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Sharing the Responsibility for Nursing Student Retention
Teaching and Learning in Nursing 15 (2020) 121e122
Contents lists available at ScienceDirect
Teaching and Learning in Nursing j o u r n a l h o m e p a g e : w w w. j o u r n a l s. e l s ev i e r. c o m / teaching-and-learning-in-nursing
Sharing the Responsibility for Nursing Student Retention Michele C. Everett, PhD Retention Specialist, Health Careers and Public Service Programs, Triton College, 2000 Fifth Ave., River Grove, Illinois 60172
a r t i c l e
i n f o
Article history: Received 6 November 2019 Received in revised form 27 December 2019 Accepted 30 December 2019 Keywords: Student retention Nursing faculty Strategies for student success First semester nursing students
a b s t r a c t Student retention continues to be a major concern for nursing programs. Although many colleges have devoted additional resources to increase student retention rates, thus far, these measures have not resulted in a significant improvement. This article provides suggestions for the role faculty can play in helping students make it through a critical make-or-break time for nursing studentsdthe first semester of nursing school. © 2020 Organization for Associate Degree Nursing. Published by Elsevier Inc. All rights reserved.
As a result of declining enrollment and reduced state and federal funding, public colleges and universities are committing additional resources to improve student retention. Despite these efforts, retention rates have not significantly improved (NSC, 2019). Understanding how to retain students is essential for the financial sustainability of these institutions; it is also a societal imperative. For example, in health career programs, the retention rate for nursing students is a source of great concern. The average completion rate for students who enroll in nursing programs is 50%. It can be lower than that for minority students (Harris, Rosenberg & O’Rourke, 2013). High nursing student attrition, occurring at the same time the demand for healthcare is increasing, has contributed to a global nursing shortage (Jeffreys, 2015). Numerous personal and academic factors contribute to a student’s decision to leave a nursing program. Today’s nursing students represent a diverse student population. Minority, English as a Second Language (ESL), and nontraditional students make up a large percentage of students. These students can often be at risk of dropping out due to additional challenges, including language barriers, and work and family responsibilities (Onovo, 2019; Priode, 2019). Many students make their decision to leave the program during the first semester; the first six weeks have been identified as the most critical time period (Jefferys, 2012; Pence, 2011). If this is the case, a logical place and time to focus retention efforts is in the classroom at the start of the first semester. The classroom is especially important at nonresidential colleges where it serves as the primary site for student interactions and engagement (Tinto, 2012). At many colleges, however, the responsibility for student retention is limited to a relatively small number of designated staff. Retention interventions typically focus on providing students with support that takes place outside the classroom, for example, orientation, peer tutoring,
and academic planning (Fontaine, 2014). Faculty, for the most part, are omitted from retention plans and initiatives. It is time to try something newda shared responsibilitydwhere nursing faculty not only share the responsibility but play an instrumental role in helping students complete their degree programs. Research provides evidence that what goes on in the classroom directly affects student success and retention. Instructor-student interaction and teaching methods have been identified as important determinants of students’ levels of engagement and persistence (Braxton, Jones, Hirschy, & Hartley, 2008; Tinto, 2012). This is also true for nursing programs. Numerous studies find that students who feel supported by faculty are more likely to be academically successful and complete their nursing degree (Colalillo, 2007; McEnroePetitte, 2011; Porter, 2008; Shapiro, 2014). This raises the question, if evidence shows that faculty play a significant role in student success and persistence, why are more faculty not incorporating strategies for retention in their classrooms? Although there are several possible reasons for this, in some cases it may simply be that faculty are unaware of retention strategies they can employ to help their students stay in the program. The following list, derived from a review of the nursing education literature and my experience working with nursing students, provides suggestions for how faculty can support students during the first semester of classes.
Strategies for Social-Emotional Support Strategies for social-emotional support focus on building positive faculty-student and student-student relationships. They promote well-being and learning and provide a sense of community and belonging.
https://doi.org/10.1016/j.teln.2019.12.009 1557-3087/© 2020 Organization for Associate Degree Nursing. Published by Elsevier Inc. All rights reserved.
