Associate Degree Nursing Program Research Articles

Analysis of social mission at associate degree nursing programs in the United States

Background“Social mission” is the contribution of a health profession's school in advancing health equity and addressing the health disparities of the society in which it exists. AimThis study aimed to understand the state of social mission in associate degree nursing (ADN) programs, and how performance varies across program types. MethodsAbout 533 programs that were members of the Organization for Associate Degree Nursing were invited to fill out an ADN-specific version of the previously developed Social Mission Metrics survey. Survey responses were analyzed using analysis of variance (ANOVA) and t-tests. ResultsForty-four programs completed the self-assessment. The majority reported having curricular content on the topics of social determinants of health, LGBTQ health, advocacy, and public health (72%-95%). Most programs had no holistic admission policy (63%) and did not require anti-bias training for admission committees (54%). Pathway programs were more common among public (76%) than private schools (33%). ConclusionsGreater focus should be placed on topics including admission policies, leadership diversity, and community involvement to enhance the social mission of ADN programs.

State of the science: A bibliometric study of associate degree nursing research and scholarship (1961-2023)

BackgroundSince their inception, associate degree nursing (ADN) programs have significantly contributed to the nursing workforce and higher education. Teaching and learning in nursing, established in 2006, has been a vital platform for disseminating ADN research. AimThis study aimed to evaluate the state of ADN science through bibliometrics to reveal the conceptual, intellectual, and social structures that influence ADN programs and policy. MethodsThis bibliometric study examined a corpus of data from 1961 to 2023. Data was sourced from Scopus, resulting in n = 453 entries. ResultsThe study revealed an annual growth rate of 4.09% in ADN-related articles and highlighted the critical contributions from top sources and authors. Foundational themes include self-efficacy, student retention, and simulation, with notable gaps in other research areas. The study revealed an increase in publications since 2006. ConclusionsThis research revealed the evolution of ADN-related publications and the need for continuous adaptation. Gaps in diversity, equity, inclusion, and evaluation practices pave the way for future-focused ADN research. The findings detailed a comprehensive overview of ADN scholarship to shape future academic inquiry.

Computer adaptive quizzing versus NCLEX review textbook in preparation for the exit HESI examination

BackgroundNursing students must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination to become licensed registered nurses. There is an identified nursing shortage, and nursing programs are faced with finding solutions to help students pass the NCLEX-RN examination and enter the workforce. Many nursing schools administer a predictor examination, such as Health Education Systems Incorporated (HESI). A gap exists in identifying solutions for NCLEX's success. AimThe purpose of this study was to evaluate differences in the exit HESI examination scores of senior-level associate degree nursing (ADN) students who used CAQ to prepare with ADN students who used NCLEX review textbooks to prepare for the exit HESI examination. MethodsThe study used a quantitative nonexperimental descriptive comparative design with archival data. Two groups of students took the exit HESI examination during their capstone course. The sample included students previously enrolled in an ADN program. Archival data were collected and analyzed using a one-way ANCOVA with a pairwise comparison post hoc analysis. ResultsThe CAQ group had higher exit HESI examination scores compared to the NCLEX review textbook preparation group. ConclusionsCAQ as a curricular adjunct can contribute to student success on standardized examinations.

Incorporation of social determinants of health: Refining Associate Degree Nursing Programs

BackgroundThere is a lack of evidence to support how social determinants of health (SDOH) are incorporated into associate degree nursing (ADN) programs. AimThe purpose of this study was to explore the integration of SDOH content into courses and the curricula of ADN programs, strategies for teaching SDOH, and factors that have influenced educators’ decisions about this education. MethodsAn interpretive description approach was employed to elicit an understanding of the influencing factors of ADN educators incorporating SDOH into their teaching-learning experiences and how this is being accomplished. Participant interviews were conducted through video-conferencing technology. ResultsThe analysis of the interviews revealed an overarching theme of Forging Ahead with Refining ADN education. Two sub-themes related to influences of SDOH incorporation: (1) living the experience of SDOH and (2) navigating the program's culture. Two sub-themes related to strategies used to incorporate SDOH: (1) creating awareness of SDOH (2) fusing SDOH with content. ConclusionThis study highlighted how ADN educators are intentionally incorporating SDOH through various strategies as experiences have emphasized the importance. There are obstacles within their program that are barriers to full program integration.

Grit as a Predictor of Academic Success Among Associate Degree Nursing Students.

