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Influence of self-efficacy, locus of control, and computer competency on student success in foundational nursing course

ProQuest Dissertations and Theses, 2011
Dissertation
Author: Rhonda H Payne
Abstract:
This retrospective correlation study was conducted to explore and identify specific predictor factors that influence student success in the initial foundational course of nursing, Fundamentals of Nursing , in Associate of Science Degree programs that prepare students to successfully sit for the NCLEX-RN exam. With the high attrition rate of students from nursing programs exacerbating an escalating national nursing shortage and threatening the quality of healthcare, critical evaluation of factors influencing nursing student success is essential in helping determine those students who are most likely to be successful in nursing student achievement and nursing program student retention. There has been intense interest and numerous studies performed in the previous few years that examined predictors for nursing student success. The majority of these studies; however, focused on academic predictors or only one or two nonacademic predictors. This study aimed to examine both specific academic and nonacademic predictors in order to provide new knowledge to nurse educators that will support effective nursing school admission policies and assist educators to incorporate interventions during the nursing program that promote nursing student success and retention. The dependent variable of the study was success in the initial Fundamentals of Nursing course, defined as satisfactorily completing the clinical component of the course, earning a grade of 75% or higher, and progression in the Associate Degree Nursing Program. Several academic and non-academic variables of interest were investigated. The independent variables included participant self-rated scores on the General Self Efficacy Scale (based on Albert Bandura's Social Learning Theory), J B Rotter's Locus of Control scale, and participant competency with computers. In addition, demographic factors of age, gender, marital/family status, employment status, pre nursing GPA, and grade in the prerequisite Anatomy and Physiology 1 course were examined statistically and assessed for influence on student success in the Fundamentals of Nursing course. Results of study revealed that the student grade in the initial science course of Anatomy and Physiology 1 was highly significant, OR = 3.87, 95% CI (1.959, 7.647) and positively related to success in the Fundamentals of Nursing Course. An additional influence found to be statistically significant in relation to success in the Fundamentals of Nursing course was computer competence scores, OR = 3.388, 95% CI (1.016, 11.296). Employment greater than 20 hours per week was found to have a negative effect on success in the Fundamentals of Nursing course, X2 (1, N = 117) = 6.11, p = .013). Research revealed that the nursing school location was significant with student success in the Fundamentals of Nursing course. T testing and One Way ANOVAs were performed to further investigate the difference in success rate between study schools. The sample of students participating in the study at each school was not significantly different in makeup, thereby supporting the integrity of the study. Results indicated that students from School B were found to have a higher rate of success in Fundamentals of Nursing, higher Anatomy and Physiology 1 grades, higher rating of Self Efficacy, and a higher Computer competency rating than students in School A. Locus of control was not found to be predictive of success in the Fundamentals of Nursing course, B = .004, OR = 1.004, 95% CI (0.876, 1.150). However, the variable was noted to be influenced more by the internal locus of control than by the external locus of control as noted in the discussion of findings. Demographic factors of age, gender, marital, and family status were not found to be significant nor predictive of success in the Fundamentals of Nursing course.

TABLE OF CONTENTS

Chapter 1 Introduction ............................ ................................................... ...................... 1

Background of the Study ........................... ................................................... ............... 1

Problem Statement ................................. ................................................... .................. 4

Purpose of the Study .............................. ................................................... ................ 10

Study Significance and Rationale .................. ................................................... ......... 11

Operational Definition of Terms ................... ................................................... ........... 12

Theoretical Assumptions and Conceptual Framework .. ............................................. 14

Research Questions and Hypothesis ................. ................................................... ........ 20

Research Hypotheses ............................... ................................................... ............. 20

Research Question Five ............................ ................................................... .......... 22

Limitations ....................................... ................................................... ....................... 27

Delimitations ..................................... ................................................... ...................... 28

Assumptions ....................................... ................................................... .................... 29

Organization of the Study ......................... ................................................... .............. 29

