Student Academic Success 1

Running head: ADMISSION CRITERIA ON STUDENT ACADEMIC SUCCESS

The Impact of Admission Criteria on Student Academic Success in Health Science Programs

Robin Garza

Spring 2009 Semester

Final Paper

Submitted in Partial Fulfillment of the Academic Scholarly Requirements for CI 5390

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The Impact of Admission Criteria on Student Academic Success in Health Science Programs

The number of students applying to health science programs is growing. Many more students

apply than are positions available. Health science program enrollment is usually limited by the

availability of clinical sites. Additionally, the majority of health science programs have one entry

point into the program and the curriculum is sequential. Unfortunately, when a student leaves by

failure or other reasons, it leaves an unfilled space for the remainder of the program class. This

results in fewer graduates entering the field, which can impact the medical community at large.

The challenge for school administrators is how to select the students that are most likely to be

successful, not only in the program, but as healthcare professionals. There are several methods of

determining admission to health science programs. The criteria used can eliminate a promising

student or admit a student that will ultimately be unsuccessful. Identifying the most useful

criteria to determine student achievement is usually defined by program completion rate, the

successful writing of a credentialing examination, and the employment rate.

Statement of the Research Question

The problem in this study was to determine if the admission criteria for health science

programs predicted student academic success in the program. This study focused on allied health

and nursing programs and excluded medical school programs. The following questions guided

this study.

1. What role does preadmission testing play in predicting student academic success?

2. Which criteria are the best predictors of student academic success?

Statement of Purpose

The community will benefit from an adequate number of qualified workers in the health

science fields. Unsuccessful students in most health science programs leaves a space that could
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have been filled by a successful student. Low attrition rates are often a criteria for programatic

accreditation. Maintaining accreditation and graduating a high percentage of admitted students in

a health science program is a common goal among health science educators. Selection criteria

should be objective and should not eliminate minority students.

Statement of Terminology

Attrition rate is the percentage of students that have withdrawn from a program either by

choice or by failure.

Health science programs include programs such as, Radiologic Technology, Diagnostic

Medical Sonography, Dental Hygiene, Dental Technology, Pharmacy Technician, Surgical

Technology, Occupational Therapy, and Physical Therapy.

Clinical sites are hospitals or outpatient clinics that provide a place for students to obtain

practical experience in their particular discipline.

Student academic success is defined by completion of a health science program and passing a

credentialing examination for the respective field.

Review of Literature

The literature reviewed in this study focused on the role of preadmission testing as a means

of determining academic success and on other criteria used as predictors of academic success.

Academic success is defined as successful completion of the program and on successfully

passing a professional credentialing exam.

Preadmisson Testing

Evans and Dirks (2001) conducted a correlational quantitative study designed to determine if

preadmission testing of psychomotor skills and psychological constructs could predict success in

the first semester dental laboratory course. The researchers found that students either had
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adequate psychomotor skills before admission, had inadequate skills but developed them during

the course, or did not have adequate skills and did not develop those skills during the course.

Three tests were used to measure spatial ability. These were given in the first week of the first

semester, before any practical lab exercises were begun. The tests were (a) the Revised

Minnesota Paper Form Board Test (RMPFBT), (b) the Dimensions, and (c) Blocks test of the IPI

Job-Test Program. A p-value of <.05 was used to correlate the independent and dependent

variables. The Blocks test and prior college GPA were the most consistent predictors of

successful completion of the first semester dental laboratory classes.

Subjectivity of grading in the classes could not be eliminated, threatening internal validity.

One of the researchers administered the tests and graded them. This threatened the internal

validity because of data collector bias. The generalizability is limited in that the subjects were

dental laboratory technology students who completed the initial semester from 1994 to 1997,

threatening the external validity.

Gardenhire and Restrepo (2003) conducted a quanitative correlational retropective study to

determine if a correlation existed between the Health Occupations Basic Entrance Test (HOBET)

scores and program completion of an associate degree respiratory therapy program. The

researchers found a strong correlation between HOBET math percentage and program

completion. The HOBET composit score and reading score showed a strong associaion with

noncompletion. A strength of the study was that the data collected was reviewed by more than

one person. Correlation was found to be significant at the p-value <.01 level.

Some of the subjects of the study may have taken extra steps to prepare for the HOBET

examination. This may have resulted in a subject characteristics threat. There was a possible

mortality threat as 10 of the 42 students did not complete the course. It was not clear how many
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of those withdrew for reasons other than failure. A threat to external validity of this research was

that the subjects were all from one program including students from 1995 to 1999.

