of standardized examinations, nursing course theory grades, and entrance criteria for identifying students at risk. Best predictors at 3 points in the curriculum (entrance, midway, and the semester before graduation) are discussed.