Innovation Center - NEPIN · motivators, barriers, perceptions, and attitudes about returning to...
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Innovation Center The Integrated Nursing Pathway: An Innovative Collaborative Model to Increase the Proportion of Baccalaureate-Prepared Nurses Colleen J. Goode, Gayle J. Preheim, Susan Bonini, Nancy K. Case, Jennifer VanderMeer, and Gina Iannelli Abstract This manuscript describes a collaborative, seamless program between a community college and a university college of nursing designed to increase the number of nurses prepared with a baccalaureate degree. The three-year Integrated Nursing Pathway provides community college students with a non-nursing associate degree, early introduction to nursing, and seamless progression through BSN education. The model includes dual admission and advising and is driven by the need for collaboration with community colleges, the need to increase the percentage of racial-ethnic minority students, the shortage of faculty, and employer preferences for BSN graduates. KEY WORDS Baccalaureate Education – Nursing Education – Academic Progression – Nursing Curriculum N ew models are needed to meet growing demand for baccalaureate-educated nurses in academia and clinical practice. Collaboration among academic nurse leaders across all education program levels is essential to create seamless pathways to increase the proportion of nurses with BSN degrees to 80 percent by 2020 (Institute of Medicine [IOM], 2011). Data for 2013 from the National Council of State Boards of Nursing [NCSBN] (2014) indicate that, of nurses taking the NCLEX-RN ® exam for the first time, only 42 percent were baccalaureate prepared. The Oregon Consortium for Nursing Education initiative projected that 70 percent of gradu- ates from associate degree nursing programs would seek a BSN degree, but only 30 percent of eligible students actually transferred to the BSN program (Munkvold, Tanner, & Herinckx, 2012). A meta-analysis to determine what is known about nurses’ motivators, barriers, perceptions, and attitudes about returning to school for a BSN degree found that cost, lack of support, curricular issues, and lack of self-confidence are barriers, while autonomy, quality care, improved clinical judgment, career advancement, and personal growth are motivators (Altmann, 2011). It is clear that more progression models for nursing need to be tested. OVERVIEW OF INTEGRATED NURSING PATHWAY The Integrated Nursing Pathway (Pathway) provides community college students a non-nursing associate degree with seamless progression through BSN education at a university college of nurs- ing. The Community College of Aurora (CCA) and the University of Colorado College of Nursing (UC-CON) simultaneously admit stu- dents to the three-year Pathway program. Dual advising by CCA and UC-CON advisers takes place when students are admitted to the Pathway program, and students receive their BSN degree within four years. Employer preferences for BSN nursing graduates, the need for collaboration with community colleges, the need to increase the percentage of racial-ethnic minority students in pre-licensure pro- grams, and the shortage of faculty drive this model. PATHWAY GOVERNANCE The UC-CON and CCA began discussing a potential partnership in 2009. The intent was to design an educational model that would pro- vide access to BSN education for community college students and avoid the tendency of associate degree graduates to terminate their studies upon completion of the ADN degree. Senior administrators from the two institutions addressed gover- nance issues having to do with prerequisites, the curriculum, simulta- neous admission, progression, and advisement. It was decided that the community college would retain tuition income and students would graduate from the CCA with an associate degree in general studies. Following the signing of a Memorandum of Understanding, About the Authors Colleen J. Goode, PhD, RN, NEA-BC, FAAN, is a professor, University of Colorado College of Nursing, Aurora. Gayle J. Preheim, EdD, RN, NEA-BC, CNE, is a professor, University of Colorado College of Nursing, Aurora. Susan Bonini, MSN, RN, is an instructor and Integrated Nursing Pathway program coordinator, University of Colorado College of Nursing, Aurora. Nancy K. Case, PhD, RN, was dean of health sciences, Community College of Aurora, Denver, Colorado. Jennifer VanderMeer, MSN, MBA, RN, is director health sciences, Community College of Aurora. Gina Iannelli, MPA, MSC, is an adviser, Community College of Aurora. For more information, contact Dr. Goode at colleen. [email protected]. Copyright © 2016 National League for Nursing doi: 10.5480/13-1253 110 March/April 2016 www.neponline.net Copyright © 2016 National League for Nursing. Unauthorized reproduction of this article is prohibited.
Transcript of Innovation Center - NEPIN · motivators, barriers, perceptions, and attitudes about returning to...
Innovation Center
The Integrated Nursing Pathway: An Innovative CollaborativeModel to Increase the Proportion ofBaccalaureate-Prepared NursesColleen J. Goode, Gayle J. Preheim, Susan Bonini, Nancy K. Case, Jennifer VanderMeer, and Gina Iannelli
Abstract
This manuscript describes a collaborative, seamless program between a community college and a university college ofnursing designed to increase the number of nurses prepared with a baccalaureate degree. The three-year Integrated NursingPathway provides community college students with a non-nursing associate degree, early introduction to nursing, andseamless progression through BSN education. The model includes dual admission and advising and is driven by the need forcollaboration with community colleges, the need to increase the percentage of racial-ethnic minority students, the shortageof faculty, and employer preferences for BSN graduates.