Chapter Two: Review of the Literature ............. ................................................... .......... 30

Introduction ...................................... ................................................... ....................... 30

Nursing Shortage .................................. ................................................... .................. 31

Academic success .................................. ................................................... ................ 32

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Attrition in Nursing Schools ...................... ................................................... ............... 33

Nursing Students as Adult Learners ................ ................................................... ....... 36

Self Efficacy ..................................... ................................................... ....................... 38

Locus of Control................................... ................................................... ................... 44

Influence of Nursing Student Computer Access and Ex pertise ................................. 46

Summary ........................................... ................................................... ..................... 49

Chapter 3: Methodology ............................ ................................................... ................. 51

Introduction ...................................... ................................................... ....................... 51

Research Design ................................... ................................................... ................. 51

Selection of participants ......................... ................................................... ................. 52

Study Subjects and Inclusion Criteria ............. ................................................... ..... 54

Instrumentation ................................... ................................................... .................... 57

General Self Efficacy Scale ....................... ................................................... .......... 57

Locus of Control .................................. ................................................... ................ 58

Secondary Database ................................ ................................................... ........... 59

Data Collection ................................... ................................................... .................... 60

Sample Size ....................................... ................................................... ................. 64

Variables ......................................... ................................................... .................... 64

Data Analysis ..................................... ................................................... ..................... 67

Statistical Analysis Methods ...................... ................................................... ............. 68

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Logistic Regression ............................... ................................................... .............. 69

Sample Size ....................................... ................................................... ................. 69

Statistical Testing ............................... ................................................... ................. 70

Logistic Regression ............................... ................................................... .............. 70

Correlation Analysis .............................. ................................................... .............. 70

Chi Square ........................................ ................................................... .................. 70

Ethical Considerations ............................ ................................................... ................ 71

Summary ........................................... ................................................... ..................... 72

Chapter 4: Presentation and Analysis of Data ...... ................................................... ...... 73

Introduction ...................................... ................................................... ....................... 73

Results of the study .............................. ................................................... .................. 73

Descriptive Statistics ............................ ................................................... ............... 75

Testing the Research Questions..................... ................................................... ........ 77

Research Question One ............................. ................................................... ......... 78

Research Question Two ............................. ................................................... ......... 78

Research Question Three ........................... ................................................... ........ 79

Research Question Four ............................ ................................................... ......... 80

Research Question Five ............................ ................................................... .......... 92

Summary ........................................... ................................................... ..................... 95

Introduction ...................................... ................................................... ....................... 96

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Summary of the Study .............................. ................................................... .............. 96

Discussion of Findings ............................ ................................................... ................ 97

Implications of Study ............................. ................................................... ................ 100

Recommendations for further research .............. ................................................... .. 100

APPENDIX A ........................................ ................................................... .................... 102

CONSENT TO PARTICIPATE IN RESEARCH ................ ....................................... 102

APPENDIX B ........................................ ................................................... .................... 106

Demographic Information ........................... ................................................... ....... 106

Academic Information .............................. ................................................... ......... 107

APPENDIX C ........................................ ................................................... ................... 108

Technology Use .................................... ................................................... ............ 108

APPENDIX D ........................................ ................................................... ................... 109

Self Efficacy Scale (Schwarzer, R. & Jerusalem, M., 2000) ............ ............................ 109

APPENDIX E ........................................ ................................................... .................... 110

Locus of Control Scale (Rotter, J.B.) ............. ................................................... ........... 110

Reference ......................................... ................................................... ........................ 115

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TABLE OF FIGURES Table 1 ........................................... ................................................... .............................. 6

Southwest Georgia Area Associate Degree Nursing Sch ool Attrition Rates ................... 6

Figure 1 Conceptual Framework: Influence of Self-E fficacy, Locus of Control, Computer competency, and Demographic Factors on Student Succ ess in Fundamentals of Nursing Course .................................... ................................................... ...................... 19

Table 2 ........................................... ................................................... ............................ 24

