A Study in Peer Mentoring for Academic Success in Nursing

Robinson, E. & Niemer, L,. (2010). A peer mentor tutor program for academic success in nursing . Nursing Education Perspectives: September 1, 2010


INDEX


The Problem

The challenge and rigor of nursing education frequently results in fairly high student attrition from these preparation programs at Northern Kentucky University. Challenges include heavy course loads, difficult science courses, and failure to realize what is needed for success in a nursing major. Also, nursing students often have part or even full-time employment, and some are responsible for family care. In 2005, course attrition rates in the first two semesters of clinical nursing and theory courses ranged from 7 percent to 17.3 percent. Given the pressing demand for qualified nurses in the profession, this attrition is counter – productive.


Summary

This report describes the design, implementation, and outcomes of a peer mentor tutor program (PMTP) for at-risk nursing students in a traditional undergraduate program. A grant provided scholarship incentives for student participants and covered costs of the extra training and materials. Criteria were determined for the selection of student mentors-tutors and the identification of at-risk students. Interventions consisted of weekly PMTP sessions offered for the first four semesters of nursing courses. Course and exam grades, plus GPA, were used to determine outcome differences between control and treatment (mentoreds) groups. Students in the treatment group were found to score significantly higher than the control group on both summative and final grades.


Literature Review

A very few studies have examined combined use of peer mentoring and peer tutoring interventions to support academic improvement. A summary of research findings by Dorsey and Baker (2004) on undergraduate mentoring yielded 51 publications on mentoring in nursing between the years 1991 and 2003.

  • Sixteen of those published works resulted in positive findings from the perspective of the mentee.
  • Five studies reported improved retention with mentoring.
  • One of the five studies used peer mentoring and tutoring for at-risk students. Results included grade improvement and close mentor-mentee relations lasting over one year (Ramsey, Blowers, Merriman, Glenn, & Terry, 2000).

This report was done to add needed understanding to this knowledge base.


Program Structure

The goals of program were to increase the retention rate of nursing students, especially during their first two semesters in nursing, and enhance the overall academic proficiency of both mentor-tutors and their mentees.

Students met weekly for tutoring and mentoring guidance. A collaborative group approach was used to facilitate learning and problem solving. Every participant had a predetermined role and responsibility, including the faculty adviser, the mentees, and the advanced level undergraduate student selected by faculty to serve as the peer mentor-tutor.

FACULTY ADVISER – This full-time faculty member was assigned a reduced teaching load. The adviser:

  • arranged mentor training sessions
  • reviewed students for inclusion in the program
  • tracked academic outcomes
  • organized peer mentor-tutor materials
  • organized scholarship incentives
  • monitored and facilitated communication between peer mentor-tutors and nursing course coordinators
  • provided mentoring for the peer mentor-tutors themselves.

PEER MENTOR-TUTORS – The program believes selection has proven to be the cornerstone of the program’s success.

Selection – The mentor-tutors:

  • were nursing students
  • had earned As or Bs in PMTP courses
  • committed to participation one semester at a time
  • were recommended by faculty
  • were interviewed by the faculty adviser
  • had a positive attitude toward mentoring tasks
  • knew departmental policies
  • understood the need for confidentiality with with peers in the program
  • signed confidentiality agreement forms.Selection of the mentors has been carefully designed and conducted.

Each peer mentor-tutor was assigned to lead groups of five student mentees.

Mentor Training – The faculty adviser and a coordinator from the university’s Office for Student Success provided mentor training on how to:

  • deal with students
  • foster a positive mentoring relationship
  • program objectives and components
  • use available campus resources
  • complete program documentation (weekly group summaries and attendance records)

Mentors received:

  • two textbooks on mentoring
  • various course materials., including handouts, notes, case studies, games, and practice questions related to their courses.

Some mentor-tutors developed practice exams, provided study guides, and developed learning games.

MENTEES – Candidates were provided information on the program via email and individual letters.

Criteria for Participation – included one or more of the following:

  • previous nursing course failure,
  • previous biological science course failure,
  • grade point average (GPA) of 2.3 to 2.8,
  • nursing adviser or nurse faculty recommendation.

Students were asked to indicate interest to the faculty adviser.

Mentor – Tutor Groups – Mentees were placed in groups according to the semester in the nursing course of study.

Mentees received no formal training. They were encouraged to contact the faculty adviser to discuss any concerns. During the first semester of the program, “mentee open communication sessions” were offered to facilitate discussion related to program strengths and weaknesses. Attendance at those sessions was low.

PMTP-SUPPORTED COURSES – All clinically focused nursing courses in the first four semesters were included in the PMTP. These courses were fundamentals, pharmacology, beginning and intermediate medical-surgical nursing, health assessment, obstetrical nursing, pediatric nursing, and psychiatric nursing. These specific courses were selected because of their higher attrition rates and the presumed student need during them for the program.

Interventions and Incentives – Peer mentor-tutor groups met weekly on campus for two hours each semester. Attendance and summaries of group meetings were documented and provided to the faculty adviser by the mentor-tutor. Mentees had to attend 75 percent of the group sessions to receive scholarship incentives. Peer mentor-tutors were encouraged to have mentees lead the focus for each session.

Although topics renaged between mentoring and course topics, typically the focus was on tutoring. Other topics included studying and test-taking skills, stress reduction, and time management.

