Associated and predictive factors of the progression pathway of undergraduate nursing students: A systematic review with meta-analysis and an international longitudinal study

Despite the international interest of High Education Institutions in nursing students’ academic success, their educational pathway evolution, and success associated and predictive factors, such factors are still unclear, and no consensus exists about definitions of academic outcomes. Therefore, a standardized methodology in studying the phenomenon is not fully utilizable. To face these issues, a systematic review with meta-analysis and an international longitudinal study were conducted. The aim of the systematic review and meta-analysis was to provide an overview of the variables influencing the academic outcomes of nursing students. Eighteen studies were included, nine of which were meta-analyzed. The differences among the seven retrieved definitions of the academic outcome mainly regarded outcome timepoint measurement and whether authors considered ‘success’ or ‘lack of success’ as academic outcome. In meta-analyses, being female, having attended a Classical, Scientific or Academic high school, and having reported higher final grades at the high school revealed association with graduation within the legal duration of the program. Contrasting and limited evidence were found for the other factors assessed in the literature, as well as for the other outcome definitions. Despite the detected heterogeneity, the topic confirmed to be historical and still of current interest. It is strongly recommended to consider the secondary school grade as students’ selection criterion. The aim of the international longitudinal study was to investigate associated and predictive factors of nursing students’ academic success, i.e. graduation within the legal duration of the program, in the Albanian context. The study was conducted in the Nursing Bachelor Program (NBP) of the University of Elbasan. Since October 2017 and 2018, independent variables of first-year students were collected at the end of each academic year. Descriptive and inferential statistics were performed at all the timepoints to identify associations with predictive power for academic success. N = 165 students were enrolled in the study, N = 124 and N = 75 students participated at the end of their second and third year, respectively. Students were very young, mainly female, belonged to low-medium social classes, and mainly had attended high secondary school; few of them have had previous working or other academic experiences and their modifiable factors mostly remained stable. Most of the students did not work or volunteer and have had financial and learning difficulties while attending the NBP. Concerns about their academic results was the main reason for ‘intention to leave’. Most of the students used to study individually and regularly, and a negative difference between students’ satisfaction and perceived importance was revealed for the investigated organizational factors of the university. Students’ empathy raised during the pathway and they reported a good perception of the clinical learning environment attended during the placements, despite they were poorly aware of the occurrence of organizational changings in the floors. Almost all the students met the reference guide during the academic years and reported a good motivation to perform the placement. Different associated/predictive factors were identified in the timepoints of data collection. The dynamic and complex nature of the phenomenon was highlighted. The secondary school grade as selection criterion was confirmed as appropriate and younger students without previous working experiences reported higher frequency of success. ‘Success’ students seem to be intrinsically more motivated than ‘not success’ students. Further research is needed to assess the role of students’ non-intellective and modifiable variables.