The purpose of this study was to explore whether grit is a predictor of success in associate degree nursing (ADN) programs. A question that challenges admission decision-making in nursing programs is "Who will succeed?" This question is particularly relevant in ADN programs, which often have higher attrition rates than baccalaureate programs. This longitudinal, mixed-methods study was conducted with 451 ADN students across nine programs, including interviews with seven unsuccessful students and nine successful students. Short Grit Scale scores were not found to be statistically significant as a predictor of academic success; however, themes that emerged from the interviews do align with the theory of grit. Further research is needed to explore whether recognizing the level of grit in students during admission processes would help identify students who are likely to succeed.

An innovative approach to NAS: Eat, Sleep, Console

Maternal substance abuse during pregnancy has dramatically increased in prevalence in the United States. Consequently, neonatal abstinence syndrome (NAS) is now a leading cause of developmental and medical problems in newborns (Thigpen and Melton, 2014). Eat, Sleep, Console (ESC) is an innovative approach to the treatment of NAS, which hospitals are implementing to improve outcomes for women and infants with perinatal opioid exposure (Whalen et al., 2018). This educational innovation project incorporates current, evidence-based practice (EBP) guidelines into the associate degree nursing (ADN) program curriculum at a community college to better prepare nurses to provide safe, therapeutic nursing care to infants and their families.

Seamless Academic Progression in Nursing Education: A Qualitative Descriptive Study.

The aim of this study was to investigate programs throughout the United States for seamless academic progression from associate degree nursing (ADN) to baccalaureate degree nursing programs (BSN). Seamless academic progression has been shown to have a positive effect on increasing the proportion of BSN nurses. Goals to increase the number of BSN-prepared nurses have not been met. A qualitative descriptive study was conducted to assess how nurse administrators of ADN programs move toward seamless academic progression for students. Three themes that described the current state of seamless progression emerged from the data: a) ongoing communication between program leaders, students, and stakeholders; b) development of pathways that enable seamless academic progression; and c) stakeholder influence on academic progression. Administrators who participated in this study shared that their progression programs were in the early developmental stages.

Nursing academic incivility awareness among ADN nursing students

As the cultural dynamics within our world are rapidly changing, the need to maintain a sense of civility is essential. Academic incivility is occurring at an alarming rate in higher education and is undermining nursing education and practice. The purpose of this research project was to identify if nursing students perceived awareness of uncivil behaviors was altered after attending an educational session on incivility. A quantitative, quasi-experimental, pre post study was conducted with nursing students in the third semester of an Associate Degree Nursing program. Although the paired t-test did not find statistical significance, awareness of the problem became evident. Nineteen student nurses from a small community college in the Midwest participated in this study. Continued research is warranted to identify approaches to increase awareness of incivility and in minimizing these behaviors for the future of our nursing profession.

Perceptions and Motivations of Associate Degree Nursing Students Engaged in Peer Mentoring and Tutoring through Supplemental Instruction

High attrition rates in associate degree nursing (ADN) programs contribute significantly to a nursing shortage in the United States that is expected to worsen. Nursing students find the learning environment stressful, intimidating, and overwhelming, leading to discouragement in the first year of their nursing education. Research is needed to identify specific retention strategies that can offer ADN students additional support and promote academic success. This study aimed to explore first-semester ADN nursing students’ experiences with peer mentoring and peer tutoring provided through supplemental instruction (SI). A basic qualitative study was conducted, and participants’ descriptions of their experiences participating in SI were documented using semi-structured interviews. The findings indicated that students feel SI is a positive experience, but improvement is needed. Exposure to different perspectives through peer mentoring and tutoring improved students’ understanding of course material. Stronger peer relationships created consistency for students. Peer mentoring boosted self-confidence among first-semester students, and attendance at SI sessions increased persistence. The findings support the use of peer mentoring to offer academic assistance to first-semester ADN students.

Enhancing Exam Performance to Increase Retention Among Students in an Associate Degree Nursing Program.

High rates of attrition are problematic for nursing programs in meeting program graduation expectations and the nursing workforce demand. In an effort to address declining program completion rates over the past 3 years and to assist with student retention, the authors explored the benefits of using The Exam Analysis (TEA) procedure with first-semester nursing students in an associate of science in nursing program. This descriptive pilot study used TEA Worksheet and surveys to collect data with 50 first-semester students. Retention, exam performance, and student experiences were explored. Use of TEA procedure benefitted students, with results revealing a retention rate of 90% (n = 45) of first-semester students and a positive rate of change between the exam average score and the final exam score. Findings support improved retention for first-semester associate degree nursing students, better exam performance, and positive experiences with using TEA procedure.

