Abstract

BackgroundThere is conflicting and limited information regarding factors that influence undergraduate nursing students' academic and clinical performance prior to entry to practice.ObjectiveTo identify factors influencing the academic and clinical performance of undergraduate nursing students throughout the course.DesignMixed methods study utilizing a retrospective cohort and a qualitative study.SettingMonash University, Melbourne, Australia.ParticipantsLongitudinal existing data of nursing undergraduate students who commenced in 2017 (n = 176) and 2018 (n = 76), and two focus groups with final year nursing students were analyzed.MethodsRetrospective students' records were used to determine the students' academic and clinical performance using the weighted average mark (WAM) of the theoretical and clinical components of the curriculum, separately. The WAM considered the year level of each unit and was scored out of 100. Multivariate linear regression was used to determine predictor factors of academic and clinical performance. Variables include entry cohort (with no previous nursing qualification vs. diploma of nursing), admission category (domestic vs. international), campus (metropolitan vs. outer metropolitan), and secondary school (year 12) results. Two focus group discussions were conducted and thematically analyzed.ResultsMore than two-thirds of the students were aged 18–20 years and mainly female. Almost 20% of the participants were international students. Students with higher secondary school (year 12) results and studying at the outer metropolitan campus achieved a higher academic performance while international students had significantly lower academic performance compared to domestic students. Students with a previous diploma of enrolled nursing and international students had lower clinical performance. Students identified that a comprehensive orientation, interactive curriculum, formal and informal support structure, and educator qualities influenced their academic and/or clinical performance.ConclusionsA supportive educational environment with an interactive curriculum may enhance students' academic and clinical performance and readiness for practice. Furthermore, targeted interventions for international students, those with lower secondary school (year 12) results, and those with a former diploma of nursing may be required to increase academic and clinical performance.

Highlights

  • With the recently celebrated International Year of the Nurse, it is timely to consider the education of tomorrow’s nursing workforce in increasingly difficult and complex environments

  • An increasing number of students enrolling in Bachelor of Nursing (BN) courses are older than 21 years of age [2] and come from diverse academic, ethnic, and cultural backgrounds [3]

  • Findings from that study concluded that international students, and those with a lower grade point average (GPA), were more likely to demonstrate lower clinical performance [6]

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Summary

Introduction

With the recently celebrated International Year of the Nurse, it is timely to consider the education of tomorrow’s nursing workforce in increasingly difficult and complex environments. Only one Australian study has examined factors such as grade point average (GPA) (the number signifying the median value of the accrued final course grades) and domestic or international status [6]. Findings from that study concluded that international students, and those with a lower GPA, were more likely to demonstrate lower clinical performance [6]. Understanding why this occurs is problematic as no qualitative studies have been done to date that explores students’ perspectives on the diverse factors that affect academic and clinical performance, including support mechanisms and structures. There is conflicting and limited information regarding factors that influence undergraduate nursing students’ academic and clinical performance prior to entry to practice

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