A Framework to Address Gaps and Build Momentum in the First 6 Weeks

Thousands of determined students enter academic nursing programs each year. Many of them quickly discover that the pace and rigor of the curriculum require more than motivation alone. Without a strong academic foundation, reliable study habits, and a clear plan for support, they struggle and fall behind.

The result is that first-year student attrition continues to be a vexing problem for nursing education.

"Academic preparedness and retention are inevitably connected," said Amy Edmison, DNP, RN, CNE, a former academic program director who is now a Nursing Education Consultant for ATI. “Preparedness measures are proactive, yet retention strategies are often reactive.”

By developing student success plans based on measures such as admissions exam results, self-assessments and personalized data, programs can become more proactive in promoting retention.  

“The big takeaway is to consider students as individuals,” Dr. Edmison said. “Everyone has strengths as well as areas for improvement. What’s important is figuring out how to find answers together.”

Current Research on Nursing Student Academic Readiness

Recent research supports the contention that proactive interventions can help get weaker students on track. Studies published in 2025 and 2026 consistently report that nursing student retention improves when programs combine early risk identification and academic support with belonging, mentoring and structured pathways for success.^1-6

This research suggests that strong predictors of first-year nursing student success include:

• achieving academic readiness before program entry^3,4
• adequate performance in prerequisite courses (especially anatomy and physiology)^1,9
• a sense of belonging and social integration into the program^1,4
• comprehensive support within the program.^4-6,9

Several of these studies note that early screening and intervention are associated with improved retention when they pair tailored resources and remediation with students who need them. For example, Phillips and Hodge found that providing nursing students with a structured 6-week program individualized to each student’s academic readiness and study skills improved course performance and contributed to overall confidence.³

Academic Readiness Is About More Than Content Knowledge

Because readiness encompasses both academic knowledge and student success skills, academic programs are working harder to create holistic environments that help students hit the ground running.

A growing number of academic nursing programs are adopting structured, multifaceted readiness interventions that begin before the first semester starts.

Research shows that an effective first-year success strategy involves identifying weaknesses across academic knowledge, study skills, mindset, and mental well-being so that programs can provide the support that will help more students persevere.

Dr. Edmison said scores on admissions exams are a valuable contributor here, because they help programs fine-tune their approach to building preparedness.

“Academic readiness should be treated as an intentional first-year success strategy, not a remediation strategy,” she said. “That’s being proactive rather than reactive.”

4 Strategies to Strengthen Academic Readiness

Whether a nursing student is prepared for the pace, expectations and complexity of the curriculum often becomes evident in the first 6 weeks of a term. But programs do not have to wait for poor exam scores to identify who needs support. By acting on readiness data earlier and pairing students with targeted resources, faculty can create a more proactive path to first-year success.

The following strategies can help nursing programs move from reacting to student difficulty to building readiness that prevents students from falling behind.

Strategy 1: Identify readiness data and use it in proactive ways.

Using data, academic nursing programs can get important insights into incoming students.

“Admissions exam scores, science grades and self-assessments are just a few of the data points you can use to make success plans and provide targeted interventions,” Dr. Edmison said. “Testing data can pinpoint the areas of highest academic weakness, so that you can address them early and directly.”

In fact, research examining 6 years of data from more than 100,000 nursing students determined that a specific admissions exam, the Test of Essential Academic Skills (ATI TEAS^®), accurately evaluates knowledge in science, math, reading, and English language usage.⁷ The analysis also found that student subscores in each subject area are significant predictors of scores in nursing fundamentals courses.

"Subscores give faculty an early opportunity to intervene before students struggle in high-stakes courses,” said study coauthor Beth Cusatis Phillips, PhD, RN, CNE, a former nursing program director who is now a strategic nursing advisor at ATI. “This means TEAS is not just a gatekeeping tool. It’s also a student success tool."

In addition to admissions exam scores, data points to consider when shaping a student’s readiness profile and success plan should include overall GPA and grade trends over time, science performance, grades in prerequisite courses, and self-assessments.

Collectively, this information helps programs move from broad assumptions about student preparedness to individualized readiness plans implemented before high-stakes coursework.

Strategy 2: Initiate readiness support before classes begin.

Another strategy to improve academic readiness is early intervention in the form of pre-enrollment support. This is the ideal time to set expectations and work with students to establish and kick off success plans, Dr. Edmison said.

“Talk to students before they enter the program about deficits and set up a game plan,” she said. “This lays groundwork for accountability, reflection, and self-awareness. This helps students develop professional comportment.”

She also recommends that faculty and advisors share direct, actionable advice about life and study skills.

“During preadmission advising, talk about organizing time and having a system for due dates,” Dr. Edmison said. “Planning their schedule can open students’ eyes to time management.”

It’s also a good time to address educational and personal stressors. “Ask about support systems, study habits, motivation, and goals. Be supportive but realistic. And refer students to appropriate resources when needed.”

Students benefit from structured support that strengthens both foundational knowledge and academic success skills.^3,9 Launch: Nursing Academic Readiness is designed for this pre-enrollment and early-program period, providing a guided path to addressing readiness gaps before coursework becomes more demanding.

Launch is a 6-week program that addresses core readiness gaps without adding to faculty responsibilities. An ATI Educator guides each student through interactive modules covering:

• anatomy and physiology
• medical terminology
• nursing math basics
• essential student success skills (time management, mindset, studying).

The ATI Educator customizes the learning path based on findings of a preprogram assessment, and faculty receive real-time reporting on students’ progress.

