Predicting retention and time to graduation within accelerated online and a hybrid RN-to-BSN programs are significant elements in leveraging the pipeline of qualified RNs with BSN degrees, but the literature lacks significant accounts of retention and time to graduation outcomes within these programs and predictive algorithm developments to offset high attrition rates. The purpose of this study was to quantitatively examine the relationships between pre-entry attributes, academic integration, and institutional characteristics on retention and time to graduation within accelerated online RN-to-BSN programs in order to begin developing a global predictive retention algorithm. This study was guided by Tinto's theories of integration and student departure (1975, 1984, 1993) and Rovai's composite persistence model. Retrospective datasets from 390 student academic records were obtained. Findings of this study revealed pre-entry GPA, number of education credits, enrollment status, 1st and 2nd course grades and GPA index scores, failed course type, size and geographic region, admission GPA standards, prerequisite criteria, academic support and retention methods were statistically significant predictors of retention and timely graduation (p <.05). A decision tree model was performed in SPSS modeler to compare multiple regression and binary logistic regression results, yielding a 96% accuracy rate on retention predictions and a 46 % on timely graduation predictions. Recommendations for future research are to examine other variables that may be associated with retention and time to graduation for results can be used to redevelop accurate predictive retention models. Having accurate predictive retention models will affect positive social change because RN-to-BSN students that successfully complete a BSN degree will impact the quality and safety of patient care.

While the development of online education has been progressing rapidly, further evaluation research is needed (Atack and Rankin, 2002; Halter et al., 2006). There is a need for further research on nursing students' experiences and satisfaction with online education, and correlating factors to promote the quality of online learning. Social presence is one factor that has been shown to affect outcomes such as satisfaction and perceived learning in online courses (Gunawardena and Zittle, 1997). <br>The purpose of this study was to assess social presence in online nursing courses and its relationship to student satisfaction and perceived learning. The theoretical framework for the study was the Framework for Assessing Outcomes in Web-based Nursing Courses (Billings, 2000). A descriptive, correlational study design was used. The study instrument was a 34-item questionnaire administered via the Internet and consisting of the Social Presence Scale and the Satisfaction Scale (Gunawardena and Zittle, 1997), and demographic questions. Subjects in the study were 128 students in an online RN-to-BSN program at one college in the northeastern United States who were taking an online nursing course during the study term. Results indicated that there was a strong relationship between overall satisfaction and overall social presence (rs = .63, p < .001)) and instructor performance (rs = .46, p < .001). Four sub-domains of social presence were identified: overall comfort with online and computer-mediated (CMC) communication, communication with CMC and the online environment, comfort and community of CMC/online environment, and attitudes toward CMC/online communication. Four sub-domains of satisfaction were identified: general satisfaction, usefulness of course, learning from course, and stimulation and ongoing learning. All sub-domains of social presence correlated highly (rs = .61 - .72, p < .001) with the satisfaction sub-domains except the communication factor which correlated to a lesser degree (rs = .39 - .45, p < .001). There was a strong relationship between perceived learning and social presence (rs = .61, p < .001) and with comfort with the online course (rs = .66, p < .001). Overall social presence, instructor performance, and the sub-domains of social presence predicted a significant amount (p < .001) of total variance in overall satisfaction and perceived learning. No significant relationships were found between the demographic factors and overall social presence or perceived learning. Females had significantly higher scores on the communication factor (p = .02) and subjects with more online course experience found the courses more useful (p = .04). / School of Nursing / Nursing / PhD / Dissertation

An associate degree in nursing is obtained in the community college setting and is designed to be completed in 2 years of full-time study. Approximately 70% of practicing registered nurses (RNs) are educated at the associate degree or diploma (vocational training) level with only 15% moving on to achieve a degree past the associate level. The purpose of this phenomenological research is to study the lived experiences of registered nurses who obtained an associate degree in nursing and, while working in a health care setting, returned to school to attain a baccalaureate degree in nursing (BSN). Data gathered during individual interviews will provide documentation of the benefits of attaining a BSN as well as identifying barriers that associate degree RNs must overcome to pursue a BSN education.

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Discussion continues about requiring a Bachelor of Science in Nursing (BSN) as the minimum requirement for entry into registered nursing practice. A Magnet-® recognized hospital located in the Northeast United States is requiring all registered nurses without a BSN (n=284 or 28%) to obtain their BSN by 2022 as a condition for employment. The purpose of this project was to quantify the potential number and rationale of nurses who are not planning to return to school. The 2 practice focused questions are (a) What is the rationale for nurses who do not plan to pursue their BSN degree and (b) What is the potential cost to the organization due to projected gaps in the workforce by 2022. The theory of reasoned action was utilized as a model of decision making. A total of 29% of non-BSN nurses responded to a questionnaire, with 54.55% replying that they plan to obtain their BSN by 2022. The primary barriers for not planning to return for a BSN were a perceived lack of the degree's value and financial issues. More than 1/3 of those respondents not planning to obtain the BSN are planning to retire, which is consistent with national trends. An extrapolation of data showed the nursing turnover rate rising to 10.62% as 2022 approaches, significantly higher than the normal rate of 5.3%. The turnover rate may increase recruiting and orientation costs for the hospital facility over both the short and long term in a state where nearly 38% of graduates have either a diploma or an associate degree in nursing. The social change implication is a need for a re-examination of roles for various levels of registered nursing or a consensus on the BSN for nursing licensure.

Basic nursing education is no longer sufficient to meet the escalating demands of today's complex healthcare environment. Recognizing the need for the advanced cognitive skills incurred by these demands, increasing numbers of registered nurses (RNs) have been enrolling in online Bachelor of Science in Nursing (BSN) programs. The problem identified in the RN to BSN degree completion program at a large Midwestern university was the lack of information as to how online teaching and learning strategies were experienced by students. Research has demonstrated that the online community of inquiry (CoI) model facilitates higher order thinking through collaborative learning strategies and the interaction of teaching, social, and cognitive presence. The purpose of this sequential explanatory mixed methods study was to investigate the perceptions of RNs enrolled in the program about a recently completed course utilizing a 34-item CoI survey and semi-structured interviews. The data from 109 completed survey responses were analyzed via descriptive statistics and indicated that student perceptions of social and teaching presence were lower than perceptions of cognitive presence, meaning that the perceived establishment of online relationships and instructor engagement were not as high as were the perceived experiences of higher order thinking. Interviews with 15 purposefully selected students were analyzed for emergent themes and suggested limited online collaboration, which is considered to be fundamental to higher order learning. Based on these findings, a faculty development workshop was designed using the CoI model to encourage collaboration. A potential increase in RN proficiency in higher order thinking fostered by the CoI model will optimize the quality of patient-related decisions, minimize medical errors, and provide the impetus to challenge the status quo in health care.

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