Retention and academic performance of undergraduate nursing students with advanced standing : a mixed-methods study

Background: Undergraduate nursing students enter university through a variety of pathways. For some students, this includes the granting of advanced standing based on recognition of prior qualifications. The impact of advanced standing on nursing students' transition, retention and success at university is not well understood. Objectives: The aim of this study was to examine the retention, academic success and experiences of students who commenced their undergraduate nursing studies with advanced standing. Design, setting, participants and methods: A sequential exploratory mixed-methods design was used in this study, which involved undergraduate nursing students enrolled at a multi-campus university in Australia. Nursing students who enrolled in 2014 and did not opt out of program level research were included in the study. Results: Students with advanced standing were older (mean 31.6 versus 25.8 years, p < 0.001) and more likely to discontinue their studies at the end of semester one (97% versus 95%, p = 0.015) than standard-entry students. Advanced standing was also shown to be an independent predictor of low GPA [OR: 1.69 (95% CI: 1.06 to 2.69]. Most students with advanced standing commenced directly into second year (45%) missing first year student connections and programs. Students reported feeling apprehensive, forgotten and ill-prepared for the expectations of university. Some showed significant strength and resilience while others were struggling to cope with the workload with minimal knowledge or understanding of supports available to them. Conclusions: The widening participation agenda is a commendable strategy; however, students who enter university with advanced standing need targeted support to promote their transition, retention and success at university.