On successful completion and grade availability, peer mentor-tutors and mentees were awarded the financial incentives of credits in their tuition accounts. Funding was supported by the Office of the Associate Provost for Student Success. Mentor-tutors were paid for the time spent during the orientation to the PMTP and for time spent mentoring and tutoring students. They were paid at rates competitive with hospital salaries, which helped the program attract well-qualified students for the peer mentor-tutor role.

Scholarship incentives applied toward tuition were available to mentees based on their level of academic achievement. For each earned A or B, mentees received $200. An earned grade of C was not awarded scholarship funds.


Study Methods

1. The study was designed to use three groups:

  • a treatment group (in the PMT Program)
  • TWO control groups:
    • students who qualified for the PMTP program but chose not to participate
    • students who did not meet risk criteria

2. Comparison of mentee test scores with the scores of the two control groups was done.

3. Program effectiveness was also measured using mentee grades for each PMTP course.


Study Results

2007 Participation – 97 participants completed the PMTP, an 80 percent completion rate.

Seventeen peer mentor-tutors participated, each with a single-group assignment.

OVERALL PERFORMANCE – Of the 97 who finished the program, for courses receiving PMTP support:

  • 7 students earned As
  • 46 earned Bs
  • 36 earned Cs
  • 8 were unsuccessful, even with participation in the PMTP.

EXAM PERFORMANCE – Mentees earned significantly higher test scores throughout the year than the control group.

  • The mean score for mentees was 83.4 %
  • The mean score for for controls was 80 %.

A statistically significant difference was found between the groups (t = 4.4, df = 199, p < .001).

1. Pharmacology exam scores for mentees were lowest The reason is believed to be that Pharmacology is taken at the onset of the nursing curriculum before students have finished anatomy and physiology. Their incomplete knowledge in these areas, and their lack as of yet of theoretical and clinical nursing experience add to the challenge.

2. Psychiatric nursing – Mentees performed marginally better than the control groups. This istypically a difficult course. However, the attrition rate in the course decreased from 6 percent to 4 percent during the PMTP. Faculty also reported that understanding of concepts and class participation improved as a result of the program.

3. Medical-surgical nursing – Mentee course exam results were higher than the control groups.

4. Obstetrical nursing – mentees performed better than the control cohort and equivalent to the class cohort.

GRADE POINT AVERAGE – Average GPA for the mentored group was 2.80, compared to 2.76 for the control group. A t-test indicated no significant differences between the groups (t = 1.075, df = 194, p = .284). GPA was the only variable tracked and compared to determine group equivalency.

ATTRITION –

1. In the first year of the PMTP, attrition rates did not change significantly when compared to previous years.

2. However, an analysis showed that mentees accounted for less than 1 percent of the attrition from nursing courses. Course outcomes and attrition have remained relatively consistent.


Lessons Learned

  • The PMT Program led to positive academic results for participants. This demonstrates the benefit of peer support for at-risk students.
  • Assigning faculty advisors a reduced teaching load was significant in creating the time needed to administer details of the program and monitor and guide the participants toward success.
  • An exciting finding was the passion for education that emerged among the student mentors. Four mentors reported the experience ioncreased itheir nterest in a career in nursing education.
  • Faculty noted a decrease in the need for them to hold one-to-one tutoring sessions,.
  • The success of this program was the result of teamwork between faculty and staff within the School of Nursing and Health Professions and the Office of Student Success, with the peer mentor-tutors and mentees, all focused on promoting student and program success.

Problems during the program included:

  • Communication concerns
  • Incomplete or delayed submission of documentation
  • Incomplete program evaluations
  • Overall attrition of approximately 20 percent
  • Some mentors and mentees failed to honor their commitment to the program. Two mentors resigned for personal reasons; some mentees stopped taking part and provided no reasons for dropping out.
  • Some scholarship incentives were late because mentors did not submit documentation of progress twice each month as required.
  • Difficulty of using electronic evaluations of the program.

Conclusions

A PMTP model can be used to improve academic performance among nursing students, both at the beginning of the program and in all programs where academic success and attrition are concerns.

Having graduate students in nursing education (rather than advanced undergarduate) serve as mentors may improve program and student success, but will remove the unanticipated benefit for mentor-tutors.


EDITOR’S NOTES – Readers with a passion for mentoring may feel disappointed by these results. Even though they are statistically significant, they are not dramatic. They are what they are, and the quality of the research design means we can trust these results.

Part of the reason the results are not greater is that the student experience is much more than academic, the narrow focus of this specific program. While mentoring can rarely address personal issues, these issues do impact student ability to cope and succeed. Some programs have tried to address these issues in nonmentoring ways, such as by providing child care on-site, pairing mentoring support with social worker support, etc.

Mentoring can be conducted on a wider-than-academic basis. other research shows that the more comprehensive the support, the greater the effect is. The most typical example is including socialization to university level life and work, and other such topics on which many other student peer mentoring programs are focused. It may be that this was done by mentors in the PMT Program but that focus was not described in this report and is doubtful given it’s academic mentoring focus.


About the Authors

Erin Robinson, MSN, RN, is an assistant professor of nursing at Northern Kentucky University, Highland Heights, Kentucky, where Louise Niemer, PhD, RN, is an associate professor and director of the Baccalaureate Nursing Program.


References

Dorsey, L. E., & Baker, C.M. (2004). Mentoring undergraduate nursing students; Assessing the state of the science. Nurse Educator, 29(6), 260-265.

Ramsey, P., Blowers, S., Merriman, C., Glenn, L. L., & Terry, L. (2000). The Nurse Center: A peer mentor-tutor project for disadvantaged nursing students in Appalachia. Nurse Educator, 25(6), 277-281.