KEY WORDS Baccalaureate Education – Nursing Education – Academic Progression – Nursing Curriculum
New models are needed to meet growing demand forbaccalaureate-educated nurses in academia and clinicalpractice. Collaboration among academic nurse leaders across
all education program levels is essential to create seamless pathwaysto increase the proportion of nurses with BSN degrees to 80 percentby 2020 (Institute of Medicine [IOM], 2011). Data for 2013 from theNational Council of State Boards of Nursing [NCSBN] (2014) indicatethat, of nurses taking the NCLEX-RN® exam for the first time, only42 percent were baccalaureate prepared. The Oregon Consortiumfor Nursing Education initiative projected that 70 percent of gradu-ates from associate degree nursing programs would seek a BSNdegree, but only 30 percent of eligible students actually transferredto the BSN program (Munkvold, Tanner, & Herinckx, 2012).
A meta-analysis to determine what is known about nurses’motivators, barriers, perceptions, and attitudes about returning toschool for a BSN degree found that cost, lack of support, curricularissues, and lack of self-confidence are barriers, while autonomy,
About the Authors Colleen J. Goode, PhD, RN, NEA-BC, FAAN, is aprofessor, University of Colorado College of Nursing, Aurora. Gayle J.Preheim, EdD, RN, NEA-BC, CNE, is a professor, University of ColoradoCollege of Nursing, Aurora. Susan Bonini, MSN, RN, is an instructor andIntegrated Nursing Pathway program coordinator, University of ColoradoCollege of Nursing, Aurora. Nancy K. Case, PhD, RN, was dean of healthsciences, Community College of Aurora, Denver, Colorado. JenniferVanderMeer, MSN, MBA, RN, is director health sciences, CommunityCollege of Aurora. Gina Iannelli, MPA, MSC, is an adviser, CommunityCollege of Aurora. For more information, contact Dr. Goode at [email protected].
Copyright © 2016 National League for Nursingdoi: 10.5480/13-1253
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quality care, improved clinical judgment, career advancement, andpersonal growth are motivators (Altmann, 2011). It is clear that moreprogression models for nursing need to be tested.
OVERVIEW OF INTEGRATED NURSING PATHWAYThe Integrated Nursing Pathway (Pathway) provides communitycollege students a non-nursing associate degree with seamlessprogression through BSN education at a university college of nurs-ing. The Community College of Aurora (CCA) and the University ofColorado College of Nursing (UC-CON) simultaneously admit stu-dents to the three-year Pathway program. Dual advising by CCAand UC-CON advisers takes place when students are admitted tothe Pathway program, and students receive their BSN degree withinfour years. Employer preferences for BSN nursing graduates, theneed for collaboration with community colleges, the need to increasethe percentage of racial-ethnicminority students in pre-licensure pro-grams, and the shortage of faculty drive this model.
PATHWAY GOVERNANCEThe UC-CON and CCA began discussing a potential partnership in2009. The intent was to design an educational model that would pro-vide access to BSN education for community college students andavoid the tendency of associate degree graduates to terminate theirstudies upon completion of the ADN degree.
Senior administrators from the two institutions addressed gover-nance issues having to do with prerequisites, the curriculum, simulta-neous admission, progression, and advisement. It was decided thatthe community college would retain tuition income and studentswould graduate from the CCA with an associate degree in generalstudies. Following the signing of a Memorandum of Understanding,
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an oversight committee was established that included academic ad-ministrators, faculty content experts, advisers, and representativesfrom the offices of admission and diversity.
CurriculumThe curriculum is based on The Essentials of Baccalaureate Educationfor Professional Nursing Practice (American Association of Colleges ofNursing, 2008). Priority in the design of the Pathway was clarity of pre-requisite courses and admission and progression criteria, ease of tran-sition across institutions, and use of a cohort model where studentsmove through the classes and program phases together. Pathwaystudents meet the same admission requirements as others admittedto theUC-CON, but Pathway studentsmust have an associate degreein general studies from CCA.
Students take 14 credits of prerequisites prior to application tothe Pathway. Provisional admission occurs in the spring semester,while students continue to take prerequisite courses. A second ad-mission review occurs after the summer prerequisites are completed.