Implementation of Simulation as an Educational Tool for Remediation in an Associate Degree Nursing Program

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Factors Affecting NCLEX-RN Success in an Associate Degree Nursing Program

An acute nursing shortage currently exists in the United States. It is important for nursing programs to prepare nursing students who are able to pass the NCLEX-RN. The purpose of this study was to determine whether a link exists between nursing student performance in program requirements and ultimate success or failure on the NCLEX-RN. A random sample of the nursing students at one community college who graduated in the calendar years of 2017 and 2018 were the population for this study. This comparative study examined data in existence to determine if there were academic factors relating to failure on NCLEX-RN. Chi-square was used to determine a relationship and phi-coefficient was used to determine the strength of that relationship between dependent and independent variables. A weak to moderate association was found between failure on NCLEX-RN and the independent variables: low score on the science portion of the TEAS test, need to repeat the first medical-surgical nursing course, and less than 850 on HESI exit. Future research should focus on the connection between mathematics scores and success in the nursing program and NCLEX-RN. Keywords: Nursing education, NCLEX-RN pass rates, nursing education readiness, healthcare education, student success. DOI: 10.7176/JEP/12-30-01 Publication date: October 31 st 2021

The Impact of the I-SAVE Program on First Semester Student Self-Efficacy in an Associate Degree Nursing Program

Nursing education is evolving; improvements and advancements are necessary in response to the nursing shortage. The Associate Degree Nursing Program is fast-paced, rigorous, and attracts a diverse student body due to the completion time of approximately four semesters. The nontraditional student, one that has multiple responsibilities, is attracted to the shorter program. A student may feel that simply getting accepted into the nursing program is the real challenge while missing the foresight of the arduous program requirements, both didactic and practicum. Nursing program retention rates are a global problem and implementing specific strategies to decrease attrition is essential. Developing interventions to promote self-efficacy for the diverse Associate Degree student body provides support that may benefit the student, if attrition is decreased the institution benefits, as well as the nursing profession. Student self-efficacy is a critical component of program success and techniques to strengthen a student’s self-efficacy may impact the success rate.

Impact of Informal Emotional Intelligence Training on Emotional Intelligence Levels of Nursing Students in an Associate Degree Nursing Program at a Community College

High levels of emotional intelligence (EI) have been shown to significantly benefit nursing students, however, there is conflicting evidence on whether EI can be developed without formal training. The purpose of this project was to assess the impact of informal EI training on associate degree nursing students. The Self-Report Emotional Intelligence Test (SSEIT) was used to assess the EI levels in a convenience sample of 98 first and final-semester associate degree nursing students enrolled in a large, public community college in Ohio. There were 42 first semester students and 56 post semester students that participated in the study. The only statistically significant difference in the groups’ demographics was the work status (p=.005) and campus (p=.041). There was no significant difference in the SSEIT scores of first-semester students (Md = 131, n = 42) and final-semester students (Md = 129, n = 56) (U = 1,103, z = -0.52, p = 0.602, r = -0.12). The results indicate that informal training had no impact on the EI scores of associate degree nursing students. Large, multi-institution research studies utilizing a randomized sample are warranted to confirm these findings.

Attrition to completion progression theory in an associate degree nursing program

Objective: This study aimed to develop a substantive theory on the process of overcoming attrition among returning students in an Associate Degree Nursing program in a private school in Arizona.Methods: A qualitative design was utilized for this study. The Classical Grounded Theory approach provided a systematic process of data collection, analysis and synthesis that led to the emergence of the Attrition to Completion Progression Theory. Theoretical sampling through in-depth interviews of ten participants who experienced temporary attrition and was successfully able to come back to succeed within the program provided a rich source of data and unique perspective of the phenomenon.Results: Four themes emerged from the grounded theory approach. The themes that emerged are: Attrition as an interplay of multiple factors; Ways of coping with attrition; Changes and modifications; and Finding new meanings as the core category. The emergent theory provided an insight into the process that the participants went through and the perceived contributory factors leading to the attrition.Conclusions: Understanding the interplay of these factors paved for a better understanding on how current and future students, faculty, and administrators can prevent attrition and assist returning students to become successful in the program towards completion.

