Abstract
<title>Abstract</title> <p> <bold>Background:</bold> Academic progression among nursing students is essential for producing a competent nursing workforce. Despite rigorous admission requirements, nursing education institutions continue to experience delayed progression, repetition, academic failure, and attrition, particularly in low- and middle-income countries. Evidence suggests that progression is influenced by multiple academic, psychological, socioeconomic, institutional, and contextual factors. <bold>Objective:</bold> To synthesize and critically evaluate the evidence on the determinants of academic progression among diploma nursing students and identify gaps in the existing literature. <bold>Methods and Results:</bold> An integrative review guided by Whittemore and Knafl's framework was conducted <bold>.</bold> The literature was searched in PubMed, Scopus, <bold>Cumulative Index to Nursing and Allied Health Literature</bold> (CINAHL), Web of Science, Google Scholar, African Journals Online (AJOL), and other sources. The search identified <bold>448</bold> records; after removal of <bold>74</bold> duplicates, <bold>374</bold> records were screened, and <bold>75</bold> full-text articles were assessed, resulting in <bold>25</bold> evidence sources included in the review. These comprised <bold>12 cross-sectional studies</bold> , <bold>3 longitudinal/cohort studies</bold> , <bold>1 quantitative analytical study</bold> , <bold>7 review articles</bold> , and <bold>2 methodological references</bold> . The review found that academic preparedness, psychological well-being, financial hardship, institutional support, educational resources, and student integration were the most consistent determinants of academic progression. However, most studies relied on cross-sectional designs and binary outcomes, with limited application of theoretical frameworks or longitudinal analytical approaches to examine progression trajectories. <bold>Conclusion:</bold> Academic progression is a dynamic, multifactorial process that cannot be explained by academic ability alone. The predominance of cross-sectional evidence highlights the need for theory-informed longitudinal studies identifying those that can model progression trajectories and identify students at risk of delayed progression or attrition, particularly in Zambia. </p>