The Kentucky Nurse - June 2022

Page 24 • Kentucky Nurse June, July, August 2022
Nursing Bridge to Success: Implementation of a Dedicated
Nursing Student Retention Program
Summer Cross, Ph.D., APRN, FNP-BC,
Associate Professor
Jennifer Rogers, DNP, APRN, FNP-BC,
Assistant Professor
School of Nursing and Health Professions
Murray State University
The national nursing shortage and stress
placed on the healthcare system as a result of the
COVID-19 pandemic has posed a strong call to
order for nursing programs to increase the number
of graduates, as well as improve the quality of
education provided. Governor Andy Beshear issued
an Executive Order December 9, 2021 declaring
Kentucky in a State of Emergency in relation to the
nursing shortage, and issued nine directives aimed
at pre-licensure nursing programs and increasing
enrollment and graduates. In addition, the National
Council of State Boards of Nursing (NCSBN)
changes to the NCLEX-RN licensing exam, which
will go into effect in Spring 2023, poses challenges
within nursing education. The Next Generation
NCLEX (NGN) incorporates a Clinical Judgment
Measurement Model aimed at assessing clinical
judgment in providing safe and effective care
(NCSBN, 2022). Five new item types are included
in the NGN: extended multiple response, extended
drag and drop, cloze (drop-down), enhanced
hotspot (highlighting), and matrix/grid. In addition,
a new scoring model for items will be used in the
new NGN exam model.
In an effort to mitigate these challenges, the
Murray State University nursing program decided to
take a proactive approach and develop a dedicated
nursing retention program that was implemented
during the Spring 2021 semester. Murray State
University offers a variety of free tutoring services
across campus in general studies courses, but major
specific tutoring was not available in the area of
nursing.
Review of Literature
Nursing student attrition is a global problem that
has been confounded by the COVID-19 pandemic
(Chan et al., 2021). Nursing students that do not
progress are subject to increased costs at both the
financial and emotional level. However, attrition
also contributes to the present nursing shortage, as
the student failure leaves an opening that is then
not filled, graduating fewer students than admitted
(Lewis, 2020). As the nursing shortage becomes
greater, nursing institutions are presented with the
challenge of implementing programs to increase
retention without decreasing NCLEX pass rates.
Nursing programs challenge students to quickly
expand their knowledge and skills. Programs move
at a rapid pace and students who find themselves
struggling to succeed require rapid intervention
from faculty (Stamps & Opton or Opten as its listed
below, 2020). Solutions to decrease attrition have
included retention counselors, tutoring and peer
mentoring (Bumby, 2020; Lewis, 2020; Miller et al.,
2019; Stamps & Opten, 2020).
In a review by Bumby (2020), mentoring and
tutoring programs were found to be effective
retention strategies in 16 studies. Hiring and
allocating faculty time to student retention initiatives
was effective in retaining students and increasing
student satisfaction for nursing programs. Miller et
al. (2019) studied the role of peer mentoring. Results
indicated that peer mentoring was helpful for both
mentees and mentors. Brown et al. (2021) explored
nursing student strengths and areas for remediation
across all years of nursing education compared to
other undergraduate students. Results indicated
that nursing students felt that remediation should
be centered in studying and/or test taking anxiety.
Encouraging learning centered approaches provided
opportunities for students to apply their strengths
within the learning environment (Brown et al., 2021).
Remediation interventions used by nursing
institutions have included service learning,
podcasts, review sessions, adaptive quizzing, extra
pharmacology and drug calculation sessions and
prelecture and post lecture faculty follow up. While
peer mentoring, allocation of faculty time and
encouragement and focus on learning centered
approaches can contribute to increased retention
rates, they each come at a cost to the nursing
institution. Therefore, further research is needed
to accurately assess the success of remediation
interventions and to determine if the outcomes are
worth the cost.
Project Design
Two nursing faculty at Murray State University
were designated as Success Coaches for the new
retention program. The retention program began
during the Spring 2021 semester and outcomes
were reviewed after the Fall 2021 semester. To
evaluate the effectiveness of the program, the
faculty submitted the program for review by the
Institutional Review Board, and were found to
not require oversight. Coordination with nursing
administration, as well as course faculty, was
imperative in the planning and implementation of
the new program. In addition, the Success Coach
team collaborated with the university printing and
design team to develop professional flyers and
logos for the program, and initiate a university
affiliated Facebook page to disseminate program
information.
Retention efforts included one-on-one tutoring
with nursing students and two workshops each
semester of 2021. In order for students to access
appointment times, Faculty Google ® calendars
were shared with students via the Canvas
course, allowing students to sign up for available
appointment slots. Topics of the workshops
included: Test Preparation, Study Skills, NCLEX test
preparation and a recorded workshop discussing
APA format. The NCLEX test preparation workshop
was conducted by two outside professional
consultants who were experts in NCLEX test
preparation, and other workshops were presented
by the Faculty Success Coaches. Following the
workshops anonymous evaluations were given
to the students in attendance. Outcomes were
reviewed at the conclusion of the Fall 2021
semester, allowing time for reflection and planning
for future semesters.
