Critical thinking dispositions and skills of senior nursing students in associate, baccalaureate, and RN-to-BSN programs

This study investigated the critical thinking dispositions and skills of senior nursing students. Study participants were students enrolled in associate (n = 137), baccalaureate (n = 102), and RN-to-BSN (n = 66) programs accredited by the Korean Ministry of Education. The California Critical Thinking Disposition Inventory (CCTDI) and California Critical Thinking Skills Test (CCTST) were used. A comparison of the CCTDI scores revealed a statistically significant difference between the students enrolled in different programs (F = 4.159, p = 0.017), as did a comparison of the CCTST scores (F = 24.205, p < 0.0001). Within the total sample (n = 305), the relationship between CCTDI and CCTST scores was significant (r = 0.305, p = 0.000). Developments in medical technology, the growing number of older adults and patients with chronic illnesses, and the demand for high-quality nursing care have led to various, increasingly complex, professional, legal, and educational issues within the nursing workplace. Therefore, nurses need creativity and critical thinking skills to make the decisions required of them in their nursing practice. In line with this, when conducting a survey of the effectiveness of nursing education, the necessity of critical thinking skills cannot be overlooked. In fact, the National League for Nursing Accrediting Commission (NLNAC) (1999) and American Association of Colleges of Nursing (AACN) (1998) require the concept of critical thinking be included as one of the core elements of curricula and that it be measured as an outcome when evaluating nursing education. In 1998, during the evaluation of colleges of nursing conducted by the South Korean Council for University Education, several universities presented the fostering of critical thinking as one of the terminal learning goals of nursing education based on the idea that critical thinking is important not only in the nursing workplace, but also in nursing education. To evaluate the effectiveness of Korea's current nursing education curriculum, focus was placed on current students in South Korea's three systems of nursing education. Each curriculum's effectiveness can be evaluated by indexing critical thinking dispositions and skills. This article intends to offer insight into the first steps necessary in reorganizing nursing education by comparing these evaluations of each of the three systems. To this end, we conducted a comparative study of the critical thinking dispositions and skills of students in 3-year associate degree (ADN), 4-year baccalaureate (BSN), and 5-year RN-to-BSN programs. The RN-to-BSN program requires students to finish a separate 2-year program after the initial 3-year ADN program.     

The relationship between selected educational outcomes of senior RN-to-BSN students and their choice of advanced placement options available in the Maryland nursing articulation model

If national standards for entry into practice are to be changed, viable routes to achievement of the BSN must be established in each state. Maryland has implemented a statewide articulation model that allows the registered nurse to obtain credit for work completed at lower division schools through one of three advanced placement options. This study sought to answer the question of whether there is a difference in selected academic outcomes of senior RN-to-BSN students who choose different pathways available in the model. Data were collected from all students (n = 113) completing clinical concepts courses at a large university school of nursing. The independent variables were mode of entry and pattern of study. The dependent variables were scores obtained on the National League for Nursing (NLN) Comprehensive Nursing Achievement Test for Baccalaureate Nursing Students and the grades obtained in the spring and fall nine-credit clinical concepts courses (examinations, formal papers, clinical evaluations). The entry pathway did not make a significant difference in terms of scores on the spring NLN examination, course tests, or paper grades. However, differences were noted in the clinical area. Transition course students achieved the highest mean clinical performance score, and direct transfer students achieved the lowest score. The implication for nursing education is that there appears to be no significant difference in academic achievement of RN-to-BSN students admitted for advanced placement using three different validating procedures.     

