THE EXAM ANALYSIS: INCREASING EQUITY AND ACCESS IN AT RISK NURSING STUDENTS

Thursday, April 23, 2015
Iris Mamier, PhD, MSN, RN , School of Nursing, Loma Linda University, Loma Linda, CA
Vaneta M. Condon, PhD, RN , School of Nursing, Loma Linda University, Loma Linda, CA
Earline W. Miller, PhD, RN , Integrity Rehab & Home Health, Killeen, TX
Barbara Ninan, MSN, RN , School of Nursing, Loma Linda University, Loma Linda, CA
Grenith Zimmerman, PhD , School of Allied Health Professions, Loma Linda University, Loma Linda, CA
Purpose: To evaluate the effect of implementing a nursing student retention tool—The Exam Analysis (TEA)©—by comparing exam scores before TEA with final exam score after TEA.

Rationale/ Background/Conceptual Basis: TEA is an evidence-based diagnostic and prescriptive program designed to help students learn from incorrect answers and re-strategize after a nursing exam. Nursing faculty often endeavor to find effective strategies to help at-risk and underperforming nursing students to adapt successfully to the demands of a rigorous academic nursing program.

Higher than average attrition rates have been reported for minority students who often face serious barriers to their academic success. Other “at-risk” groups include non-traditional nursing students who may commute, or who work more than 16 hours/week or may juggle family responsibilities while going to nursing school.

When compared to students who maintain strong passing grades, at-risk students may have inadequate test taking skills and greater anxiety. At-risk students who underperform are more likely to have inadequate learning strategies, are less likely to seek help, sometimes appear to be less motivated and may have less cognitive behavioral engagement.

While early work on student attrition focused on the belief that academic failure resulted from the student’s lack of motivation and ability, this blaming the victim mentality is partially responsible for the continued  inequity in graduation rates for minority and disadvantaged students.  However, even in institutions that strive to create an academic and social environment that leads to success, faculty are often at a loss in knowing how to specifically support students academically.  TEA is an intervention strategy that can promote student academic success and ultimately leading to increased retention rates.

Methods: A summative evaluative design was used with 221 nursing students who had an initial and final TEA in Fundamentals of Professional Nursing (Fundamentals) and/or Medical Surgical Nursing I (Med-Surg I) from September, 2007 through June, 2010. Program outcomes were evaluated using student records and exam results and SPSS version 22.0 for the statistical analysis. Student initial and final exam scores, test means, and test standard deviations as well as student demographic information and admissions testing results were analyzed using paired t-tests and chi-square tests.

Results: Students who participated in TEA in each of the courses (Fundamentals and Med-Surg I) scored significantly higher on their final exam (p = .001 and p = < .001, respectively). The grade for the final exam increased at least one half letter grade for 63.4% of students in Fundamentals and 51.7% of students in Med-Surg I.

Implications: This study suggests that TEA is an intervention strategy that promotes at-risk students’ academic success leading to increased retention rates. If students learn from past mistakes and effectively re-strategize they can change their academic performance significantly. TEA then provides a tool for nurse educators who seek to provide educational, psychological, and functional support for at-risk students.