• unlimited access with print and download
    $ 37 00
  • read full document, no print or download, expires after 72 hours
    $ 4 99
More info
Unlimited access including download and printing, plus availability for reading and annotating in your in your Udini library.
  • Access to this article in your Udini library for 72 hours from purchase.
  • The article will not be available for download or print.
  • Upgrade to the full version of this document at a reduced price.
  • Your trial access payment is credited when purchasing the full version.
Buy
Continue searching

Predictors of success for associate degree nursing programs in a Texas community college system

Dissertation
Author: Tabitha Anderson Service
Abstract:
The purpose of this study was to identify the predictors of persistence among students who successfully completed the requirements for associate degree nursing programs in the Lone Star Community College System. The Bean and Metzner model of nontraditional undergraduate student attrition provided the underlying theoretical framework for this study. Subjects were a convenience sample of 215 nursing students aged 18 to 59 years old (M = 31.54) who had enrolled in the two-year ADN programs offered by the five colleges in the college system in 2004. Research questions were developed to explore the relationships among demographic, financial, and academic variables, and program completion. A data collection sheet was designed to facilitate the systematic collection of data for each student in the study. Data were gathered, abstracted, or computed from several sources. Information was obtained from individual student files, class records, college transcripts, and institutional records. Data were analyzed using descriptive statistics, Chi-square, t-tests, and backward stepwise logistic regression. Race/ethnicity, financial aid, and cumulative pre-requisite grade point average, combined with HESI math and reading comprehension scores and English, psychology, and biology grades were shown to significantly predict the successful completion of the ADN program. Students of White-Non-Hispanic origin were more likely than students of a different race/ethnicity to successfully complete the nursing program. Students who successfully completed the nursing program had higher scores on both components of the HESI test, higher academic GPAs for all courses, and higher cumulative pre-requisite grade point averages than students who did not complete the program. Furthermore, students who received some form of financial aid were more likely to successfully complete the nursing program than were students who had not received financial assistance. Cumulative pre-requisite grade point average, HESI reading comprehension score, and Biology 2402 GPA predicted program completion. Cumulative pre-requisite grade point average was the strongest predictor of program completion. Based on study results, administrators and faculty should work together to design and implement an institution-specific comprehensive retention plan with suitable interventions. Further research could build on study findings by replicating this research as closely as possible, controlling for other environmental factors such as family responsibilities, employment status, and social support.

TABLE OF CONTENTS LIST OF FIGURES ......................................................................................................... viii LIST OF TABLES ............................................................................................................. ix ACKNOWLEDGMENTS ...................................................................................................x Chapter 1: INTRODUCTION..............................................................................................1 Historical Perspective ......................................................................................................1 The Problem ....................................................................................................................4 Purpose of the Study ........................................................................................................7 Research Questions ..........................................................................................................8 Hypotheses .......................................................................................................................9 Significance of the study ................................................................................................10 Definition of Terms........................................................................................................11 Limitations .....................................................................................................................12 Assumptions ...................................................................................................................13 Underlying Theoretical Framework ...............................................................................13 The Hypothetical Model ................................................................................................16 Chapter Summary ..........................................................................................................19 Chapter 2: LITERATURE REVIEW.................................................................................20 Academic Effects ...........................................................................................................21 Admission/Entrance Examination .................................................................................26 Non-academic Effects ....................................................................................................29 Race/Ethnicity, Age, and Gender ...................................................................................30 Financial Aid ..................................................................................................................35 Chapter Summary ..........................................................................................................38 Chapter 3: METHODOLOGY ...........................................................................................40 The Problem ...................................................................................................................40

