Third Annual Mid-Atlantic Regional Conference of Community College EducatorsOctober 23, 2009

Kathleen M. Martin, DNP, RN

FCC experiences◦15-25% attrition in first year

? Minority students ? ESOL student

1. Identify factors associated with early departure from a two-year nursing program

2. Special attention was placed on factors associated with minority nursing students

Vincent Tinto

“A Longitudinal Model of Institutional Departure”

Tinto, V. (1993). Leaving college: rethinking the causes and cures of student attrition. (2nd ed.). Chicago: The University of Chicago Press

Departure Decision

Time (T)

Family Background

Skills and Abilities

Prior Schooling

Intentions

Goal and Institutional Commitments

External Commitments

Pre-entry Attributes

Goal & Commitments

Academic Performance

Faculty Staff Interactions

Formal

Informal

Extracurricular Activities

Peer Group Interactions

Formal

Informal

Academic System

Social System

Institutional Experiences

Academic Integration

Social Integration

Intentions

Goal and Institutional Commitment

External Commitments

Integration Goal & Commitments Outcome

External Community

Departure Decision

Family and community background◦ Social status, parents education, size of community

Personal attributes◦ Sex, race, physical handicaps

Skills◦ Intellectual and social

Financial resources Dispositions

◦ Motivations, intellectual, social and political preferences Pre-college educational experiences

◦ College prep or AP HS curriculum◦ HS GPA

Tinto, V. (1993) Leaving college: Rethinking the causes and cures of student attrition (2nd Ed) Chicago: The University of Chicago Press

Higher Education Literature◦ERIC database

Nursing Education Literature◦CINAHL database

Search terms◦Education, nursing◦High risk or At risk student◦College student

Community college students◦ Low degree attainment

First-generation college students◦ 1.3 times more likely to not complete college degree

High-school curriculum Type of higher education institution Socio-economic status Hispanic

Basic knowledge testing◦Nurse Entrance Test (NET)

Academic background◦Developmental reading◦GPA

Racial and cultural background◦Minority race

“Which student pre-entry attributes are predictive of nursing student early departure from a two-year nursing program?”

Study Design

Descriptive, correlational study utilizing administrative data at FCC

FCC PeopleSoft: Student database◦ Integrated database

Demographic student information Grades Advising notes Billing

◦Accurate

FCC Student Financial Aid Records◦Need-based aid◦Reliable electronically generated by funding organization

Student transfer transcripts◦Paper copies of official transcripts◦Electronically stored in PeopleSoft

Reliable data Required for admission to program

FCC Nursing Student Information Sheet◦Plan to work during nursing program?◦CNA prior to admission to program?◦No missing data

IRB approval from SOM (10/29/07) FCC Approval of Use of Human Participants Password protected computer for data storage Identifiers removed

Pre-entry attributes◦Students individual characteristics

Goals and commitments◦External commitments

Outcome◦Early departure – failing or withdrawing from any of the

three first-year nursing courses

Independent VariablesIndependent Variables SourceSourceAge/SexAge/Sex PeopleSoftPeopleSoft

Race/ethnicityRace/ethnicity PeopleSoftPeopleSoft

# times science prerequisites taken: # times science prerequisites taken: A&P I or II, Microbiology: Once/more A&P I or II, Microbiology: Once/more than oncethan once

PeopleSoft or student PeopleSoft or student transcripttranscript

Nursing major: RN or PNNursing major: RN or PN PeopleSoftPeopleSoft

SES: Yes/NoSES: Yes/No Financial Aid RecordsFinancial Aid Records

ESL English: Yes/NoESL English: Yes/No PeopleSoft or Student PeopleSoft or Student TranscriptTranscript

Developmental English: Yes/NoDevelopmental English: Yes/No PeopleSoft or Student PeopleSoft or Student TranscriptTranscript

Work during program: Yes/NoWork during program: Yes/No Nursing Student Information Nursing Student Information SheetSheet

CNA on admission to program: CNA on admission to program: Yes/NoYes/No

Nursing Student Information Nursing Student Information SheetSheet

Dependent VariableDependent Variable SourceSource

Student course failure or Student course failure or withdrawal failing in first year of withdrawal failing in first year of nursing programnursing program

PeopleSoftPeopleSoft

Failure/W in NU 101Failure/W in NU 101 PeopleSoftPeopleSoft

Failure/W in NU 210Failure/W in NU 210 PeopleSoftPeopleSoft

Failure/W in NU 211Failure/W in NU 211 PeopleSoftPeopleSoft

Which first-year nursing student pre-entry attributes predict early departure?

