Impetus and Creation of an Accelerated Second-Degree Baccalaureate Nursing Program Readmission Policy

Characteristics of ASDBN Students

ASDBN student profiles indicate the uniqueness and diversity of this student population. The ASDBN student typically presents with unique academic and personal needs requiring robust student support systems to be successful (Rouse & Rooda, 2010). Nursing faculty and program administrators must understand the compelling needs of the ASDBN student in order to assist, support, and engage them for successful nursing program completion and passing the licensing examination. There is also a need for nursing faculty and program administrators to have a structured and rigorous readmission policy in place when ASDBN students apply for readmission.

ASDBN programs reportedly attract older nursing students who tend to be more mature and academically accomplished, and who have enrichment through life skills as a result of previous work and life experiences (Bennett et al., 2003; Feldman & Jordet, 1989; Wu & Connelly, 1992). ASDBN students have a previously earned degree from another academic program. When ASDBN students do come with a previously earned degree, the previously earned degree is typically from another academic program not in the health-care sector. Biology and psychology are the most common majors entering ASDBN programs (Bennett et al., 2003; Seldomridge & DiBartolo, 2005; Wu & Connelly, 1992). Faculty teaching ASDBN students find it to be a positive experience and at some level not all that different in teaching traditional-age bachelor of science in nursing (BSN) prelicensure students (Millett, Stickler, & Wang, 2015; Rico, Beal, & Davies, 2010).

One other significant characteristic that sets ASDBN students apart from other non-ASBDN students is that these students have typically worked and have life skills, effective communication skills, and critical thinking or decision-making skills as a result of their life experiences (Rouse & Rooda, 2010). ASDBN students tend to see the ASDBN program as very high stakes when they return to school for their nursing degree, and many of them have maximized their student loan capacities. For ASDBN students returning to school, failure is not an option. When an ASDBN student fails, there will be numerous challenges for nursing faculty and nursing program leadership challenges unless there is a comprehensive readmission policy to determine which ASDBN students should be readmitted.

Attrition and Graduation Characteristics of ASDBN Student Populations

Cangelosi and Whitt (2005) report that second-degree nursing students have higher decision-making scores when compared with their counterparts who do not have a previous baccalaureate degree. The ASDBN student is a prime target population for nursing programs to recruit and educate. For example, the ASDBN student with higher decision-making capacity tends to be better critical thinkers in patient care encounters. One of the major attributes contributing to the higher decision-making capacity of the ASDBN population is that their life skills and experiences have enhanced their decision-making capacity, critical thinking, and problem-solving skills (Shiber, 2003). Attrition rates tend to be lower than average for ASDBN students, and graduation rates are commensurately higher. While the studies are limited in number, employer ratings of ASDBN graduates are higher than traditional BSN graduates (Shiber, 2003). The evaluative data often speak to the level of maturity of the ASDBN graduates and their ability to handle critical problems.

Attrition and graduation characteristics of the ASDBN students are significant factors for understanding the value of the policy presented in this brief article. Unfortunately, there is a dearth of research in these ASDBN program areas (Payne & Mullen, 2014; Raines, 2013; Schwartz, Sharts-Hopko, & Bhattacharya, 2015; Siler, DeBasio, & Roberts, 2008). In 2015, Raines noted that RNs are often the largest health-care profession in most health-care organizations. She reports that accelerated, second-degree nursing graduates were viewed as one potential solution to the shortage of nursing graduates. But she reported that there is no data examining accelerated graduates and their perceptions about being a nurse after being in the workforce or their perceptions of their nursing job. For example, Schwartz and Gambescia (2017) conducted a literature review focused on the research that examines ASDBN graduates beyond their student experiences or early significant career events or outcomes (i.e., beyond 2 years) in order to provide a better understanding of “what had become of ASDBN graduates” years after completion of their BSN program. Surprisingly, they found only two articles that looked at this question. Some best practice articles do appear (Schwartz & Gambescia, 2015) but much more needs to be done in this area. In fairness to investigators disseminating information in the ASDBN area, the student profile as accelerated is quite different from the student profiles in the larger literature in the adult continuing education literature, that is, the ASDBN student is pursuing a second baccalaureate degree; whereas most adult continuing education students that are accelerating are completing their first undergraduate degree. Therefore, the ASDBN research may be more challenging to access given it is mixed in with the robust BSN literature and the large but diverse subject matter degree programs in the adult continuing education literature (Kasworm, 2014).