Academic programs that use Launch report statistically significant improvements in fundamentals scores³ and higher first-year nursing student retention rates. In surveys, more than 90% of students who complete Launch say they believe it contributes to their success and self-confidence.

Strategy 3: Make academic success skills a central focus.

Academic readiness is often viewed in terms of content knowledge, especially in foundational science. But this lens provides an incomplete picture. Students may understand key concepts in a subject area but struggle if they lack the study habits, test-taking skills, or confidence to apply that knowledge in a nursing curriculum.

Given this fact, readiness support should help students strengthen how they learn. It should not focus solely on what they know. Skills such as determining the focus of study sessions, establishing due dates, breaking down complex reading assignments, and reflecting on personal performance can help students become more powerful participants in their own success.

This is one area where Launch: Nursing Academic Readiness is especially well aligned with first-year success goals. In addition to foundational content review, Launch shapes essential student success skills such as time management, mindset, and studying. Students receive this guidance in interactive modules in their customized learning path.

For faculty, this type of structured support creates consistency and provides visibility into student progress. This guided preparation and skill-building support doesn’t require faculty to design or manage a separate readiness curriculum — and it yields tangible results.

“Launch equips students with the necessary skills to step into the nursing program well-prepared,” said Marinela Castaño, DNP, MSN, RN, CNE, Director of Nursing at Lone Star College. After integrating Launch into the ADN program at Lone Star College, first-year student attrition decreased in consecutive cohorts.  

Strategy 4: Normalize individualized support.

Individualized support should not be reserved for students who are already struggling. When programs normalize providing help early, students are more likely to view readiness support as standard in professional education rather than a sign that they may not belong in the program.

“Remediation should be individualized and part of daily preparation, not just for those struggling,” Dr. Edmison said.

That distinction matters. A student who needs to strengthen anatomy and physiology knowledge may require a different type of support than a student who understands the content but struggles with time management, test preparation, or confidence. A structured readiness plan gives faculty and advisors a way to identify those differences earlier and connect students with support that fits their specific needs.

When individualized support is built into the student experience from the start, it fosters a more supportive academic culture, Dr. Edmison said. Students see that preparation, reflection, coaching and skill-building are expected parts of nursing education — not emergency measures reserved for students who experience struggles.

The Best Retention Strategies Begin Before Attrition Becomes a Concern

Evolving research shows that the most effective retention strategies often begin before attrition becomes a concern.

For academic nursing programs, that involves:

• applying readiness data earlier
• addressing gaps before students enter high-stakes coursework
• providing structured support to help students develop the knowledge, habits and confidence to persevere.

Implementing the academic readiness strategies outlined in this article is not complicated, but it often requires a recalibration in thinking.

“This is not a checklist but a cultural shift,” Dr. Edmison said. “It’s about meeting students where they are, to get them where they need to be.”

References

1. Bennett M, Travelsted M, Shoumake V, Atkinson M. Effect of a Living-Learning Community on Nursing Student Outcomes — a Prospective Cohort Study. Nursing Reports. 2025;15(5):144. https://doi.org/10.3390/nursrep15050144
2. Park EO, Chang K, Koduah S. Structured Assessments: Enhancing Success in Early Nursing Education and Student Retention. Nursing Reports. 2025;15:335. https://doi.org/10.3390/nursrep15090335
3. Phillips BC, Hodge K. Enhancing Student Retention in Nursing Education: Strategies and Interventions. Teaching and Learning in Nursing. 2025. https://doi.org/10.1016/j.teln.2025.02.018
4. Sheikaleslami RL, Princeton DM, Hansen LIM, Kisa S, Goyal AR. Examining Factors Associated With Attrition, Strategies for Retention Among Undergraduate Nursing Students, and Identified Research Gaps: A Scoping Review. Nursing Reports. 2025;15(6):182. https://doi.org/10.3390/nursrep15060182
5. Tomlinson AN, Cameron NG. Association of Peer Mentoring on Nursing Student Retention: A Systematic Literature Review. Journal of Nursing Education. 2025;64(5):294-298. https://doi.org/10.3928/01484834-20250108-08
6. Whittington KD, Montoya J. Navigating the Path to Student Retention: Exploring the Impact of Mentorship, Preceptors, and Clinical Readiness. Journal of Clinical Medical Images. Case Reports. 2024;4(1):1645. https://jcmimagescasereports.org/article/JCM-V4-1645.pdf
7. Yoo H, Zhou X, Phillips B. Predictive validity of preadmission assessment on early nursing academic readiness: impact of COVID-19. Nurse Educator. 2025;50(5): 277-282. doi:10.1097/NNE.0000000000001891   
8. Natan MB, Hazanov Y. Predictors of Academic and Progression Outcomes in Undergraduate Nursing Education: A Scoping Review and the Admission-Adaptation-Outcome Model. Nurse Education in Practice. 2026;94:104859. https://doi.org/10.1016/j.nepr.2026.104859
9. Fooladi E, Karim MN, Vance S, Walker L, Zanjani ME, Ilic D, Brand G. Factors Associated With Undergraduate Nursing Students’ Academic and Clinical Performance: A Mixed-Methods Study. Frontiers in Medicine. 2022;9:793591. https://doi.org/10.3389/fmed.2022.793591

About the author: Michelle Perron is a healthcare writer and editor who develops evidence-based content for ATI Nursing Education. With more than 20 years of experience in healthcare publishing, journal development, medical editing, and editorial management, she helps connect nursing research and education best practices to today's faculty needs.