vi

Research Questions ........................................................................................................42 Research Design.............................................................................................................43 Setting ............................................................................................................................43 Population ......................................................................................................................44 Data Collection ..............................................................................................................45 Independent Variables ...................................................................................................46 Dependent Variables ......................................................................................................48 Data Analysis .................................................................................................................49 Chapter 4: FINDINGS .......................................................................................................53 Completers .....................................................................................................................55 Non-Completers. ............................................................................................................55 Research Question One ..................................................................................................56 Demographic Variables ..............................................................................................56 Research Question Two .................................................................................................60 HESI Entrance Exam ..................................................................................................60 Research Question Three ...............................................................................................62 Cumulative Pre-requisite Grade Point Average .........................................................62 Research Question Four .................................................................................................63 Biophysical Science, Psychology, and English Course GPAs ...................................63 Research Question Five .................................................................................................65 Financial Aid ..............................................................................................................65 Research Question Six ...................................................................................................66 Chapter 5: SUMMARY, DISCUSSION, CONCLUSIONS, AND RECOMMENDATIONS ............................................................................................69 Summary ........................................................................................................................69 Discussion ......................................................................................................................73 Age, Race/Ethnicity, and Gender ...............................................................................73 Academics ..................................................................................................................76 Financial Aid ..............................................................................................................79

vii

Conclusions ....................................................................................................................80 Recommendations for Practice ......................................................................................82 Recommendations for Future Research .........................................................................84 REFERENCES ..................................................................................................................85 Appendix A: Data Collection Sheet ...................................................................................90 Appendix B: Stepwise Logistic Regression Output...........................................................91

viii

LIST OF FIGURES Figure 1.1. Conceptual Model of Nontraditional Student Attrition ..................................14 Figure 1.2. Hypothetical Model: Summary of the relationship demographic, financial, and academic variables that lead to completion of the two-year nursing program ..........................................................................................................18

ix

LIST OF TABLES Table 4.1. Demographic, Financial, and Academic Characteristics of Study Population ............................................................................................54 Table 4.2. Descriptive Statistics for Variables Used in Analyses by Completion of Program..................................................................................57 Table 4.3. Comparison of Completers and Non-Completers on Age ...............................58 Table 4.4. Comparison of Completers and Non-Completers on Race/Ethnicity ..............59 Table 4.5. Comparison of Completers and Non-Completers on Gender ..........................60 Table 4.6. Results of the t-test for Academic Variables (N= 212) ....................................61 Table 4.7. Comparison of Completers and Non-Completers on Financial Aid ................66 Table 4.8. Results of the Stepwise Logistic Regression for Completion of Program (N =212) ............................................................................................68

x

ACKNOWLEDGMENTS I would like to take this opportunity to thank the members of my committee: Drs. Edgar Farmer, Edgar Yoder, Judith Kolb, and Mona Counts. I am very grateful for their time and effort. I would especially like to thank Dr. Farmer, who served as both my advisor and the chair of my committee, for his help and guidance throughout this process. I would also like to thank Dr. Kenneth Gray, who served as my advisor and committee chair during the preliminary stages of my degree, but had to withdraw due to his retirement. I would also like to thank the executive committee at Lone Star College System, for granting me access to the data used in this study. I am especially indebted to my husband, Ray Service, and my children, Ray, Jr., Elizabeth, and Christian, who have made tremendous sacrifices in supporting me throughout the completion of this degree. I love you dearly.

1

Chapter 1

INTRODUCTION Historical Perspective The nursing shortage in the United States has been dramatically increasing in recent times, and at a time when the aging population and the need for health care services are projected to increase significantly as well. In July 2002, the Health Resources and Services Administration reported in Projected Supply, Demand, and Shortages of Registered Nurses: 2000-2020, that in the year 2000, approximately 30 states had experienced a shortage of registered nurses (RNs). In addition, the report‟s authors projected a significant increase in this shortage by the year 2020 and the inclusion of 15 additional states, including the District of Columbia (Health Resources and Services Administration, 2002). By 2012, the U.S. Bureau of Labor Statistics projected that the number of new and replacement nurses needed would be in excess of one million. Consequently, for the first time in the nation‟s labor and workforce projection data, Registered Nursing has been identified by the U.S. Department of Labor as the top occupation in terms of job growth through the year 2012 (Health Resources and Services Administration, 2002). The nursing shortage dilemma has been compounded even further by the continuous struggle of both two-year nursing programs at community colleges and four- year programs at universities to increase enrollment and retention levels to meet the ever- rising demand for nursing care. According to the National Council of State Boards of Nursing (as cited by American Association of Colleges of Nursing, 2002), the number of

