Contribution of basic sciences to academic success in nursing education

Medicinal chemistry curriculum and pedagogical practices at Canadian pharmacy schools: Towards standardization of practice

INTRODUCTION

Medicinal chemistry instruction in PharmD programs at Canadian universities is considered an important foundational science. However, with few guidelines for the required content most programs have observed a decrease in hours of medicinal chemistry instruction. A Medicinal Chemistry Special Interest Group (SIG) was formed to address these issues nationally and initiated a pan-Canadian environmental scan to better understand the depth and breadth of medicinal chemistry instruction.

METHODS

The SIG carried out an environmental scan to identify medicinal chemistry content, delivery and assessments in PharmD programs in Canada.

RESULTS

Core medicinal chemistry concepts across the PharmD programs are in general agreement with those listed by the Accreditation Council for Pharmacy Education. Medicinal chemistry was typically taught as didactic lectures either as a standalone course or within a pharmacology course, although one program integrated some medicinal chemistry within therapeutics focused problem-based learning. There was no consistent time in program where medicinal chemistry occurred.

CONCLUSIONS

The SIG found that similar medicinal chemistry content is taught across all Canadian PharmD programs, but incorporation of medicinal chemistry in therapeutics courses was minimal. Core concepts within six high-level overarching themes that guide our collective instruction were identified. The core concepts require developing high-level cognitive processes such as knowledge application and synthesis that practicing pharmacists are expected to possess for entry to practice. We the authors posit that in addition to providing a unique tool for pharmacists to employ in therapeutic decision-making, medicinal chemistry also provides early practice of important problem-solving and critical thinking skills.

Basic science course grades predict success in the Israel mandatory nursing certification test among students enrolled in a second career program

BACKGROUND

With the constant urgent need to meet the demands of the future workforce, nursing education institutes are under increasing pressure to graduate more quality students. One way to achieve higher numbers of graduates would be to identify factors that predict nursing students' academic success. No reports of such predictors were found for students in accelerated programs for non-nursing Bachelor's degree graduates.

OBJECTIVES

This study was designed to examine the relationships between demographic characteristics, course grades in basic science and medical-surgical courses, and the final scores achieved by students in the Israel mandatory RN certification test.

DESIGN, SETTINGS, AND PARTICIPANTS

164 students, enrolled in four courses of a second career in nursing program (accelerated program) in an academic nursing school in central Israel, participated in this retrospective study.

METHODS

Socio-demographic data and the final grades for basic science courses (chemistry and biochemistry, microbiology, anatomy and physiology, pathology, and pharmacology), the major Medical-Surgical course, and the RN certification test, were collected from the institutional database and analyzed.

RESULTS

Positive correlations were found between the mandatory RN certification test score, and the final grades of all the studies except the pathology course and Medical-Surgical course. The final RN certification test score was predicted by the final grades, with anatomy and physiology (p < 0.001), and pharmacology (p < 0.003), explaining 40% of the variance of the dependent variable. There were no statistical effects of demographic variables.

CONCLUSIONS

Early evaluation and prediction of academic success for nursing students in the second career program may guide effective interventions designed to promote students' skills and improve their ability to complete the mandatory RN certification test successfully.

The Effectiveness of an Augmented Reality Head-Mounted Display in Learning Skull Anatomy at a Community College

Despite an increase in the use of technology in undergraduate anatomy education, and the rising popularity of online anatomy courses at community colleges in the United States, there have been no reports on the efficacy of augmented reality on anatomy education in this population. The purpose of this study was to test the hypothesis that augmented reality is an effective and engaging tool for learning anatomy in community college students. Participants recruited from Cuyahoga Community College (Cleveland, OH) studied skull anatomy using either traditional tools (i.e., textbook and plastic skull model) or an augmented reality head-mounted display with an interactive virtual skull application. Comparison of knowledge before and following the study period revealed that augmented reality was an effective tool for learning skull anatomy: pre-quiz = 32.7% (± 25.2); mean (± SD), post-quiz = 61.8% (± 19.5); n = 15; t₍₂₈₎ = 3.53; P = 0.001. The traditional tools were equally effective: pre-quiz = 44.9 % (± 18.6), post-quiz = 67.9 % (± 17.3); n = 17; t₍₃₂₎ = 3.73; P = 0.0007. Students rated the augmented reality device as 9.6 (± 1.0); mean (± SD) when asked if it fit the statement "fun to use" on a semantic differential scale from 1 (poor) to 10 (excellent). In conclusion, this study found that augmented reality is an effective and engaging tool for the instruction of skull anatomy at a community college.

