Remediation and course repetition: the domino effect on academics and economics

The international nursing shortage has increased recruitment of students, who may be under or unprepared, into higher education institutions (college or university).

The global economic downturn and the movement toward standardizing nursing education and practice regulations has encouraged higher education to recruit and retain aspiring nursing students. However, deficiencies in mathematics and English have been linked to disappointing results with economic consequences.

The objective of this study was to describe the incidence and monetary costs associated with remediation, course repetitions, delay to graduation, and first time passage on the American licensing exam National Council Licensure Examination for Registered Nurses.

A convenience sample of 103 sophomore nursing students from a college in the northeast United States was followed to graduation. The sample was predominately female, single, age 18-25 years, and White.

Mathematics and English remediation courses taken were 123. There were 148 course repetitions with 104 in the biological sciences and 44 in nursing. Direct relationships were found between the number of overall remedial courses and course repeats (r = .40, p =  <.001, CI = 95%) with a strong negative correlation with the number of course repetitions (r = -.60, p =  <.001, CI = 95%) and on-time graduation. Sixty-two students (60%) of the original cohort graduated and took the registered nurse licensing examination with 56 passing. In this American study, the direct and indirect cost of remediation, course repetition and lost income opportunity was greater than $1.6 million.

Interdisciplinary collaboration, including nursing faculty, is critical in the recruitment and retention of nursing students. Without structured pre-admission evaluation the short and long term financial and academic effects of under or unprepared students is disquieting.