2

first-time, U.S. educated nursing school graduates who took the NCLEX-RN, the national licensure examination for registered nurses, decreased by 20% from 1995–2003. A comparison with 1995 revealed that 19,820 fewer students in this category of test takers took the exam in 2003 (American Association of Colleges of Nursing, 2002). Enrollments in all basic RN preparation programs have declined each year over the last five consecutive years. According to the National League for Nursing (as cited in American Association of Colleges of Nursing, 2005), between 1995 and 1999, the number of programs of most types increased in the United States. Despite this overall growth in the total number of nursing programs (from 3,137 to 3,220 or 2.6%), the number of students enrolled in and graduating from nursing programs has declined with the exception of a 4% increase in doctoral programs. Consistent with enrollment declines, a 13.6% overall decline in graduations from all types of programs occurred between 1995 and 1999. The clear trend is toward an increase in the number of programs occurring simultaneously with a decrease in the number of enrollments and graduations from those programs (American Association of Colleges of Nursing, 2005). Currently, the Texas Board of Nurse Examiners does not collect data on attrition in nursing programs. However, other factors including enrollment and graduation trends, suggest that many nursing programs throughout the United States are experiencing high attrition rates among their students. Community colleges that offer the Associate Degree in Nursing (ADN) are especially affected by this trend. White and Mosely (as cited in Sandiford & Jackson, 2003) suggested that attrition rates as high as 41% are seen in some institutions, predominantly the community colleges with open admission policies. Many

3

states such as California and Texas have high dropout rates. According to the California Postsecondary Education Commission, in the 2003–2004 academic year, nursing programs at community colleges statewide had an attrition rate of 17.1%, compared with 10.8% for Bachelor of Science degree in Nursing (BSN) programs at four-year colleges (California Postsecondary Education Commission, 2003). Comparatively, preliminary data on the retention of ADN and BSN students in Texas for academic year 2003–2004, indicated that the total retention rate was 88.5%, representing a total loss of 1,101 students, compared to 95.8 % or a total loss of 291 students (Texas Department of State Health Services, 2005). A study by nurse researchers at the University of Pennsylvania (as cited in American Association of Colleges of Nursing, 2005) found that have more nurses available to be at the bedside could save thousands of patient lives each year. The researchers also determined that patients who have common surgeries in hospitals with high nurse-to-patient ratios have an up to 31% greater chance of dying. The study found that every additional patient in an average hospital nurse‟s workload increased the risk of death among surgical patients by 7%. In addition, it was suggested that having too few nurses may actually cost more money given the high costs of replacing burnt-out nurses and caring for patients with poor outcomes (American Association of Colleges of Nursing, 2005). Consequently, the importance of nurse attrition reduction activities by state, local government, nursing institutions, and other stakeholders is imperative and cannot be overstated. An adequate and steady supply of quality health care providers is critical to

4

the stability of medical services throughout Texas, especially in rural and underserved urban areas, where ensuring an adequate supply has always been a challenge (Statewide Health Coordinating Council, 2005). Therefore, it now becomes pivotal in this health care crisis and current economic climate for nurse educators to reduce attrition rates among nursing students and promote academic success. The Problem Despite graduation trends in Texas from 1998–2004 that indicate a 63.6% increase in graduates of BSN programs and a 15.3% increase in graduates of ADN programs, a consistent and increasing rate of attrition among nursing student in ADN programs still exists (Texas Department of State Health Services, 2005). Increased enrollment has been found to be the primary reason for graduation increases. However, this overall increase in enrollment does not indicate a parallel increase in nursing graduates and reduction in attrition rates. Several reasons have been cited for nursing student attrition as reported by nursing programs, including academic failure, financial difficulties, family constraints, health problems, and students‟ second thoughts about the program (whether it was the right choice for them) (Texas Department of State Health Services, 2005). The problem of nurse attrition paints a very challenging picture for Texas (Statewide Health Coordinating Council, 2005), and is especially important during a time when the demand for new RN graduates and health care services exceed the supply of nurses. Currently, there are approximately 201,194 licensed nurses and 93,342 certified nurse aides, accounting for 53.5% of the total health workforce in Texas. These numbers differ from study to study, but a majority agrees that the most severe health workforce