A Bayesian Approach to Gateway Course Identification With Implications for the Prenursing Curriculum

BACKGROUND

Analysis of student performance in gateway courses has been an important predictor of successful admission into upper-division nursing.

PURPOSE

The aim was to explore the utility of a Bayesian statistical framework for determining threshold grades in prenursing courses that serve as gateways for successful admission into upper-division nursing programs.

METHODS

Records of 3500 prenursing students who entered the prenursing program of a midsized public university during the past decade were analyzed. The Bayesian framework was used to incorporate conditional probabilistic concepts of sensitivity and specificity to calculate gateway impact of various grade level cutoffs on successful upper-division nursing admission.

RESULTS

Identification, sequencing, and combination of grades attained in these gateway courses revealed different pathways to successful admission into upper-division nursing based on first-semester grade point average and ethnicity.

CONCLUSIONS

Identification of primary/secondary gateway courses enhances successful matriculation and provides valuable information for advisors and curriculum planners for prenursing majors.

A combination of active learning strategies improves student academic outcomes in first-year paramedic bioscience

Bioscience is a foundational unit (subject) of undergraduate allied health degree programs, providing students the scientific basis underpinning their clinical practice. However, despite its significance, bioscience is a difficult academic hurdle for many students to master. The introduction of active learning strategies, including small team-based guided-inquiry learning approaches, has been shown to significantly reduce this hurdle and improve assessment outcomes for the learner. Guided team-based activities can aid in this approach by also building broader skills and capabilities, like teamwork and communication, as well as subject-specific knowledge and skills, thereby positively influencing student assessment outcomes. This paper details the redesign and evaluation of two first-year Bioscience for Paramedics units with the introduction of guided-inquiry learning, as well as other active learning strategies, and assesses their impact on student performance. Results indicate that active learning used within a classroom and in the large lecture theater setting improved students' grades with positive student perception of their learning experience.

Predictors of academic performance in the discipline specific bioscience paper: A retrospective quantitative study [corrected]

INTRODUCTION

The cohort of students enrolled in the discipline-specific bioscience paper reflects a structural diversity in that it includes students of multiple ethnicities, varied age groups, differing scholastic and life experiences. These divergent identities of students are known to influence academic performance. The purpose of this retrospective quantitative study was to determine the ability of a set of variables such as age, gender, ethnicity, level of prior education, the place from which prior education was obtained, work experience and prior academic achievement to predict academic performance in the discipline-specific bioscience paper.

METHOD

The sample for this study was a purposive sample of all oral health students who had enrolled in the paper at the Auckland University of Technology from 2011 to 2014. The desensitised empirical data of 116 students from the University's database were subject to multivariable regression analysis. Pearson's correlation coefficients were calculated.

RESULTS

Prior academic achievement was a statistically significant predictor variable (P < 0.001) for the academic performance in the discipline-specific bioscience paper and was also positively correlated (r = 0.641, P < 0.001) to the grades in the discipline-specific bioscience paper.

CONCLUSION

Prior academic achievement was the only variable that was demonstrated to be correlated to and predictive of the academic performance in the discipline-specific bioscience paper.

Performance in grade 12 mathematics and science predicts student nurses' performance in first year science modules at a university in the Western Cape

Background

The demand for highly qualified and skilled nurses is increasing in South Africa as well as around the world. Having a background in science can create a significant advantage for students wishing to enrol for an undergraduate nursing qualification because nursing as profession is grounded in scientific evidence.

Aim

The aim of this study was to investigate the predictive validity of grade 12 mathematics and science on the academic performance of first year student nurses in science modules.

Method

A quantitative research method using a cross-sectional predictive design was employed in this study. The participants included first year Bachelor of Nursing students enrolled at a university in the Western Cape, South Africa. Descriptive and inferential statistics were performed to analyse the data by using the IBM Statistical Package for Social Sciences versions 24. Descriptive analysis of all variables was performed as well as the Spearman’s rank correlation test to describe the relationship among the study variables. Standard multiple linear regressions analysis was performed to determine the predictive validity of grade 12 mathematics and science on the academic performance of first year student nurses in science modules.