Hypothesis and Variables .......................... ................................................... ................. 24

Table 3 ........................................... ................................................... ............................ 55

Study Nursing Schools Demographic Data .................................................. ................. 55

Table 4 ........................................... ................................................... ............................ 66

Research Variables .................................................. ................................................... .. 66

Table 5 ........................................... ................................................... ............................ 76

Description of Study Sample .................................................. ....................................... 76

Table 6 ........................................... ................................................... ............................ 77

Descriptive Statistics .................................................. ................................................... 77

Table 7 ........................................... ................................................... ............................ 79

Computer Competence and Success in Fundamentals of Nursing Course ................... 79

Table 8 ........................................... ................................................... ............................ 82

Success in Fundamentals of Nursing Course by Gender .............................................. 82

Table 9 ........................................... ................................................... ............................ 84

Student Success in Nursing Fundamentals Course – Em ployed 20 > hours per week . 84

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Table 10 .......................................... ................................................... ........................... 85

Final Grade in Fundamentals of Nursing Course .................................................. ........ 85

Table 11 .......................................... ................................................... ........................... 87

Successful in Fundamentals of Nursing Course Colleg e Course .................................. 87

Table 12 .......................................... ................................................... ........................... 90

Comparison of Study Colleges on Anatomy and Physiol ogy 1 grades, Pre-Nursing Grade Point Average, Self Efficacy Score, Computer competency, Locus of Control Score, and Success in Fundamentals of Nursing Cours e ............................................. 90

Table 13 .......................................... ................................................... ........................... 92

Successful in Fundamentals of Nursing and Anatomy a nd Physiology 1 Grade Correlation .................................................. ................................................... ................ 92

Table 14 .......................................... ................................ Error! Bookmark not defined.

Predictor Variables .................................................. ........ Error! Bookmark not defined.

Table 15 .......................................... ................................................... ........................... 94

Odds Ratio predicting who will be successful in Fun damentals of Nursing Course ...... 94

Table 16 .......................................... ................................ Error! Bookmark not defined.

Variable Correlations .................................................. ..... Error! Bookmark not defined.

ABSTRACT Influence Of Self-Efficacy, Locus Of Control, And C omputer Competency On Student Success In Foundational Nursing Course

Rhonda H. Payne, TUI University 2011

This retrospective correlation study was conducted to explore and identify specific predictor factors that influence student s uccess in the initial foundational course of nursing, Fundamentals of Nursing , in Associate of Science Degree programs that prepare students to successfully sit for the NCLEX-RN exam. With the high attrition rate of students from nursi ng programs exacerbating an escalating national nursing shortage and threate ning the quality of healthcare, critical evaluation of factors influencing nursing student success is essential in helping determine those students who are most likel y to be successful in nursing student achievement and nursing program student ret ention. There has been intense interest and numerous studies performed in the previous few years that examined predictors for nursing student success. Th e majority of these studies; however, focused on academic predictors or only one or two nonacademic predictors. This study aimed to examine both specif ic academic and nonacademic predictors in order to provide new know ledge to nurse educators that will support effective nursing school admissio n policies and assist educators to incorporate interventions during the nursing pro gram that promote nursing student success and retention.

The dependent variable of the study was success in the initial Fundamentals of Nursing course, defined as satisfac torily completing the clinical component of the course, earning a grade of 75% or higher, and progression in the Associate Degree Nursing Program. Several acade mic and non-academic variables of interest were investigated. The indepe ndent variables included participant self-rated scores on the General Self E fficacy Scale (based on Albert Bandura’s Social Learning Theory), J B Rotter’s Loc us of Control scale, and participant competency with computers. In addition, demographic factors of age, gender, marital/family status, employment status, p re nursing GPA, and grade in the prerequisite Anatomy and Physiology 1 course we re examined statistically and assessed for influence on student success in th e Fundamentals of Nursing course. Results of study revealed that the student grade in the initial science course of Anatomy and Physiology 1 was highly signi ficant, OR = 3.87, 95% CI (1.959, 7.647) and positively related to success in the Fundamentals of Nursing Course. An additional influence found to be statist ically significant in relation to success in the Fundamentals of Nursing course was c omputer competence scores, OR = 3.388, 95% CI (1.016, 11.296). Employm ent greater than 20 hours per week was found to have a negative effect on suc cess in the Fundamentals of Nursing course, X 2 (1, N = 117) = 6.11, p = .013). Research revealed that the nursing school location was significant with student success in the Fundamentals of Nursing cour se. T testing and One Way ANOVAs were performed to further investigate the di fference in success rate

