Course Correction: How Early Action and Support Improve First-Year Retention in Nursing Students
The transition to college can be challenging for many students, but for those entering rigorous fields like nursing, the stakes are especially high. Because more and more students begin their nursing journey with weaknesses in foundational areas, first-year attrition rates are significant. The problem is so prevalent that 71% of faculty who answered a recent ATI Nursing Education survey identified academic underpreparedness as a top concern.
Could earlier action and support improve first-year retention rates in prelicensure nursing students? Absolutely. This article explains how nursing programs can improve students’ academic preparedness by providing targeted, multifaceted support programs that shore up essential knowledge, teach study skills, and support mental well-being — all without additional demands on faculty.
The Challenge of Academic Underpreparedness
Academic performance data show that students in general are entering college settings at a disadvantage. Scores on evaluative exams such as the ACT continue to decline long after the height of the COVID-19 pandemic — calling high school GPAs into question.
In a 2024 essay, the Bloomberg News editorial board described the padding of classroom grades as routine. “Over the past decade, average scores on the ACT exam declined in English, math, social studies and science, yet test takers’ self-reported grade-point averages in all four subjects went up,” the board wrote.
One of many reasons that grade inflation does not serve students well is that it can exacerbate educational inequalities. As the Fordham Institute points out, high school students who receive artificially elevated grades are accepted into programs based on an inaccurate picture of their actual performance and readiness. This means they may not receive the support and interventions they need to improve. Given such disadvantages, it’s not surprising that first-year dropout rate among college freshman recently soared to 23%.
These trends are worrisome for all, but they have an especially sharp impact when it comes to nursing. The United States faces a shortage of 78,000 full-time RNs in 2025 and 63,000 in 2030. Given that so many new nurses are needed in the workforce, first-year attrition warrants immediate attention.
So where exactly are first-year students struggling? Across the country, faculty report weaknesses in basic reading, math, science, and English. They also cite poor study skills and mental health challenges as additional significant contributors to attrition. In fact, nursing students are more likely than college students in other degree programs to experience anxiety, depression, and stress — with almost half reporting these symptoms (Stubin & Dehan, 2024).
The Role of Academic and Emotional Support
The study by Stubin & Dehan suggests that when programs provide academic and emotional support to first-year nursing students, retaining students and fostering their success becomes more feasible. This type of support can be especially effective when it incorporates tutoring, mentoring, and mental health resources.
Research performed by ATI Nursing Education in 2024 found that a customized program focused on improving the academic, study and personal skills required for nursing programs helped improve student performance and progress in prelicensure practical nursing and associate degree nursing programs. These results suggest that tailored support programs can make a significant difference in student outcomes.
The customized program evaluated in this new research is Launch: Nursing Academic Readiness®, developed by ATI. Launch provides personalized study plans, one-on-one guidance from nurse educators, and comprehensive content covering essential academic skills. ATI introduced Launch in 2023 and released an updated version with content additions and expansions in January 2025. The new features include faculty and student user enhancements and quizzes, tutorials and assessments to measure progress more thoroughly and frequently.
“Launch helps students learn and review critical skills needed for nursing program success,” said Beth Phillips, PhD, RN, CNE, CHSE, the lead investigator for the study that assessed the effectiveness of Launch. “This research is critically important because it shows that Launch can help address student attrition rates.”
Dr. Phillips is the Strategic Nursing Advisor and Senior Manager of Content Strategy for ATI Nursing Education. She and coinvestigator Kari Hodge, PhD, manager of psychometrics at Ascend Learning Healthcare (parent company of ATI), analyzed data from PN and ADN nursing programs that implemented Launch: Nursing Academic Readiness and identified statistically significant improvements on proctored assessments.
The results of the study, which has been submitted for journal publication, show that Launch can pinpoint student weaknesses and help address them in time to keep students on track in the first year of a program.
“Understanding and providing what students need to be successful during nursing school is imperative for nursing and, ultimately, healthcare in general,” Dr. Phillips said. “Launch determines what each student needs and provides a customized approach to meeting those needs.”
How Does Launch Improve Nursing Student Readiness?
Launch: Nursing Academic Readiness improves nursing student readiness by targeting the 5 key areas in which first-year students struggle:
- reading, math, science, and English
- medical terminology
- anatomy and physiology
- study skills and test-taking strategies
- mental health and well-being.
Students enrolled in a nursing program that incorporates Launch are paired with an ATI Educator who guides them through the 6-week program, comprised of these modules:
- Module 1: Orientation & Preprogram Assessment. Students meet their ATI Educator and get acquainted with Launch: Nursing Academic Readiness. The educator administers a comprehensive preprogram assessment to assess all skills and provides a personalized study plan for each student.
- Module 2: Success Skills. Students learn skills that are essential to good academic performance, including how to develop a strong and confident mindset and achieve and maintain well-being, and how to study and perform well on tests. New in 2025, this module includes mental health simulations and a video tutorial on growth mindset.
- Module 3: Nursing Math Basics (New in 2025). Students learn about the importance of math in nursing. The content teaches the need for accuracy in medication administration and helps each student build skills in these areas. This module provides pre- and post-module assessments to evaluate comprehension.
- Module 4: Medical Terminology (New in 2025). Students learn common medical terms and frequently used medical language and abbreviations. The ATI Educator oversees pre- and post-module assessments to evaluate comprehension.
- Module 5: Anatomy & Physiology (Enhanced in 2025). The ATI Educator personalizes this module to each student, which has 39 A&P tutorials available for assignment. New in 2025, this module provides pre- and post-module assessments to evaluate comprehension.
- Module 6: Postprogram Assessment & Evaluation. Students complete a comprehensive postprogram assessment that evaluates their progress. Students who don’t score satisfactorily receive further direction from the ATI Educator.
Reversing First-Year Attrition Is Possible With Early Intervention
Early action and support are crucial in improving first-year retention rates in prelicensure nursing students. Academic weaknesses are preventing many first-year nursing students from progressing through a program, limiting the growth of the nursing workforce. Proven support programs that strengthen academic skills, study skills and well-being can make a substantial difference. Launch: Nursing Academic Readiness closes common academic gaps by providing targeted, comprehensive support and assessment of readiness to proceed in a nursing program.
Get Students on Track with Launch: Nursing Academic Readiness
Launch: Nursing Academic Readiness has been powered up with more content, resources and user enhancements. Strengthen first-year student performance without additional demands on faculty. Click here to connect with an ATI representative.
References
Bloomberg News Editorial Board. (2024). Grade inflation in U.S. schools is worsening the learning loss crisis. Bloomberg News. https://www.bloomberg.com/opinion/articles/2024-03-14/grade-inflation-in-us-schools-is-worsening-the-learning-loss-crisis
Fordham Institute. (20204). Grade inflation and why it matters. Thomas B. Fordham Institute. https://fordhaminstitute.org/national/commentary/grade-inflation-why-it-matters-and-how-stop-it
Hanson, M. (2024). College Dropout Rates. EducationData.org. https://educationdata.org/college-dropout-rates
Health Resources and Services Administration Health Workforce. (2022). Nurse Workforce Projections, 2020-2035. https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/Nursing-Workforce-Projections-Factsheet.pdf
Stubin, C.A., Dahan, T.A. (2024). Supporting mental health well-being in the most vulnerable future nurses. Nursing Education Perspectives, 45 (5), 281-286. DOI: 10.1097/01.NEP.0000000000001297