Results

The results of this study showed that grade 12 physical science is not a significant predictor (p > 0.062) of performance in first year science modules. The multiple linear regression revealed that grade 12 mathematics and life science grades explained 37.1% to 38.1% (R² = 0.381 and adj R² = 0.371) of the variation in the first year science grade distributions.

Conclusion

Based on the results of the study it is evident that performance in grade 12 mathematics (β = 2.997) and life science (β = 3.175) subjects is a significant predictor (p < 0.001) of the performance in first year science modules for student nurses at the university identified for this study.

Predicting University Success in Psychology: Are Subject-Specific Skills Important?

The relationship between previous academic achievement and subsequent success at university was explored in a retrospective study of 56 UK psychology students. It was found that the subjects studied at A-level, and the grades obtained, did not predict performance at university. In contrast, GCSE grades, in particular those achieved in Science and English, were significant predictors of final year marks. Once at university, first and second year results had an incremental ability to predict final year performance, with an additional effect of undertaking a work placement. The implications of the results are discussed within the context of recent literature relating to cognitive and non-cognitive predictors of academic performance.

Student nurse selection and predictability of academic success: The Multiple Mini Interview project

BACKGROUND

With recent reports of public enquiries into failure to care, universities are under pressure to ensure that candidates selected for undergraduate nursing programmes demonstrate academic potential as well as characteristics and values such as compassion, empathy and integrity. The Multiple Mini Interview (MMI) was used in one university as a way of ensuring that candidates had the appropriate numeracy and literacy skills as well as a range of communication, empathy, decision-making and problem-solving skills as well as ethical insights and integrity, initiative and team-work.

OBJECTIVES

To ascertain whether there is evidence of bias in MMIs (gender, age, nationality and location of secondary education) and to determine the extent to which the MMI is predictive of academic success in nursing.

DESIGN

A longitudinal retrospective analysis of student demographics, MMI data and the assessment marks for years 1, 2 and 3.

SETTINGS

One university in southwest London.

PARTICIPANTS

One cohort of students who commenced their programme in September 2011, including students in all four fields of nursing (adult, child, mental health and learning disability).

METHODS

Inferential statistics and a Bayesian Multilevel Model.

RESULTS

MMI in conjunction with MMI numeracy test and MMI literacy test shows little or no bias in terms of ages, gender, nationality or location of secondary school education. Although MMI in conjunction with numeracy and literacy testing is predictive of academic success, it is only weakly predictive.

CONCLUSIONS

The MMI used in conjunction with literacy and numeracy testing appears to be a successful technique for selecting candidates for nursing. However, other selection methods such as psychological profiling or testing of emotional intelligence may add to the extent to which selection methods are predictive of academic success on nursing.

Teaching science content in nursing programs in Australia: a cross-sectional survey of academics

BACKGROUND

Professional nursing practice is informed by biological, social and behavioural sciences. In undergraduate pre-registration nursing programs, biological sciences typically include anatomy, physiology, microbiology, chemistry, physics and pharmacology. The current gap in the literature results in a lack of information about the content and depth of biological sciences being taught in nursing curricula. The aim of this study was to establish what priority is given to the teaching of science topics in these programs in order to inform an understanding of the relative importance placed on this subject area in contemporary nursing education.

METHOD

This study employed a cross-sectional survey method. This paper reports on the first phase of a larger project examining science content in nursing programs. An existing questionnaire was modified and delivered online for completion by academics who teach science to nurses in these programs. This paper reports on the relative priority given by respondents to the teaching of 177 topics contained in the questionnaire.

RESULTS

Of the relatively small population of academics who teach science to nursing students, thirty (n = 30) completed the survey. Findings indicate strong support for the teaching of science in these programs, with particular priority given to the basic concepts of bioscience and gross system anatomy. Of concern, most science subject areas outside of these domains were ranked as being of moderate or low priority.

CONCLUSION

While the small sample size limited the conclusions able to be drawn from this study, the findings supported previous studies that indicated inadequacies in the teaching of science content in nursing curricula. Nevertheless, these findings have raised questions about the current philosophy that underpins nursing education in Australia and whether existing practices are clearly focused on preparing students for the demands of contemporary nursing practice. Academics responsible for the design and implementation of nursing curricula are encouraged to review the content of current programs in light of the findings of this research.

