What works in promoting and maintaining diversity in nursing programs

BACKGROUND

The presence of a registered nurse (RN) workforce that is culturally and linguistically familiar with underrepresented minorities promotes effective health care for patients. A lack of diversity in the nursing education pipeline has led to a lack of diversity among registered nurses.

METHODS

This qualitative descriptive study explored faculty perceptions of factors that attracted and maintained a diverse nursing student body at three different universities with large percentages of minority students. Websites were evaluated for diversity and audio-taped telephone interviews were conducted with nursing faculty using a semistructured set of open-ended questions.

RESULTS

College location, online courses, community outreach programs, the presence of a diverse faculty and students, faculty accessibility, and financial aid with low college costs were identified as common factors in attracting and retaining minority students. Barriers included the cost for low socioeconomic status students, inadequate primary and secondary educational preparation, inherent bias in the institution, competition from other schools, admission policies, and limited diversity in leadership and faculty.

CONCLUSIONS

Commitment to improving and maintaining diversity in nursing programs requires a sustained faculty effort to make the programs fit for the minority student.

Predicting NCLEX-RN performance: cross-validating an identified classification procedure

This study was an attempt to cross-validate a procedure from an earlier study for predicting NCLEX-RN performance. In the original study, a discriminant function was developed on 313 baccalaureate nursing graduates (1988 through 1990), which used 15 variables to correctly categorize more than 91 per cent of them on NCLEX-RN performance. This study used 142 subjects who graduated in 1991 and 1992 to evaluate the adequacy of the classification procedure. Subjects in this more recent sample differed significantly from those in the first on several variables, including SAT scores, physiology grades, and nursing grades. Eight-four per cent of the subjects in the cross-validation sample were correctly classified using the original discriminant function. More than 62 per cent of failures and 87 per cent of passes were correctly categorized. These results suggest that it is statistically and ethically sound to use this discriminant function to identify future students in danger of NCLEX-RN failure.

Is There Evidence of Failing to Fail in Our Schools of Nursing?

AIM

To assess evidence for "failing to fail" in undergraduate nursing programs.

BACKGROUND

Literature on grading practices largely focuses on clinical or academic grading. Reviewing both as distinct entities may miss a more systemic grading problem.

METHOD

A cross-sectional survey targeted 235 faculty within university and community colleges in a western state. Chi-square tests of independence explored the relation between institutional and faculty variables.

RESULTS

The response rate was 34 percent. Results suggest failing to fail may be evident across the sector in both clinical and academic settings: 43 percent of respondents had awarded higher grades than merited; 17.7 percent had passed written examinations they felt should fail; 66 percent believed they had worked with students who should not have passed their previous placement.

CONCLUSION

Failing to fail cuts across instructional settings. Further exploration is imperative if schools are to better engender a climate for rigorously measuring student attainment.

Predicting nursing GPA and national council licensure examination for registered nurses (NCLEX-RN): a thorough analysis

The study involved prediction of GPA in a nursing program and NCLEX-RN licensure score following completion of the program. The sample included 155 students who completed and 34 who failed to complete a baccalaureate nursing program for the 1984-1986 years. The best set of predictors of nursing GPA included ACT composite score, anatomy grade, and chemistry grade, R = .73. The best set of predictors of NCLEX-RN included ACT composite score, high school percentile rank, nursing GPA, and chemistry grade, R = .68. Classification of withdrawn and completing groups and also pass and fail NCLEX-RN performance via discriminant analysis provided results comparable to those of previous research; however, residual analysis indicated very large residuals for those withdrawing from the program as well as those who failed the licensure exam. An alternative to discriminant analysis for classifying students is suggested.

Reduced withdrawal and failure rates of accelerated nursing students enrolled in pharmacology is associated with a supportive intervention

BACKGROUND

To reduce nursing shortages, accelerated nursing programs are available for domestic and international students. However, the withdrawal and failure rates from these programs may be different than for the traditional programs. The main aim of our study was to improve the retention and experience of accelerated nursing students.

METHODS

The academic background, age, withdrawal and failure rates of the accelerated and traditional students were determined. Data from 2009 and 2010 were collected prior to intervention. In an attempt to reduce the withdrawal of accelerated students, we set up an intervention, which was available to all students. The assessment of the intervention was a pre-post-test design with non-equivalent groups (the traditional and the accelerated students). The elements of the intervention were a) a formative website activity of some basic concepts in anatomy, physiology and pharmacology, b) a workshop addressing study skills and online resources, and c) resource lectures in anatomy/physiology and microbiology. The formative website and workshop was evaluated using questionnaires.