between study schools. The sample of students part icipating in the study at each school was not significantly different in makeup, t hereby supporting the integrity of the study. Results indicated that students from School B were found to have a higher rate of success in Fundamentals of Nursing, higher Anatomy and Physiology 1 grades, higher rating of Self Efficacy , and a higher Computer competency rating than students in School A. Locus of control was not found to be predictive of success in the Fundamentals of Nursing course, B = .004, OR = 1.00 4, 95% CI (0.876, 1.150). However, the variable was noted to be influenced mo re by the internal locus of control than by the external locus of control as no ted in the discussion of findings. Demographic factors of age, gender, marital, and fa mily status were not found to be significant nor predictive of success in the Fun damentals of Nursing course.

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Chapter 1 Introduction Background of the Study The goal of this retrospective correlation research study will be to investigate whether, and to what extent, the variab les of first-year nursing student self-measurement of self-efficacy, locus of control , and access and proficiency in technology are associated to success in the Fundame ntals of Nursing Course of students in a community college setting. In additio n, the relationship of student grade in Anatomy and Physiology 1 (the initial requ ired science course for students entering the nursing profession) and demog raphic factors and student success in the Fundamentals of Nursing course will be explored. According to the American Nurses Association (ANA; 2004), “The nation is facing an impending shortage of nurses that is expe cted to peak by 2020” (¶1). Nursing schools, public leaders, healthcare leaders , and the general public is affected by the lack of Registered Nurses (RNs) ava ilable. As the population ages, the expectation is that an increasing number of RNs will be required simply to maintain the current level of healthcare. In addition, the current environmental and politic al concerns of increasing pandemic disease, occurrence of manmade and natural disasters, and increasing threats of war, requires significant inc reases in the health care workforce (CDC, 2006b; Farmer, Jimenez, Rubinson, & Talmor, 2004; USDHHS, 2006a, 2006d;WHO, 2006a). (Wray, Whitehead, Setter, & Treas, 2006). The national nursing shortage and factors that increase the demand for increasing the

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nursing workforce in the face of national, state, a nd local disasters create the potential for a public health crisis (Wray et al, 2 006; CDC, 2006a; WHO, 2006f). Nursing programs have attempted to meet demand for nurses by increasing enrollment and lobbying successfully for increases in program funding by colleges and states for students. Unfortunately, the problem of nursing student attrition hampers the best efforts of nursing progr ams and aggravates the national shortage of Registered Nurses in the Unite d States. In 2003, the National League for Nursing reported a positive upward trend in the nursing workforce supply; however, by 2006, the American College of Healthcare Executives (2006) reported that in 2005, 85% of hospital administrators determined hospitals did not have en ough registered nurses to meet patient care demands. The United States Bureau of Labor statistics indicated by 2014, more than 1.2 million new and re placement nursing positions would be needed to meet the public healthcare needs (American Association of Colleges of Nursing, 2006). Multiple extensive efforts to decrease attrition ha ve been made by nursing programs including strengthening admission procedur es and implementing retention programs. Regrettably, the problems of at trition continue to persist in nursing schools across the country. Admission to a nursing program is competitive and many potential students are denied admission each semester. Attrition from nursing programs affects not only th e specific student who is accepted to a nursing program and unsuccessful, but also the student denied admission that may have been successful. Attrition rates are costly to students,