The Impact of a Student Success Workshop on Perceived Academic Self-Efficacy in First-year Associate Degree Nursing Students: A Pilot Study

Nurse educators are required to create supportive learning environments that promote student success and wellbeing. Assessing and addressing academic self-efficacy is an important aspect of the supportive learning environment. The literature context relative to the value of addressing academic self-efficacy in the facilitation of nursing student success was explored. A Doctor of Nursing Practice (DNP) project was designed and implemented to study the impact of a student success workshop on perceptions of academic self-efficacy among first year prelicensure nursing students. The quasi-experimental pre-test/post-test study design utilized a convenience sample of first-year nursing students in an Associate Degree Nursing program. The College Academic Self Efficacy Scale (CASES) was administered before and after the implementation of a student success workshop. Study data was analyzed to determine if the study intervention impacted perceived academic self-efficacy among the research participants. Although total mean CASES scores did not show a statistically significant increase between the pretest and posttest assessments of academic self-efficacy, the study offers a foundation to support continued efforts by nurse educators to design, implement, and study student success interventions within prelicensure nursing curriculums.

Strengthening Geriatric Content in an Associate Degree Nursing Program: A Pilot Study

The purpose of this pilot study was to strengthen geriatric content in an associate degree nursing 1st semester freshman fundamentals course and evaluate changes in the scores related to students’ knowledge and attitudes toward older adults. A quasi-experimental within-subject pretest–posttest design was utilized. The Facts on Aging Quiz and Multifactorial Attitude Survey were used to assess knowledge and attitudes of 22 nursing students at the beginning and end of the semester. Although there was no significant statistical increase in knowledge, there was an overall increase in knowledge. Three of the 20 statements showed a statistically significant increase in attitude. The results of this study may be helpful for education and practice in providing appropriate education to associate degree nursing students in the care of older adults.

Fundamentals of Nursing Practice and the Culturally Diverse ESL Nursing Students: The Students’ Perspectives for Teaching and Learning in Nursing

English as-a-Second Language (ESL) nursing students who enroll in the Fundamentals of Nursing Practice course have been known to experience multiple challenges in nursing programs around the country. The central challenge ESL students experience is acclimating to the American education system, a system which differs from the education system in their countries of origin. This results in a high attrition rate, particularly in the Fundamentals of Nursing Practice course which is the entry-level course. This study explored the experiences and challenges of a group of culturally diverse ESL nursing students in an Associate Degree Nursing (ADN) program in the Northeastern United States, who passed the course. The purpose of the study was to uncover what helped the participants succeed. The goal was to utilize the participants’ recommendations to improve the teaching and learning needs of ESL nursing students’, and to reduce high attrition rates. A descriptive phenomenological approach utilizing bracketing was used to explore the challenges the participants experienced. The common challenges encountered by the participants were: language barriers, a lack of faculty support and mentorship, difficulty with teaching and learning styles, and a lack of critical thinking and application skills. Also, difficulty with concepts and applications in clinical practice, and racism and discrimination in the learning environment were contributors to their learning challenges. Findings showed that the language barrier was particularly detrimental when it came to the participants’ reading, comprehension, and communication. Further findings encompassed the knowledge deficit about critical thinking, concepts, and application of concepts in clinical practice. Additional findings revealed that the participants struggled to balance school, work, and the challenges of being an immigrant, all of which effected their learning.

Primary Sources and Intensity of Stressors in an Associate Degree Nursing Program Student Population

The common experience of student stress while completing a nursing education program has been universally acknowledged and documented throughout the literature. However, studies explicitly targeted on stressors for associate degree nursing students (ADN) are limited in the literature. The purpose of this project focused on understanding the primary sources and intensity of stressors in an ADN program student population, using descriptive research methods. Nursing students at a large, urban, public community college in Texas were invited to participate in an anonymous online survey which included demographic questions and Costa and Polak’s Instrument for the Assessment of Stress in Nursing Students. The participant sample had a majority percentage of students who identified as a racial or ethnic minority and a significant percentage of participants with low socioeconomic status. The study results confirmed the presence of stress during all four semesters of nursing school, with reported high and extreme levels of stress caused from both internal and external sources, as related to the students’ program of study. As ADN students have not often been studied with relation to nursing school stress, the findings of the project add important new data to the literature which can be used to build upon the base of knowledge in future research.

Determining the Rate of Educational Advancement of Associate Degree Nursing Graduates: A Replicable Method to Establish the ADN as a Pathway to the Baccalaureate in Nursing

This article reports on the initial analysis of a database constructed to track the educational advancement of graduates’ of a public associate degree nursing (ADN) consortium in the northeast United States. This study offers a valid, reliable, and replicable method for ADN programs to determine the frequency and rate of the educational advancement of graduates to demonstrate a critical program outcome measure and to show that these programs are contributing to the educational progression of the nation’s nursing workforce. In addition, this research represents a contribution to the body of evidence for a new paradigm of nursing education that demonstrates the ADN as a clear pathway to the BSN, essential to reach 80% BSN by 2020. The alignment of demographic and academic variables with educational advancement is a recommendation for further study.