Addressing academic challenges: A quasi-experimental study on the effect of remedial exam strategy for nursing students with low academic performance


academic performance
nursing students
remedial exam
academic success
Saudi Arabia

How to Cite

Hassan, E. M. G. . (2023). Addressing academic challenges: A quasi-experimental study on the effect of remedial exam strategy for nursing students with low academic performance. Belitung Nursing Journal, 9(4), 369–376.
Google Scholar

Link to Google Scholar

Accepted for publication: 2023-07-11
Peer reviewed: Yes

Related articles in

Search Relations - Article by Author(s)

Share this article on:


Background: Universities are responsible for providing education and support to all students, including those who may be underachieving. To fulfill this responsibility, universities need effective strategies to help these students graduate successfully.

Objective: This study aimed to evaluate the effectiveness of a midterm remedial exam strategy in improving the academic performance of nursing students.

Methods: A quasi-experimental design was employed to conduct this research at a private college in Dammam, Saudi Arabia’s eastern region. The study included 306 convenient bachelor nursing students who had failed their midterm exam. Of these, 103 students voluntarily participated in the remedial midterm exam (intervention group) to enhance their midterm scores, while 203 students did not take the remedial exam (control group). Data collection took place in the spring of 2022 by reviewing course files and student records, encompassing formative and summative evaluations across 14 courses. Data analysis involved using SPSS (2023) and Jamovi (version 2.3, 2022) software to conduct paired t-tests, Mann-Whitney, and correlational tests.

Results: The remedial group demonstrated significant differences between their midterm and remedial exam scores. However, only 15.5% of students in the remedial group passed the exam, despite 68% showing improvement. Additionally, there were significant differences between the intervention and control groups in midterm and overall course scores. The control group outperformed the remedial group in the midterm, final exams, and overall course scores (p <0.05).

Conclusion: Remedial exams can be beneficial for students who are close to passing but may not effectively support those who perform poorly. To address this, implementing a comprehensive remedial program or providing ongoing remedial activities throughout the course can offer better support for strongly underperforming students. Additionally, educational institutions can enhance students’ motivation and performance by providing study skills classes and time-management workshops, equipping them with valuable tools for academic success.


Copyright (c) 2023 Eman M. Gaber Hassan

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Article Metrics

Total views 237 [Abstract: 139 | PDF: 93 | XML: 5 ]


Download data is not yet available.

PlumX Metrics

Declaration of Conflicting Interest

There is no conflict of interest to report in this study.


This paper would not have been feasible without the participation of nursing students and colleagues who helped in gathering data. Most thankful to Ms. Noorhan Hatem for her time and effort in revising, editing, and proofreading the study.

Author’s Contribution

The author solely contributed to all of the research efforts.

Data Availability

Upon a reasonable request, the corresponding author will make available the datasets used and/or analyzed during the current study for the journal reviewer panel only. Data were not made public as a web link because it includes students’ scores and the results of institutional exams.

Declaration of Use of AI in Scientific Writing

The author did not employ any artificial intelligence (AI) or AI-assisted technology during the writing of this paper except the tools that were used for checking spelling, grammar, and references.


Abdulghani, H. M., Alanazi, K., Alotaibi, R., Alsubeeh, N. A., Ahmad, T., & Haque, S. (2023). Prevalence of potential dropout thoughts and their influential factors among Saudi medical students. SAGE Open, 13(1), 21582440221146966.

Asio, J. M. R., & Jimenez, E. (2020). Effect of remediation activities on grade 5 pupils’ academic performance in technology and livelihood education (TLE). Pedagogical Research, 5(4), em0075.

Balduf, M. (2009). Underachievement among college students. Journal of Advanced Academics, 20(2), 274-294.

Bergey, B. W., Deacon, S. H., & Parrila, R. K. (2017). Metacognitive reading and study strategies and academic achievement of university students with and without a history of reading difficulties. Journal of Learning Disabilities, 50(1), 81-94.

Bettinger, E. P., & Long, B. T. (2009). Addressing the needs of underprepared students in higher education: Does college remediation work? Journal of Human Resources, 44(3), 736-771.

Bierer, S. B., Dannefer, E. F., & Tetzlaff, J. E. (2015). Time to loosen the apron strings: Cohort-based evaluation of a learner-driven remediation model at one medical school. Journal of General Internal Medicine, 30, 1339-1343.

Carr, S. M. (2011). NCLEX-RN pass rate peril: One school's journey through curriculum revision, standardized testing, and attitudinal change. Nursing Education Perspectives, 32(6), 384-388.

