Early identification helps faculty provide the right support at the right time

Every nursing student’s journey begins with hope. But this hope often is dashed by academic and personal challenges that derail progress.

When nursing programs identify at-risk students early, they can provide interventions that keep students on track. The benefits of this approach are immense, extending from students to educational institutions to the U.S. healthcare system.

This article shares 4 strategies to provide the early identification and support thousands of students require to succeed in nursing programs and in their careers.

The Impact of Nursing Student Attrition Extends Beyond the Classroom

In terms of financial impact, both students and institutions suffer when the dream of a nursing career fades. Students must absorb the financial and personal impacts of not earning a degree they counted on, and institutions lose tuition revenue for successive semesters of the cohort because they cannot replace the students who don’t progress.

But the effects ripple further. Nursing student attrition means fewer nurses enter the workforce, exacerbating the nursing shortage and negatively affecting patient care.^1,2

The upshot is that every student who fails to complete their program represents a missed opportunity to strengthen the healthcare workforce. So how can nursing programs meet the retention challenge?  

The first step is to identify at-risk students early. Programs that do so retain more students who have the potential to succeed on the NCLEX and enter nursing practice.

This isn’t as straightforward as its sounds. Given the comprehensive demands of teaching, even the most skilled faculty can miss signs of academic need. That’s where predictive data and analytics play a powerful role.  

Evidence-Based Strategies Can Identify At-Risk Students

Across many fields of study in higher education, predictive analytics and continuous academic performance tracking — also known as machine learning — can identify students at risk.^3-6 Research shows that this should be a program’s first step toward increasing student retention.

In one of the most recent evaluations of student data algorithms, a 2025 study found that the use of machine learning approaches to identify at-risk students and predict academic success generated valuable insights into student behavior and performance.³

“A comprehensive approach to student support, informed by data analytics, can address multiple factors influencing academic success, leading to better outcomes,” the authors wrote. “… By leveraging these technologies, institutions can make data-driven decisions to enhance student success, improve teaching and learning practices, and optimize resource allocation.”

Predictive data analytics can be adapted to suit the specific needs of an institution. One of the most effective applications in nursing programs is to identify students at greatest risk of failure within the first semester. This has the potential to save institutions time, money and resources.

A 2021 study of a predictive analytics approach surmised with 88% accuracy whether a student would pass or fail a course by the fifth week of an academic program.⁴ This analysis focused on students in a computer programming curriculum, but the results reinforce the consensus that analyzing LMS data and other objective markers of student engagement and knowledge can accurately identify at-risk students.

Predictive analysis can also be helpful at the end of the first year. A 2021 study of BSN students used machine learning approaches to analyze likelihood of program success based on first-year metrics.⁵ The researchers determined that predictive analysis at the end of the first academic year could determine graduation outcomes for more than 80% of students. Prediction accuracy reached 90% after the second year and 99% after the third year.⁵

In another application of machine learning in healthcare education, researchers used a predictive model to analyze first-year student assessment data from 5 cohorts of physician assistant students.⁶ The approach predicted with 93% certainty the students’ certification exam score — a full year before they would take the test. The findings allowed faculty and students to address weaknesses well before the exam date, the authors said.

Using Predictive Data to Provide Support for At-Risk Nursing Students

Dan Heath, the author of business books including Upstream: The Quest to Solve Problems Before They Happen, once described data as the summary of thousands of stories. To make the stories meaningful, the data must be shared and applied.

It’s apropos guidance for nursing programs seeking to translate data into customized learning approaches that will keep students on track toward graduation.

The factors that negatively influence a nursing student’s ability to progress are often categorized as extrinsic and intrinsic. Extrinsic factors encompass socioeconomic factors such as the need to work full time while in nursing school or the pressure of family responsibilities. Intrinsic factors can include poor academic preparedness, low self-confidence, or anxiety.