Teaching science content in nursing programs in Australia: a cross-sectional survey of academics

BACKGROUND

Professional nursing practice is informed by biological, social and behavioural sciences. In undergraduate pre-registration nursing programs, biological sciences typically include anatomy, physiology, microbiology, chemistry, physics and pharmacology. The current gap in the literature results in a lack of information about the content and depth of biological sciences being taught in nursing curricula. The aim of this study was to establish what priority is given to the teaching of science topics in these programs in order to inform an understanding of the relative importance placed on this subject area in contemporary nursing education.

METHOD

This study employed a cross-sectional survey method. This paper reports on the first phase of a larger project examining science content in nursing programs. An existing questionnaire was modified and delivered online for completion by academics who teach science to nurses in these programs. This paper reports on the relative priority given by respondents to the teaching of 177 topics contained in the questionnaire.

RESULTS

Of the relatively small population of academics who teach science to nursing students, thirty (n = 30) completed the survey. Findings indicate strong support for the teaching of science in these programs, with particular priority given to the basic concepts of bioscience and gross system anatomy. Of concern, most science subject areas outside of these domains were ranked as being of moderate or low priority.

CONCLUSION

While the small sample size limited the conclusions able to be drawn from this study, the findings supported previous studies that indicated inadequacies in the teaching of science content in nursing curricula. Nevertheless, these findings have raised questions about the current philosophy that underpins nursing education in Australia and whether existing practices are clearly focused on preparing students for the demands of contemporary nursing practice. Academics responsible for the design and implementation of nursing curricula are encouraged to review the content of current programs in light of the findings of this research.

The 'bioscience problem' for nursing students: an integrative review of published evaluations of Year 1 bioscience, and proposed directions for curriculum development

BACKGROUND

The difficulties that nursing students have in learning human biosciences have given cause for concern for over 20 years but the problem remains.

OBJECTIVE

To conduct an integrative review of published primary research into the 'bioscience problem', evaluate their outcomes, and provide a contemporary analysis of potential directions for curriculum planners.

REVIEW METHODS

A systematic search of electronic databases CINAHL, Medline, British Nursing Index and Google Scholar was conducted for empirical research studies, published between 1990 and 2013, designed to either predict performance of students in bioscience assessments in Year 1 of their studies or identify in-course curriculum delivery issues.

RESULTS

The search generated nineteen papers that met inclusion criteria. Twelve papers involved predictive factors for bioscience attainment and seven surveyed student views on curriculum issues. Four others that surveyed reflections of later-year students or qualified nurses on Year 1 outcomes were also retained for additional context. Prediction based on pre-admission academic achievement was not reliable. Student factors including age at entry, self-efficacy in science, and having appropriate study skills in particular appear to be confounding factors. In-course influences such as teaching strategy or lecturer skills are also inconsistent and likely to represent confounders operating at local, institutional level.

CONCLUSIONS

The integrative review approach enabled analysis of incongruencies between studies that have been a barrier to curriculum development. Sound admissions criteria based on pre-university academic performance show promise in resolving the 'bioscience problem' but will likely be contingent on innovative support early in Year 1 for study skills and the fundamentals of human bioscience, plus attention to local quality assurance for curriculum delivery.

Factors related to academic success among nursing students: a descriptive correlational research study

BACKGROUND

The current rise in employment is improving forecasts for the future supply of registered nurses; however sizeable shortages are still projected. With the intention of improving academic success in nursing students, related factors need to be better understood.

OBJECTIVES

The purpose of the correlational study was to describe the relationship between emotional intelligence, psychological empowerment, resilience, spiritual well-being, and academic success in undergraduate and graduate nursing students.

DESIGN/SETTING

A descriptive correlational design was utilized. The study was set in a private Catholic university.

PARTICIPANTS

There were 124 participants. There were 59% undergraduate and 41% graduate students.

METHODS

Background data, in addition to the Spreitzer Psychological Empowerment Scale, the Wagnild and Young Resilience Scale, and the Spiritual Well-Being Scale and the Mayer-Salovey-Caruso Emotional Intelligence Test, was collected from students who met study criteria.

