Quality Remediation Programs Lead to Successful Learning

Background: The mission of nursing programs is to prepare as many students as possible to pass the first-time attempt on the National Council Licensure Examination-RN (NCLEX-RN®). If a school’s first-time pass rate drops below 80%, the school is at risk of being closed by the State Board of Nursing. Furthermore, a student’s ability to work as a registered nurse (RN) depends on passing the NCLEX-RN®, and the overall impact on our nation’s health due to the current nursing shortage. Purpose: The purpose of this study was to examine the policies and strategies used in nursing programs to increase NCLEX-RN® first-time attempt pass rates and student retention rates. This study focused on Associate Degree in Nursing (ADN) programs due to their less rigorous admission criteria, larger enrollment numbers, and higher percentage of students enrolled who are considered more “at-risk” of not being successful in graduating and passing the first-time attempt of the NCLEX-RN®, in comparison to four-year nursing programs. The research questions were: 1) What remediation policies and strategies were implemented in nursing programs to increase student retention rates? 2) What remediation policies and strategies were implemented in nursing programs to increase NCLEX-RN® exam first-time pass rates? Methods: The research study was a qualitative descriptive study using semi-structured interviews. Participants were designees of ADN programs in Texas with an 80% passing rate for the 2017 NCLEX-RN® and a retention rate of 50% or higher. Five nursing directors and one Success Coordinator, representing six programs, were interviewed. The research questions were asked in an open-ended manner to provide insight on the strategies implemented for student success. Probing questions were asked based on the participants’ responses. The data collected in these interviews were analyzed to identify the common tendencies, frequencies, and variations of the policies and strategies implemented by the different nursing programs. A seven-step coding protocol was used and included: 1) defining the themes as independent constructs, 2) transcribing the interviews, 3) identifying relevant parts for analysis, 4) producing an initial template, 5) developing the template, 6) using the final template to interpret the findings, and 7) performing a “quality and reflexivity” check to prevent bias and preconceived assumptions. Findings: The findings of this study were consistent with previous studies that examined variables and remediation strategies that had an impact on student success. For Research Question 1, participants felt that a combination of academic and non-academic remedial strategies contributed greatly towards student success. Additionally, programs that used a block-based curriculum had higher student retention rates. For Research Question 2, a standardized “NCLEX-RN” predictability exam was administered to all students and a remediation plan was developed based off those results. Additionally, programs that used integrated curriculum had higher NCLEX-RN® pass rates. Conclusion: Admirable was the participants’ holistic approach toward educating students. Noteworthy, it appeared even though the block-based programs had a higher percentage of at-risk students, they produced the same percentage of RNs as the integrated curriculum programs. Participants acknowledged the importance of administration’s support and partnership in promoting students’ success.