Program Characteristics of ASDBN Programs

ASDBN programs typically range from 12 to 18 months (AACN, 2014). ASDBN programs typically consist of a nursing curriculum in which there are accelerated courses taught in a time-shortened manner. Some nursing programs simply accelerate the existing nursing curriculum and teach all requisite content in an abbreviated period of time. Intensive and time-shortened course and programs are common in many academic settings primarily due to the number of nontraditional students (Bentley, 2006). Intensive and time-shortened nursing programs are very attractive and sought after by many students including nursing students in ASDBN programs. One of the most compelling reasons the ASDBN programs are so attractive to prospective nursing students is that they can produce baccalaureate-prepared nurses in less time than many other nursing educational trajectories. For example, some of the other nursing programs take a great deal more time to produce a nursing graduate as evidenced in the educational trajectory going from a licensed practical nurse (LPN) to RN to BSN (Benner, Sutphen, Leonard, & Day, 2009; Institute of Medicine, 2011; Vinal & Whitman, 1994). And while the LPN entry has slowed in the aforementioned trajectory, there is a significant number of people entering this pathway given the shift in the need for LPNs in “more varied roles in community-based settings with vulnerable populations” (NLN Board of Governors, 2014, p. 4).

There is no doubt that ASDBN graduates are able to be move through ASDBN programs rapidly and that ASDBN graduates contribute significantly to the nursing workforce in contemporary health-care systems in a variety of roles and ways.

Nursing Program Administrator Challenges With ASDBN Readmission Decisions

ASDBN students dismissed from a program frequently apply for program readmission. Nursing program administrators often face the difficult and daunting task of program readmission requests. Nursing program administrators face complexity in decision making for program readmission requests and must take multiple, relevant factors into consideration when deciding whether to readmit an ASDBN student or not. Program readmission requests take several components into consideration when making a program readmission decision. For example, significant and compelling factors to be examined in a program readmission decision include the student’s overall academic performance, number of terms completed, student academic promise, as well as any extenuating circumstances that may have impacted student failure. Due to the high level of complexity in readmission decisions, it is relevant for ASDBN programs to have a transparent and articulate ASDBN readmission policy for nursing program administrators to apply. The following describes one ASDBN program’s readmission policy.

One Program’s Response

Drexel University College of Nursing and Health Profession’s ASDBN program is 1 year in length and is based on an academic quarter system. One academic quarter consists of 10 weeks. In a full-time plan of study, the ASDBN student takes at least 21 credits in each quarter. At the program’s inception, the academic dismissal policy stated that three or more failures would result in academic program dismissal. To return to the program, a dismissed student needed to submit application to the BSN Admissions Committee. The BSN Admissions Committee would review the application examining academic performance patterns, extenuating personal circumstances, and student plans for remediation. The BSN Admissions Committee would then make a recommendation for or against program readmission to the ASDBN department chair. If the department chair did not support a readmission, the student could then appeal the readmission decision to the dean.

Policy Problems

Several problems accompanied this readmission policy. For example, the ASDBN program readmission process appeared to be more subjective than objective. The BSN Admissions Committee expressed concern that it was difficult to validate a students’ claim that extenuating and extraordinary factors resulted in their academic difficulties.

There was also an issue with respect to the impact of cultural diversity with the readmission policy. For example, faculty expressed concern that students from some ethnic backgrounds were less likely to make a request for program readmission. This was due to the fact that the student’s culture caused them to view a request for program readmission as being disrespectful of nursing program policies.

Faculty also expressed concern that regularly readmitting dismissed students would result in a de facto four course failure dismissal policy. For example, if a student acquired three failures, was dismissed, and then readmitted with the provision that another course failure would result in a final dismissal, the student would, in effect, be permitted four failures before being permanently separated from the program. This was a clear departure from the three course failure policy faculty had supported and adopted. In addition, students who were readmitted to the program, acquired another failure, and were dismissed for the final time expressed much concern that they incurred additional debt, yet ultimately did not earn a degree. Many requested program readmission again reasoning that they were now closer to program completion than when they were first dismissed. While program readmission was not offered to these students, addressing the request and managing the intense emotions of the students and their families often consumed a tremendous amount of unproductive administrative time. Based on the previously existing ASDBN program readmission policy and associated problems applying it objectively, it was readily apparent that a more structured policy for ASDBN program readmission requests was needed.