Generalizability cannot be determined from such a small subject group.

Ostrye (2001) conducted a correlational quanitative research study using archival data. five

Psychological Service Bureau-Aptitude for Practical Nursing Examination (PSB-APNE)

subscale scores and type of remedial basic skill courses taken were used as preadmission

independent variables. Passing the NCLEX-PN was the dependent variable. Forward inclusion

logistic regression procedures were used to determine the probablility of passing the licensure

examination. The PSB-APNE Natural Science subscale test score (PSB-science) and remedial

reading were shown to partially correlate with the NCLEX-PN performance. The PSB-science

score was the best preadmission predictor of successfully writing the NCLEX-PN test on the first

attempt. Having taken remedial reading was the best preadmission predictor for failing the

NCLEX-PN test on the first try.

There were no considerations made for varying course loads, or environmental factors such

as family support creating a possible subject characterization threat, thereby threatening internal

validity. Generalizability was difficult to make toward other nursing programs because this was a

study confined to only one institution threatening external validity.

Gallagher, Bomba, and Crane (2001) used a quanitative correlational study to determine if

the Nurse Entrance Test (NET) is a better predictor of academic success in an associate degree

nursing (ADN) program than the Registered Nurse Entrance Exam.(RNEE). The NET and the

RNEE scores were compared with success in the first nursing course. Logistic regression

analyses were used with a significance at the p = < .05 level. The reading comprehension subtest

of the RNEE was statistaically significant at r = 0.23. Preadmission testing scores did not prove
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to be good predictors of success for completion of the program or the students ability to pass the

NCLEX-RN examination. The NET subtests did not show any significant difference between

success or failure. The mathmatics score correlated with the nonsuccessful students' mean in that

it was significantly higher than the successful student.

A possible threat to the internal validity of this study was subjects characteristics. Although

the reasearchers randomly assigned students to 12 different sections of the first year nursing

course, the students, n = 121, were all students admitted to the ADN program. There was no

information given about the subjects characteristics, such as, socioeconomic, ethnic, age, or

academic background. A possible threat to external validity was that the subjects of this study

were not determined to be a homogeneous sample of the applicant pool therefore generalizability

cannot be expected.

Other criteria

Espen, Wright, and Killion (2006) used a qualitative survey design to identify admission

criteria commonly used for entry level radiologic technology programs in Oklahoma and Texas.

The researchers were successful in that they identified; cumulative grade point average (GPA),

successful completion of science and related courses, interviews, and standardized testing as the

most commonly used criteria. None of the programs surveyed used all of those criteria. The

researchers used both a quantitative and qualitative research method to survey all 45 Joint

Review Committee on Education in Radiologic Technology (JRCERT) accredited programs in

Oklahoma and Texas of which 34 responded. Surveys requested information about program

prerequisites and the admission process. Admission criteria identified by these researchers were

(a) preadmission tests, such as, American College Test (ACT), Texas Academic Skills Program

(TASP), Health Occupations Basic Entrance Test (HOBET), Scholastic Aptitude Test (SAT),
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Tests of Adult Basic Education (TABE), COMPASS, and facility generated exams, (b)

interviews, (c) academic skills, such as, cumulative grade point average (GPA), GPA for specific

courses, writing and reading skills, and math and science courses completed and (d) prior work

or volunteer time in a medically related field. None of the programs surveyed used all of those

criteria. The researchers chose not to calculate reliability or validity. They also did not correlate

specific prerequisites to program completion. This lack of statistical analysis weakens the

research, although these weaknesses were identified by the researchers. The strength of this study

was that the researchers identified several questions to be answered by additional research. The

researchers suggested obtaining more specific data to correlate and determine predictors of

academic success. This research was useful in that it identified common admission criteria.

The subjective interpretation of the open ended style of survey questions can cause an

instrumentation threat, threatening the internal validity of this study. The external validity is

threatened by the small sample size of the survey that was limited to Oklahoma and Texas

making a generalizability threat.

Alzahrami, Thomas, and Bauman (2007) conducted a quantitative correlational study to

measure a variety of predictors used to select dental hygiene students most likely to graduate

within the expected time frame and to pass the National Board Dental Hygiene Examination

(NBDHE). The independent variables used were incoming college grade point average; grade

point average in prerequisite college science courses; individual final course grade in chemistry

I, human anatomy and physiology I, microbiology; individual final course grades in first year

dental hygiene courses; oral anatomy and histology, and oral pathology, also considered werer

whether prerequisite science courses were taken at a two year college or a 4 year college and

admission criteria points (ACP). ACP is defined as a ranking score custom designed by the
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program which include a variety of criteria, including incoming GPA and college science GPA.

