Beyond GPA: Why Nursing Admissions Needs a Holistic Makeover

Delecia Parker, DNP, MSN, RN

When nursing programs review applicants, the first things they look at are usually the same: GPA, ACT/SAT scores, entrance exam results. And honestly, those numbers matter. They tell us a lot about whether a student can handle the academic rigor of a nursing program.

But here's what they don't tell us: Can this person sit with a frightened patient and make them feel seen? Will they honor a patient's values even when they differ from their own? Do they have the empathy and compassion that define truly great nursing care?

That gap is exactly what nursing education is being challenged to address.

What the Standards Say

In 2021, the American Association of Colleges of Nursing (AACN) updated The Essentials, the guiding framework for nursing education nationwide. Domain 2 puts Person-Centered Care front and center as a core competency.

According to the AACN (2021), person-centered care means respecting the diversity of individuals and honoring their unique preferences, values, needs, and lived experiences. It means recognizing patients as active partners in their own care — not passive recipients of it. When nurses practice this way, care becomes more meaningful and patient outcomes genuinely improve.

The AACN has also called on schools of nursing to adopt more holistic admissions processes — ones that weigh both quantitative and qualitative measures when evaluating applicants (AACN, 2020).

So, the standard is clear. The question to be answered: Is there a clear, consistent way to assess these qualities at the admissions stage?

The Gap We Can't Ignore

Research strongly supports GPA, ACT scores, and entrance exams as reliable predictors of academic success in nursing programs. That evidence is solid. But academic readiness and professional readiness aren't the same thing.

Zamanzadeh et al. (2020) found that when a person's non-academic attributes — things like empathy, compassion, and values — don't align with their chosen career, the consequences are real: job dissatisfaction, burnout, declining performance, and diminished patient care. In a profession as demanding and relationship-driven as nursing, that misalignment has serious implications.

The research community increasingly recognizes this. Yet despite growing awareness, there's still no standardized, widely-accepted toolkit for assessing non-academic attributes during admissions. Interviews, personal statements, letters of reference, personality assessments, situational judgment scenarios — all of these have been proposed, but there's little agreement on which attributes to prioritize, how to measure them, or which tools are most reliable.

The result? Most programs lean on what's measurable and leave the rest to intuition. That's a gap worth closing.

What Can We Do About It?

The good news is that promising approaches exist. The challenge is implementing them with intention and rigor.

Structured Interviews — Traditional single-interviewer or panel formats can be useful, but they're vulnerable to bias and don't always give applicants the space to share their full story (Al-Awabdeh et al., 2025). Multiple mini-interviews (MMIs) have shown better reliability and validity, though consensus on what to assess and how to score it remains elusive.

Situational Judgment Scenarios — When paired with clearly defined rubrics, these scenarios can effectively reveal how an applicant thinks and responds in person-centered situations — making values and reasoning visible in a way a GPA simply cannot.

Evidence-Based Scoring Frameworks — Tools like the Experiences, Attributes, and Metrics (EAM) Model (Hinds & Sanner-Stiehr, 2025) offer a more structured, multi-dimensional approach to applicant evaluation — one that goes beyond checking boxes and gets at the whole person.

Personal Statements & Letters of Reference — When reviewed with a defined lens, these can offer meaningful insight into an applicant's values, experiences, and relational awareness.

No single method is a silver bullet. The most effective approach combines multiple strategies, uses structured scoring, and is grounded in a clear understanding of what attributes matter — and why.

The Bottom Line

Nursing admissions has traditionally been built around a simple question: Can this student handle the coursework? That question still matters. But it's not enough on its own.

The more complete question is: Can this student become the kind of nurse patients need — one who is not only competent, but compassionate, respectful, and genuinely person-centered?

Answering that question requires more than a transcript. It requires an admissions process designed to see the whole applicant. We're not there yet — but the path forward is becoming clearer, and the stakes are too high not to keep moving in that direction. Let us all be challenged to move beyond GPA and consider a holistic makeover.

For additional information, please visit:

 Al-Awabdeh, E., Hani, S., Bayliss-Pratt, L., Aljabery, M., Ibrahim, R., Salameh, A. (2025). Admission criteria for undergraduate nursing programs: A narrative literature review. Sage Open Nursing, 11, pg. 1-16. DOI: doi.org/10.1177/23779608251381667

American Association of Colleges of Nursing. (2020). Promising practices in holistic admissions review: White paper. https://www.aacnnursing.org/

American Association of Colleges of Nursing, (2021). The essentials: Core competencies for professional nursing education. https://www.aacnnursing.org/Portals/0/PDFs/Publications/Essentials-2021.pdf

Song, Y., Lafond, C., Vincent, C., Kim, M., Park, C., McCreary, L. (2023). Critical soft skill competencies that clinical nurse educators consider important to evaluate in nurses. Nursing Open Wiley, pg. 1-13. DOI: https://doi.org/10.1002/nop2.70047

Zamanzadeh, V, Ghahramanian, A., Valizadeh, L., Bagheriyeh, F., Lynagh, M. (2020). A scoping review of admission criteria and selection methods in nursing education. BMC Nursing, 19(121) pg. 1-17. DOI: https://doi.org/10.1186/s12912-020-00510-1

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May 15, 2026