Professional Documents
Culture Documents
Success
Strategies
for
Nursing Students
Success Strategies for Nursing Students 2
November, 2006
Welcome
Best Wishes!
Table of Contents
I. Nursing School
A. What to expect
B. Care planning process
C. Student Nursing Associations
VI. References
Success Strategies for Nursing Students 4
Nursing School
What to expect …
Everyone who starts nursing school knows what they hope to accomplish by the end of the
program – graduation from the nursing program along with the opportunity to take the state
nursing licensure exam and to enter the practice of nursing. What many students do not know is
exactly what to anticipate in the journey toward achieving these goals. Being aware of the
expectations and having the tools to assist you in meeting these requirements will help you in
being successful in this process.
Nursing school encompasses different types of learning opportunities. These include lectures and
activities in the classroom as well as laboratory and clinical experiences. Clinical experiences will be
added to your experiences each week. They will take you to different healthcare settings, including
long-term care facilities, acute care hospitals and community health settings.
Care Planning
Care planning is like the skeleton upon which nursing care for individual patients is built. The care
planning process includes five (5) steps: assessment, establishing a nursing diagnosis, planning
outcomes and interventions, implementing those interventions, and evaluating the success of the
process. Learning how to carry out this process will enhance your clinical practice.
Assessment
Assessment refers to the activities of assessing your patients. This includes looking, listening and
feeling for clues about their condition. You will assess their physical, mental and psychosocial
status through assessment techniques that you learn in nursing school. You will consider the
information that you discover from your assessment to formulate a nursing diagnosis. The nursing
diagnosis is one of the keys to successful nursing practice.
Nursing Diagnoses
For your reference, here are the formats for nursing diagnoses with some sample diagnoses:
Risk Diagnosis: Risk for (or Potential for) Problem related to Etiology.
Example: Risk for injury related to altered mobility and mental disorientation.
Example: Effective individual coping related to adequate support systems as evidenced by client’s
active participation in medical treatment regimen.
Planning
The planning phase of the care planning process includes identification of outcomes or goals that
address the nursing diagnoses and interventions or actions that will assist the client in achieving
those outcomes. In developing these steps of the care plan, you should refer to the nursing
diagnosis for clues.
Outcomes
The outcomes should be aimed at resolving the problem, preventing the risk, or sustaining the
wellness condition. Relevant outcomes will address the symptoms, etiology or indications in a way
that leads to achieving the ideal situation for the client - given their personal circumstances.
Outcomes are client-centered and state what client behavior is expected. These behaviors may be
passive or active on the part of the client. The client’s maintaining lab values within normal limits
is passive, while the client’s performing deep breathing exercises every two hours is an active
behavior.
Interventions
Nursing interventions will include strategies to assist the client in achieving the outcome(s). Unlike
the outcomes, the intervention is healthcare provider-centered and will state what members of the
healthcare team, including the nurse, will do to address the condition identified in the nursing
diagnosis.
Implementation
Implementation refers to the actual application of the care plan. This will be where the
interventions are carried out to facilitate the client’s achievement of the outcomes that have been
identified.
Evaluation
If the client is not meeting the outcome(s), consideration needs to be given as to whether the
outcomes were realistic and measurable and/or whether the interventions were appropriate and
adequate in helping the client to achieve the outcomes. If problems are found with the outcomes or
interventions, the care plan should be revised for the client.
Nurses do not practice in isolation but rather are part of group of professionals who are larger than
themselves individually. Professional nursing organizations have been established to inspire
professional camaraderie. Membership and participation in these organizations allows nurses to put
their voices together to speak out on issues in a powerful way. Many nursing organizations address
clinical specialties while some others draw ethnic groups together. Others address the interests of
the profession at large. You can obtain listings of and information about professional nursing
associations by researching the internet.
The nursing organization most relevant to you as a nursing student will probably be the National
Student Nurses Association (NSNA). Most states have their own student nurses’ associations that
are constituents of the NSNA. Additionally, some colleges have their own ethnic or multi-cultural
nursing associations. These efforts offer additional support to minority students. The nursing
department administration at your college should be able to provide information to you about these
associations and how to become members.
Success Strategies for Nursing Students 7
Personal Management
Time Management
Efficient time management is essential to your success in nursing school. With only so many hours
in a day and the volumes of information that you must learn to become prepared to enter the
nursing profession, you must carefully consider how to accomplish everything. Here are some
strategies for effectively managing your time.
1. At the beginning of each semester, prepare a calendar that includes all the activities in your
life. This calendar should be updated as changes occur. Activities to be included on this
calendar include:
Scheduled classes
Class assignments, including reading and required submissions
Scheduled tests
Planned school activities, such as clinical rotations and extracurricular activities
Work
Family activities
2. Every Sunday, the upcoming week’s schedule should be reviewed. This will help you avoid
surprises and assure that all necessary activities are included. This review should include:
Daily classes
Review of class notes to see if any additions are needed
Allotment of time for working on assignments and projects
Test preparation
3. Each evening, you should review the schedule for that day and for the following day. This
review should include:
Checking to see that all scheduled tasks for the day have been accomplished and checked
off
Moving unaccomplished tasks to future dates as needed
Reviewing the day’s class notes and making additions
The following suggestions are offered by the Academic Skills Center at Dartmouth College (2001).
1. Count all your time as time to be used and make every attempt to get
satisfaction out of every moment.
2. Find something to enjoy in whatever you do.
3. Try to be an optimist and seek out the good in your life.
4. Find ways to build on your successes.
5. Stop regretting your failures and start learning from your mistakes.
6. Remind yourself, "There is always enough time for the important
things." If it is important, you should be able to make time to do it.
7. Continually look at ways of freeing up your time.
8. Examine your old habits and search for ways to change or eliminate
them.
9. Try to use waiting time-review notes or do practice problems.
Success Strategies for Nursing Students 8
10. Keep paper or a calendar with you to jot down the things you have to
do or notes to yourself.