Many authors have studied interventions to address these factors and help students who are at risk. From among these, 3 approaches stand out in the literature:

1. Success coaching
2. Student support services
3. Mentorship by peers or faculty. 

Success Coaching Can Improve Confidence & Skills

Success coaching supports a student’s academic and personal growth by helping them build applicable skills, manage challenges, and connect with appropriate resources in the academic institution. This holistic approach has been examined in multiple studies. One of these reported on the success of a coaching program that uses existing resources to foster student confidence.

In a quality improvement study published in 2024 in the International Journal of Nursing and Health Care Research, Karen Arca-Contreras, DNP, RN-BC, described how faculty success coaches at the College of Staten Island improved student performance and confidence.⁷

The student success coaching program incorporates facets of the American Nurses Association competencies for nurse coaching and resources such as the American Holistic Nurses Association principles of nurse coaching.

At the College of Staten Island, the program takes a proactive approach that incorporates teaching study skills and time management. It also emphasizes the value of professional integration into campus organizations.

In this model, faculty members provide success coaching to all students — the guidance is not limited to students determined to be at risk. This is a major strength of the program, Dr. Arca-Contreras wrote, because first-semester students are the most vulnerable to departure from a program — whether they are at academic risk or not.

The results of this success coaching approach include:⁷

• increased student satisfaction with the start of the academic program
• close connections with peer mentor tutoring, counseling, and other resources
• greater professional integration into the campus and healthcare community.

Among nontraditional students, the study found that this approach produces an additional advantage: Coaches are often able to identify factors affecting attrition early in the first semester.

Another model for student success coaching is less structured. Instead of scheduled coaching, some institutions make services available at any time during a program. At PennState Ross and Carole Nese College of Nursing, for example, all 9 campuses have designated academic success coaches. These are faculty members with a particular interest in student retention and academic support, and students can access them directly as. needed. At University of Texas Health San Antonio, a Student Success Center provides free one-on-one coaching by appointment.

In complement to success coaching or as an alternative, support services are another key element for student retention.  

Support Services Can Reduce Risk Factors & Obstacles

Providing comprehensive support services, including academic tutoring, mental health counseling and financial aid, is a widely accepted strategy to help address common academic risk factors. But less structured, lower-dollar services also make a difference. In fact, annual reports from the National Survey of Student Engagement show that when incoming students feel well supported by their institution, they are more likely to be successful.

This conclusion is supported in a qualitative study of nursing students completed in 2024.⁸ Jessica Dugas, PhD, MN, BScN, a professor at Sault College of Applied Arts and Technology, explored how nursing students perceive the effects of retention strategies on their academic progress. Through one-on-one interviews with nursing students, she identified 3 central themes as being most influential on students’ ability to progress:

• balance in personal life and academia
• visualization of success
• sense of belonging.

“These findings suggest that student-centered activities, social relationships, enhanced orientation, student support services, and learning accommodations greatly contributed to academic progress,” Dr. Dugas wrote.

All study participants said faculty interactions were influential in their ability to progress. They also identified institution-provided resources such as the student support office and learning accommodations as beneficial.

Another qualitative study followed students in an accelerated BSN program to identify factors that enabled them to complete their nursing program after failing a course.⁹

The researcher, Catherine Dillinger, PhD, MEd, RN, noted that students who repeat a course tend to be a hidden subgroup in research, even though the scenario is not uncommon in prelicensure programs. These students have the potential for program success but may require additional resources and support systems. Dr. Dillinger is director of the prelicensure nursing program at Olivet Nazerene University, where she is also an associate professor.

In this study, students identified the following as important to their resilience:

• gaining a better understanding of program expectations
• learning strategies to overcome academic and nonacademic obstacles
• receiving advice and encouragement from faculty and peers
• participating in more clinical and simulation experiences.

Importantly, students singled out faculty support as instrumental. They expressed “overwhelming” appreciation for their instructors.