The dependent variables are graduation or nongraduation within two years of enrollment and the

NBDHE score. All independent variables were not found to be significant at the p = .05 level

except for oral anatomy and pathology at the p = < .0001 level, which were variables that

occurred after admission to the program. The only variable that had any significance at

preadmission was the ACP score which had a p-value of 0.0245. A strength of this study was the

statistical analysis, which used multiple linear regression analysis with a p-value of less than or

equal to 0.05.

There was a significant correlation, however this proved to be a weakness of the study

because the criteria used to generate the ACP was not clearly defined making a data

characteristics threat, and threatening its internal validity. The research was confined to the Old

Dominion University Gene W. Hirschfeld School of Dental Hygiene baccalaureate degree dental

hygiene program making broad generalities to other programs impossible, and making

generalizability an external threat.

Noonan, Sedlacek, and Veerasamy (2005) conducted a correlational quantitative study to

investigate the possibility of using noncognitive variables in selecting students for health science

programs at a western community college. The researchers conducted multiple regression

analyses comparing the Noncognitive Questionnaire (NCQ) with each GPA. NCQ scores were

predictors and the GPA was the criterion. A significance level of .05 showed that the NCQ scale

for Community Service correlated most across multiple correlations, followed by Leadership and

Strong Support Person. Cumulative GPA correlated at the highest with (R = .66) over a four year

period. The article did not describe the training of the NCQ scorers, but there was an interater

reliability of 85%. This was still low considering the impact the NCQ score had on the predicted
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GPA. This was an instrumentation threat of data collector characteristics. The study was

conducted over a four year period comparing early GPA to later GPA and cumulative GPA.

A maturation threat was a possibility because students would mature over this time period,

which caused threats to internal validity. The research was conducted on 263 subjects of a

western community college. The researchers did not give details of the socioeconomic makeup

of the subject group. It is possible that this group does not represent the group of applicants to

other health science programs in western community colleges. It cannot be determined if this

was a generalization threat.

Arzu, Goodfellow, and Gardenhire (2008) conducted a correlational quantitative study to

investigate the relationship of science GPA, nonscience GPA, and cumulative GPA with student

scores on the certified respiratory therapist (CRT) and the written registry for respiratory

therapist (WRRT) examinations. The researchers used a multiple regression analysis with a .05

significance level. Science GPA and cumulative GPA were determined to be the best predictors

of success for the respiratory therapy program and the CRT examination.

The science and math scores for some of the students were transferred from other universities

causing a subject characteristics threat as well as, threatening internal validity. The study

included students admitted to a four year respiratory therapy program between 1995 and 2005.

This resulted in a generalization threat because the results can only be generalized to that group

of students, which was an external threat.

Dockter (2001) conducted a quanitative correlational study to determine which preadmission

factors determined student academic success and success on the national physical therapy

licensing examination (NPTE). The preadmission factors were age, attainment of a bachelor's

degree, core course GPA, total admission score, preadmission clinical experience hours,
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interview points, and writing sample points. The researcher correlated the data using a stepwise

linear regression analysis at a p = < .05 significance level. The researcher determined that the

best predictor was total admission points. Total admission points is comprised of GPA = 60%,

verbal interview = 32%, and writing sample score = 8%. The core GPA was found to have a

significant correlation to both student academic success and passing the NPTE, but it was not

best predictor of students success on both dependant variables.

The researcher used a convenience sample of 107 students admitted to the Physical Therapy

Program at the University of Mary in Bismarck, North Dakota. There is a possibility that this

represented a subject characteristics threat to the internal validity of the study because the

students in the study were already admitted to the program. An external threat to this study is that

it was conducted at a university in North Dakota. The results of this study may not be

generalizable to other programs in other parts of the country.

