Differences in the performances of baccalaureate, associate degree, and diploma nurses: a meta-analysis

The findings of 139 studies of nurses educated in one of three basic nursing education programs (associate degree, diploma, and baccalaureate degree) were synthesized using meta-analysis. The results indicated significant differences between professional (BSN) and technical (AD and diploma) nurses on measures of nurse performance. Measures resulting in larger effects for professional nurses included communication skills, knowledge, problem-solving, and professional role. No differences resulted from studies of nurses from the two technical programs, AD and diploma. Further analyses indicated that the effects could not be solely attributed to substantive and methodological features of the studies. However, the hospital setting where a study was conducted and years of nursing experience decreased the size of the effect. The results of the meta-analysis have implications for policy development about educational preparation and for service expectations of professional and technical nurses.