“Participants felt that the faculty continued to provide encouragement and support that helped them achieve their success,” Dr. Dillinger wrote. “Faculty encouraged students to learn from academic and personal negative experiences, creating trustworthy relationships. Faculty also provided a ‘don’t quit’ attitude, believing everyone deserved a second chance.”

Mentorship Programs Can Prepare Students for Practice

Encouragement within the context of personal connection is also a feature of peer mentorship, another effective strategy to support at-risk students. In nursing programs, research shows that peer mentorship can help increase student retention, success, and preparation for professional practice.^10,11 

Peer mentoring helps mitigate stress and burnout by creating a supportive, caring environment.¹⁰ Mentors can provide encouragement, model coping strategies, and help mentees navigate the pressures of clinical and academic life. This support enhances resilience, confidence, and overall well-being.¹⁰

The benefits of peer mentorship can also extend to mentors. Nursing students who serve as mentors often develop leadership skills, communication skills, and a deeper sense of responsibility. ¹² These experiences enrich their educational journey and prepare them for future leadership roles.

Predictive Analytics with Targeted Support Improves Program Outcomes

Early identification of at-risk nursing students is more than a best practice — it’s an imperative. With the right tools and interventions, programs can turn more struggles into successes. Predictive analytics provides an objective way to identify student needs early, but the human response — coaching, support services, and mentorship — is necessary to turn insight into impact.

By combining data-informed decision-making with compassionate, student-centered support, nursing programs can reduce attrition, improve outcomes, and ultimately contribute to a stronger, more resilient healthcare workforce.

References

1. American Association of Colleges of Nursing (AACN). Nursing Shortage Fact Sheet. 2024.
2. Carter J. The Dangerous Impact of the National Nursing Shortage. United Nurses Associations of California/Union of Health Care Professionals. 2022.
3. Ngulube P, Masumbika M. Predicting Academic Success and Identifying At-Risk Students: A Systematic Review of Data Analytics and Machine Learning Approaches in Higher Education Institutions. Educational Administration Theory and Practice Journal. 2025. DOI: 10.53555/kuey.v31i1.8447
4.  Albreiki B, Habuza T, Shuqfa Z, Serhani MA, Zaki N, Harous S. Customized Rule-Based Model to Identify At-Risk Students and Propose Rational Remedial Actions. Big Data Cognitive Computing. 2021;5(4):71.
5. Hannaford L, Chen X, Kunes-Connell M. Predicting nursing baccalaureate program graduates using machine learning models: A quantitative research study. Nurse Education Today. 2021;99:104784. https://doi.org/10.1016/j.nedt.2021.104784
6.  Kumar A, Edwards R, Walker L. The Application of Adaptive Minimum Match k-Nearest Neighbors to Identify At-risk Students in Health Professions Education. The Journal of Physician Assistant Education. 2023;34(3). https://doi.org/10.1097/JPA.0000000000000513
7.  Arca-Contreras K. Success Coaching: A Proactive Student Support Strategy. International Journal of Nursing and Health Care Research. 2024;6:1506. https://doi.org/10.29011/2688-9501.101506
8.  Dugas J. Student Nurse Experiences of Retention Strategies and the Perceived Contribution to Academic Progress. 2024; dissertation.
9.  Dillinger C. Repeating Accelerated Baccalaureate Nursing Courses: A Qualitative Study of Stories of Persistence. 2022; dissertation.
10.  Tomlinson A, Cameron NG. Association of peer mentoring on nursing student retention: A systematic literature review. Journal of Nursing Education. 2025;64(5):294-298. doi: 10.3928/01484834-20250108-08. 
11.  Kramer D. The Importance of Mentorship Programs in Nursing. In: A Guide for Developing a Culture of Caring Through Nursing Peer Mentorship Programs. (2024, Springer).
12.  Johnston K, Lawver C, Keil S. Learning to Lead — Empowering Nursing Students as Peer Mentors. Kansas Nurse. 2024;99(3).