Byrd, Garza, and Nieswiadomy (1999) conducted an causal comparative study to determine

admission criteria predictive of students' completion of a baccalaureate nursing program. The

variables used were age on admission, ethnicity, previous baccalaureate degree, cumulative

science GPA, cumulative social science GPA, cumulative prenursing GPA, and letter grade in

each nursing course during the first and second semester of the nursing program. The Wald chi-

square test and odds ratio were used to determine the significance of predictions at a 95%

confidense intervals. Predictions were made using logistic regression. Significance levels of p =

< .05 were used. Age, ethnicity, science GPA, and prenursing GPA successfully predicted

successful completion of the nursing program in 77% of the cases. In a second model, the

researchers excluded data on the students who dropped out of the program. Age, ethnicity,

science GPA, prenursing GPA successfully predicted 87.8% completion of the nursing program.
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There was a subject characteristics threat to internal validity as the data were collected from

students already accepted to the nursing program. An external threat to validity existed because

the location of the subjects was from a narrow sample of one nursing program over a three year

period.

Statement of Conclusions

Research demonstrated that there is a positive correlation between math and science scores

on preadmission testing to academic success. Conversely having had remedial reading and a high

HOBET reading score showed a negative correlation with academic success. The Block test

demonstrated success in dental laboratory classes requiring spatial ability. Pre­admission testing 

is a valid method of predicting academic success, except for the study by Gallagher, Bomba, and

Crane (2001) which found that preadmission testing did not predict success or failure in an ADN

program. The best predictors of academic success are academic skills in science and math as

determined by course grades, GPA, and having a strong support person and leadership skills.

Statement of Recommendations for Further Research

Further research should be done to determine if the Block test can predict student academic 

success in other health science programs requiring spatial ability. Further research should be

done to determine if preadmission testing correlates to scores in specific courses.

Statement of Implications for Classroom Instruction

Most health science programs accept a new group of students each year. The number of

students accepted is determined by the number of clinical positions available to the students for

the practical applications portion of the course of study. When a student drops out or fails, an

open spot will typically remain in the program until that groups completion. Determining the

best criteria to retain students without failure will help produce the largest number of graduates
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in the health sciences. Also, students that have a greater background knowlege or aptitude for the

course of study will also be more cost effective students. Students that are better prepared for the

course of study will not drain the resources of the faculty, staff and facilities. Many of the health

science and nursing programs have similar admission practices. The criteria for success in each

of the different health science fields may be different. Students preparing for admission to a

health science program will often take one or two courses at a time in order to achieve the

highest possible grade. Many students will retake a course for a better grade if the grade first

achieved is not to their liking. When students face the rigors of a full time course of study in the

program, some will be overwhelmed and not do as well as their preadmission scores indicate.

The literature reviewed here did not address this issue. Admission criteria should not

inadvertently exclude a group of people that may be successful in a health science or nursing

program. The better the selection process is at identifying applicants that will be successful, the

more health care workers will be available for quality patient care.
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References

Alzahrani, M. J., Thomas, E. M., Bauman, D. B. (2007). Predictors of student success in an

entry-level baccalaureate dental hygiene program. Journal Of Dental Hygiene, 81(2), 51-64.

Arzu, A., Goodfellow, L. T., & Gardenhire, D. S. (2008, Fall). Admission criteria as predictors of

student performance on the national board for respiratory care examinations. Respiratory

Care Education Annual 17, 1-6.

Byrd, G., Garza, C., Nieswiadomy, R. (1999). Predictors of successful completion of a

baccalaureate nursing program. Nurse Educator, 24(6), 33-37.

Dockter, M. (2001). An analysis of physical therapy preadmission factors on academic success

and success on the national licensing examination. Journal of Physical Therapy Education,

15(1), 60-64.

Espen, D., Wright, D. L., & Killion, J. (2006). Admission requirements for radiography

programs. Radiologic Technology, 77(5), 366-372.

Evans, J. G., & Dirks, S. J. (2001). Relationships of admissions data and measurements of

psychological constructs with psychomotor performance of dental technology students.

Journal of Dental Education, 65(9), 874-882.

Gallagher, P. A., Bomba, C., & Crane, L. R. (2001). Using an admissions exam to predict student

success in an ADN program. Nurse Educator, 26(3), 132-135.

Gardenhire, D. S., & Restrepo, R. D. (2003, Fall). Study of predictor variable for program

completion in an associate degree respiratory care program. Respiratory Care Education

Annual, 12, 21-28.

Noonan, B. M., Sedlacek, W. E., & Veerasamy, S. (2005). Employing noncognitive variables in

admitting and advising community college students. Community College Journal of

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Research and Practice, 29(6), 463-469.

Ostrye, M. E. (2001). Predicting NCLEX-PN performance for practical nursing students. Nurse

Educator, 26(4), 170-174.