5

shortage in the state of Texas is the nursing shortage (Statewide Health Coordinating Council, 2005). Compounding the problem is the fact that Texas‟s aging population is increasing drastically, incidences of obesity are on the rise, and related chronic illnesses associated with obesity are also increasing (Statewide Health Coordinating Council, 2005), in combination with increasing numbers of medically uninsured patients and the changing demographics of the state population. Nursing school capacity is an issue in Texas, and is not unique to only a few institutions, but to a majority of community colleges offering the ADN program. According to a 2005 study by the Texas Higher Education Coordinating Board (as cited in Texas Department of State Health Services, 2005), 34% (approximately 4,220) of the total qualified applicants in 2003 were denied admission to the state‟s initial RN- licensure programs (Texas Department of State Health Services, 2005). With the capacity of nursing schools a factor in enrollment rates and no urgent fix to the problem, improvement of retention rates would appear to be critical. A total of 37 community colleges and junior colleges in Texas offer ADN programs. These programs include a balance of general studies, nursing education and clinical experiences. The course plan prepares a graduate to function as a direct care provider. Courses are usually in the biological, physical, and social sciences. Clinical experiences are in nearby hospitals (Texas Nurses Association, n.d.). Although the number of institutions that provide some form of nursing programs seems large enough, a majority suffer from the problem of attrition among nursing students.

6

The Lone Star College System is among the Texas community colleges that are not exempt from the phenomenon of student attrition within nursing programs. Situated in the North Houston metro area of Texas, the Lone Star College System serves 1,400 square miles in Harris and Montgomery Counties, and has a student population of approximately 50,000 enrolled in credit courses and about 14,000 enrolled in continuing education. The system is among the largest and fastest growing community college districts in Texas, with five distinct colleges: (1) Lone Star College–Cy-Fair, (2) Lone Star College–Kingwood, (3) Lone Star College–Montgomery, (4) Lone Star College– North Harris, and (5) Lone Star College–Tomball. Current student enrollment has seen a drastic increase over the past few years. Furthermore, the nursing programs at each college has modified their recruitment efforts and increased the number of students accepted to the program. Nonetheless, attrition rates as high as 40% have been seen in the nursing programs of a few colleges within the system. Consequently, considerable revenue as well as student services are reduced and lost. In addition, student attrition has had an adverse effect on students and further compromised the nursing shortage in Texas communities. This trend has been somewhat consistent over a period of time; to date, no formal study has been conducted in this area. This fact has provided an impetus for understanding the factors that predict nursing students‟ persistence in the ADN program. If such predictive factors can be identified, then intervention strategies can be designed and implemented to increase retention rates.

7

Purpose of the Study The purpose of this study was to identify the predictors of persistence among students who successfully completed the requirements of the Associate Degree Nursing programs in the Lone Star Community College System by studying the relationship between student persistence and certain demographic, financial, and academic variables. Data were examined from five colleges in the Lone Star Community College System. Each college offers an ADN program; admissions requirements and procedures are similar across programs. The associate degree nursing programs at the individual colleges of the Lone Star Community College System established admission criteria that students must meet prior to application submission. Students must complete a set of pre-requisite courses with a minimum GPA of 2.5 and grade of “C” or above in those courses. For the purpose of this study, prerequisite courses include Human Anatomy and Physiology I and II, General Psychology, and Composition and Rhetoric. Additional courses may be completed prior to admission in order to increase an applicant‟s chance of being selected for the program. However, these courses can be completed after admission. These courses include Human Anatomy and Physiology II, Microbiology and Pathology, Life-span Growth and Development, and Interpersonal Communication. Students must also complete the reading comprehension and math assessment tests of the Nurse Pre-Entrance Exam (HESI) and achieve scores of 70% or higher to be eligible for admission. These admission criteria, according to Bean and Metzner (1985), are students‟ characteristics when entering college as well as academic outcomes that influence student persistence.