11. Examine and revise your lifetime goals on a monthly basis and be sure
to include progress towards those goals on a daily basis.
12. Put up reminders in your home or office about your goals.
13. Always keep those long term goals in mind.
14. Plan your day each morning or the night before and set priorities for
yourself.
15. Maintain and develop a list of specific things to be done each day, set
your priorities and the get the most important ones done as soon in
the day as you can. Evaluate your progress at the end of the day
briefly.
16. Look ahead in your month and try and anticipate what is going to
happen so you can better schedule your time.
17. Try rewarding yourself when you get things done as you had planned,
especially the important ones.
18. Do first things first.
19. Have confidence in yourself and in your judgment of priorities and
stick to them no matter what.
20. When you catch yourself procrastinating-ask yourself, "What am I
avoiding?"
21. Start with the most difficult parts of projects, then either the worst is
done or you may find you don't have to do all the other small tasks.
22. Catch yourself when you are involved in unproductive projects and
stop as soon as you can.
23. Find time to concentrate on high priority items or activities.
24. Concentrate on one thing at a time.
25. Put your efforts in areas that provide long term benefits.
26. Push yourself and be persistent, especially when you know you are
doing well.
27. Think on paper when possible-it makes it easier to review and revise.
28. Be sure and set deadlines for yourself whenever possible.
29. Delegate responsibilities whenever possible.
30. Ask for advice when needed.
Stress Management
Nursing school imposes a separate and distinct level of stress on students. Students are expected
to acquire a great deal of knowledge and demonstrate the ability to apply that knowledge in a
relatively short period of time. Training programs for registered nurses, whether in pursuit of an
Associates Degree in Nursing (ADN) or Baccalaureate Degree in Nursing (BSN), typically include
four semesters of learning. During these four semesters, many students enter the nursing program
with no experience in the healthcare environment. They are expected to quickly progress and be
able to demonstrate an adequate clinical skill level to be deemed competent to enter the nursing
profession. This can impose high levels of stress on an individual.
While a certain level of stress is useful for maintaining optimal motivational levels for learning, it is
well known that being overly stressed may result in impeding learning. Studies of nursing students’
experiences have revealed that excessive stress is commonly felt while participating in nursing
education programs. High levels of stress actually have been found to prevent students from
performing at their best level.
Success Strategies for Nursing Students 9
The stressors that students encounter in nursing school have been identified by students of nursing
for many years and are not likely to change. In fact, as technological advances are made, nurses
must be prepared to function in these highly technological settings - while remembering to focus
on the patient. Additionally, when nursing students graduate and enter practice settings; they are
likely to encounter continued stress due to inadequate resources and budgetary restrictions. For
these reasons, it is important that nursing students develop methods for managing their stress
levels. This strategy enables the student to have both a positive learning experience while in
school as well as to be prepared to effectively cope upon entering the profession.
The Academic Skills Center at Dartmouth College (2001) offers the following methods for managing
stress effectively:
The Academic Skills Center at Dartmouth College (2001) offers the following excerpt to students at
their website. It is from an article by Geoffrey Cowley in Newsweek, June 14, 1999,:
Aside from dealing directly with stressors and the stressful responses they elicit, you should also
consider using relaxation techniques to lower your personal threshold for becoming “stressed out”.
These techniques include doing any activity that leads you to relax. They may be either active or
passive.
Active and passive approaches may include the following either alone or in combination:
Physical exercise
Counseling
Socializing with family and friends
Meditation
Yoga
Massage
Music
Cinematherapy
Aromatherapy
Naps
Bubble bath and a glass of wine
Selecting activities to reduce stress and to promote relaxation is highly individualized. You should
experiment and find what you most enjoy and find helpful. You need to strike a balance to prevent
excessive levels of stress and to perform your best.
Motivation
Motivation is necessary for achieving any goal. Some people are more motivated than others.
Additionally, some people are motivated to excel while others have just enough “push” to get the
job done. Many factors influence the levels of motivation that we have to set goals and then to
pursue them.
If you have entered nursing school, you have set the goals of passing your nursing courses,
graduating from the program, passing the NCLEX-RN exam, and working as a nurse. It is critical
that you keep these goals uppermost during your journey through nursing school. This will help to
keep you focused on why you are working so hard to master the nursing curriculum.
While in nursing school, this must be considered your primary job. You must carefully block out
time to allow for studying and participation in the classes, lab sessions, and clinical shifts. You need
to solicit as much support as possible from family and friends. They should provide encouragement
and assist in meeting other needs, such as child care or household maintenance.
Motivation includes the drive to accomplish goals in combination with the ability to avoid
procrastination. Maintaining adequate motivation will assist in avoiding procrastination. The Center
for Advancement of Learning at Muskingum College (n.d.) suggests the following actions to support
a non-procrastination plan:
A Non-Procrastination Plan
Make a Schedule
Get Motivated
How do you prioritize success in school, social life, work, and other
activities in your life? If school is your first priority, that work must
come before any other activities. If you decide success in school is not
your first priority, then don't expect high grades.
Take Responsibility
Step back and critically examine cause and effect relationships in your
life. How do you explain failures? To what factors do you attribute
them? Be honest. Did you receive a poor grade on a project because
you started it late or didn't put in enough time? Avoid rationalizations
like "The prof hates me" or "I didn't understand the assignment."
Thoughtfully examine the consequences of your behavior.
Make two activity lists: "Things I like to do" and "Things I have to do."
Mix up activities from both lists and work on each activity for a short
period of time. Alternating between fun and distasteful tasks helps to
maintain motivation and interest.
Think Small
Success Strategies for Nursing Students 12
Be Realistic
Some people procrastinate because they have too much to do. They
have every intention of doing things in a timely manner, but they run
out of time. There are only 24 hours in a day. Thoughtfully examine
your obligations and responsibilities. Is your schedule realistic? Are
you involved in too many activities? Don't "spread yourself too thinnly"
because none of your projects will get the full attention they deserve.
Focus on Assets
Rewards
Reward yourself lavishly when tasks are completed on time. Make the
reward appropriate for the difficulty and boredom of the task.