Chevalier, T. M., Parrila, R., Ritchie, K. C., & Deacon, S. H. (2017). The role of metacognitive reading strategies, metacognitive study and learning strategies, and behavioral study and learning strategies in predicting academic success in students with and without a history of reading difficulties. Journal of Learning Disabilities, 50(1), 34-48.

Cleland, J., Mackenzie, R. K., Ross, S., Sinclair, H. K., & Lee, A. J. (2010). A remedial intervention linked to a formative assessment is effective in terms of improving student performance in subsequent degree examinations. Medical Teacher, 32(4), e185-e190.

Deacon, S. H., Tucker, R., Bergey, B. W., Laroche, A., & Parrila, R. (2017). Personalized outreach to university students with a history of reading difficulties: Early screening and outreach to support academically at-risk students. Journal of College Student Development, 58(3), 432-450.

Drew, C. (2022). Remedial education - advantages, disadvantages & examples.

Esposito, E. R., Palmer, E. C., Douglass, A. R., Malcom, D. R., Cox, A. G., Raake, S. E., & Daugherty, K. K. (2019). Intersession remediation to minimize attrition in a three-year pharmacy program. American Journal of Pharmaceutical Education, 83(9), 7326.

Ferman, B., & Fontes, L. F. (2021). Having a second chance: The consequences of remedial exams. SSRN.

Hvidman, U., & Sievertsen, H. H. (2021). High-stakes grades and student behavior. Journal of Human Resources, 56(3), 821-849.

International Bureau of Education. (2022). Remedial activities.

Kolo, A. G., Jaafar, W., & Ahmad, N. B. (2017). Relationship between academic self-efficacy believed of college students and academic performance. IOSR Journal of Humanities and Social Science (IOSR-JHSS), 22(1), 75-80.

Lindo, J. M., Sanders, N. J., & Oreopoulos, P. (2010). Ability, gender, and performance standards: Evidence from academic probation. American Economic Journal: Applied Economics, 2(2), 95-117.

Martorell, P., & McFarlin Jr, I. (2011). Help or hindrance? The effects of college remediation on academic and labor market outcomes. The Review of Economics and Statistics, 93(2), 436-454.

McCoach, D. B., & Siegle, D. (2003). The school attitude assessment survey-revised: A new instrument to identify academically able students who underachieve. Educational and Psychological Measurement, 63(3), 414-429.

National Center for Education Statistics (NCES). (2022). Undergraduate retention and graduation rates. U.S. Department of Education, Institute of Education Sciences.

Nietzel, M. T. (2018). Remedial education: Escaping higher education's hotel California. Forbes.

Renzulli, S. J. (2015). Using learning strategies to improve the academic performance of university students on academic probation. The Journal of the National Academic Advising Association, 35(1), 29-41.

Ritchotte, J., Rubenstein, L., & Murry, F. (2015). Reversing the underachievement of gifted middle school students: Lessons from another field. Gifted Child Today, 38(2), 103-113.

Ritchotte, J. A., Matthews, M. S., & Flowers, C. P. (2014). The validity of the achievement-orientation model for gifted middle school students: An exploratory study. Gifted Child Quarterly, 58(3), 183-198.

Snyder, K. E., Fong, C. J., Painter, J. K., Pittard, C. M., Barr, S. M., & Patall, E. A. (2019). Interventions for academically underachieving students: A systematic review and meta-analysis. Educational Research Review, 28, 100294.

Symonds, William, C., Robert Schwartz, & Ferguson, R. F. (2011). Pathways to prosperity: Meeting the challenge of preparing young Americans for the 21st century. Cambridge, MA: Harvard University Graduate School of Education.

Tseng, S.-F., Yu, L.-C., Wu, H.-S., & Chao, P.-Y. (2016, 2016). Measuring engagement: Student profiling and the effects of remedial learning counseling. The International Workshop on Learning Analytics and Educational Data Mining (LAEDM 2016) In conjunction with CRIWG/CollabTech 2016, Kanazawa, Japan.

Vandenbussche, J., Ritter, L., & Scherrer, C. (2018). An incentivized early remediation program in Calculus I. International Journal of Mathematical Education in Science and Technology, 49(8), 1235-1249.

Veas, A., Gilar, R., Miñano, P., & Castejón, J.-L. (2016). Estimation of the proportion of underachieving students in Compulsory Secondary Education in Spain: An application of the Rasch model. Frontiers in Psychology, 7, 303.

Zeidenberg, M., Jenkins, P. D., & Calcagno, J. C. (2007). Do student success courses actually help community college students succeed? CCRC Brief, 36, 1-6.

Readers are able to give us their valuable feedbacks here. The comments will be reviewed by the editors and then published here. Important Note: The "Comments" related to the Galley Proof PDF must NOT be submitted via this form. Authors should submit their comments on their galley proofs only via system