ASDBN Program Readmission Policy Development

The priority concern in developing an ASDBN program readmission policy was to remove the subjective nature of the readmission policy. Primarily there was a need to create a readmission policy to facilitate and expedite the decision-making process in a more objective and transparent manner. A major challenge and underlying assumption of ASDBN program dismissal is that every student who is dismissed has a knowledge deficiency; however, the previously existing policy did not address or assess knowledge deficiency. The rationale for creating a new policy that assessed knowledge deficiency was that students dismissed from the program must now demonstrate in a compelling manner that they are students highly likely to complete the ASDBN program.

It was apparent there needed to be a valid and reliable standardized readmission examination to assess knowledge deficiency. The standardized readmission examination would aid and facilitate nursing faculty and nursing program leadership to decide which ASDBN students should be readmitted. Therefore, we used questions from the Elsevier HESI exam which the program uses throughout a student’s progression in the program and as a summative exam before granting the degree to students. This provided valid and reliable means to objectively assess students’ readiness to continue in the program. The readmission exam included all curricular content ASDBN students had up to the time of the students’ dismissal from the program.

When students take the standardized readmission examination they are permitted and encouraged to use program and university resources. For example, program and university resources include use of the nursing skills laboratory, staff tutoring, and university libraries. Students are permitted two attempts to take the readmission examination to meet the readmission criteria. Since no makeup exams are offered, two exam opportunities help to eliminate concerns related to the possible impact of extraneous variables on exam performance (i.e., student illness or other personal issues) that may arise with just one testing opportunity.

Dismissed students are required to apply for program readmission the term following their program dismissal. The purpose of this timing requirement for program readmission is to eliminate adverse effects from a protracted period of time away from the program of study. Initially, ASDBN students returning to the program following program readmission were required to follow a part-time plan of study. Being in the part-time plan of study became an issue and barrier as part-time student status frequently impacts student financial aid often rendering the student ineligible for financial aid. Due to the impact of the part-time student status, this requirement was removed. Readmitted students are still highly encouraged to consider a part-time plan of study whenever feasible. There are no exceptions to the ASDBN program readmission policy for ASDBN students.

Outcomes of Policy Revision

The majority of dismissed ASDBN students have not elected for program readmission. Many of the ASDBN students reported concerns about the degree of remediation needed to successfully pass the standardized readmission examination. Approximately one third to one half of ASDBN students dismissed each term applied for program readmission. Of those students, approximately one third passed the examination.

There were significantly fewer academic problems for students admitted under the new program readmission policy. Despite this improvement, the minimal passing exam grade for readmission was increased. The decision was based on data indicating that students scoring at or slightly above the passing readmission score struggled academically. The increase in the minimal passing score for the standardized readmission examination resulted in no additional students failures. The change in the cut score for passing the standardized readmission examination change was recent, and it is too early to draw any firm conclusions.

There have been numerous benefits to implementation of this new readmission policy. ASDBN students who have passed the readmission exam have reported a sense of accomplishment returning to the program with a solid command of curricular content they reported they previously did not have. ASDBN students now view the readmission process as one in which they play an important and active role through their remediation efforts. ASDBN students not meeting the exam passing score after two testing opportunities often verbalize that an accelerated BSN program is not the best fit for their individual learning styles. In these cases of dismissal, ASDBN students are counseled regarding other educational pathways for becoming a RN or other health-care careers. Finally, ASDBN faculty report that readmitted ASDBN students are better able to master curricular content in ways similar to their peers and able to maximize nursing program and other academic and student resources and support(s) available to them.

Conclusion

ASDBN students make enormous sacrifices to return to school to pursue a BSN in an accelerated curricular format. The nature and extent of these sacrifices make academic dismissals devastating for this student population. When an ASDBN student is dismissed from their nursing program, they frequently request program readmission. This article describes the processes and rationale one ASDBN program used to developing a more subjective and transparent readmission. The ASDBN program readmission policy developed requires a minimum grade for ASDBN student achievement on a valid and reliable, standardized readmission examination making the ASDBN readmission process more objective and transparent to the ASDBN student. The standardized readmission examination assesses curricular content cumulatively and comprehensively up to the point of student dismissal. Administrators, faculty, and students report significant benefits after implementation of the ASDBN program readmission policy including improved student academic outcomes and student and faculty satisfaction.