122
M.C. Everett / Teaching and Learning in Nursing 15 (2020) 121e122
Create a safe and supportive learning environment that promotes inclusion and an appreciation of diversity. Provide opportunities for students to share experiences from their lives and from their perspectives (Day & Beard, 2019). Establish positive relationships with your students. Be welcoming, accessible, and approachable. Get to know your students. Encourage them to stop by your office. Show them that you care about them as individuals (McEnroe-Petitte, 2011). Adopt a holistic approach to student development. Understand and address the nonacademic factors that may influence student learning (Jeffreys, 2015). Build in opportunities for students to discuss motivation, self-confidence, and how to balance school, family, and work demandsda skill that is critically important for nontraditional students (Priode, 2019). Help students set goals. Promote wellness. Make sure, early in the semester, that students know about campus support services. Stress the importance of seeking help at the first sign of an issue that may affect their well-being and performance. Work collaboratively with retention and other support staff to address individual student needs. Encourage peer interaction. Engage in community-building activities (Fontaine, 2014). Provide opportunities for students to form friendships with their classmates. Strategies for Academic Support Strategies for academic support focus on preparing students for success, peer teaching and mentoring, effective teaching, and assessment. Provide an extended orientation at the beginning of the semester that prepares students for success and the challenges ahead (Fontaine, 2014). Design the first semester curriculum to allow enough class time to cover the required course content. Make the content covered in class relevant to your students’ lives. Discuss how the information presented will help them have a successful nursing career (Crookes, Crookes, & Walsh, 2013). Use effective pedagogy. Employ teaching methods that best help you achieve your intended learning outcomes. Use studentcentered strategies that encourage active engagement (Bradshaw & Lowenstein, 2011). Encourage students to form peer study groups and/or find a study partner. Provide peer tutors and peer mentorsdstudents who have successfully completed the class who can provide academic support (Robinson & Niemer, 2010). Prepare students for quizzes and tests before the first quiz and exam. Provide the information and resources they need to do well on the exam, for example, study guides that identify the key material covered on the test, information about the format of the test, practice questions, and test-taking strategies. Do your part to reduce your students’ test anxiety! Make sure your test questions are well written and clear (Onovo, 2019). Understand that some of your students may have specific learning needs, especially ESL students (Onovo, 2019). Make immediate referrals to appropriate student support services. Provide an extensive test review after every test, but especially after the first test. Engage students in a reflective test review (Tinnon, 2018). Assess individual student progress. Early identification and intervention are key!
Engage in a continuous process of reflective assessment of your teaching and student learning outcomes.
Conclusion Understanding how to increase nursing student retention is a persistent challenge. Current retention policies and practice have not effectively addressed the problem. It is time for a different approachda shared responsibility, where all members of the college community do their part to help students complete their degrees. Knowing that many students make their decision to leave the program during the first six weeks of nursing school suggests that retention efforts should focus on what goes on in the classroom at the beginning of the first semester. Consequently, faculty should be encouraged to provide learning experiences that promote student success by incorporating retention strategies into their first semester classes. By sharing the responsibility for student retention, faculty can make an important contribution to the college, society, and most importantly, they can make a positive difference in the lives of their students and in the many lives their students will touch during their successful and rewarding nursing careers. References Bradshaw M., Lowenstein A., eds (2011). Innovative teaching strategies in nursing and related health professions. Sudbury, MA: Jones and Bartlett