Admitting the Right Nursing Students: Why the Numbers Matter

New Research Demonstrates the Value of Standardized Admission Assessments

High attrition rates continue to challenge nursing programs at all degree levels, placing added pressure on admissions decisions. A new study encompassing more than 100,000 students¹ shows that standardized nursing admission assessments can reduce these pressures by identifying the students most likely to succeed — before they enroll.

A key reason for high attrition is the academic demands of a nursing curriculum. Programs can therefore optimize nursing student retention and NCLEX pass rates by evaluating academic preparedness in the subject areas foundational to nursing school: reading, math, science and English.^2-7

Overview of Approaches to Nursing Admission

Academic nursing programs use a variety of approaches to select incoming students.

In a combination approach, programs may assess candidates in 3 ways:^3-5 

• evaluation of cognitive academic abilities through standardized test performance
• evaluation of past academic performance (e.g., high school grade point average)
• evaluation of noncognitive measures such as resiliency, motivation, and problem-solving and communication skills.

In a standardized assessment approach, programs focus on how students perform in standardized testing. This method reflects research showing that a student’s cognitive capacities are pivotal to academic success. In particular, the domains of reading, math, science and English play a critical role in academic performance.⁸

Large-Scale Study Shows Standardized Testing is Valuable

A recent study examining 6 years of data from more than 100,000 nursing students confirmed that standardized admission assessment — specifically, the Test of Essential Academic Skills (TEAS) — remains a reliable predictor of early nursing student success.¹ The validity and effectiveness of standardized admissions testing was evident even through the unprecedented education challenges of the COVID-19 pandemic.¹

The research, published in the September/October 2025 issue of Nurse Educator, used correlation and regression analyses to evaluate nationwide test scores for ADN (N=61,045) and BSN (N=39,180) students who took both the ATI TEAS and the ATI Content Mastery Series Fundamentals Assessment. This analysis examined how well TEAS scores predicted student performance across 3 distinct periods including the COVID-19 pandemic:

• January 2018–February 2020 — the prepandemic period
• March 2020-August 2021 — the pandemic period
• September 2021-December 2023 — the postpandemic period.

The authors found that student scores in the 4 content areas on the TEAS — reading, science, English and mathematics — were significant predictors of fundamentals scores across all periods. This predictive strength declined during the pandemic period (March 2020 to August 2021), which is consistent with published nursing education research encompassing this event. This study brings new perspective to academic understanding of the influence of COVID-19 on nursing school admissions and student performance.

"While numerous studies have predicted early nursing school success to determine the criterion-related validity of admission tests, few studies have evaluated the predictive validity of these tests in the context of the impact of COVID-19," said Xuechun Zhou, PhD, a coauthor of the study. Dr. Zhou is a senior psychometrician at Ascend Learning, the parent company of ATI Nursing Education. The study coauthors were Hanwook Yoo, PhD, manager of psychometrics at Ascend Learning, and Beth Cusatis Phillips, PhD, strategic nursing advisor at Ascend Learning.

Why Programs Should Evaluate All Cognitive Skills

This 2025 analysis fills a gap in understanding about how major educational disruptions affect the reliability of admission assessments. It also provides important insights for nurse educators and admission committees:

• TEAS remains predictive across all content areas: All 4 TEAS content areas — reading, math, science, and English — significantly predicted early academic success in nursing programs. Reading and science were the strongest predictors, consistent with previous research findings.
• The pandemic impact was real — but temporary: While the predictive strength of TEAS scores declined during the pandemic period, this effect was temporary. The analysis documented a recovery in predictive validity during the postpandemic period, but it was not quite to prepandemic levels.
• Evidence supports comprehensive assessment: The findings reinforce that when making admission decisions, nursing schools should consider all TEAS content areas rather than relying on a single criterion. Each domain contributes valuable information about a student's likelihood of success.

“The findings in this study support the inclusion of standardized academic tests as a part of nursing school admission decisions,” the authors concluded. “All major content areas, such as reading, math, science and English, are essential cognitive academic skills and should be considered. In other words, to ensure selected applicants can complete their education and develop all professional qualifications, it is not sufficient to adopt one single criterion to predict students’ success.”

TEAS Scores Help Programs Predict Nursing Student Success

This study adds to the growing body of evidence supporting the use of standardized admission assessments in nursing education and provides valuable insights into how major educational disruptions can temporarily affect — but not eliminate — the predictive validity of these tools.

For nursing programs navigating admission decisions in a postpandemic world, this study provides evidence that TEAS continues to serve as a valuable component of comprehensive, evidence-based admission criteria.

The research demonstrates that while external factors like the pandemic can temporarily affect the relationship between admission assessments and student outcomes, the fundamental predictive value of evidence-based standardized assessment, followed by the delivery of comprehensive academic preparation, remains intact.

For nursing programs committed to both maintaining standards and expanding access to the profession, this research offers a roadmap: Use standardized assessments wisely, understand their limitations, and invest in helping admitted students succeed — regardless of their entry point.

Behind every admissions test score is an aspiring nurse whose success depends not just on their preadmission preparation, but on the support and opportunities their academic programs provide.

Learn more about comprehensive, evidence-based admission practices here.

References

1. 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
2. Canzan F, Saiani L, Mezzalira E, et al. Why do nursing students leave bachelor program? Findings from a qualitative descriptive study. BMC Nursing. 2022;21(1):71-80. doi:10.1186/s12912-022- 00851-z
3. Merkley BR. Student nurse attrition: a half century of research. Journal of Nursing Education and Practice. 2015;6(3):71-75. DOI: 10.5430/jnep.v6n3p71
4. Al-Alawi R, Oliver G, Donaldson JF. Systematic review: predictors of students’ success in baccalaureate nursing programs. Nurse Education in Practice. 2020;48:102865. https://pubmed.ncbi.nlm.nih.gov/32927338/
5. Zamanzadeh V, Ghahramanian A, Valizadeh L, Bagheriyeh F, Lynagh M. A scoping review of admission criteria and selection methods in nursing education. BMC Nursing. 2020;19(1):121. https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-020-00510-1
6. Assessment Technologies Institute (ATI) Research. Predicting early nursing school performance in an ADN program: How do the ATI TEAS version 7 preparedness levels predict RN CMS Fundamentals performance? ATI Nursing Education; 2024.
7. Assessment Technologies Institute (ATI) Research. Predicting early nursing school performance in a BSN program: How do the ATI TEAS version 7 preparedness levels predict RN CMS Fundamentals performance? ATI Nursing Education; 2024.  
8. Arastaman G, Bulus M, Kontas H, Ozcan B. Understanding the role of cognitive constructs employed in reading in global math and science achievement. Frontiers in Psychology. 2024;15:1470977. Doi:10.3389/fpsyg.2024.1470977