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nursing programs, and healthcare alike by decreasin g the number of potential graduates from schools of nursing and contributing to the nursing shortage. Many studies highlight the much higher than desir ed attrition rates for nursing students and attempt to determine potential academic and non academic contributing causes of this undesired attrition rat e (Sodders, 2005; Schuetz, 2005, Ehrenfeld et al, 1997 & 2000, Sadler, 2003, B ragg, 2006, Glossop, 2002). No empirical work to date; however, explores the mu ltiple focus of theories of Self-Efficacy (Bandura, 1987), as conceptualized and measured by the Self Efficacy Scale (Schwarzer, & Jerusalem, 2000), Locus of Control, as theorized by JB Rotter and measured by the Locus of Control Scale (1966, 1975 ), and proficiency in technology. In addition, this study investigates influence of demographic factors, including relationship of stud ent grade in the initial science prerequisite course of Human Anatomy and Physiology 1 and success in the initial nursing program course of Fundamentals of N ursing. An Associate Degree in Nursing is a challenging and expensive program of study for students and a significant investment by stakeholders in nursing schools at large. Attrition; therefore, is extremel y costly to students, nursing programs, and the nursing profession. “Student attr ition (dropping out) wastes time and resources which schools of nursing can ill afford” (Ehrenfeld, 1997). The high attrition rate is of particular concern, a s there is an increasing shortage of Registered Nurses in the United States.

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It is hoped that this study will determine the infl uences, if any, of self- efficacy, locus of control, proficiency in technolo gy, grade in A & P 1, and/or demographic factors, to student success in the firs t semester of an Associate Degree in Nursing (ADN) Program. Results may potent ially affect both pre- nursing programs and ADN instructional programs by identifying students likely to be successful and through adaptation of methods and programs to promote nursing student success. Problem Statement “The data is daunting. …Attrition rates of 20 to 5 0 percent in most nursing programs …an encouraging 16.6 percent leap in 2003 nursing school enrollments—and not enough to meet future demand” (Cedars-Sinai Medical Center, 2004). Attrition from … Schools of Nursing is in excess of 50%” (Weems, 2005).The high attrition rates of nursing students affect not only the students, but also the nursing programs, and the nursing professi on. The attrition of nursing students decreases the number of graduate student n urses entering the nursing profession further affecting the nursing shortage. “Attrition …costs students …subsequent earning power and …effect on their sens e of self worth…costs schools of nursing faculty effort and resources …ev ery student who does not complete a program, one fewer nurse is available to the health care system” (Pringle, 2005). ”Particularly at community colleges, attrition is a problem campus wide and the multiple factors influencing this are noted in the Associate Degree Nursing Programs. “Community colleges serve 53% of all first-time students

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enrolled in public higher education, including disp roportionate numbers of working, first-generation, adult, and other traditi onally underrepresented students” (Snyder, Tan, & Hoffman, 2004). “High le vels of first-year attrition are a longstanding problem. About half of all first-yea r community college students leave higher education before the beginning of thei r second year--a rate that has held steady for over 40 years” (Schuetz, P., 2005). Community college "students often juggle the demands of full-time jobs and fami ly duties." (Smith,) Nursing schools in community colleges have the same populat ion and challenges with attrition as well as multiple issues specific to nu rsing attrition. Specific school attrition rates are difficult to de termine, as the reporting of these rates varies among institutions and is confid ential when reports are developed. This researcher conducted a telephone su rvey In Southwest Georgia, Northwest Florida, and Southeast Alabama, to determ ine whether attrition rates were highest in the initial nursing course in compa rison to the total attrition rate of the program. The researcher contacted four area community colleg e Associate Degree Nursing schools including the two programs that wil l be researched in the proposed study. Nursing program directors are often reluctant to discuss attrition rates but each agreed to provide information based on confidentiality. Attempts to verify reported attrition rates with the Georgia St ate Board of Nursing was unsuccessful as reporting of attrition rates is not mandatory. This complexity in determining nursing school attri tion rates is not unique to Georgia or to the United States. “Although calcu lation of attrition rates is