RESULTS

The accelerated nursing students were five years older than the traditional students (p < 0.0001). The withdrawal rates from a pharmacology course are higher for accelerated nursing students, than for traditional students who have undertaken first year courses in anatomy and physiology (p = 0.04 in 2010). The withdrawing students were predominantly the domestic students with non-university qualifications or equivalent experience. The failure rates were also higher for this group, compared to the traditional students (p = 0.05 in 2009 and 0.03 in 2010). In contrast, the withdrawal rates for the international and domestic graduate accelerated students were very low. After the intervention, the withdrawal and failure rates in pharmacology for domestic accelerated students with non-university qualifications were not significantly different than those of traditional students.

CONCLUSIONS

The accelerated international and domestic graduate nursing students have low withdrawal rates and high success rates in a pharmacology course. However, domestic students with non-university qualifications have higher withdrawal and failure rates than other nursing students and may be underprepared for university study in pharmacology in nursing programs. The introduction of an intervention was associated with reduced withdrawal and failure rates for these students in the pharmacology course.

Tool Development for Evaluation of Clinical Nurse Specialist Competencies in Graduate Students

PURPOSE

The purpose of this study was psychometric testing of the tool, Self Evaluation of CNS Competency Development.

METHODS

The tool was developed using the NACNS competencies, with some concepts added to reflect graduate program objectives. The student sample was 33 students who provided informed consent and completed the tool. The preceptor sample was 6 preceptors who clinically supervised 6 students.

RESULTS

As expected, independent samples t tests with matched pairs of 6 students and preceptors showed that there were no mean differences in 9 of the 12 categories within the 3 spheres of influence. Using the contrasted groups approach, discriminant function analysis showed that 91.7% of beginning and ending students were correctly classified. Cronbach alpha was estimated as .96.

CONCLUSION

Results show partial support for criterion-related validity and construct validity. Tool reliability is satisfactory. Further testing with larger samples of students and clinical nurse specialists is recommended.

Predictors of nurses' level of participation in student care: A multivariable analysis

OBJECTIVE

To determine the association and predictive nature of certain socio-demographic, education, work and research variables on nurses' participation level in the clinical care of students.

DESIGN

A cross-sectional analytical study using a validated questionnaire between February and June 2014.

SETTING AND PARTICIPANTS

A consecutive sample of 117 nurses who worked in public health centres in the province of Castellón (Spain) in 2014. The nurses who had never mentored students and the questionnaires that were <50% complete were excluded.

METHODS

A descriptive analysis of the sample and an association analysis between variables were performed. The questionnaire and its dimensions were performed with a logistic regression and the maximum likelihood method, which used a complementary log-log link method. The concordance index was calculated using contingency tables.

RESULTS

The mean age was 42.56 years, and the overall mean questionnaire score was 122.84 (SD = 18.69; 95% CI: 119.415-126.26). Across the sample, 58.1% (n = 68) of the nurses obtained an Excellent score, followed by Adequate in 41% (n = 48). Overall, the predictive variables were age, mentoring of students in the last 5 years and previous training to mentor students.

CONCLUSION

The main predictive variable for greater participation in the mentorship of students was previous training in mentoring. This study also reflected on other variables that could influence nurses' participation in student mentoring.

Structuring educational decisions using the multiple sorting task: An example focusing on international placements in nursing

Practical examples of the steps involved in the planning and execution of the multiple sorting task are frequently lacking in published reports. This article demonstrates how the multiple sorting task can be used to structure conversations with a group of health professionals planning an international placement for nursing students. Sixteen participants were drawn from diverse professional backgrounds, including academia, clinical practice, government policy, and placement administrators. Participants sorted 17 statements written on cards into categories of their choice and noted why they sorted the cards into these particular groups. Data were analysed using multidimensional scaling and qualitative perspectives. The analysis identified four key themes that detailed the participants' views about international placements. These findings demonstrate how the multiple sorting task can be used to generate information that facilitates the examination of important facets of health care practice that universities could cover in preparing students for international placements.

