A Structured Remediation Strategy to Support At-Risk Nursing Students: An Application of Transformative Learning Theory

BACKGROUND: Declining NCLEX-RN pass rates and rising nursing program attrition are worsening the U.S. nursing workforce shortage. Early course-level remediation is critical for identifying and supporting at-risk undergraduate nursing students. PROBLEM: Most remediation strategies focus on summative assessments such as standardized exit exams, leaving limited structured approaches to address poor performance on course exams, which strongly predict progression, retention, and licensure success. APPROACH: A structured, theory-guided remediation strategy was developed and implemented in a prelicensure baccalaureate nursing program in the northeastern United States. Grounded in Transformative Learning Theory and nursing remediation frameworks, the model emphasizes early identification of learning gaps, individualized support, and integration of institutional academic and psychosocial resources. OUTCOMES: The strategy improved course exam performance among at-risk students and was adopted as departmental policy. Both students and faculty reported improved exam readiness and greater engagement with support services. CONCLUSIONS: Early theory-guided course-based remediation enhances retention, progression, and preparation of practice-ready nursing graduates.