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fraught with difficulty it appears that attrition w ithin nursing education is comparatively high” (Bradley, 2007). In addition, calculation of nursing program attrition rates vary, as some schools do not includ e students that return to the program within a specified period. Results of the convenience survey of area schools w ere somewhat disquieting with reported results of attrition rate s of 23 – 54 percent overall, in every instance the majority of the attrition occurr ed in the first nursing course (Refer to Table 1). Table 1 Southwest Georgia Area Associate Degree Nursing Sch ool Attrition Rates

School A School B School C School D Overall Program Attrition Rate

23%

36%

54%

43% First Course Attrition Rate

15%

22%

35%

25%

According to the National League of Nursing (NLN) “ Since three-fifths, or 59%, of all new RN students continue to enter nursi ng programs via associate degree nursing programs in community colleges it is relevant to particularly attend to this sector” (2003). The impact of nursin g school attrition extends far beyond the student ─ it also has an adverse impact on faculty morale” ( Burack, J., 2004).

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In addition, attrition of nursing students not onl y results in current decrease of nursing graduates in a nursing program, it also limits the availability of future nurses and decreases the potential nursin g faculty, which is becoming an increasing concern.

According to Hinshaw, the shortage of nurses requir es that schools of nursing produce more graduates; how ever, the shortage of nursing faculty limits enrollment numbers and decre ases the number of graduates who could become nursing faculty and reso lve the faculty shortage (American Association of Colleges of Nursing, 2004; Hinshaw; Nevidjon & Erickson, 2001; Oblinger, 2005; Skiba). Moreover, e ven with the current enrollment numbers increasing, many community colle ges cannot accommodate eligible applicants; greater than 12% across all pr ogram types remain wait-listed due to a lack of skilled nursing faculty (AACC, 200 3; Valiga, 2002). “A record number of 125,000 applications were turned away in 2004 from nursing programs at all levels” (NLN, 2004). It is vital th at those students selected in such a competitive market have a higher potential for su ccessful completion of the nursing program than currently exists. The fact that Associate Degree Nursing programs are highly competitive, and in many areas, have increasingly rigorous acade mic requirements would imply that entering students are highly motivated a nd prepared and that attrition would consequently be low; unfortunately, attrition rate evidence does not support this assumption. It is likely therefore, th at factors other than academic ability must have an influence of success of studen ts in a nursing program.

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Determining which factors are supportive of student success and decreasing student attrition in nursing school are priorities for nursing programs today and have been for some time. “Studies of attr ition from nursing courses have tended to concentrate on causation, trying, la rgely unsuccessfully, to elicit what causes drop out” (Moseley, & Mead, 2008). Perh aps it would be beneficial to consider what reasons may inspire a student to e nter a nursing program as well as which characteristics are found in students that preserve through challenges and are ultimately successful. “The high rate of attrition among nursing students has caused some nursing leaders to think about the necessity of considering students' personality during the pro cess of admission into nursing schools” (Adib-Hajbaghery & Dianati, 2005). Understanding of contributing factors of individual student success may lead to planning of admissions and programs develop ed by nursing programs that support a greater number of students to be suc cessful thereby decreasing the rampant attrition rates plaguing so many progra ms. It is possible that an individual’s personality traits, belief systems, an d psychosocial skills contribute as much to career success as intellect and technica l skills. “A growing body of research suggests that a second dimension, psycholo gical functioning, may be as important as academic factors in predicting psyc hosocial adjustment to college” (Mallinckrodt, 1988; Mallinckrodt & Leong, 1992; Pancer, Hunsberger, Pratt, & Alisat, 2000; Rice, 1992: Wintre & Yaffe, 2000) as noted by Estrada in the 2006 College Student Journal .