Confidence
Life as a nursing student is laden with opportunities for feeling unsure of yourself. You will be
presented with many new and unfamiliar circumstances in an environment with high expectations.
You must be kind to yourself and remember that you are a student and that learning takes time. In
fact, as a nurse, you will never stop needing to learn and to be open to changing to practice in the
most current evidence-based manner so that you can offer the best standard of care to your
patients. Achieving a sufficient level of self-confidence is essential as you progress in nursing
school and in life in general. Having a high level of self-esteem is important as you proceed in the
nursing program working to build self-confidence in your new role as a nurse.
The UT Learning Center at the University of Texas at Austin (2006) offers the following suggestions
for building self-esteem:
1. Free yourself from "shoulds". Live your life on the basis of what is
possible for you and what feels right to you instead of what you or
others think you "should" do. "Shoulds" distract us from identifying
and fulfilling our own needs, abilities, interests and personal goals.
Success Strategies for Nursing Students 13
Find out what you want and what you are good at, value those, and
take actions designed to fulfill your potential.
2. Respect your own needs. Recognize and take care of your own needs
and wants first. Identify what really fulfills you — not just immediate
gratifications. Respecting your deeper needs will increase your sense
of worth and well-being.
3. Set achievable goals. Establish goals on the basis of what you can
realistically achieve, and then work step-by-step to develop your
potential. To strive always for perfectionist, absolute goals — for
example, "Anything less than an A in school is always unacceptable" —
invites stress and failure.
4. Talk to yourself positively. Stop listening to your "cruel inner critic."
When you notice that you are doubting or judging yourself, replace
such thoughts with self-accepting thoughts, balanced self-assessment
and self-supportive direction.
5. Test your reality. Separate your emotional reactions — your fears and
bad feelings — from the reality of your current situation. For example,
you may feel stupid, anxious and hopeless about a project, but if you
think about it, you may still have the ability and opportunity to
accomplish something in it.
6. Experience success. Seek out and put yourself in situations in which
the probability of success is high. Look for projects which stretch —
but don't overwhelm — your abilities. "Image" yourself succeeding.
Whatever you accomplish, let yourself acknowledge and experience
success and good feelings about it.
7. Take chances. New experiences are learning experiences which can
build self-confidence. Expect to make mistakes as part of the process;
don't be disappointed if you don't do it perfectly. Feel good about
trying something new, making progress and increasing your
competence.
8. Solve problems. Don't avoid problems, and don't moil about them.
Face them, and identify ways to solve them or cope with them. If you
run away from problems you can solve, you threaten your self-
confidence.
9. Make decisions. Practice making and implementing positive decisions
flexibly but firmly, and trust yourself to deal with the consequences.
When you assert yourself, you enhance your sense of yourself, learn
more, and increase your self-confidence.
10. Develop your skills. Know what you can and can't do. Assess the skills
you need; learn and practice those.
11. Emphasize your strengths. Focus on what you can do rather than what
you cannot. Accept current limitations and live comfortably within
them, even as you consider what strengths you might want or need to
develop next.
12. Rely on your own opinion of yourself. Entertain feedback from others,
but don't rely on their opinions. Depend on your own values in making
decisions and deciding how you feel about yourself and what is right
for you to do.
Maintenance of personal health is critical to academic success in nursing school. Being alert and
paying attention in learning sitautions may not occur with compromised health. Proper sleep,
Success Strategies for Nursing Students 14
nutrition, exercise and relaxation is necessary for good health. Adequate rest is essential to optimal
performance. Having a healthy balance of these elements may assist with your ability to
concentrate as teaching occurs. Health concerns should be addressed with a healthcare practitioner
so that proper diagnoses and treatment may be obtained. As noted with good stress management,
ideal personal health management needs to be carried out in an ongoing manner.
Improper sleep can cause many problems for students. These range from inability to learn to
inability to recall what you have learned. Additionally, for nursing students, adequate sleep is
essential prior to attending clinical shifts where you are responsible to provide care for patients.
The Academic Skills Center at Dartmouth College (2001) cites Peter Hauri from the Upjohn
Company who offers the following guidelines for getting adequate sleep.
6. Hunger may disturb sleep. A light bedtime snack (especially warm milk
or similar drink) seems to help many individuals sleep.
7. An occasional sleeping pill may be of some benefit, but the chronic use
of hypnotics is ineffective at most and detrimental in some insomniacs.
8. Caffeine in the evening disturbs sleep, even in persons who do not feel
it does.
9. Alcohol helps tense people to fall asleep fast, but the ensuing sleep is
then fragmented.
10. Rather than trying harder and harder to fall asleep during a poor night,
switching on the light and doing something else may help the
individual who feels angry, frustrated, or tense about being unable to
sleep.
Success Strategies for Nursing Students 15
When confronted with large volumes of information to learn, often including information that may
seem complex, the need to set yourself up for effective concentration is paramount to your
success. This includes identification of an appropriate area and time schedule to enhance your
efforts. The following suggestions are offered by the Cook Counseling Center at Virginia Tech
(2006) regarding concentration:
A. Find a specific place (or places) that you can use for studying (for
example, the campus libraries, vacant classrooms, quiet areas in the
student center, bedroom at home, etc.)
good lighting
ventilation
a comfortable chair, but not too comfortable
a desk large enough to spread out your materials
D. Insure that your study area does not have the following:
A. Don't set a goal as vague and large as ... "I am going to spend all
day Saturday studying!" You will only set yourself up for failure and
discouragement.
B. Take the time block that you have scheduled for study and set a
reachable study goal. (for example: finish reading 3 sections of
chapter seven in my Psych. text, or complete one math problem, or
write the rough draft of the introduction to my English paper, etc.)
Success Strategies for Nursing Students 16
C. Set your goal when you sit down to study but before you begin to
work.
Set a goal that you can reach. You may, in fact, do more than
your goal but set a reasonable goal even if it seems too easy.
