Document Type



Doctor of Philosophy



Date of Defense


Graduate Advisor

Dr. Kathie Records


Dr. Ericka Sanner-Stiehr

Dr. Keui-Hsiang Hsueh

Dr. Kimberly Allen


Accreditation standards, such as those of the American Association of Colleges of Nursing Commission on Collegiate Nursing Education’s program indicators, require pre-licensure programs of nursing to report outcome metrics which includes program completion rates. In response to regulatory requirements and accreditation standards, pre-licensure programs of nursing have an interest in selecting applicants most likely to meet outcomes standards. Attrition is a serious issue with implications for students, pre-licensure programs of nursing, the nursing workforce, and populations requiring nursing care. Academic failure due to insufficient cognitive aptitude often contributes to the attrition rate. Pre-licensure programs of nursing may consider interviews, essays, and volunteer work during the admission process, although traditionally, pre-licensure program admission criteria have primarily focused on measures of academic preparedness and current knowledge. The most commonly used criteria in considering an applicant’s admission to pre-licensure programs of nursing have been prerequisite courses, science grades, cumulative GPA, and standardized nursing admission exams. The overall aim of this dissertation work was to determine the utility of using standardized nursing admission exams with a critical thinking component as a predictive admission criterion of first semester academic success. An integrative review was conducted to identify the standardized admission exams most predictive of nursing student success. Next, an original Nursing Cognitive Aptitude Model was presented to guide expanding standardized nursing admission exams by including a critical thinking component to predict first semester academic success. Finally, a complex associational design study was conducted to determine if a relationship existed between current scholastic knowledge (HESI A2 composite scores), critical thinking ability (HESI A2 Critical Thinking scores), prior academic performance (pre-nursing overall GPA), and first semester baccalaureate nursing student academic success. The model containing prior academic performance, current scholastic knowledge, and critical thinking ability was predictive of overall first semester nursing grade average. Further, critical thinking ability was the best predictor of success in each individual first semester nursing course. By identifying admission criteria most predictive of academic success, pre-licensure programs of nursing can improve retention rates, improve program outcomes, and increase the number of nurses entering the workforce.

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