Meeting the challenge of mobility in nursing education: one program's response

Plans for the future include exploring linkages with baccalaureate programs, developing online offerings for courses at the ADN level, and tracking retention according to admission requirements. The department head has presented a proposal to the local BSN programs that will allow selected students in the ADN program to take one of their nursing courses at the RN-BSN level prior to graduation. A lead instructor at the ADN level is participating in a Title III grant to design online course offerings. A faculty member has been assigned the responsibility to track retention and develop a retention plan for the division. So far, we have recognized the following advantages of the new curriculum. 1) The liberal articulation for CNA and LPN means that these individuals can become registered nurses in less time. 2) Students have the opportunity to become credentialed at an earlier level and enter the workforce prior to becoming a registered nurse. 3) Implementation of the new curriculum has been a way to capitalize on college resources in order to maximize enrollment. In the past, some slots in the low enrollment NA and PN programs were not filled. As a result of the implementation of the new curriculum, we admitted a total of 65 (37%) more students in 2001 than we did in 2000 because we were able to fill available spaces in these low enrollment programs with ADN students. In a time of tight fiscal resources and increasing demands for healthcare providers, this multiple entry, multiple exit program provides an effective strategy for meeting the challenges confronting nursing education in the 21st century.     

A formalized mentoring program for LPN-to-RN students

Nursing programs across the United States are faced with the challenge to admit greater numbers of students and improve retention and progression rates of enrolled students. Associate degree nursing (ADN) programs produce the largest percentage of registered nurse (RN) graduates in comparison with other basic RN programs (National League for Nursing, 2006). Many states and academic institutions have begun to realize that the large pool of licensed practical nurses (LPNs) is a viable source of quality ADN students. LPN students in LPN-to-RN completion programs can often complete degrees and be eligible to take state board RN examinations in half the time of a traditional ADN student. Faculty at Ohio University-Chillicothe (OU-C) examined strategies to enhance the LPN-to-RN transition program on the campus and to promote retention and progression of this unique population of nursing students in the ADN program. The faculty researchers developed the Nursing Success program after a review of the literature and with support from an internal grant from the OU-C Faculty Summer Research Fund. This article describes this formalized, faculty-driven student mentoring program designed for LPN-to-RN students at OU-C and the outcomes of the initial implementation.     

Effects of an intervention plan on nursing student success

Student attrition from nursing programs due to academic failure negatively affects students, nursing programs, and the health care industry. The purpose of this retrospective study was to determine the success of an intervention plan for practical nursing (PN) and associate degree nursing (ADN) students who were at risk for failure in coursework compared with outcomes from years without the plan. Records of 384 students were accessed. A 6% decrease in involuntary withdrawal due to academic failure with the intervention plans was noted. Sixty-four percent of the PN students and 86% of the ADN students with a plan completed the program. Ninety-six percent of the PN students and 84% of ADN students in intervention plans were successful on the NCLEX(?) on the first attempt. A statistically significant difference (p < 0.001) between traditional and nontraditional students in program completion existed prior to the intervention, which was eliminated with implementation of the intervention plans.     

RN-to-BSN education: Creating a Context that Uncovers New Possibilities

After 6 years of steady decline in enrollments, RN-to-BSN programs experienced an increase in enrollments from 2002 to 2003. Based on findings from a hermeneutic phenomenological study that examined the connection between faculty and students in RN-to-BSN programs, the theme, "Creating a Context that Uncovers New Possibilities," offered insight into how nurse educators can transform the teaching-learning environment to meet the needs of this valuable group of nursing students. This article describes this interpretive study and suggests strategies nurse educators can use to enhance the educational context and create new possibilities that meet RN-to-BSN students' expectations.     

Who’s uncivil to who? Perceptions of incivility in pre-licensure nursing programs

The purpose of this study was to determine if there were differences in the perceptions of uncivil behaviors among nursing students and faculty according to pre-licensure nursing program types, and if there were any relationships in reported uncivil behaviors to the variables of age, gender, ethnic/racial background, and parental level of education. The sample was a convenience sample of 159 pre-licensure senior nursing students and 14 nursing faculty from four schools of nursing in the northeastern United States: two Bachelor of Science in Nursing (BSN) programs, one Associate Degree in Nursing (ADN) program, and one hospital-based diploma nursing program. The nursing students and nursing faculty were administered a mixed method, validated survey instrument, the Incivility in Nursing Education (INE) Survey (Clark et al., 2009). The results of the survey identified similarities and differences between the BSN, ADN, and diploma nursing programs for both the perceptions and experiences of uncivil behaviors, however no significant differences were found between the demographic variables and the occurrence of uncivil behaviors.     

