While many students compete aggressively to enter into nursing schools, those who succeed have no guarantee they will be successful in their nursing studies, graduating, and passing the National Council Licensing Exam for Registered Nurses (NCLEX-RN^®). This study's objective was to gain a better understanding of how nursing students approach learning and to determine what characterizes the successful student. The study's design was based on the theoretical framework of the students' approach to learning, which ultimately impacts on the students' learning outcome.

This study followed a non-experimental causal-comparative study design using the Revised Approach to Studying Inventory – Short Version (RASI-SV) to measure the students' use of deep, strategic, and surface learning approaches in the classroom and a modified RASI-SV for clinical learning to assess learning in the direct patient care environment. Both learning inventories were given to Associate Degree nursing students enrolled in an adult health nursing course. The study also compared the impact of the students' learning approach on their adult health nursing course grade, nursing GPA, and clinical performance level. Further analysis included examining the influence of the students' presage characteristics – gender, student type (adult or traditional age), and prior experience in a health care setting.

Results showed that Associate Degree Nursing students employ strategic learning in both the classroom and in the clinical environment as their predominant learning approach. However, when strategic learning is combined with a high level of deep learning; the students experienced more academic success. Results also showed a consistent negative correlation of surface learning with academic achievement.

In addition, the students' strategic and deep learning approaches scores were significantly higher (p <.001) in the clinical learning environment and the surface learning approach was lower in comparison to the learning approaches in the classroom. The deep clinical learning approach also had a positive impact on the students' course grades.

And finally, presage characteristics had limited impact on the students' learning outcomes. Adults had higher NGPA and students with prior experience in a patient care setting used less surface learning approaches and had higher clinical grades.