RESULTS

In a combined sample, academic success was correlated with overall spiritual well-being, empowerment and resilience. Although academic success was not correlated with overall emotional intelligence, it was correlated with the emotional intelligence branch four (managing emotions) score. When undergraduate and graduate students were considered separately, only one correlation was found to be significantly related to academic success in the undergraduate sample, namely, emotional intelligence branch one (perceiving emotions). When examining the data from just graduate level nurses, significant relationships were found between total emotional intelligence with academic success, resilience with academic success, and psychological empowerment with academic success.

CONCLUSION

The significant relationship between psychological empowerment, resilience, spiritual well-being and academic success in this study supports the statements in the literature that these concepts may play an important role in persistence through the challenges of nursing education. Research is needed to examine if strategies to enhance empowerment, resilience, and spiritual well-being can increase academic success in a test-retest design.

Biosciences within the pre-registration (pre-requisite) curriculum: an integrative literature review of curriculum interventions 1990-2012

BACKGROUND

The learning of biosciences is well-documented to be problematic as students find the subjects amongst the most difficult and anxiety-provoking of their pre-registration programme. Studies suggest that learning consequently is not at the level anticipated by the profession. Curriculum innovations might improve the situation but the effectiveness of applied interventions has not been evaluated.

OBJECTIVE

To undertake an integrative review and narrative synthesis of curriculum interventions and evaluate their effect on the learning of biosciences by pre-registration student nurses. Review methods A systematic search of electronic databases CINAHL, Medline, British Nursing Index and Google Scholar for empirical research studies was designed to evaluate the introduction of a curriculum intervention related to the biosciences, published in 1990-2012. Studies were evaluated for design, receptivity of the intervention and impact on bioscience learning.

RESULTS

The search generated fourteen papers that met inclusion criteria. Seven studies introduced on-line learning packages, five an active learning format into classroom teaching or practical sessions, and two applied Audience Response Technology as an exercise in self-testing and reflection. Almost all studies reported a high level of student satisfaction, though in some there were access/utilization issues for students using on-line learning. Self-reporting suggested positive experiences, but objective evaluation suggests that impacts on learning were variable and unconvincing even where an effect on course progress was identified. Adjunct on-line programmes also show promise for supporting basic science or language acquisition.

CONCLUSIONS

Published studies of curriculum interventions, including on-line support, have focused too heavily on the perceived benefit to students rather than objective measures of impact on actual learning. Future studies should include rigorous assessment evaluations within their design if interventions are to be adopted to reduce the 'bioscience problem'.

Organized music instruction as a predictor of nursing student success

Stringent admission criteria exist for nursing programs in the United States, but better predictors of success are needed to reduce student attrition. Research indicates that organized music experiences are associated with greater academic success. This exploratory study examined the association between early music experiences and undergraduate nursing student success. Findings suggest that students with a music background were more likely to graduate, have higher grade point averages, and pass the licensure examination. Previous music education might be considered as an additional predictor of nursing student success.

Predictors of academic performance of nursing and paramedic students in first year bioscience

The expanding scope of practice of paramedics and nurses demands they possess a sophisticated knowledge of bioscience to enable them to think critically and make rational clinical decisions. It is well documented that nursing students struggle with bioscience but there are no studies examining the performance of paramedic students in this crucial subject. In this study, we compared the academic performance of first year nursing, paramedic and nursing/paramedic double degree students in a bioscience subject. Regression analyses were used to identify predictors of academic success. Data revealed a low success rate in bioscience for all three degree programs (63.2, 58.8, and 67.6% respectively) and a strong correlation between academic success in bioscience and non-bioscience subjects (r(2)=0.49). The best predictors of overall academic success were the University Admission Index score and mature entry into the course. Previous study of biology was associated with an increased bioscience and overall GPA but not with non-bioscience grades. Discriminant analysis was used to develop a model that could predict overall academic success with an accuracy of 78.5%. These criteria may be useful during the admission process and for the early identification of students at risk of failure.

Association between academic and non-academic variables and academic success of diploma nursing students in Pakistan

This paper reports findings of an exploratory study conducted to determine an association between academic and non-academic factors and academic success of nursing diploma students in a province of Pakistan. Data were collected from the academic records of a cohort of 628 students. Multiple linear regression was used to identify the predictive association between certain academic and non-academic factors and academic success of the students. Regression models for each of three years were developed. Results indicated academic factors including preadmission qualifications, previous academic performance, academic performance in year one, academic performance in year two and type of school are significantly associated with the academic success of the students. Among non-academic factors, gender and place of domicile were found to be significantly associated with the academic success of the students.