The relationship of academic variables as predictors of success on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) in a selected associate degree program.

Identifying valid variables to predict success of nursing students on the NCLEX-RN has captivated the interest of nursing educators for decades. The determination of such variables would enable nursing programs to devise pertinent admission criteria, identify and intervene with students at risk of failing, and provide needed advisement and academic supports to increase the likelihood of passing the NCLEX-RN. This study examined six academic and non-academic variables. Study variables included: pre-admission GPA, failing a clinical nursing course, two NLN test scores, age, and race. These variables have been explored in numerous past studies to predict success on the NCLEX-RN. However, the majority of studies have examined these variables in baccalaureate of science nursing (BSN) student populations. Few studies on associate degree nursing (ADN) student populations were found. The purpose of this study was to examine six academic and non-academic variables, explored in previous studies that mostly looked at BSN students, to determine if these same variables could predict success or failure on the NCLEX-RN for students of an ADN program. Data were obtained from a convenience sample of thirty-eight, May 1997 nursing student graduates from a public urban university's ADN program. Findings from the study indicated that four of the variables had significant relationships with NCLEX-RN success.     

Avoiding socialization pitfalls in accelerated second-degree nursing education: the returning-to-school syndrome model

Second-degree students are highly motivated and tend to excel academically. However, nurse educators in accelerated programs face challenges in socializing these students to the nursing role. One pitfall is the hostility that may develop if students perceive a mismatch between their expectations and their new role as baccalaureate nursing (BSN) students in a fast-paced and intense program. This article discusses the applicability of the returning-to-school syndrome model in helping second-degree nursing students maneuver successfully through an accelerated BSN program. This 3-stage model has been previously applied in RN-to-BSN education. Using the model in an accelerated BSN curriculum to identify transition points and offer student support through specific stages can better prepare students to meet the challenges of accelerated education, as well as help nurse educators become more adept at providing resources and implementing supportive strategies at the appropriate time.     

Encouraging associate degree nursing students to pursue a bachelor of science in nursing: The faculty role

Faculty in associate degree nursing (ADN) programs have unique opportunities to encourage and guide students to continue their nursing education. At a time when the nursing profession needs advanced clinical leaders and educators, the bachelor of science in nursing (BSN) provides ADN graduates a stepping stone to advanced education and career opportunities. Faculty approaches to encourage ongoing student education, organized from the theory of adult learning by M. S. Knowles (1970), are provided. These include engaging students in the process, showing how the BSN can be relevant to students' lives, and assisting students in finding a BSN program that fits their lifestyle.     

Increasing RN-BSN enrollments: facilitating articulation through curriculum reform

Increasing enrollments in nursing programs is one method to deal with the shortage of nurses. However, the majority of these new graduates will be educated at the associate degree in nursing (ADN) level. The need to increase the number of nurses educated at the baccalaureate (BSN) level is significant. Research has shown that patient outcomes can be attributed to higher levels of nursing education. A viable way to increase the volume of BSN graduates is to promote statewide and mandated articulation agreements and create an environment where academic progression is facilitated. The initial step in the process of implementing articulation agreements is to bring together nursing educators at the BSN and ADN level to assess prerequisites, transfer credits, and evaluate overall curriculum. This article reviews the current trends in registered nurse-BSN curriculum at 13 public 4-year universities in California and discusses the potential opportunities to reform curriculum and facilitate articulation.     