Year one of the Pathway includes completion of a course co-taught by a CCA nurse faculty member and a UC-CON facultymember. This feature of the curriculum responds to calls for intro-duction to the profession early in the nursing curriculum (Benner,Sutphen, Leonard, & Day, 2010). The faculty-developed course,“Pathway to Professional Nursing: Quality Improvement and Safety,”includes the context of professional nursing, roles and responsibilities
FIGURE 1. The Integrated Nursing Pathway to Baccalaureate Education.
Nursing Education Perspectives
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of the professional nurse, essential knowledge, skills, and attitudesfor team participation in a culture of safety and quality improvement,and interpersonal communication skills critical to the nurse-patientrelationship. Classes are taught on both campuses to give Pathwaystudents exposure to a large university campus. Early immersion inprofessional nursing is a hallmark of the Pathway (see Figure 1).
AdvisingTo facilitate successful progression in the Pathway model, an aca-demic adviser with a dedicated workload is assigned from each insti-tution. Academic advising sessions for Pathway students are arrangedwith both CCA and UC-CON academic advisers present. Strategiesthat facilitate dual advising and develop a sense of student belongingto the program include an orientation specifically for Pathway studentsto both academic institutions. Email accounts are provided at bothinstitutions to facilitate communication and for access to the healthsciences library and facilities.
RESULTS AND DISCUSSIONThe target enrollment for the Pathway cohorts is 30 students peryear. However, because of a desire to get the program implemented,a decision was made to begin with a smaller cohort of 18 students.Of the 18 students in the initial cohort, 13 earned an associate degreefrom CCA in 2011; in May 2013, all 13 graduated from the UC-CON
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and all passed the NCLEX-RN. The second cohort consisted of24 students; 20 in this group obtained an associate degree, and16 are seniors in the UC-CON. Thirty were admitted to the third cohort,and 26 who finished with an associate degree are in their junior year atUC-CON.
Evidence of increased opportunity and enhanced diversity isdemonstrated in themost recently admitted cohort. The group is eth-nically and racially diverse, and 25 percent are men, with 25 percentfirst-generation college students. With a better understanding of attri-tion statistics, the plans are to admit more than 30 students infuture cohorts.
The Pathway emphasizes the value of a diverse student popula-tion as a way of achieving excellence in practice, reflective of the cul-tural diversity of health care recipients. With an average of 50 percentgender and ethnic diversity, the Integrated Nursing Pathway studentswill better serve the patient populations they reflect. Enrichment of theUC-CON student body and enhancement of diversity within the nurs-ing workforce are significant strengths of the program.
The Pathway model was developed with the intent to be repli-cated by other community colleges and universities. CCA did nothave an existing nursing program, which is recognized as an advan-tage in the initial development of an integrated model. A secondMemorandum of Understanding has been signed with another com-munity college, which had closed its ADN program. Community col-leges with current ADN nursing programs could collaborate with afour-year college or university and offer this innovative option for stu-dents whose goal is BSN education.
CONCLUSIONThe IOM (2011) recommends that nurses obtain higher levels ofeducation through systems of education that provide seamless
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academic progression. This recommendation is foundational to thisinnovative model of nursing education. The Pathway supports thevalue of the community college path to nursing education and elimi-nates the dropout potential of ADN licensure.
The mission and goals of the partnership between the Universityof Colorado and the Aurora Community College System call forgreater access to quality education for citizens of the state. The Inte-grated Nursing Pathway focuses on student potential and diversity,employer hiring trends for BSN graduates, and the need by consumersfor a well-educated, diverse nursing workforce (Blegen, Goode,Park, Vaughn, & Spetz, 2013). It is a successful response to callsfor radical advances in pathways to nursing licensure and a radicalnew understanding of the nursing curriculum (Benner et al., 2010).
REFERENCESAltmann, T. K. (2011). Registered nurses returning to school for a bachelor’s degree
in nursing: Issues emerging fromameta-analysis of the research.ContemporaryNurse, 39(2), 256-272.
American Association of Colleges of Nursing (2008). The essentials of baccalaureateeducation for professional nursing practice. Retrieved from www.aacn.nche.edu/education-resources/BaccEssentials08.pdf
Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Educating nurses: A call forradical transformation. San Francisco, CA: Jossey-Bass.
Blegen, M. A., Goode, C. J., Park, S. H., Vaughn, T., & Spetz, J. (2013). Baccalau-reate education in nursing and patient outcomes. Journal of Nursing Administra-tion, 43(2), 89-94. doi:10.1097/NNA.0b013e31827f2028
Institute of Medicine. (2011). The future of nursing: Leading change, advancinghealth. Washington, DC: National Academies Press.
Munkvold, J., Tanner, C. A., Herinckx, H. (2012). Factors affecting the academic pro-gression of associate degree graduates. Journal of Nursing Education, 51(4),232-235.
National Council of State Boards of Nursing. (2014). Exam statistics and publica-tions. Retrieved from www.ncsbn.org/1237.htm
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