Grades in Prerequisite Courses as Predictors of Success in a Nursing Program
Authors:   ,   Andrews University, Foster Elaine 
Published: April 2023

Problem: The U.S. Bureau of Labor Statistics forecast that by 2016 more than one million new and replacement nurses will be needed to fill jobs in the health care field . In order to meet the medical needs of a changing society, schools of nursing must continue to educate and graduate significant numbers of nurses. This may be done by increasing the success rates of those who are admitted in nursing programs. Success rate is thought to be related to admission criteria used to admit students which, in turn, may reduce attrition rate, which is between 20 to 40% in nursing programs. The purpose of this study was to examine if success was related to grades in prerequisite courses among a group of nursing students at Southwestern Michigan College. The prerequisite courses analyzed were Chemistry, Anatomy and Physiology, Algebra, Psychology, and Speech. Success was defined as having graduated from the associate degree nursing program at the college. Method: This study was a quantitative study utilizing secondary data analysis of the five prerequisite courses that were taken prior to admission into the nursing program at Southwestern Michigan College. A comparative mode of inquiry was used to investigate whether there was a difference in prerequisite grades between those who graduated and those who did not graduate from the nursing program. The influence of gender on success was also examined. Results: Mean grade point averages ranged from a low of 2.38 (SD=0.99) in Mathematics for non-graduates to a high of 3.21 (SD=0.84) in Speech for graduates. At α =0.01, t-tests for independent samples indicated that significant differences in grade point averages were found between graduates and non-graduates in Biology, Chemistry, and Psychology. A two-way analysis of variance indicated that no significant interaction effects were found between gender and success in all five prerequisite courses. A direct discriminant analysis showed that a linear combination of the five prerequisite courses significantly differentiated graduates from non-graduates (λ=0.95, χ2=16.81, p=0.005). Most highly correlated with the discriminant function was Biology (0.959), followed by Mathematics (0.475), Chemistry (0.472) and Psychology (0.445). Conclusion: Overall, grades in prerequisite courses can be utilized to a degree to help establish evidence-based criteria for admission into the nursing program. The following recommendations are made based on the results of this research study. 1. Students seeking admission into the nursing program should demonstrate a minimum grade of a “B” (3.0) in the Biology course since that course appeared to be the strongest predictor for student success and graduation from the nursing program. 2. Students seeking admission into the nursing program should have a minimum cumulative GPA of a 2.8 and a prerequisite cumulative GPA average of 2.8 on the five prerequisite courses. 3. The nursing program should consider utilizing a weighted admission procedure or process, which would place a greater emphasis on the grades in Biology, Chemistry, and Math. This would allow for the courses that have a greater impact on success to have a greater influence when prerequisite courses are considered for admission criteria. 4. The information from this study may be used to identify potential high-risk students so that appropriate support mechanisms can be developed to increase their odds of successfully completing the nursing program. 5. Further studies on the influence of repeating prerequisite courses on success should be conducted. In this study, only about 50% of those who repeated one or more prerequisite course graduated from the nursing program. 6. This study examined the influence of five prerequisite courses on success in a nursing program. The influence of non-cognitive factors on success in nursing programs should be investigated in future studies.