The cognitive style of nursing students: educational implications for teaching and learning

As cognitive and kinesthetic demands on nursing students increase, so does the need for optimal learning environments. Witkin's empirically supported measure of field dependent/independent cognitive style assesses the manner in which students perceive and process information and classifies them along a continuum of field dependence to field independence. Witkin's Groups Embedded Figures Test (GEFT) was administered to 876 students enrolled in 10 health care programs. Statistically significant differences in the GEFT mean scores of students enrolled in the different programs were discovered. The effect size was moderate. Undergraduate nursing students scored higher on the GEFT than did graduate or RN-to-BSN nursing students. However, nursing students were classified as more field dependent than students in other health-related disciplines. Due to their cognitive processing requirements, field-dependent nursing students may be at risk for academic failure. Therefore, instructional strategies tailored to students' needs should be incorporated into the nursing curriculum.     

Diffusion of associate degree nursing programs among U.S. community colleges

Examinations of the adoption and diffusion processes relative to innovations have focused on a variety of factors including the characteristics of the environment, the adoptive unit, and the innovation itself. This study explored the relationship between environmental factors, organizational characteristics, and the spread of 2-year associate degree nursing (ADN) programs among community colleges in the U.S. Data were secured from census materials, educational directories, community college catalogs, various other documents, and interviews with community college representatives. Results indicated that such factors as general population heterogeneity, change and wealth, and various measures of the need for nurses and nursing education were not useful predictors of the prevalence of ADN programs among the population of community colleges in a state. Two-year colleges that operated ADN programs were larger, wealthier, offered more occupational programs, and were more likely to be publicly controlled than were community colleges that had not adopted the ADN program feature. Analysis of case materials suggested that at the community level, hospitals and hospital-sponsored nursing schools were important factors in the community college's decision to adopt or reject the ADN program feature.     

Recruitment and retention of associate degree nursing faculty

Associate degree nursing (ADN) programs are influenced by many of the same factors affecting the recruitment and retention of nursing faculty in baccalaureate and graduate degree nursing programs. This article examines these factors along with strategies that have the potential to affect recruitment and retention. Factors affecting recruitment include the unique nature of the ADN educator role and salary. Factors affecting retention are salary, workload, and work hours. Beginning recruitment with students, while they are still enrolled in the program, and mentoring part-time clinical faculty are possible ways to recruit full-time faculty. Numerous initiatives designed to supplement the recruitment and retention efforts of individual nursing programs, developed by the National League for Nursing, are identified. Solutions to this shortage must be identified so there are adequate numbers of full-time faculty to achieve the goal of high-quality graduates who are committed to patient safety.     

A comparison of the learning styles among different nursing programs in Taiwan: implications for nursing education

The purpose of this study was to explore the learning style of students in a two-year and a five-year associate degree nursing program, and a two-year baccalaureate degree of nursing program in Taiwan. The Chinese version of the Myers-Briggs Type Indicator (MBTI) form M is an instrument that measures individual preferences in four dichotomous dimensions of Jungian theory: extraversion/introversion; sensing/intuition; thinking/feeling; and judging/perceiving. The study sample included 425 nursing students: 94 students in a two-year associate degree of nursing (ADN) program, 235 students in a five-year ADN program, and 96 students in a two-year bachelor of science in nursing (BSN) program. Analyses of the data revealed that the most common learning styles were introversion, sensing, thinking, and judging (ISTJ) and introversion, sensing, feeling, and judging (ISFJ) among Taiwanese nursing students. The findings of the study indicated that the SJs comprised 41.3% of the participating nursing students. The SJ is a popular preference in nursing. A large sample is recommended for further research. This study can guide nursing educators in the design of classroom and clinical instructional strategies to respond to individual needs in order to enhance student success.     

Social integration of the advanced placement LPN: a peer mentoring program

The shortage of registered nurses (RN) had made licensed practical nurse (LPN) to RN educational programs common. These programs give credit for previous learning and advance place the LPN in the nursing curriculum. Faculty have developed courses to ensure that the LPN is academically prepared to enter the nursing program. However, is the LPN socially prepared to enter into a cohesive group of traditional students? The authors discuss a peer mentoring program designed to ease the social integration of the LPNs, resulting in their perception that they are an equal and valued member of the class.