Title : Increasing nursing student success with early individual remediation
Abstract:
Background: Nurse educators should implement remediation strategies to reduce student nurse attrition, improve graduation rates, and ultimately decrease the nursing shortage. This pilot study aimed to increase the retention rate of at-risk nursing students in an undergraduate ‘Pharmacology for Nursing’ course by implementing remediation strategies immediately after the first failed exam.
Methods: Five specific remediation interventions were implemented after the first failed exam. These five methods include: review of incorrect questions, rephrasing of exam questions, review of audio-lectures, review of exam preparation and methods for reading the assigned textbook. Unit exam scores and course failure rates pre and post implementation of individualized remediation were measured.
Results: Students who completed the remediation demonstrated a statistically significant increase in their scores from the first failed exam to the last exam taken. M = increase of 17.3 percentiles; p < .0001; 95% CI = (13.8, 20.9). Cohen’s d = 0.604, indicated a medium to large educationally significant increase in the Pharmacology course pass rates.
Conclusions/Discussion: The results from this individualized remediation pilot program were similar to the data that both Hadenfeldt (2011) and Wiles (2015) reported. Hadenfeldt (2011) and Wiles (2015) described improvement in student scores and nursing program completion after initiating individualized examination review and/or comprehensive improvement plans.
Based on the comments, the student’s perceptions were very positive about the early individualized remediation process. Students felt they learned valuable study skills and that faculty interaction was key. These findings are consistent with research by Wiles (2015) and Poorman, Webb, and Mastorovich (2002) where positive benefits were noted by students when implementing individualized feedback and faculty-initiated interactions.
Strengths of this pilot study included demonstration of statistical significance (p < 0.0001) by increasing the Pharmacology unit exam percentile scores from the first failed exam to the final unit exam by a mean of 17.3 percentiles upon completion of the remediation process. In addition, educational significance was achieved (Cohen’s d = 0.604) by increasing the Pharmacology course pass rates for the cohort of students who participated in the pilot early remediation intervention (100%) as compared to the previous cohorts (88.08%). Limitations of the pilot study included a short project time interval of eight weeks, use of convenience sampling and a small non-random sample size.
In summary, employing an early individualized remediation process for at-risk nursing students demonstrated significant success in retention of nursing students in a Pharmacology course. However, factors to consider for future course implementation and study replication include the amount of time required for this level of individual remediation and the level of faculty commitment, both of which are significant. For this individual remediation to be successfully implemented and supported by faculty it will require administrative support for course and workload adjustments when calculating faculty work hours. Financial benefit to the college needs to be calculated. Students who are retained continue to pay tuition. Revenue gained from retaining students needs to be compared against the increased cost of faculty time/workload to support this type of intensive remediation program.