8

The research study was conducted by specifically looking at student reading comprehension and math scores on the HESI, which is administered to incoming nursing students; age, race/ethnicity, and gender; cumulative pre-requisite GPA, biophysical science, psychology, and English course GPAs; and financial aid to see if these variables were predictive of successful completion of the nursing program. If a relationship is found to exist among the variables, and the findings provide insight into the populations most adversely affected by attrition––for example, minority populations and those with academic and financial difficulties––then this information can be used by nursing program administrators to develop retention strategies and implement intervention programs to eliminate the disproportionate burden of attrition in these affected populations. Research Questions This research study will address the following questions: 1. To what extent do demographic characteristics differentiate between nursing students who successfully completed the ADN nursing program and those students who did not complete the program? 2. To what extent are there differences in reading comprehension scores and math scores of the Nurse Pre-Entrance Exam (HESI) among nursing students who successfully completed the ADN nursing program and those students who did not complete the program?

9

3. To what extent are there differences in cumulative pre-requisite course grade point average among nursing students who successfully completed the ADN nursing program and those students who did not complete the program? 4. To what extent are there differences in biophysical science, psychology, and English course GPAs among nursing students who successfully completed the ADN nursing program and those students who did not complete the program? 5. To what extent does financial differentiate between nursing students who successfully completed the ADN nursing program and those students who did not complete the program? 6. What, if any, of the demographic characteristics, cumulative pre-requisite course grade point average, HESI scores, biophysical science, psychology, and English course GPAs, and financial aid predict the successful completion of the requirements of the ADN nursing program? Hypotheses The research hypotheses developed for this study were: 1. There will be significant difference in successful completion of the ADN nursing program between the demographic characteristics of nursing students. 2. There will be significant differences between the reading comprehension scores and math scores of the Nurse Pre-Entrance Exam (HESI) of nursing students who successfully completed the ADN nursing program and those students who did not complete the program.

10

3. There will be significant differences between the cumulative pre-requisite grade point average of nursing students who successfully completed the ADN nursing program and those students who did not complete the program. 4. There will be significant differences between the biophysical science, psychology, and English course GPAs of nursing students who successfully completed the ADN nursing program and those students who did not complete the program. 5. There will be significant difference in successful program completion between those students who received financial aid and those students who did not received any form of financial aid. 6. Demographic characteristics, pre-requisite grade point average, HESI scores, biophysical science, psychology, and English course GPAs, and financial aid will be significant predictors of successful completion of the requirements of the ADN nursing program. Significance of the study High attrition rates are a major concern for nursing education––a significantly high attrition rate negatively affects the supply of RNs needed in an already tight employment marketplace. Effective admission and progression standards are imperative because physical space and financial and human resources limit enrollment capability (Sadler, 2003). In conjunction with limited resources, the advent of the nursing shortage due to high attrition rates in nursing programs is creating a burden on the health care system, students, and the institution. Furthermore, state and federal support continues to decline (Statewide Health Coordinating Council, 2005). Consequently, the increased importance

11

of retention and graduation to nursing education add emphasis to determining predictors of the successful completion of associate nursing programs, especially those offered at the community college level. This study focused on factors as the major reason for attrition and tried to show that non completion is an indicator of these underlying factors. The study was institution-specific and provided important institutional information to nursing program administrators and faculty that enables a better understanding of the attrition problem within the culture of their institution. Thus, the data can be used to design a comprehensive retention plan with suitable interventions. The results are also very important in recruitment activities by enabling admissions to be less focused on specific student attributes as a single determinant of student persistence and more selective of individuals who are more compatible with the nursing profession and therefore more likely to succeed in the nursing program. In addition, the results lay the groundwork for additional studies designed to expand the knowledge base about predictive factors and consequences associated with the problem of attrition. Definition of Terms Attrition––the number of students who withdraw from studies prior to completion for a range of reasons, including difficulties in balancing study and other commitments, academic failure, personal problems, financial problems etc. Persistence––completing all educational requirements that lead to graduation.