Project Outcomes
Success Coaching Appointments
During the Spring 2021 and Fall 2021 semesters,
28 students utilized the one-on-one tutoring
sessions with a Success Coach, which accounted for
13.8% of the 203 admitted BSN students in 2021.
The total Success Coaching appointments were
94, and involved appointments for exam review,
test preparation, time management, study skills
and planning, paper review and APA formatting
assistance, and stress management.
Workshops
The faculty coordinated and conducted four
workshops over the following topics: Spring 2021
Study Skills (35 students in attendance) and Exam
Prep (six in attendance); Fall 2021 NGN Examination
Prep (77 in attendance) and APA formatting
(recorded workshop that was distributed for
viewing by all BSN students).
Student Feedback
Student feedback was elicited at the completion
of each workshop to evaluate program effectiveness
and plan future workshops using a brief survey
developed by the Success Coaches. One suggestion
that was received from multiple participants was
a future workshop geared at preparing beginning
nursing students for clinical rotations. Feedback
on information provided, presenter enthusiasm,
presenter delivery of content, and location was
overwhelmingly positive.
Individual feedback from students that sought
out one-on-one tutoring with a Success Coach
included comments such as: “It helped me to
understand the best way to go about studying as
well as helping me understand information that
was confusing” and “It’s helped me find different
study methods!”
Conclusion
The Bridge to Success program was developed
in response to student requests, nursing
program needs to enhance retention efforts, and
nursing education and workforce needs. When
implementing a new program, nursing institutions
must consider associated costs. Administration
within the School of Nursing and Health Professions
worked with the two success coaches to ensure
time was allotted in their faculty teaching load to
develop and implement the program in 2021. Funds
for workshops and supplies were supplied from the
dean and the BSN program budget. In addition,
donations were received from the local Sigma
Theta Tau International chapter and the Kentucky
Association of Nursing Students school chapter to
supply food and drinks at workshops. All in all, the
program was implemented with minimal additional
costs and Success Coaches were given the support
needed to develop and initiate a successful
retention program over the course of a calendar
year.
The future direction of the program has utilized
the student feedback and will continue offering
Success Coaching each semester. Feedback will
continue to be elicited, and additional metrics
will be analyzed, such as student graduation and
retention rates, to evaluate long-term efficacy.
Workshops will continue to be offered to students
based on student feedback and program needs,
including a Clinical Success workshop. Initiation of
peer mentoring will be explored. Success of this
program can be replicated with minimal costs to
enhance retention efforts and improve student
success. The Success Coaches are willing to serve
as a resource for nursing programs and faculty who
wish to develop a retention program.
References
Beshear, A. (2021). Executive Order 2021-913. Retrieved
from https://kbn.ky.gov/General/Documents/emergencyorder-relating-to-nursing-shortage.pdf
Brown, J., McDonald, M., Besse, C., Manson, P., McDonald,
R., Rohatinsky, N., & Singh, M. (2021). Nursing students’
academic success factors: A quantitative cross-sectional
study. Nurse Educator, 46(2), E23–E27.doi:10.1097/
NNE.0000000000000882
Bumby, J. C. (2020). Evidence-based interventions
for retention of nursing students: A review of the
literature. Nurse Educator, 45(6), 312–315. doi:10.1097/
NNE.0000000000000797
Chan, G.K., Bitton, J.R., Allgeyer, R.L., Elliott, D., Hudson,
L.R., & Moulton Burwell, P. (2021). The impact of
COVID-19 on the nursing workforce: A national
overview. OJIN: The Online Journal of Issues in Nursing,
26(26). doi:10.3912/OJIN.Vol26No02Man02
Lewis, L. S. (2020). Nursing students who fail and repeat
courses: A scoping review. Nurse Educator, 45(1), 30–34.
https://doi:10.1097/NNE.0000000000000667.
Miller, H., Bosselait, L., Venturato, L., Irion, K., Schmidt, N.,
DiGeronimo, J., & Pritchard, T. (2019). Benefits of peer
mentoring in prelicensure nursing education: A dual
perspective. Nurse Educator, 44(3), 159–163.doi:10.1097/
NNE.0000000000000573
National Council of State Boards of Nursing (NCSBN).
(2022). Next generation NCLEX project. Retrieved from
https://www.ncsbn.org/next-generation-nclex.htm
Stamps, A., & Opton, L. (2020). The retention counselor
in nursing: A unique success strategy. Nurse Educator,
45(2), 87.doi:10.1097/NNE.0000000000000740