Publishers. Braxton, J. M., Jones, W. A., Hirschy, A. S., Hartley, H. V. (2008). The role of active learning in college student persistence. New Directions for Teaching and Learning, 115, 71e83. https://doi.org/10.1002/tl.326. Colalillo, G. (2007). Mentoring as a retention strategy in a diverse, multicultural, urban associate degree nursing program. Teaching and Learning in Nursing, 2(2), 28e33. https://doi.org/10.1016/j.teln.2007.01.005. Crookes, K., Crookes, P., Walsh, K. (2013). Meaningful and engaging teaching techniques for student nurses: A literature review. Nurse Education in Practice, 13, 239e243. https://doi.org/10.1016/j.nepr.2013.04.008. Day, L., Beard, K. V. (2019). Meaningful inclusion of diverse voices: The case for culturally responsive teaching in nursing education. Journal of Professional Nursing, 31, 277e281. https://doi.org/10.1016/j.profnurs.2019.01.002. Fontaine, K. (2014). Effects of a retention intervention program for associate degree nursing students. Nursing Education Perspectives, 35(2), 94e99. https://doi.org/ 10.5480/12-815.1. Harris, R. C., Rosenberg, L. F., O'Rourke, M. E. (2013). Addressing the challenges of nursing student attrition. The Journal of Nursing Education, 53(1), 31e37. https:// doi.org/10.3928/01484834-20131218-03. Jeffreys, M. (2012). Nursing student retention: Understanding the process and making a difference. New York: Springer Publishing Company. Jeffreys, M. (2015). Nursing Universal Retention and Success model: Overview and action ideas for optimizing outcomes AeZ. Nurse Education Today, 35(3), 425e431. https://doi.org/10.1016/j.nedt.2014.11.004. McEnroe-Petitte, D. (2011). Impact of faculty caring on student retention and success. Teaching and Learning in Nursing, 6(2), 80e83. https://doi.org/10.1016/ j.teln.2010.12.005. NSC Research Center. (Jul 10, 2019). Persistence & Retention e 2019. Retrieved from https://nscresearchcenter.org/snapshotreport35-first-year-persistence-and-retention/. Onovo, G. N. (2019). Fundamentals of nursing practice and the culturally diverse ESL nursing students: The students’ perspectives for teaching and learning in nursing. Teaching and Learning in Nursing, 14, 238e245. https://doi.org/10.1016/ j.teln.2019.03.003. Pence, P. (2011). Predictors of retention among undergraduate students attending associate-degree nursing programs in Illinois. Teaching and Learning in Nursing, 6(3), 131e138. https://doi.org/10.1016/j.teln.2011.01.004. Porter, K. (2008). Current trends in student retention: A literature review. Teaching and Learning in Nursing, 3(1), 3e5. https://doi.org/10.1016/j.teln.2007.09.001. Priode, K. (2019). Juggling school with life: How successful non-traditional nursing students stay in school. Teaching and Learning in Nursing, 14, 117e121. https://doi.org/ 10.1016/j.teln.2018.12.010. Robinson, E., Niemer, L. (2010). A peer mentor tutor program for academic success in nursing. Nursing Education Research, 31(5), 286e289. Shapiro, A. (2014). Test anxiety among nursing students: A systematic review. Teaching and Learning in Nursing, 9(4), 193e202. https://doi.org/10.1016/ j.teln.2014.06.001. Tinnon, E. (2018). Reflective test review: The first step in student retention. Teaching and Learning in Nursing, 13(1), 31e34. https://doi.org/10.1016/ j.teln.2017.09.001. Tinto, V. (2012). Completing college: Rethinking institutional action. Chicago, IL: The University of Chicago Press.
Contents lists available at ScienceDirect
Teaching and Learning in Nursing j o u r n a l h o m e p a g e : w w w. j o u r n a l s. e l s ev i e r. c o m / teaching-and-learning-in-nursing
Sharing the Responsibility for Nursing Student Retention Michele C. Everett, PhD Retention Specialist, Health Careers and Public Service Programs, Triton College, 2000 Fifth Ave., River Grove, Illinois 60172
a r t i c l e
i n f o
Article history: Received 6 November 2019 Received in revised form 27 December 2019 Accepted 30 December 2019 Keywords: Student retention Nursing faculty Strategies for student success First semester nursing students
a b s t r a c t Student retention continues to be a major concern for nursing programs. Although many colleges have devoted additional resources to increase student retention rates, thus far, these measures have not resulted in a significant improvement. This article provides suggestions for the role faculty can play in helping students make it through a critical make-or-break time for nursing studentsdthe first semester of nursing school. © 2020 Organization for Associate Degree Nursing. Published by Elsevier Inc. All rights reserved.
