Student Persistence in Baccalaureate Nursing Programs

The Institute of Medicine identified the nursing workforce shortage as a critical issue for the United States healthcare system. To address this issue, educators are challenged to increase the number and diversity of baccalaureate-prepared (BSN) nurses. BSN programs report attrition rates up to 50%, with higher rates reported in underrepresented minority (URM) students. The purpose of this study was to examine factors that helped students to persist and succeed in a BSN program. Aims included 1) Determine associations among background characteristics, academic factors, and success outcomes, 2) determine if the association between academic factors and success outcomes is moderated by background characteristics, and 3) explore the perceptions of underrepresented minority (URM) students regarding key elements that influenced their persistence in a baccalaureate nursing program. The study conceptual model was developed from Tinto’s theory of student departure and Bean and Metzner’s non-traditional undergraduate student attrition model by combining aspects of background characteristics, academic factors, and success outcomes. The study was conducted with students recruited from three nursing colleges in two phases. Phase 1: survey questions from the Modified College Persistence Questionnaire (CPQ) and Connor-Davidson Resilience Scale (CD-RISC) were administered via Qualtrics to measure variables such as absenteeism, advising, resilience, and satisfaction. Multiple regression analysis was used to analyze quantitative data. Phase 2: interviews were conducted to explore perceptions of URM students and analyzed using directed content analysis Results: The sample included 110 students (7.3% Black/African American; 11.8% Hispanic; 24.5% first generation college students). The associations among background characteristics (race, ethnicity, and first-generation student status), academic factors (cognitive, behavioral, and non-cognitive), and success outcomes (grade point average and satisfaction) were analyzed. Self-efficacy was a significant predictor of GPA. First-generation student status significantly moderated the effect of absenteeism and sense of belonging on GPA while URM status significantly moderated the effect of advising and sense of belonging on satisfaction with the nursing program. Qualitative data supported quantitative findings. The results of this study provides the foundation for the development of strategies to enhance the persistence and success of nursing students, improve the retention rates of BSN students, and impact nursing workforce diversity.