Reading Strategies
Everyone has to identify an approach to reading that is effective for them. This is especially
important in nursing school where there is so much to read. A couple examples of specific
strategies are discussed at a website, How-To-Study.com: A Study Skills Resource Site (n.d.).
These strategies include the SQRW and the REDW. The SQRW reading strategy is summarized as
follows:
Survey.
Surveying brings to mind what you already know about the topic of a
chapter and prepares you for learning more. To survey a chapter, read
the title, introduction, headings, and the summary or conclusion. Also,
examine all visuals such as pictures, tables, maps, and/or graphs and
read the caption that goes with each. By surveying a chapter, you will
quickly learn what the chapter is about.
Question.
You need to have questions in your mind as you read. Questions give
you a purpose for reading and help you stay focused on the reading
assignment. Form questions by changing each chapter heading into a
question. Use the words who, what, when, where, why, or how to form
questions. For example, for the heading "Uses of Electricity" in a
chapter about how science improves lives, you might form the
question "What are some uses of electricity?" If a heading is stated as
a question, use that question. When a heading contains more than one
idea, form a question for each idea. Do not form questions for the
Introduction, Summary, or Conclusion.
Read.
Read the information that follows each heading to find the answer to
each question you formed. As you do this, you may decide you need to
change a question or turn it into several questions to be answered.
Stay focused and flexible so you can gather as much information as
you need to answer each question.
Success Strategies for Nursing Students 17
Write.
Write each question and its answer in your notebook. Reread each of
your written answers to be sure each answer is legible and contains all
the important information needed to answer the question.
As you practice using SQRW, you will find you learn more and have
good study notes to use to prepare for class participation and tests.
HINT: Once you complete the Survey step for the entire chapter,
complete the Question, Read, and Write steps for the first heading.
Then complete the Question, Read, and Write steps for the second
heading, and so on for the remaining headings in the chapter.
Read
Read the entire paragraph to get an idea of what the paragraph is
about. You may find it helpful to whisper the words as you read or to
form a picture in your mind of what you are reading. Once you have a
general idea of what the paragraph is about, go on to the next step.
Examine
Examine each sentence in the paragraph to identify the important
words that tell what the sentence is about. Ignore the words that are
not needed to tell what the sentence is about. If you are allowed to,
draw a line through the words to be ignored. For each sentence, write
on a sheet of paper the words that tell what the sentence is about.
Decide
Reread the words you wrote for each sentence in the paragraph.
Decide which sentence contains the words you wrote that best
describe the main idea of the paragraph. These words are the main
idea of the paragraph. The sentence that contains these words is the
topic sentence. The other words you wrote are the supporting details
for the main idea.
Write
Write the main idea for each paragraph in your notebook. This will
provide you with a written record of the most important ideas you
learned. This written record will be helpful if you have to take a test
that covers the reading assignment.
Success Strategies for Nursing Students 18
A great deal of the reading that you will be expected to complete in nursing school is about
complex topics. The Center for Advancement of Learning at Muskingum College (n.d.) offers the
following suggestions for reading difficult material.
Repetition.
o Read over the assignment once. Switch to another task for a
period of time or sleep on it. Re-read the material later or on
the following day. Review the assignment periodically.
Remediation.
o Consult supplemental resources for learning fundamental
information needed to understand the reading assignment.
Possibilities include introductory textbooks, student workbooks
or study guides to textbooks, lab manuals, and survey books.
Consult with Professionals.
o Additional help in understanding difficult readings may be
obtained from the instructor during office hours, from graduate
assistants, and from professional tutors. Peer tutors or upper-
class majors may also provide valuable assistance.
Essential Words.
o Focus on key words in the text. Emphasize verbs and nouns
only; ignore or cross out unnecessary adjectives and adverbs.
Look for terms in bold print or italics.
Review and Summarize.
o Review after reading each paragraph of text. Identify the main
idea of each paragraph. Be sure to understand each paragraph
before moving on to the next. Review at the end of each
section as well as at the end of the chapter. Develop your own
summary of the chapter and compare it to the summary
presented in the book.
Make Reading More Active.
o Comprehension may be improved if one uses senses other than
vision while reading. Stimulate the auditory sense by reading
aloud or listening to tape recordings of the text. Take notes
during or after reading difficult material.
Make Reading Interactive.
o Work with another student. Read to each other, and take turns
summarizing sections or chapters of text. "Teach" each other
the more difficult concepts, making liberal use of visual aids.
Relate the material to personal experiences.
Review Questions.
Success Strategies for Nursing Students 19
Note-taking
The Cornell Method of note-taking is recommended by multiple learning institutions. This system
requires that the student identify key words and list relevant points or pertinence. This method of
note-taking forces the student to categorize information and provides a good outline for later
study.
The Center for Advancement of Learning at Muskingum College (n.d.) provides the following
directions for using the Cornell method:
Documentation
o Write the following information at the top of each page: student
name, course, date, and page number.
Record Notes
o During lecture, record the main ideas and concepts on the right
side of the page. This is the notes column.
Success Strategies for Nursing Students 20
o Use both sections of the notes to prepare for quizzes and exams.
Study Skills
Study skills are essential for nursing students. Here are some general principles about the use of
study skills.
Schedule study time into sessions of 20 to 30 minutes, which is the average attention span
of most people. Breaks should be scheduled between these sessions.
Develop a plan that schedules study time for all necessary topics as this will increase your
chances of covering all necessary material.
Squeeze studying into small periods of spare time, such as time between classes.
Memorization
about what they are saying, and 90% of what they do (Muskingum College, n.d.). Given this
information the wisest strategy for study success would be to use a combination of methods that
offer opportunities to engage the material to be learned in a variety of ways. A variety of study
strategies will be discussed in this section. You may want to experiment with them to find the most
effective ones for you.
The Academic Skills Center at Dartmouth College (2001) offers the following strategies for assisting
your memory.
Specific study methods have been identified by different learning institutions to aid with
memorization. Some of these methods are described below.