12

Associate Degree Nursing (ADN)––degree program that is completed after two consecutive years of clinical instruction, usually within a community college or junior college setting. Retention––reduction of attrition. Registered Nurse (RN)––from one of the three educational options (diploma program, associate degree, and bachelor‟s degree), who after graduation passed a national licensure examination and then qualified to practice as a licensed Registered Nurse. Registered Nurses work in hospitals, doctors‟ offices, nursing homes, and home health agencies, and in public and occupational health (Healthcare Decisions Group, 2000). Integration––the extent to which students involve themselves in academic and social domains of college life (Tinto, 1975). Limitations The limitations of this study were as follows: 1. The size of the sample was limited to students enrolled in the Associate Degree- Nursing program who withdrew, failed, or successfully completed their program. 2. A convenience sample was used and participants were not randomly assigned to any group and may not be comparable on all other factors, so a selection bias may be present. 3. The research area was not randomly selected. The data were collected from the 2004– 2006 cohorts of community college students from five colleges in the Lone Star

13

Community College System in Texas; therefore, generalizability may be limited to similar groups and study settings in Texas. Assumptions 1. The methods used in collecting and managing the data were efficient and confidential. 2. All student files and records were accurate. 3. All questions on the admission application were answered by the students. 4. The method of acceptance of all nursing students was consistent for each individual college in the institution. 5. There was no significant variance in prerequisites requirements, course material, and testing methods among the schools during the study period. 6. The Nurse Pre-Entrance Exam (HESI) is a valid and reliable tool. 7. Financial aid information was accurate. Underlying Theoretical Framework The Bean and Metzner (1985) model of nontraditional undergraduate student attrition provided the underlying theoretical framework for this study (Figure 1.1). The model proposes that a student‟s decisions about persistence in college are influenced by three sets of variables: background and defining variables, academic variables, and environmental variables. Figure 1.1 provides a visual depiction of Bean and Metzner‟s (1985) Conceptual Model of Student Attrition.

14

Figure 1. 1 . Conceptual Model of Non traditional Student Attrition

Source: Bean, J.P., & Metzner, B.S. (1985). A conceptual model of nontraditional undergraduate student attrition. Review of Educational Research, 55, 485-540.

15

Background and defining variables included gender, race, age, educational goals, high school performance, and number of hours enrolled. These variables, according to the model, illustrate a student‟s characteristics on entering college. It is proposed that educational goals and high school performance are the most predictive variables, although they may interact with other variables. Academic variables include study hours, study skills, academic advising, absenteeism, major and job certainty, and course availability. These variables represent the student‟s participation in the academic progression at the college. Bean and Metzner (1985) proposed academic variables directly influence each student‟s academic performance, in turn influencing persistence. Consequently, high performing students with good academic grades (as measured by grade-point average) due to good study skills, high class attendance, adequate study hours, good academic advising, major and job certainty, and greater course availability will persist in a program at higher rates than students with poor academic performance (Bean & Metzner, 1985). Environmental variables include finances, family responsibilities, hours of employment, outside engagement, and opportunity to transfer to other programs or colleges and are factors external to the collegiate environment that may affect students‟ persistence during their attendance of college. Environmental variables are predicted to have a direct effect on a student‟s decision to withdraw or dropout from a college program. Bean and Metzner (1985) based this prediction on two basic assumptions: (1) the interaction between the nontraditional students and the external environment is greater than the interaction between the student and the institution; and (2) there is

16

negligible social integration into extracurricular activities because nontraditional student interaction with the college environment is primarily focused on academic programs. According to Bean and Metzner (1985), these three sets of variables interrelate and result in an array of academic and psychological outcomes that directly influence persistence and retention in college. The Hypothetical Model Guided by the Bean and Metzner (1985) model of nontraditional undergraduate student attrition, a hypothetical model was identified that incorporated various variables. This study did not attempt to test all variables identified in Bean and Metzner‟s (1985) model, but examined the influence of select background and defining, academic, and environmental variables from the model, as well as admission exam scores, on successful completion by ADN nursing students in a community college system in Texas. Variables constructed from the model of nontraditional undergraduate student attrition included age, race/ethnicity, gender, finances, cumulative pre-requisite grade point average (GPA), and biophysical science, psychology, and English course GPAs. In keeping with the model developed by Bean and Metzner (1985), the background and defining variables were categorized into demographic variables, including age, race/ethnicity, and gender. Bean and Metzner proposed that these variables have both a direct and interactive influence on student persistence. In this model, however, only the direct effect was considered. Existing institutional data were used for this study. Data on academic variables in the Bean and Metzner‟s (1985) model, such as study hours, study skills, academic