The biological sciences in nursing: a developing country perspective

AIM

This paper reports a study to inform curriculum development by exploring the contribution of bioscience education programmes to nurses' clinical practice, their understanding of the rationale for practice, and their perceptions of their continuing professional development needs.

BACKGROUND

The future of the health services worldwide depends on nurse education programmes equipping practitioners to deliver safe and effective patient care. In the developed world, the structure and indicative content of nursing curricula have been debated extensively. However, despite the rapid expansion in nursing roles brought about by social change, there is little information on the educational needs of nurses in developing countries.

METHODS

This study was undertaken in government teaching hospitals in Cape Town, South Africa in 2003. A purposive sample of 54 nurses from a range of clinical settings completed questionnaires and described critical incidents where bioscience knowledge had directed practice. Questionnaires were analysed descriptively, in the main. Analysis of critical incident reports was based on Akinsanya's bionursing model.

FINDINGS

Most nurses felt that their understanding of the biological, but not the physical sciences, was adequate or better: all felt confident with their knowledge of anatomy, compared with 57.4% (31/54) for microbiology. Respondents attributed the successes and failures of their education programmes to their teachers' delivery of content, ability to relate to practice and management of the process of learning. The biological, but not the physical, sciences were universally (96-100%) regarded as relevant to nursing. However, the critical incidents and nurses' own reports indicated a need for further education in pharmacology (40/54, 74.1%) and microbiology (29/54, 53.7%).

CONCLUSION

To meet the needs of nurses in developing countries, and empower them to meet the increasingly complex demands of their expanding roles, nurse educators need to consider increasing the curriculum content in certain key areas, including pharmacology and microbiology.

Appraisal Skills as a Public Health Competency for Evidence-Based Care

With the demand for evidence-based practice, a greater need for health professionals' research expertise has emerged. Insufficient knowledge and inadequate competencies in research methods have been identified as barriers. Training endeavors to increase students' research awareness have been extensive. The study detailed in this article examines three research modules aimed at increasing health professionals' research knowledge. The effects that four demographic dimensions (gender, disability, ethnic group, and age bracket) and five educational parameters (academic term, mode of study, nature of module, qualification aim, and entry qualification) have on student contentment are investigated. According to these parameters, there were no differences in students' performance on the research modules. However, there were significant differences in satisfaction with the module administration, content, integration, and assessment procedures; the module team and university resources; and the module relevance and stimulation.

Predictors of academic success in a Bachelor of Nursing course

A longitudinal study of one Bachelor of Nursing course (n=181) was carried out to determine the relationship between academic outcomes and pre-entry qualifications and to discuss the progress and success of students with conventional and non-conventional qualifications. A multi-linear regression analysis was used to determine which pre-entry qualification best explained the variation in the course marks. Results identified that the number of GCSE A grades obtained significantly predicted success on the BN course. On the basis of this finding it has been suggested that the new AS levels, introduced as part of the reformed 16-19 curriculum, may have greater predictive value than current A levels since they allow a broader range of study. Students entering the course with non-conventional qualifications were found to achieve slightly lower marks throughout the course and had a high rate of attrition. Further research is needed to replicate these findings and to determine whether high grades in any specific subject, for example Biology, improve the predictive value of pre-entry qualifications.

NCLEX-RN performance: predicting success on the computerized examination

Since the adoption of the Computerized Adaptive Testing (CAT) format of the National Certification Licensure Examination for Registered Nurses (NCLEX-RN), no studies have been reported in the literature on predictors of successful performance by baccalaureate nursing graduates on the licensure examination. In this study, a discriminant analysis was used to identify which of 21 variables can be significant predictors of success on the CAT NCLEX-RN. The convenience sample consisted of 289 individuals who graduated from a baccalaureate nursing program between 1995 and 1998. Seven significant predictor variables were identified. The total number of C+ or lower grades earned in nursing theory courses was the best predictor, followed by grades in several individual nursing courses. More than 93 per cent of graduates were correctly classified. Ninety-four per cent of NCLEX "passes" were correctly classified, as were 92 per cent of NCLEX failures. This degree of accuracy in classifying CAT NCLEX-RN failures represents a marked improvement over results reported in previous studies of licensure examinations, and suggests the discriminant function will be helpful in identifying future students in danger of failure. J Prof Nurs 17:158-165, 2001.