Mnemonics
Mnemonics refers to organizing material by arranging key words in an order where the first letter
of each is arranged into an order that forms a word or acronym that is more easily memorized.
Each letter is then used as a cue to recall a word or phrase.
Example:
What are the qualities of a scientist? (mnemonic answer: PIPOC)
P erserverance
I ntelligence
Success Strategies for Nursing Students 23
P atience
O riginality
C uriosity
Grouping
Grouping is a strategy that can be helpful when trying to recall a long list of items. Rather than
attempting to remember the entire list, where items in the middle tend to be forgotten, the long
list is broken down into several smaller lists making it easier to commit to memory.
Alphabetizing
Alphabetizing offers an easy and quick method for list memorization. Note that this strategy may
be used in combination with other strategies, such as grouping or mnemonics.
Rhymes, songs, and poems may offer an easier strategy for remembering information than rote
memorization.
The Center for Advancement of Learning at Muskingum College (n.d.) offers these guidelines for
the use of rhymes, songs and poems in studying:
Study Cards
The use of study cards is helpful in memorization as they engage the learner in both kinesthetic
and visual manners. The more ways that a student engages in learning information the more likely
the student will recall that information. If the student also verbalizes the writings on the cards they
will be also engaging their sense of hearing.
Outlining
Outlining material to be remembered can be effective when there is a large volume of information
to be recalled. This is done by identifying key points from the body of information and then
arranging it in a logical order that can be more easily remembered.
RCRC Strategy
The RCRC strategy (Read, Cover, Recite, Check) is useful for memorizing information. It may be
helpful in learning definitions and facts. This would be a good way for nursing students to study
Success Strategies for Nursing Students 24
medication dosing and laboratory values. Muskingum College (n.d.) provides the following steps for
this strategy.
Rehearsal Strategies
Rehearsal strategies are intended to be repeated a number of times to commit new information to
memory. These methods allow for active participation in learning, which improves learning.
Muskingum College (n.d.) offers the following information about rehearsal strategies.
For more information on recitation and review, see the Reciting and
Spacing Reviews section of this page.
Task Checklists
Study Actively
Visual Aids
Visual aids can be powerful tools to assist with learning. Combining the use of these tools with
other learning tools that engage the other senses actively will enhance the learning. Some
examples of visual aids include:
Tables
Flow charts
Outlines
Concept maps (fishbone diagram, spider maps)
The ability to visualize these items when in situations calling for recall of information is often used
unconsciously. Students may intensify the effectiveness of this strategy by calling upon formalizing
their use of visualization and by calling upon other senses to cement the new information into their
memory. Muskingum College (n.d.) provides the following directions for visual association.
Chaining
Chaining is a study strategy where the student links concepts to each other, two at a time. This
strategy seems especially to some of the material that nursing students must learn, such as
pathophysiology where one physiological response leads to the next which leads to the next and so
on. Muskingum College offers the following directions for using the chaining strategy.
Color Coding
Color coding is a highly versatile study strategy as it may be used during many different study
activities, such as reading, note-taking and test preparation. Color coding may be used as a way of
organizing information, such as highlighting main ideas in a particular color, pertinent details in a
different color, and subtopics in yet a third color. Color coding may be done by writing or
highlighting in different colors. Muskingum College (n.d.) offers these suggestions for using color
coding.
Try writing flash cards about different topics in different colors of inks
or on different colors of index cards.
Use different colors of ink to arrange information in outline form. To
distinguish main points from supporting details, write the former in
one color and the latter in another. To distinguish information related
to different topics, write the main points and supporting details for
each topic in a unique color of ink.
Identify important information in the notes or textbook by using
colored highlighters.
Study Groups
Study groups offer a wonderful opportunity for sparking motivation as accountability to group
members may help to keep you enthusiastic about accomplishing the learning tasks. The idea
behind study groups is to divide learning into smaller tasks that are accomplished by individual
Success Strategies for Nursing Students 27
members and then collectively shared with the group to enhance everyone’s learning. Muskingum
College (n.d.) discusses examples of how study groups can be used.
Exam Preparation Study Group
o For a management class, the instructor is going to test students
over lecture notes and required readings.
o Members of the study group divide the material into the
following topics: product strategies, process strategies, location
strategies, and human resources strategies.
o Each member writes a summary of his/her topic, combining
both lecture and reading material.
o Each member also makes up three essay questions for his/her
material.
o The study group meets to exchange information.
Homework Completion Study Groups
o A geology lab assignment involves walking around campus and
identifying different types of rocks.
o Members of the study group divide the area into four parts:
residence hall area, quad area, recreation area, and south
campus.
o Each member tours one of the areas and records the rocks in it.
o Then the study group tours all the areas together and each
member explains his/her results for his/her area.
Notetaking Study Group
o Three students who are auditory learners are having trouble
keeping up with notetaking in Arts and Humanities.
o Each member of the group takes notes for about 18 minutes
during class.
o When not taking notes, the other members of the group listen
closely to the lecture and just write down the major points.
o Then the group meets after class to put the notes together in
an organized manner, to check for discrepencies, and to review
main points.
Learning Strategies Study Group
o A group of biology students form a study group for an
introductory course.
o They discuss strategies for learning the material for the exams.
o They decide to use flash cards, tables, and sample questions.
o Each member of the group is responsible for applying one of
these strategies to the exam material.
o They meet to exchange their results.
Reading Study Group
o A marketing reading assignment is divided into parts and
assigned to members of a study group.
o Each member intensively reads his/her section and prepares a
summary.
o Then each member skims the other sections.
o The study group meets to exchange notes and discuss the
reading.
Success Strategies for Nursing Students 28
When deciding to form a study group it is important to proceed in an organized manner to facilitate
learning and to avoid problems that can occur. How-To-Study.com (n.d.) offers the concrete advice
regarding the formation of study groups.
Get to know your classmates by talking with them before class, during
breaks, and after class. When selecting a classmate to join your study
group, you should be able to answer YES for each of the following
questions:
o Is this classmate motivated to do well?
o Does this classmate understand the subject matter?
o Is this classmate dependable?
o Would this classmate be tolerant of the ideas of others?
o Would you like to work with this classmate?