As a result of declining enrollment and reduced state and federal funding, public colleges and universities are committing additional resources to improve student retention. Despite these efforts, retention rates have not significantly improved (NSC, 2019). Understanding how to retain students is essential for the financial sustainability of these institutions; it is also a societal imperative. For example, in health career programs, the retention rate for nursing students is a source of great concern. The average completion rate for students who enroll in nursing programs is 50%. It can be lower than that for minority students (Harris, Rosenberg & O’Rourke, 2013). High nursing student attrition, occurring at the same time the demand for healthcare is increasing, has contributed to a global nursing shortage (Jeffreys, 2015). Numerous personal and academic factors contribute to a student’s decision to leave a nursing program. Today’s nursing students represent a diverse student population. Minority, English as a Second Language (ESL), and nontraditional students make up a large percentage of students. These students can often be at risk of dropping out due to additional challenges, including language barriers, and work and family responsibilities (Onovo, 2019; Priode, 2019). Many students make their decision to leave the program during the first semester; the first six weeks have been identified as the most critical time period (Jefferys, 2012; Pence, 2011). If this is the case, a logical place and time to focus retention efforts is in the classroom at the start of the first semester. The classroom is especially important at nonresidential colleges where it serves as the primary site for student interactions and engagement (Tinto, 2012). At many colleges, however, the responsibility for student retention is limited to a relatively small number of designated staff. Retention interventions typically focus on providing students with support that takes place outside the classroom, for example, orientation, peer tutoring,
and academic planning (Fontaine, 2014). Faculty, for the most part, are omitted from retention plans and initiatives. It is time to try something newda shared responsibilitydwhere nursing faculty not only share the responsibility but play an instrumental role in helping students complete their degree programs. Research provides evidence that what goes on in the classroom directly affects student success and retention. Instructor-student interaction and teaching methods have been identified as important determinants of students’ levels of engagement and persistence (Braxton, Jones, Hirschy, & Hartley, 2008; Tinto, 2012). This is also true for nursing programs. Numerous studies find that students who feel supported by faculty are more likely to be academically successful and complete their nursing degree (Colalillo, 2007; McEnroePetitte, 2011; Porter, 2008; Shapiro, 2014). This raises the question, if evidence shows that faculty play a significant role in student success and persistence, why are more faculty not incorporating strategies for retention in their classrooms? Although there are several possible reasons for this, in some cases it may simply be that faculty are unaware of retention strategies they can employ to help their students stay in the program. The following list, derived from a review of the nursing education literature and my experience working with nursing students, provides suggestions for how faculty can support students during the first semester of classes.
Strategies for Social-Emotional Support Strategies for social-emotional support focus on building positive faculty-student and student-student relationships. They promote well-being and learning and provide a sense of community and belonging.
https://doi.org/10.1016/j.teln.2019.12.009 1557-3087/© 2020 Organization for Associate Degree Nursing. Published by Elsevier Inc. All rights reserved.
122
M.C. Everett / Teaching and Learning in Nursing 15 (2020) 121e122
Create a safe and supportive learning environment that promotes inclusion and an appreciation of diversity. Provide opportunities for students to share experiences from their lives and from their perspectives (Day & Beard, 2019). Establish positive relationships with your students. Be welcoming, accessible, and approachable. Get to know your students. Encourage them to stop by your office. Show them that you care about them as individuals (McEnroe-Petitte, 2011). Adopt a holistic approach to student development. Understand and address the nonacademic factors that may influence student learning (Jeffreys, 2015). Build in opportunities for students to discuss motivation, self-confidence, and how to balance school, family, and work demandsda skill that is critically important for nontraditional students (Priode, 2019). Help students set goals. Promote wellness. Make sure, early in the semester, that students know about campus support services. Stress the importance of seeking help at the first sign of an issue that may affect their well-being and performance. Work collaboratively with retention and other support staff to address individual student needs. Encourage peer interaction. Engage in community-building activities (Fontaine, 2014). Provide opportunities for students to form friendships with their classmates. Strategies for Academic Support Strategies for academic support focus on preparing students for success, peer teaching and mentoring, effective teaching, and assessment. Provide an extended orientation at the beginning of the semester that prepares students for success and the challenges ahead (Fontaine, 2014). Design the first semester curriculum to allow enough class time to cover the required course content. Make the content covered in class relevant to your students’ lives. Discuss how the information presented will help them have a successful nursing career (Crookes, Crookes, & Walsh, 2013). Use effective pedagogy. Employ teaching methods that best help you achieve your intended learning outcomes. Use studentcentered strategies that encourage active engagement (Bradshaw & Lowenstein, 2011). Encourage students to form peer study groups and/or find a study partner. Provide peer tutors and peer mentorsdstudents who have successfully completed the class who can provide academic support (Robinson & Niemer, 2010). Prepare students for quizzes and tests before the first quiz and exam. Provide the information and resources they need to do well on the exam, for example, study guides that identify the key material covered on the test, information about the format of the test, practice questions, and test-taking strategies. Do your part to reduce your students’ test anxiety! Make sure your test questions are well written and clear (Onovo, 2019). Understand that some of your students may have specific learning needs, especially ESL students (Onovo, 2019). Make immediate referrals to appropriate student support services. Provide an extensive test review after every test, but especially after the first test. Engage students in a reflective test review (Tinnon, 2018). Assess individual student progress. Early identification and intervention are key!
Engage in a continuous process of reflective assessment of your teaching and student learning outcomes.
