Academic success and throughput rates have become essential measures of institutional performance in higher education globally. By extension, degree programs in higher education institutions such as universities need regular scrutiny of their throughput and output data to enable a comprehensive grasp of the factors that impact these measures. Addressing these factors is crucial for the sustainability of academic programs and their overall contribution to institutional performance.
Failure to attain academic success, particularly in the first year of study, leads to an early exit from education programs and considerable losses for the student and the institution. For those students who remain in the education system, it means delayed completion and graduation, and for some, a change in degree or career choice. In particular, change in career choice and early exit from nursing degree programs has become an international concern [1] amid critical nursing shortages. Pressure points for attrition appear to be in the first two years of a four-year Bachelor of Nursing degree, locally and internationally [2, 3].
In these years of study, attrition and failure are attributed, broadly, to academic and non-academic factors. Academic factors include a wide range of cognitive traits and tests that provide some measure of an individual’s ability and/or suitability for a program of study. Academic-cognitive skills are usually assessed in four main dimensions: mathematics, language, natural sciences and reasoning skills, mainly through standardised tests and academic records.[4] Non-academic factors, broadly, include socio-cultural-economic perspectives and institutional factors that affect student adjustment, concentration, motivation and wellness – many of these shown to be crucial success factors.[4, 5]
Non-academic factors are considered essential, judging by the range of support and investment opportunities made available by governments, funders and universities. Social constructs such as motivation and academic self-concept have been shown to have a significant positive association with academic achievement [6, 7], more specifically among nursing students [8, 9], and among students in distance learning contexts.[10]
Academic performance factors such as school-leaving grades, Grade Point Average (GPA) and other academic indicators for selection, play a significant role in student success and retention. In the United States (US), it was found that students with higher GPAs in high school and college, and higher grades in recently completed nursing courses were more likely to be successful and to remain in the program. [11] Comparable results were also reported at King Saud University, where the high school grade average, aptitude test and achievement test were found to be significantly associated with allied health students’ academic performance. [12]
In the context of the institution in this study, applicants are selected for nursing studies in the same way as for other health sciences degrees. Standardised tests are used exclusively to determine an admission score – its role in nursing students’ ability to succeed is poorly understood. With the focus of this paper on cognitive factors only, academic success in the context of the baccalaureate program was defined as the award of a pass mark (≥ 50%) for all first-year courses, permitting a student to proceed to the second year (progression outcome). The study is based on the premise that if we better understand why students do not succeed in the first year despite being selected on academic merit, recommendations for support and/or policy changes can be directed at selection processes that concentrate on cognitive factors only.
Literature review
A scoping review of the existing evidence shows that the selection of students for nursing studies is informed mainly by cognitive and non-cognitive abilities.[4, 13] Assessing cognitive skills is recommended in selecting nursing students to admit applicants with a high level of readiness for both clinical and academic success.[14, 15] Reasoning skills have become increasingly important in an expanded set of cognitive abilities that are required for competent, responsive nursing care in highly complex and technology-enhanced healthcare environments. While research evidence in this domain is scant but developing, there are growing calls for assessing reasoning skills during admission processes.[15, 16]
Different tests are used to select applicants who have the greatest potential for success in the study of nursing, hence, their suitability for the profession. Although achieving a certain level of academic achievement prior to commencing university education is a necessary criterion, it is insufficient on its own.[17, 18] A combination of prior academic achievement and admissions tests are reported to be the best indicator of nursing students’ success in pre-registration nursing programs[13], underscoring the importance of cognitive factors in the selection of nursing students. Findings from a scoping review on undergraduate nursing program admission criteria in the US showed that the GPA was the selection criterion most cited in the literature.[19] Amid various nursing program admission criteria, the predictive value of cognitive factors appears to dominate, supporting their continued use in nursing education systems.[19] In their study of second-year nursing students, local scholars found cognitive factors to have a more substantial predictive power in relation to academic performance when compared to other demographic variables, except for race. Framed by South Africa’s divisive past along racial lines, the latter is a significant predictor of academic performance.[20]
South African schooling and higher education system
In an attempt to redress past inequalities in education, South African schools are classified into five quintiles based on the unemployment rate and literacy level of the community where the school is located; poor communities are home to quintile 1 schools (SQ1) whereas quintile 5 schools (SQ5) are found in more affluent communities.[21] The purpose of this ranking is to improve government funding to impoverished schools provided in the National Norms and Standards for School Funding.[21, 22] Schools classified as SQ1 and SQ2 are located in impoverished areas and would receive more funding per child, while SQ5 in affluent areas receive comparatively less government funding.[22, 23]
More than 20 years on, the school quintile system may have addressed the funding disparities but not the quality of education and applicants’ ability to access university education. Teachers with good subject knowledge, such as in Mathematics, are concentrated in quintile 5 schools [24], which produce more university entrants and graduates. [25] This means that lower quintile schools would continue to produce candidates who are ill-equipped for university studies.
On completing high school, school-leavers are awarded a National Senior Certificate (NSC) that describes and categorises school performance and suggests the higher education program the students may qualify for i.e. Higher Certificate, National Diploma or Bachelor’s degree. The National Benchmark Tests (NBT) and the NSC are generally used to select students for places in the Bachelor of Nursing (BN) program at universities in South Africa. However, some universities use the APS, a score calculated from the last schooling year. [26] The main difference is that the NSC is an assessment tool for learners exiting high school, whereas the NBT is a tool for entry-level benchmarking into universities. [27] Applicants are ranked using a Composite Index (CI), where the NBT and NSC each contributes 50%. The CI is derived from three NBT domains and five NSC subjects (English, Mathematics, Physical Sciences or Life Sciences, and two subjects in which an applicant attains the highest mark, except for the subject, Life Orientation.[28] These two assessments differ in their purpose, design and intention.[29]
The NBT is a criterion-referenced test designed to assess students’ entry-level skills in three domains: NBT mathematics (NBT MAT), NBT academic literacy (NBT AL) and NBT quantitative literacy (NBT QL). NBT MAT tests prospective students’ understanding of mathematical concepts related to mathematics, physics and chemistry. NBT QL is designed to assess students’ abilities to engage with mathematics and the quantitative demands of higher education; NBT AL assesses students’ reading skills, reasoning skills, and their ability to engage with the language demands of higher education.[28–30] Performance in these domains is categorised into levels that indicate the entry-level skills and the recommended support the student would need from the university.[28]
Study Aim
The study aimed to determine the predictors of academic success based on the selection tests for the Bachelor of Nursing degree. The research questions were: What is the proportion of variance explained by the NBT domains and NSC subjects in predicting students’ success in the first year of study? What are the predictors for passing the first year? Is there an association between NBT performance levels, school quintiles and first-year progression outcome?