Invite enough of these classmates to work with you in a study group until
you have formed a group of three to five. A larger group may allow some
members to avoid responsibility, may lead to cliques, and may make
group management more of an issue than learning.
Decide how often and for how long you will meet. Meeting two or three
times a week is probably best. If you plan a long study session, make sure
you include time for breaks. A study session of about 60 to 90 minutes is
usually best.
Decide where you will meet. Select a meeting place that is available and is
free from distractions. An empty classroom or a group study room in the
library is a possibility.
Decide on the goals of the study group. Goals can include comparing and
updating notes, discussing readings, and preparing for exams.
Decide who the leader will be for the first study session. Also decide
whether it will be the same person each session or whether there will be a
rotating leader. The leader of a study session should be responsible for
meeting the goals of that study session.
Clearly decide the agenda for the first study session and the
responsibilities of each group member for that session.
Develop a list of all group members that includes their names, telephone
numbers, and email addresses. Make sure each group member has this
list and update the list as needed.
Success Strategies for Nursing Students 29
7. Group members feel free to criticize each other but keep their
criticisms constructive and objective. This can encourage group
members to reveal their weaknesses so that the group can help to
strengthen them.
10. Above all, the positive attitude that “we can do this together” is
maintained.
1. Do not let the study group get distracted from its agenda and goals.
2. Do not let the study group become a social group. You can socialize at
other times.
4. Do not the let the session become a negative forum for complaining
about teachers and courses.
Testing Strategies
Test anxiety
The meaning of text anxiety is just what it says – too much anxiety about a test. Most people
experience some level of anxiety prior to and/or at the time of testing. In fact a certain level of
anxiety inspires us to perform at our peak level. However, when a student is overly anxious,
effective test preparation and test-taking can be elusive.
Graduation from nursing school and entry into the profession is dependent upon testing
successfully. Nursing students must become savvy in coping with test anxiety to accomplish their
goals.
To determine how to best deal with test anxiety, it is helpful to determine whether this is a
challenge for you. The following questions are offered by How-To-Study.com to assess if you are
affected by test anxiety.
2. When studying for a test, I find many things that distract me.
Here are some things you can do before, during, and after a
test to reduce your test anxiety.
3. Go into the test well rested and well fed. Get enough sleep the
night before the test. Eat a light and nutritious meal before the test.
Stay away from junk foods.
4. Stay relaxed during the test. Taking slow, deep breaths can
help. Focus on positive self-statements such as “I can do this.”
5. Follow a plan for taking the test. Don’t panic even if you find
the test difficult. Stay with your plan!
6. Don’t worry about other students finishing the test before you
do. Take the time that you need to do your best.
7. Once you finish the test and hand it in, forget about it
temporarily. There is nothing more you can do until the graded test is
returned to you. Turn your attention and effort to new assignments
and tests.
The Academic Skills Center at Dartmouth College (2001) offers the following guidelines, adapted
from the Harvard Law School Health Service, to combat test anxiety.
5) Don't use drugs or alcohol -- they can decrease your ability to think
clearly. Take medication only under the supervision of a physician.
Test Preparation
Test preparation begins when the course begins and should be ongoing each day during the course
through the use of study skills, such as the ones described in the Study Skills section of this
resource. However some strategies specific to test preparation will be discussed in this section. The
University of Texas at Austin offers excellent advice regarding self-management during exam
weeks.
Do you find yourself panicking when you have several exams to take in
a short period? Do you feel a lot more stress during mid-terms and
finals?
1. TAKE TIME TO RELAX. Cope with your excess tension before and
between exams through rest, exercise and deep muscle relaxation. For
example, long walks and bike rides are excellent ways to release
nervous energy and maintain your stamina for the duration of your
exam period.
2. ALLOW LARGE BLOCKS OF TIME FOR STUDYING. Block out hour spans
for getting down concepts and basic relationships.
3. ALLOW SHORT PERIODS FOR REVIEW. Use the odd moments, in the
shower or walking across campus, for recall and review. Run through
the information frequently; this will ensure that you remember it and it
will broaden your understanding.
4. VARY WHAT YOU STUDY. Don't study for two similar courses
consecutively. It is better to break the pattern with a completely
different study approach. For example, study chemistry and then
French instead of chemistry and then physics.
5. SCHEDULE BREAKS. Respect your concentration span. Especially if you
haven't studied much all semester, it may be difficult to study for
several hours at a time. Starting your exam period with impossibly
long study periods is likely to leave you exhausted before it is all over.
6. STAY WITH YOUR ROUTINE. Stick to your normal daily routine as
much as possible. If you do get off your routine and need extra time,
avoid staying up all night; go to bed at your regular time and get up a
couple of hours earlier than you normally would, to continue studying.
You will be able to understand and remember more when you are
rested than you would if you postpone rest.
THE NIGHT BEFORE. As you approach the first exam, and the time
between exams,
2. AVOID STAYING UP ALL NIGHT. The shorter you are on sleep the less
clearly you will be able to think and write what you know on the exam.
3. CRAM SELECTIVELY. The night before an exam when you are more
anxious than usual is one of the least effective times for study. Your
ability to deal with concepts and synthesize material is greatly
reduced, and even your ability to memorize is impaired by marked
anxiety. Cramming only serves to make you more frantic about the
exam and, hence, less prepared to do your best. If you do come up to
exam time unprepared, use your last minute studying as a review of
key concepts, instead of trying to learn it all. Be realistic about what
you can accomplish: set priorities based on what you expect to be
emphasized on the test. Stay calm.
4. DON'T GO TO THE MOVIES. Don't get involved in any activities that
might either interfere with what you have been learning or make you
feel so guilty that you come home to study far into the night to make
up for lost time. Review and relax.
Success Strategies for Nursing Students 34
Some strategies related to anticipation of the exam content and format are suggested by
Muskingum College (n.d.) and are worth considering.