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Personality is defined as “The quality or condition of being a person. The totality of qualities and traits, as of character o r behavior, that is peculiar to a specific person. The pattern of collective characte r, behavioral, temperamental, emotional, and mental traits of a person” (American Heritage Dictionary, 2007). Personality traits are more or less stable internal factors that make one person’s behavior consistent from one time to another, and d ifferent from the behavior other people would manifest in comparable situation s’ (Child, 1968). Pervin’s definition of personality, characterizes it as "the complex organization of cognitions, affects, and behaviors that gives direc tion and pattern (coherence) to the person's life" (1996, pg. 414). The concern about attrition and “fit to professio n” is not limited to one gender or one ethnicity of nursing students. “Despi te increasing numbers of males choosing to undertake nursing as a career, at trition by males from nursing courses continues to be problematic” (Stott, 2007).

Extensive previous research has focused on various potential predictive factors of nursing student success including pre-nu rsing GPA and scores of various standardized pre-nursing admission entrance exams as well as multiple other potential factors. “Previous academic perform ance was shown to have a statistically significant relationship with first s emester nursing school performance” (Potolsky, 2003). In addition, socioec onomic status, family, cultural, and environmental influences have been investigated at various intervals; findings of these studies, however, are insufficien t to explain the ongoing attrition

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rates of nursing schools that continue despite exte nsive research and multiple efforts that are largely unsuccessful at decreasing those attrition rates. An extensive search of available literature was con ducted but no studies were found that studied the potential influences of nursing student success and individual influences of self-efficacy, locus of co ntrol, and competency in technology. If a relationship between these factors exists, the highest attrition may be related to a correlation of those components of the adult personality. “While there is a plethora of literature relating t o student attrition, there is an absence of evidence in relation to the experiences of those students who are struggling to meet the demands of nursing programme s” (Robshaw, 2004). Determining the influence, if any, of personality f actors of self-efficacy and locus of control, environmental demographic factors , and proficiency with technology on student success in nursing school may help decrease student attrition thereby leading to a greater number of nu rsing school graduates and higher numbers of Registered Nurses. Increased numb ers of Registered Nurses will improve the overall status of healthcare benef iting society as a whole. Purpose of the Study The goal of this retrospective correlation research study will be to investigate whether, and to what extent, the variab les of beginning nursing student self-measurement of self-efficacy, locus of control, and access and proficiency in technology are associated to success in the Fundamentals of Nursing Course of students in a community college s etting in Southwest Georgia. In addition, the relationship of student grade in t he Anatomy and Physiology 1

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course and demographic factors of age, gender, fami ly/marital status, and employment status with student success in the Funda mentals of Nursing course will be investigated. Study Significance and Rationale The nursing shortage continues to increase in the U nited States and worldwide with devastating consequences. “The short age of registered nurses is already having ill effects on the U.S. health care delivery system: 90% of long term care organizations lack sufficient nurse staff ing to provide even the most basic care” (Centers for Medicare and Medicaid Serv ices, 2002). “There are 126,000 nursing positions currently unf illed in hospitals across the United States” (Pricewaterhouse Coopers, 2001). The necessity to increase graduation of student nurses is obvious; however, m any factors hamper the abilities of colleges to provide this increase incl uding limited availability of student seats in colleges due to restricted space, resource s, and nursing faculty. This study offers several potential contributions t o nursing students, nursing education, and the nursing profession. Firs t, it presents a nonacademic student measure, to assess influences of specific p ersonality factors of self- efficacy, locus of control, and the influence of te chnology access and proficiency on beginning nursing student success, which may sup port students by enhancing self-awareness. In addition, increasing the body of knowledge may assist nursing faculty to design teaching methods that support dev elopment of retention programs and help alleviate the nursing student att rition rate.