Conclusion Understanding how to increase nursing student retention is a persistent challenge. Current retention policies and practice have not effectively addressed the problem. It is time for a different approachda shared responsibility, where all members of the college community do their part to help students complete their degrees. Knowing that many students make their decision to leave the program during the first six weeks of nursing school suggests that retention efforts should focus on what goes on in the classroom at the beginning of the first semester. Consequently, faculty should be encouraged to provide learning experiences that promote student success by incorporating retention strategies into their first semester classes. By sharing the responsibility for student retention, faculty can make an important contribution to the college, society, and most importantly, they can make a positive difference in the lives of their students and in the many lives their students will touch during their successful and rewarding nursing careers. References Bradshaw M., Lowenstein A., eds (2011). Innovative teaching strategies in nursing and related health professions. Sudbury, MA: Jones and Bartlett Publishers. Braxton, J. M., Jones, W. A., Hirschy, A. S., Hartley, H. V. (2008). The role of active learning in college student persistence. New Directions for Teaching and Learning, 115, 71e83. https://doi.org/10.1002/tl.326. Colalillo, G. (2007). Mentoring as a retention strategy in a diverse, multicultural, urban associate degree nursing program. Teaching and Learning in Nursing, 2(2), 28e33. https://doi.org/10.1016/j.teln.2007.01.005. Crookes, K., Crookes, P., Walsh, K. (2013). Meaningful and engaging teaching techniques for student nurses: A literature review. Nurse Education in Practice, 13, 239e243. https://doi.org/10.1016/j.nepr.2013.04.008. Day, L., Beard, K. V. (2019). Meaningful inclusion of diverse voices: The case for culturally responsive teaching in nursing education. Journal of Professional Nursing, 31, 277e281. https://doi.org/10.1016/j.profnurs.2019.01.002. Fontaine, K. (2014). Effects of a retention intervention program for associate degree nursing students. Nursing Education Perspectives, 35(2), 94e99. https://doi.org/ 10.5480/12-815.1. Harris, R. C., Rosenberg, L. F., O'Rourke, M. E. (2013). Addressing the challenges of nursing student attrition. The Journal of Nursing Education, 53(1), 31e37. https:// doi.org/10.3928/01484834-20131218-03. Jeffreys, M. (2012). Nursing student retention: Understanding the process and making a difference. New York: Springer Publishing Company. Jeffreys, M. (2015). Nursing Universal Retention and Success model: Overview and action ideas for optimizing outcomes AeZ. Nurse Education Today, 35(3), 425e431. https://doi.org/10.1016/j.nedt.2014.11.004. McEnroe-Petitte, D. (2011). Impact of faculty caring on student retention and success. Teaching and Learning in Nursing, 6(2), 80e83. https://doi.org/10.1016/ j.teln.2010.12.005. NSC Research Center. (Jul 10, 2019). Persistence & Retention e 2019. Retrieved from https://nscresearchcenter.org/snapshotreport35-first-year-persistence-and-retention/. Onovo, G. N. (2019). Fundamentals of nursing practice and the culturally diverse ESL nursing students: The students’ perspectives for teaching and learning in nursing. Teaching and Learning in Nursing, 14, 238e245. https://doi.org/10.1016/ j.teln.2019.03.003. Pence, P. (2011). Predictors of retention among undergraduate students attending associate-degree nursing programs in Illinois. Teaching and Learning in Nursing, 6(3), 131e138. https://doi.org/10.1016/j.teln.2011.01.004. Porter, K. (2008). Current trends in student retention: A literature review. Teaching and Learning in Nursing, 3(1), 3e5. https://doi.org/10.1016/j.teln.2007.09.001. Priode, K. (2019). Juggling school with life: How successful non-traditional nursing students stay in school. Teaching and Learning in Nursing, 14, 117e121. https://doi.org/ 10.1016/j.teln.2018.12.010. Robinson, E., Niemer, L. (2010). A peer mentor tutor program for academic success in nursing. Nursing Education Research, 31(5), 286e289. Shapiro, A. (2014). Test anxiety among nursing students: A systematic review. Teaching and Learning in Nursing, 9(4), 193e202. https://doi.org/10.1016/ j.teln.2014.06.001. Tinnon, E. (2018). Reflective test review: The first step in student retention. Teaching and Learning in Nursing, 13(1), 31e34. https://doi.org/10.1016/ j.teln.2017.09.001. Tinto, V. (2012). Completing college: Rethinking institutional action. Chicago, IL: The University of Chicago Press.