Educational Program and Risk Assessment In Nursing What is Risk Assessment?
Risk assessment in nursing education is the process of identifying and evaluating factors that may hinder students’ ability to access, progress through, graduate from nursing programs, and pass crucial licensure and certification exams, such as the NCLEX-RN. This assessment is essential for recognizing students at risk of failure due to personal, academic, financial, or social challenges, and for developing interventions that support their success.
Factors contributing to students being “at risk” include:
- English as a second language (ESL)
- Being a first-generation college student
- Retaking prerequisite science courses to meet minimum grade requirements
- Not completing necessary prerequisite coursework within five years
- Scoring below average on pre-entrance exams
- Low overall and science GPAs (below 3.0)
- Working part-time (20+ hours) or full-time (40+ hours)
- Family responsibilities, especially without support systems.
Risk assessment helps educators implement early interventions, identify students who need support, and track progress throughout their educational journey.
Students at Risk to Pass NCLEX-RN
Passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN) is a key outcome for pre-licensure nursing programs. Many research studies over the past two decades have focused on identifying risk factors that may hinder students’ ability to pass the NCLEX-RN. One such tool is Breckenridge’s Risk Assessment Profile, Strategies for Success (RAPSS), a 13-item instrument used to assess at-risk students during admission and progression in nursing programs. It is designed to predict graduation rates and NCLEX-RN success, helping faculty implement strategies to improve students’ potential for academic achievement.
The Students at Risk, Strategies for Success (SRSS) and Nursing Workforce Diversity (NWD) programs use RAPSS to support underserved, underrepresented, and diverse students. These programs aim to close the gaps caused by poverty and educational disparities, helping students earn their Bachelor of Science in Nursing (BSN) and pass the NCLEX-RN on the first attempt. Financial support, such as stipends or scholarships, is often provided to students in these programs, improving retention and graduation rates.
Moreover, initiatives like the Success in Learning Individualized Pathways Program (SLIPP), developed by Condon et al. (2013), offer individualized support to students at high risk of attrition. By identifying high-risk students early on, programs like SLIPP are able to provide targeted interventions to promote student success in nursing education.
Risk Factors for Students’ Success
Several studies have identified specific risk factors that can negatively impact nursing students’ success. Over the past two decades, targeted interventions have been developed to address these challenges. Some of the major barriers include:
- English as a Second Language (ESL) Students:
- ESL students often face challenges with self-confidence, reading, writing, and learning. Language barriers, including difficulty with English grammar and tense, can significantly impact academic performance, leading to isolation and prejudice (Billings & Halstead, 2012; Scheele et al., 2010).
- Hispanic Students:
- Hispanic students frequently struggle with a lack of financial, emotional, and academic support, as well as non-culturally appropriate curricula and language barriers (Bond et al., 2008; Moceri, 2010). Programs like Mount Carmel’s Learning Trail help Hispanic students succeed by offering mentoring, tutoring, and counseling services.
- Academic Performance and Anxiety:
- The risk of failing the NCLEX-RN increases for students who earn multiple C grades or lower in nursing courses. Additionally, test anxiety and low predicted NCLEX-RN scores further heighten the risk of failure (Hopkins, 2008).
- Predictors of Academic Failure:
- Factors such as low SAT/ACT scores, cumulative GPA, math and reading scores, as well as non-academic factors like age, race, and gender, contribute to the risk of failure. To mitigate this, nursing programs have implemented stringent admission criteria, such as limiting admission to students with no more than one failed science course (McGahee, Gramling, & Reid, 2010).
Effective interventions involve identifying students at risk early and connecting them with support services such as tutoring, mentoring, and academic counseling. Additionally, faculty can provide culturally sensitive teaching and mentorship to foster student success.
Organizations and Programs for Financial Support of Nursing Students
Several organizations and programs offer financial support to help nursing students overcome financial barriers and increase retention and graduation rates. Notable examples include:
- Outreach and Pipeline Programs:
- Schools and healthcare organizations are developing outreach and pipeline programs targeting high school students, aimed at strengthening recruitment and retention efforts in nursing. These programs encourage financial support and emphasize building a robust infrastructure for student retention (Benner et al., 2010).
- Health Resources and Services Administration (HRSA):
- HRSA’s Nursing Workforce Diversity (NWD) Program supports underserved and diverse students by offering financial aid through stipends or scholarships. These funds provide crucial assistance to students who might otherwise struggle to finance their education.
- Environmental and Demographic Influences:
- Financial status, living arrangements, family responsibilities, transportation, and access to scholarships or financial aid have a significant impact on student retention and success (Jeffreys, 2012). In many cases, environmental factors have been found to be more influential in predicting student retention than traditional academic predictors.
Breckenridge’s RAPSS tool provides a prospective approach by assessing both academic and demographic factors during the admission process, identifying students who require early intervention and remediation. Financial and social support provided through outreach programs and scholarships plays a key role in promoting success for nursing students at risk.
Conclusion
Risk assessment in nursing education is an essential tool for identifying students who are at risk of failure, particularly in passing the NCLEX-RN and progressing through nursing programs. By identifying both personal and academic risk factors early on, nursing educators can implement strategies such as targeted remediation, individualized support, and financial assistance to help students succeed. Programs like RAPSS and SLIPP provide invaluable support to diverse and underserved student populations, ultimately increasing the number of successful nursing graduates entering the workforce.