This study investigated the effectiveness of traditional admission criteria in predicting first-semester success in prelicensure nursing programs. With increasing attention to fairness and accessibility in higher education, nursing programs must reassess the reliance on standardized tests and science grade point averages (GPA) to identify accurate predictors of student success.
Background
Admission to prelicensure nursing programs is competitive, with many schools using standardized tests, such as the Test of Essential Academic Skills (TEAS®) and the American College Testing (ACT®), alongside cumulative and science GPAs to rank applicants. However, these metrics may reflect outdated practices that create barriers for underrepresented groups, particularly as education costs and the diversity of the student population increase. Current nursing education guidelines lack standardization in admission practices, offering flexibility but few validated best practices.
A midwestern nursing program required applicants to meet minimum scores on the TEAS® or ACT®, maintain a 2.75 or 3.0 GPA depending on the track, and achieve a cumulative GPA of 3.0 in core science courses. This study aimed to determine whether these criteria predict success in first-semester nursing courses and how they align with evolving educational priorities.
Literature Review
Research on nursing admission criteria has primarily focused on standardized tests and pre-nursing GPAs. Systematic reviews indicate that science GPAs and standardized tests can predict success in nursing programs but suggest that no single variable is sufficient to guarantee positive outcomes (Al-Alawi et al., 2020; Crawford et al., 2020). Additionally, the predictive value of these criteria has been called into question in recent years, highlighting the need for each institution to evaluate its standards. Studies have increasingly recommended more holistic approaches to admissions, integrating broader assessments of student potential.
Research Questions and Methodology
The study employed Astin’s (2012) Input-Environment-Outcome (I-E-O) model to analyze the relationship between first-semester nursing GPA and academic variables, including TEAS® scores, ACT® scores, pre-nursing GPAs, and science GPAs in courses such as chemistry, anatomy and physiology, microbiology, pathophysiology, and pharmacology. Using a predictive correlational design, researchers conducted a retrospective analysis of student records from six cohorts of prelicensure nursing students admitted between 2021 and 2022.
The inclusion criteria required enrollment in one of these cohorts, while exclusions included students from a satellite campus, those on leave during their first semester, and students with unverifiable data. Linear regression was applied to a final sample of 259 records to identify significant predictors of first-semester GPA.
Key Findings
The regression model revealed statistically significant relationships between first-semester GPA and two variables: ACT® composite scores and pharmacology GPA. ACT® scores accounted for 3.8% of the variance in first-semester GPA, while pharmacology GPA contributed 4.1%. Variables often emphasized in admissions, such as TEAS® scores and chemistry GPA, did not correlate significantly with first-semester performance. The overall model explained only 18.6% of the variance in first-semester GPA, suggesting that other factors, such as teaching quality, engagement, or personal attributes, likely play a substantial role in student success.
Discussion
These findings challenge traditional admissions practices that heavily weight standardized tests and science GPAs. While ACT® scores and pharmacology GPA were modest predictors of success, their limited predictive power highlights the need to consider additional factors influencing academic outcomes. The lack of correlation between TEAS® scores and first-semester GPA is particularly notable, given the widespread use of TEAS® as an admission criterion in nursing programs.
The results align with calls for holistic admissions practices that move beyond academic metrics to include personal statements, letters of recommendation, and extracurricular activities. These approaches aim to recognize students’ diverse strengths and potential while maintaining academic standards and reducing barriers for underrepresented applicants.
Implications and Recommendations
Based on the findings, the nursing program dropped TEAS® and ACT® requirements and revised its applicant scoring rubric to emphasize holistic admissions criteria. These changes aim to foster a more inclusive process that supports equity and diversity while finding candidates likely to succeed. The shift also aligns with recommendations from the American Association of Colleges of Nursing, which advocates for admissions practices that assess a broader range of attributes.
Future research should explore long-term outcomes, such as program completion and NCLEX first-pass success, to validate the efficacy of holistic admissions. Replicating this study across diverse institutions would offer broader insights into the reliability of various admission criteria.
Limitations
Several limitations must be considered when interpreting the findings. The study used convenience sampling from a single institution, which may limit generalizability. Data discrepancies for one cohort and the exclusion of confounding variables, such as socioeconomic status, study habits, and prior academic preparation, could have influenced the results. Additionally, grading policies during the COVID-19 pandemic may have inflated science GPAs, potentially affecting the findings.
Conclusions
This study contributes to the growing body of evidence questioning the reliance on standardized tests and science GPAs in nursing admissions. The findings suggest that ACT® scores and pharmacology GPA offer limited predictive value and that broader, more holistic criteria are needed to assess student potential. By shifting toward more inclusive and comprehensive admissions practices, nursing programs can better support diversity and equity while maintaining academic rigor.
Future research should validate these findings in different settings and explore additional predictors of success, including personal resilience, engagement, and noncognitive attributes. Such efforts can inform more effective and fair admissions practices, ultimately strengthening the nursing workforce to meet the diverse needs of healthcare systems.
Full references available upon request.
References
Al-Alawi, R., Oliver, G., & Donaldson, J. F. (2020). Systematic review: Predictors of students’ success in baccalaureate nursing programs. Nurse Education in Practice, 48, 102865. https://doi.org/10.1016/j.nepr.2020.102865.
Astin, A. W., & Antonio, A. L. (2012). Assessment for excellence: The philosophy and practice of assessment and evaluation in higher education (2nd ed.). Rowman & Littlefield Publishers.
Crawford, C., Black, P., Melby, V., & Fitzpatrick, B. (2021). An exploration of the predictive validity of selection criteria on progress outcomes for pre-registration nursing programmes – A systematic review. Journal of Clinical Nursing, 30(17-18), 2489-2513. https://doi.org/10.1111/jocn.15730.