17

advising, absenteeism, major and job certainty, and course availability, were either not available or not regularly updated in the institution‟s database. The gathering of these data, as mentioned below, would have been time-consuming and expensive. As a result, these variables were not used in the academic variable construct. According to Bean and Metzner (1985), their model presumed a direct effect of GPA on persistence decisions. Grade point average, an academic outcome that the model of nontraditional undergraduate student attrition regards as a direct consequence of various academic variables, was viewed as the academic variable construct of the hypothetical model, as well as admission exam scores. In this model, pre-requisite GPA, reading comprehension and math scores on the pre-entrance exam, and biophysical science, psychology, and English course GPAs, were hypothesized to have a direct effect on persistence. The environmental variable in the model used financial aid as a single construct and was hypothesized to have direct effects on persistence. With respect to the present study, the additional environmental variables (family responsibilities, hours of employment, outside engagement, and opportunity to transfer to other programs or colleges) were not relevant to the final model in explaining variance in nursing program outcomes. The collection of environmental data was to have to been done using surveys of the cohorts tracked in this research study, but the strategy was felt to be expensive, time-consuming, and technically difficult, with modest benefits in terms of enhancing the predictive power of the hypothetical model. Furthermore, several prior studies have suggested that environmental data were not powerful predictors or held comparatively little explanatory power when compared with cognitive (academic) variables (The Center

18

for Student Success, 2002). Consequently, the use of additional environmental data and their expected importance was not highlighted in the present study. In this model, the psychological outcomes were excluded from the framework since there was no particular interest in perceived attitudes about college. Neither compensatory interaction effects nor any other interactions were included in the study framework. Only direct effects presumed most important were included. Figure 1.2 provides a visual depiction of the hypothetical model.

Full document contains 113 pages
Abstract: The purpose of this study was to identify the predictors of persistence among students who successfully completed the requirements for associate degree nursing programs in the Lone Star Community College System. The Bean and Metzner model of nontraditional undergraduate student attrition provided the underlying theoretical framework for this study. Subjects were a convenience sample of 215 nursing students aged 18 to 59 years old (M = 31.54) who had enrolled in the two-year ADN programs offered by the five colleges in the college system in 2004. Research questions were developed to explore the relationships among demographic, financial, and academic variables, and program completion. A data collection sheet was designed to facilitate the systematic collection of data for each student in the study. Data were gathered, abstracted, or computed from several sources. Information was obtained from individual student files, class records, college transcripts, and institutional records. Data were analyzed using descriptive statistics, Chi-square, t-tests, and backward stepwise logistic regression. Race/ethnicity, financial aid, and cumulative pre-requisite grade point average, combined with HESI math and reading comprehension scores and English, psychology, and biology grades were shown to significantly predict the successful completion of the ADN program. Students of White-Non-Hispanic origin were more likely than students of a different race/ethnicity to successfully complete the nursing program. Students who successfully completed the nursing program had higher scores on both components of the HESI test, higher academic GPAs for all courses, and higher cumulative pre-requisite grade point averages than students who did not complete the program. Furthermore, students who received some form of financial aid were more likely to successfully complete the nursing program than were students who had not received financial assistance. Cumulative pre-requisite grade point average, HESI reading comprehension score, and Biology 2402 GPA predicted program completion. Cumulative pre-requisite grade point average was the strongest predictor of program completion. Based on study results, administrators and faculty should work together to design and implement an institution-specific comprehensive retention plan with suitable interventions. Further research could build on study findings by replicating this research as closely as possible, controlling for other environmental factors such as family responsibilities, employment status, and social support.