Effects of textual cue manipulation on student recall in an information mapped nutrition text

Using the subject area of nutrition, this study examined the effects of different instructional features of an adjunctive text for nursing students who varied in reading level. Specifically, the study investigated the effects of both variations in instructional features of information-mapped text and the differences in student reading levels on immediate recall scores and work time spent on the modules. A sample of 65 nursing students was classified into high and low reading groups according to the Nelson-Denny Reading Test, then randomly assigned to one of the three treatment groups. Analysis of covariance indicated significant treatment effects after adjusting the recall scores for the influence of verbal aptitude. Information-mapped text with either postquestions or postquestions and feedback yielded higher recall scores than information-mapped text alone. Subjects whose modules contained postquestions or postquestions and feedback spent significantly more work time than subjects whose modules did not contain those features; however, when the recall scores were adjusted for the influence of work time spent on the modules, there were no significant differences. Conclusions and recommendations for the text construction process, especially for the adjunctive nursing text, are presented.

Predicting NCLEX-RN success: can it be simplified?

The purpose of this study was to compare a simple, easily calculated method for predicting student success on the nursing licensure exam (NCLEX-RN) with more statistically complex methods of prediction. The Risk Appraisal Instrument (RAI), designed by Barkley, Rhodes, and Dufour (1), does not require sophisticated statistical methods, and the authors suggest it may be adapted for use in other nursing programs. We modified the RAI to suit the University of Delaware nursing program, and retroactively applied the Delaware RAI (DRAI) formula to the records of 538 students who graduated from our undergraduate baccalaureate nursing program between 1995 and 1998. Nearly 61 percent of NCLEX-RN failures were correctly classified, and 72 percent were accurately classified overall. While this more simple prediction might be helpful as a predictor of risk, it does not approach the 76 percent to 92 percent correct prediction of failure in recently published studies using statistically more complex methods.

The Impact of Nursing Students' Cultural Diversity on the Intention and Attitudes Towards the Use of Information Technology (IT)

This research highlights the challenge for nursing educators in understanding, developing awareness, and preparing strategies to manage the impact of nursing students' cultural diversity on the relationship between the intention to use computer and attitudes, self-efficacy, innovativeness, and threat and challenge.

The RCN warns against a two-tier system with HCA apprenticeships

New apprenticeships for healthcare assistants who do not have the qualifications to undertake nursing degrees must not undermine the profession's graduate-entry status, the RCN has warned.

Development of a prediction model for early diagnosis of not passing the national council of licensure examination for registered associate degree nurses

Passing the national licensure examination for registered nurses (NCLEX-RN) in the US is a critical outcome of the nursing program. Research has been conducted to identify which nursing students are at risk for not passing the NCLEX-RN test. The purpose of this study was to investigate whether any of several student covariates can be used to accurately identify associate in science in nursing (ASN) students that are at-risk for failing the NCLEX-RN test. Covariates included in the study were demographics, students' pre-admission grade point average (GPA), the scores of test of essential skills (TEAS), and the assessment technologies institute® (ATI)'s comprehensive scores for a pre-RN examination test. Chi-squared automatic interaction detection, or CHAID analysis, was used to develop the model. One covariate, ATI comprehensive test scores, was found to accurately identify all at-risk ASN students. The model explained that students identified as "at-risk" had a failure rate nearly two-and-a-half times as high as the general population.

[Hygiene during leisure time among third year students from the Department of Nursing and Health Sciences]

The aim of the study was the assessment of hygiene of leisure time among third year students from Faculty of Nursing and Health Science of Lublin Medical Academy. It analysed passive and active ways of spending free time. The study involved 106 students (55 stationary and 51 extramural) and it was conducted by means of questionnaire. The study revealed that students prefer passive types of spending their leisure time. The most popular activity was listening to the radio, to which they devoted average 2.9 hours a day (listening to music mainly). Extramural students listened to the radio shorter than stationary ones (the difference was statistically significant). Students spent also a lot of their time watching television (average 1.5 hours a day), reading books and newspapers (average 1.85 hours a day) and doing housework, which is an active way of rest (average 2.7 hours a day), mainly preparing meals and shopping. Students devoted the least of their free time to sleep during the day in spite of the fact it is an excellent way of rest. The study found also that physical activity was not a favourite type of spending free time. Every third student did not do any sport. Stationary students did sport 4 times longer than extramural (the difference was statistically significant). Only 31% practiced taking a daily walk and only 44% of students made tourist trips. 81.9% of them went away during summer holidays, but only 31% of them during the winter break. Undoubtedly, the way of spending free time by the students under examination was not hygienic as it did not give them a sense of relaxation and rest; also the students themselves were not satisfied with it.