Failure in first year course =ƒ ( age) + ( sex) + ( race) +

( #science Pre-requisite) + ( nursing major) + ( CNA) + ( Developmental English) + ( ESL English) + ( plan to work) + ( Financial Aid) + error

Student enrolled in fall 2005 and fall 2006, day option (n=124 students)

26 (21%) minorities 9 (7.3%) men 21 (17%) PN majors/103 (83%) RN majors

Sample (n=124)◦Mean age 32.2 year (SD 9.46) ◦Predominately female (93%)◦ 21% minority race, 79% white◦ 35% received need-based financial aid◦ 66% plan to work during nursing program◦ 25% were CNA’s upon admission

Two groups:◦ Fall 2005 (n=63)◦ Fall 2006 (n=61)

Fall 2006 significantly younger (t=2.589, p=.011) Fall 2006 repeated Anatomy & Physiology I with greater

frequency (2 =4.689, p=.030) Fall 2006 repeated Anatomy & Physiology II with greater

frequency (2 =5.140, p=.023) Fall 2006 students “Repeated any science prerequisite”

with greater frequency (2 =8.549, p=.003)

Three significant relationships:◦Anatomy & Physiology I more than once (2 =15.613,

p<.001)◦Anatomy & Physiology II more than once (2 =13.169,

p<.001)◦Students who repeated any science prerequisite

(Anatomy & Physiology I, II or Microbiology) (2 =15.455, p<.001).

First regression:◦Two parameters (Rule of 10)◦Predicted 85.5% of cases◦Students who took Anatomy & Physiology I more

than once were 5.24 times more likely to fail a first-year nursing course (CI 1.725,15.975, p=.004)

◦Students who took Anatomy & Physiology II more than once were 5.23 times more likely to fail a first-year nursing course (CI 1.252, 21.849, p=.023)

Hosmer & Lemeshow, 2000, p. 347

Second regression:◦Entered all student characteristics of interest at once

P< .25 at bivariate level Strongly supported in literature

◦Predicted 83.9% of cases◦Being a male increased a student’s risk of failure 6.56

times (OR=6.56; CI 1.044, 41.18)◦Repeating Anatomy & Physiology I or II increased a

students risk of failure by about 7 times (A & P I, OR 7.053; CI 1.952, 25.487; A & P II, OR 6.690; CI 1.304, 34.324)

Minority status did not influence early departure (OR=0.58; CI 0.108, 3.174)

Prerequisite science performance is predictive of early departure

Strengthen pool of nursing program candidates◦Policies and procedures must discourage practice of

repeating science prerequisites Average grades when multiple attempts? Accept first attempt grade?

◦ Inform high school faculty and counselors about rigors of nursing program

◦ Inform student of rigors of nursing program Advisor

Increase nursing faculty informal contact with students ◦ Initiate collaboration between nursing and science faculty

at FCC Speak to students in science prerequisite courses

◦ Initiate opportunities for student-faculty interaction outside of class

Students◦ Family Orientation

Classroom strategies◦Create “Learning Community”

Male students◦Replicate using larger sample size

FCC has initiated cohort scheduling◦ Fall lecture groups maintained in Spring for both courses◦Maintains student contacts with study partners, psycho-

social support

FCC has initiated the “Family Orientation” effective June 2008Student and family member speakers for Q & A◦Very positive student feedback!

Allied Health Advisor aware of study findings

Currently seeking FT Nursing Tutor/Mentor Currently have Clinical Mentors

Will be seeking FT Nursing Recruitment and Retention Specialist – non-nurse position Will evaluate current method for selecting students from

pool of applicants May consider mentoring program Will plan time for students and faculty to meet informally