If the instructor offers few hints and you've never had a test from
him/her before, try analyzing his/her behavior for clues. Consider the
types of information emphasized in lecture, the nature of assignments,
and the manner of lecture presentation. Ask yourself: Does the
instructor focus on details? Does he/she emphasize facts or ideas?
Would he/she ask "trick" questions? What's his/her goal in teaching
and attitude toward testing? Has he/she encouraged students to
evaluate and interpret concepts?
Talk with students who have taken the class before. Not only may they
have old tests, but they may provide insights into instructor
expectations, main ideas, and grading procedures. Current classmates
may have ideas about the major topics to study.
Most texts provide review questions at the end of each chapter or unit.
These should give you ideas of what may be asked on the test. Or try
turning the chapter headings into questions. Check the index listing of
people and concepts; the more page references, the more important
the idea.
Doing practice test questions is a wonderful way to prepare for an exam. Study groups could work
together to prepare test questions for group members to use. Muskingum College (n.d.) offers the
following guidelines for using this approach for test preparation.
Confidence
Students should do whatever they can to enhance their confidence in their exam preparation and
test-taking skills prior to taking an exam. A good level of self-confidence will help to diminish test
anxiety and to prompt optimal performance. If a student believes they will do well on an exam,
they are more likely to do so.
Being over prepared is a good strategy for making oneself more confident and minimizing test
anxiety. Study until you are certain that you know the material. Test yourself on the material either
independently or with a study group to assure your knowledge of the material.
Test-taking
Effective test-taking requires that you approach the exam with strategies to aid you in responding
correctly to test items. In this section discussion will include suggestions for responding to multiple
choice questions, which are the most popular types of questions on exams in nursing school, as
well as being the format used on the NCLEX-RN state licensure exams.
The DETER strategy offers an overall approach to test-taking that is relevant to all test types. How-
To-Study.com (n.d.) offers the following explanation of this approach.
D = Directions
Success Strategies for Nursing Students 38
E = Examine
Examine the entire test to see how much you have to do.
Only by knowing the entire task can you break it down into parts that
become manageable for you.
T = Time
Once you have examined the entire test, decide how much time you
will spend on each item.
If there are different points for items, plan to spend the most time on
the items that count for the most points.
Planning your time is especially important for essay tests where you
must avoid spending so much time on one item that you have little
time left for other test items.
E = Easiest
The second E in DETER reminds you to answer the items you find
easiest first.
If you get stuck on a difficult item that comes up early in the test, you
may not get to answer items that test things you know.
R = Review
If you have planned your time correctly, you will have time to review
your answers and make them as complete and accurate as possible.
Also make sure to review the test directions to be certain you have
answered all items required.
Information Dumping
Information dumping is a test-taking strategy that may help you in recalling information that you
are afraid that you will forget or confuse. With this strategy you quickly write down information
that you want to remember when beginning the test either on the test booklet or scrap paper, as
allowed by the instructor. Examples of information that you may want to include may be names,
dates, formulas, mnemonics or visuals that helped you memorize test material. Be sure that this is
allowed by the instructor to avoid allegations of cheating.
How-To-Study.com (n.d.) offers the following suggestions regarding responding to multiple choice
test items.
Success Strategies for Nursing Students 39
1. Circle or underline important words in the item. This will help you
focus on the information most needed to identify the correct answer
choice.
2. Read all the answer choices before selecting one. It is just as likely for
the last answer choice to be correct as the first.
3. Cross out answer choices you are certain are not correct. This will
help you narrow down the correct answer choice.
4. Look for two answer choices that are opposites. One of these two
answer choices is likely to be correct.
5. Look for hints about the correct answer choice in other items on the
test. The correct answer choice may be part of another item on the
test.
6. Look for answer choices that contain language used by your teacher or
found in your textbooks. An answer choice that contains such
language is usually correct.
7. Do not change your initial answer unless you are sure another answer
choice is correct. More often than not, your first choice is correct.
8. Choose “all of the above” if you are certain all other answer choices in
the item are correct. Do not choose “all of the above” if even just one
of the other answer choices is not correct.
9. Choose “none of the above” if you are certain all other answer choices
in the item are incorrect. Do not choose “none of the above” if even
just one of the other answer choices is correct.
The Cook Counseling Center at Virginia Tech (n.d.) offers some strategies to
use with difficult exam questions. Here are their recommendations.
C. Use a strategy.
Anticipate the answer and look for the one most like what you expect.
Be flexible. You may not always find exactly the choice you are looking
for. Then, you must choose the best of the options available.
Use logical reasoning. For each possible answer, ask yourself, "What
would happen if . . . "?
If you guess at an answer, check your guess against what you already
know and against what your logical reasoning tells you.
Post-Test Review
Once the test has been completed often a test review will be offered to students.
This may be done once the test is graded or prior to the grading. In either case it is
wise for students to attend this review as it offers the opportunity to gain insight
into how the instructors who prepared the test were thinking and what to expect in
future exams. Hopper (2006) offers a dozen reasons to review a returned test,
which are well worth sharing.
Check the point total to make sure it is right. Look for mistakes
in grading.
Know what questions you missed and why you missed them.
The reason you missed the question is often as important in
taking your next test as the answer.
Study the instructor's comments especially for essay questions
so that you will know what is expected next time.
Look for kinds of questions and tricky questions that the
instructor likes to use.
See if the questions came from the text or the lecture.
Concentrate more on that source for the next exam.
Correct and understand what you missed. This is information
you need to know. It may appear on a later test or the final.
Analyze the type of problems you missed so you can review
strategies for that type of question.
Review to get an idea what kind of test the instructor might
give next time.
Review to put information back into long term memory.
You want to ask questions while the test is "fresh."
Review how you studied for the exam. Look for better ways.
Maintaining Self-Image
Despite how you do on a test it is important to maintain a healthy self-image. The experience of
each exam should be used to identify methods for doing better on future tests. Although adequate
grades for passing the course are the ultimate goal, much can be learned from an exam that you
fail, specifically how to do things differently on the next test.