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Finally, the study results may help to decrease att rition overall through increased understanding of contributing factors of attrition. Decreasing attrition will result in an increase in the number of student s successfully completing nursing programs and entering the nursing professio n thereby helping to alleviate the nursing shortage. Operational Definition of Terms The following definitions are used throughout this research study: 1. Associate Degree of Nursing Program: The Associa te Degree of Nursing (ADN) program is a program of study in an accredite d college that culminates with the Associate of Science degree in Nursing and the right to apply to sit the NCLEX – RN exam after successful completion of the program. 2. Accredited school of nursing: An accredited scho ol of nursing is a 2-year ADN program recognized by the National League for Nursi ng Accrediting Commission (National League for Nursing Accrediting Commission , 2006b), an agency identified by the U.S. Secretary of Education as a national nursing accreditation entity. The National League for Nursing Accrediting Commission meets specific national education standards that ensure the qualit y and integrity of the ADN program to prepare entry-level registered nurses to pass the NCLEX-RN exam and practice safe health care (National League for Nursing Accrediting Commission, 2006b; Ratliff, Lubinescu, & Gaffney, 2 001). 3. Attrition: The failure of a nursing student to p rogress from the Fundamentals of Nursing Course due to unsatisfactory academic pe rformance or because of any other factor.

Full document contains 144 pages
Abstract: This retrospective correlation study was conducted to explore and identify specific predictor factors that influence student success in the initial foundational course of nursing, Fundamentals of Nursing , in Associate of Science Degree programs that prepare students to successfully sit for the NCLEX-RN exam. With the high attrition rate of students from nursing programs exacerbating an escalating national nursing shortage and threatening the quality of healthcare, critical evaluation of factors influencing nursing student success is essential in helping determine those students who are most likely to be successful in nursing student achievement and nursing program student retention. There has been intense interest and numerous studies performed in the previous few years that examined predictors for nursing student success. The majority of these studies; however, focused on academic predictors or only one or two nonacademic predictors. This study aimed to examine both specific academic and nonacademic predictors in order to provide new knowledge to nurse educators that will support effective nursing school admission policies and assist educators to incorporate interventions during the nursing program that promote nursing student success and retention. The dependent variable of the study was success in the initial Fundamentals of Nursing course, defined as satisfactorily completing the clinical component of the course, earning a grade of 75% or higher, and progression in the Associate Degree Nursing Program. Several academic and non-academic variables of interest were investigated. The independent variables included participant self-rated scores on the General Self Efficacy Scale (based on Albert Bandura's Social Learning Theory), J B Rotter's Locus of Control scale, and participant competency with computers. In addition, demographic factors of age, gender, marital/family status, employment status, pre nursing GPA, and grade in the prerequisite Anatomy and Physiology 1 course were examined statistically and assessed for influence on student success in the Fundamentals of Nursing course. Results of study revealed that the student grade in the initial science course of Anatomy and Physiology 1 was highly significant, OR = 3.87, 95% CI (1.959, 7.647) and positively related to success in the Fundamentals of Nursing Course. An additional influence found to be statistically significant in relation to success in the Fundamentals of Nursing course was computer competence scores, OR = 3.388, 95% CI (1.016, 11.296). Employment greater than 20 hours per week was found to have a negative effect on success in the Fundamentals of Nursing course, X2 (1, N = 117) = 6.11, p = .013). Research revealed that the nursing school location was significant with student success in the Fundamentals of Nursing course. T testing and One Way ANOVAs were performed to further investigate the difference in success rate between study schools. The sample of students participating in the study at each school was not significantly different in makeup, thereby supporting the integrity of the study. Results indicated that students from School B were found to have a higher rate of success in Fundamentals of Nursing, higher Anatomy and Physiology 1 grades, higher rating of Self Efficacy, and a higher Computer competency rating than students in School A. Locus of control was not found to be predictive of success in the Fundamentals of Nursing course, B = .004, OR = 1.004, 95% CI (0.876, 1.150). However, the variable was noted to be influenced more by the internal locus of control than by the external locus of control as noted in the discussion of findings. Demographic factors of age, gender, marital, and family status were not found to be significant nor predictive of success in the Fundamentals of Nursing course.