Success Strategies for Nursing Students 41
You need to focus on what you did right and identify what could have been done better or
differently. Evaluate your test preparation strategies and your approach to test-taking and
determine how you what changes you will make as you approach the next exam.
Additionally, acknowledge the positive aspects of your performance in the nursing program. These
successes can be viewed as examples of your personal success and remind you that you can be
successful in test-taking. You need to focus on the positive and ignore any negative self-talk or
comments from others that distract you from being positive. You can succeed in this nursing
program if you set your mind to it!
Success Strategies for Nursing Students 42
Students with English-as-a-Second-Language (ESL) often face unique challenges, including the
adaptation to American culture, language barriers and social isolation. There are some strategies
that can be undertaken to assist with minimizing these challenges and enhancing educational
success with students with ESL.
The University of Texas at Austin offers specific advice regarding English acquisition to students
with ESL. These strategies would also assist the non-native American student with becoming more
comfortable with the American culture. Some of these suggestions are specific to the University of
Texas at Austin but can be adapted to other learning institutions.
1. Sign up for informal classes. You'll learn something and there will be
lots of chances to discuss class matters with other students and
teachers.
2. Visit the academic department that teaches your native language (or
the Department of Linguistics if there is not such a department). Ask
to post a notice that you would like to exchange conversation practice
with an American who is learning your language. Include your name,
phone number and when you can be reached on the notice.
3. Volunteer your time to help handicapped students, old people, children
or others. You will learn more about American life and feel useful as
well.
4. After class, ask another student to explain a point you didn't
understand or disagreed with. Continue this conversation over a cup of
coffee or glass of beer at the Texas Union! Form a study group with
other students to discuss the course and prepare for exams. Talk to
your professors during their office hours about course concerns.
5. Ask Reference Librarians for research assistance at the libraries. Their
job is to help students with such questions, and they can give you
excellent suggestions for your work. If you're not familiar with the
resources of the libraries, take the self-guided tour which is on
Success Strategies for Nursing Students 43
cassette tape. Ask for this at the information desk in the main lobby of
the PCL.
6. Join a club or recreational sports activity on campus. These are often
advertised in the Daily Texan and new people are welcome in most of
the groups.
7. In the grocery story, ask the vegetable or meat counter clerk how to
cook some item of food.
8. In a restaurant, ask the waiter or waitress what a dish is made of and
how it is prepared.
9. Get an American roommate. There are lists of prospective roommates
at the UT Housing and Food Office in Kinsolving Dorm or you can add
your name to the list. Also, pay attention to the Texan for
announcements of a "Roommate Fair" and look around the Union
bulletin boards for "Roommate Wanted" signs.
10. If you belong to a church, join the local one, or at least visit there and
get to know a few members. Some churches have special activities for
international students.
11. Watch the news on television or listen to it on the radio. Try to
understand what is being said. Make a list of words, phrases or news
stories you don't understand and ask an American friend about them.
Pay special attention to idioms.
12. Read the comics in the newspaper. Clip any that confuse you and ask
a friend to explain them. You'll find many idiomatic and slang
expressions and also learn more about the American sense of humor!
13. If you live with your family or other people from your country, set
aside a period of time every day, for example during dinner, to speak
nothing but English. This provides excellent practice for you and them
too.
Often minority nursing students have difficulties meeting nurses who are of their ethnic or cultural
background. Getting in touch with nurses from similar cultural and ethnic backgrounds should help
to minimize social isolation. Included here is a list of nursing associations addressing cultural
and/or ethnic minorities within nursing practice in the United States. This listing was provided at
minoritynurse.com (2006):
Contact: syeo@aapina.org
http://www.aapina.org
rosariomay@aol.com
www.philippinenursesaa.org
Students who have difficulty with concentration will be challenged by nursing curriculums as they
need to be able to focus to learn large amounts of information. Muskingum College (n.d.) offers
several suggestions to assist these students in their college education experience. These
suggestions are as follows.
Task Orientation
Concentrate
Reduce stress
Evaluate
Think about the subject matter before class; those five minutes spent
walking to class are the perfect time for this.
Arrive early to class so you can select a seat in the least distracting
part of the room (see the section on Eliminating External Distractions
of this page).
While waiting for class to begin, review previous day's notes to get in
the frame of mind of the subject.
Take the appropriate materials to class: note books, books, pens,
pencils, calculator, etc.
Complete assignments in a timely manner.
Do assigned readings before they are to be covered in class (even for
math courses). You have to read them some time, so best to do it
Success Strategies for Nursing Students 47
Course Schedules
Personal Time
Success Strategies for Nursing Students 48
Tutoring Sessions
Group Learning
The following strategies can make group sessions more productive for
attention deficit students.
Color coding and highlighters help the student pay attention to more
important information.
Visual aids such as charts, graphs, flashcards, and timelines may help
students to focus.
Compensatory Considerations
Legislature requires that learning institutions offer accommodations for students with certain
conditions that might prevent them from being successful in educational endeavors. If you have a
learning, health, emotional, or physical condition that interferes with your ability to perform in
school you need to consult with the nursing department at your school to see how you may
proceed to be considered for accommodations.
The following table, offering examples of student characteristics and possible accommodations was
developed by the University of the State of New York, the State Education Department, and the
Office of Vocational and Education Services for Individuals with Disabilities (2006).
References
Hopper, C. (2006). The study skills help page learning strategies for success. Retrieved
10/24/06 at http://www.mtsu.edu/~studskl/
The University of the State of New York, the State Education Department, & the Office
of Vocational and Education for Individuals with Disabilities. (2006). Test access
and accommodations for students with disabilities. Retrieved 10/27/06 at
http://www.vesid.nysed.gov/specialed/publications/policy/testaccess/policyguide.
htm
Virginia Tech Cook Counseling Center. (2006). Concentration: Some basic guidelines.
Retrieved 10/23/06 at http://www.ucc.vt.edu/stdysk/concentr.html