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2013-2014 Assessment Report

School of Nursing

Nursing, Master's

Expected Outcome 1: Advanced Practice Knowledge

AU/AUMSON MSN students will be able to transition from a student to a professional advanced practice nurse in the area of nursing education or primary care nurse practitioner. Internal and external outcome assessments will be described in regard to advanced practice knowledge.

Assessment Method 1: NURS 7816 Teaching-Learning Modules (internal nurse educator)

Assessment Method Description NURS 7816 Teaching-Learning Modules are a series of course assignments that require the nurse educator students construct and implement effective educational materials to a variety of target audiences. These modules provided assignments built on established teaching-learning strategies with the final project evaluated for inclusion of effective educational methods. AU/AUMSON expected outcome is an aggregate average of 80% or higher on these modules. The grading rubric for this assessment is included below.

NURS 7816 Teaching-Learning Modules Faculty Evaluation Sheet

Assignment components Points possible

Points awarded

Module I: Intra-professional Education: Complexity, Challenges and Issues

Use of appropriate technology Synthesis of theories and research Articulate the role of the educator

20

Module II: Developing Curriculum/Course Frameworks, Outcomes, and Competencies

Educational services for diverse populations

Sensitive, ethical, and competent teaching-learning processes with diverse groups

Synthesis of theories and research Articulate the role of the educator

20

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Module III: Using innovative and evolving technology- advantages and disadvantages

Use evidence-based practices Use of appropriate technology

20

Participate in on-line discussion 25 APA format Flow and comprehensive documentation of ideas Lack of typos and spelling/grammar errors

15

TOTAL POINTS Points possible

Points awarded

100

Findings NURS 7816, spring 2014, was completed by 2 nurse educator students and met the benchmark. Analysis by the course leader revealed that these 2 students provided effective instruction through the use of several technology platforms and the use of appropriate teaching-learning strategies. As more on-line instruction is common for MSN program – this was a focus of this assignment.

How did you use findings for improvement? Ongoing assessment of student performance related teaching learning strategies and educational methods is critical to prepare a nurse to be an effective teacher at the MSN level. Health promotion is the future of healthcare and reduction of health care costs and therefore essential for a NP student and practicing nurse practitioner. Since both of these projects meet or exceed the benchmark, minimal changes will be made in the assignments for the next cohort. Information related to synthesis and reporting of evidence will be emphasized in both of these courses. Monitoring of these internal measures will continue to be measured. Changes in future assignments will be made related to student outcomes as well as changes in the educational and health promotion literature.

Additional Comments Assessment Method 2: NURS 7446/7556 Health Promotion Project (internal PNCP)

Assessment Method Description NURS 7446/7556 Health Promotion Project requires the primary care nurse practitioners to assess their current clinical (practice) setting to identify learning needs for a selected group of patients. Once the learning needs and

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target audience are identified the student constructs and implements a teaching project with a health promotion focus. This assignment requires the student to present their project in a written form for faculty evaluation, implementation of the project in the clinical setting with evaluation by their healthcare preceptors, and present to peer students results in a peer evaluation. AU/AUMSON expected outcome is an aggregate average of 80% or higher on both written and oral communication of project. Course faculty will evaluate the findings from these projects and modify course content as indicated. Women’s/Child Health Promotion Project guidelines are provided below: Women’s/Child Health Promotion Project The student will develop a community serve project that is directed toward health promotion, health prevention, or health education. The project will include an interactive time with the group of women and/or children. The project will be implemented utilizing teaching tools, such as a brochure or handout as part of the intervention. The intervention will include teaching about health promotion, health prevention, or health education (Learning Objectives 3, 6, 7). Components/Criteria - Project Development and Implementation (70%): 10% Definition and description of the problem – Address and describe women’s/child health problems. 10% Description of Implementation – Collaborate with other health professionals to provide a community health project for a group of women or children. 10% Design of the project – Management plan addresses health promotion, disease prevention, and/or acute and chronic illnesses. 20% Delivery of the project – Identify and use appropriate teaching learning theory /strategies (identify theorist) to deliver program to individuals, families, and groups. The skills and behaviors to promote health, prevent disease, and manage the acute chronic illnesses that affects your population. The skills and behaviors to promote health, prevent disease,

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and manage the acute chronic illnesses that affects your population. 20% Evaluation of the problem – Evaluate the effectiveness of the project. - Written Presentation (20%): • Written skills – Documentation is clear. Appropriate medical terminology is used. Irrelevant and redundant words, phrases, and other distracting information are omitted. • Organization – Documentation is well organized. Format follows a standard and has a logical flow. • APA format and references – Current (less than 3 years old) research articles and references are used to guide decisions regarding diagnosis and treatment. - Online Presentation/Oral Presentation (10%) • Presentation – Professional presentation of your community service project to your peers. Make sure that documentation is clear, appropriate medical terminology is used, irrelevant and redundant words, phases, and other distracting information are omitted.

Findings NURS 7446/7556, fall 2013, was completed by 19 nurse practitioner students. A variety of practice settings and health promotion topics were used by these students as a means to promote health and prevent disease. Analysis by course faculty revealed that four (4) students used the placement of this course assignment (fall) to promote compliance with the annual influenza immunization in adult, geriatric, pediatric, and women’s settings. Student reflection and evaluation by program participates demonstrated a higher than the national average compliance in receiving the annual influenza vaccine following this health promotion project implementation.

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How did you use findings for improvement? Ongoing assessment of student performance related teaching learning strategies and educational methods is critical to prepare a nurse to be an effective teacher at the MSN level. Health promotion is the future of healthcare and reduction of health care costs and therefore essential for a NP student and practicing nurse practitioner. Since both of these projects meet or exceed the benchmark, minimal changes will be made in the assignments for the next cohort. Information related to synthesis and reporting of evidence will be emphasized in both of these courses. Monitoring of these internal measures will continue to be measured. Changes in future assignments will be made related to student outcomes as well as changes in the educational and health promotion literature.

Additional Comments Assessment Method 3: HESI APRN_Family NP Exit Exam

Assessment Method Description The HESI APRN _ Family NP Exit Exam was developed based on the American Nurses Credentialing Association (ANCC) and American Association of Nurse Practitioners (AANP) domains of practice to be a predictive test for successful passing of national certification. HESI has identified a raw score of 800 on this exam as highly predictive of the student passing the national certification examination required to practice as a family nurse practitioner. This exam consists of 100 application items covering the area of family nurse practitioner practice. Clinical practice questions are included on this HESI examination and assess advanced practice knowledge related to the care of geriatric, adult, women, and pediatric patients. HESI APRN_ Family NP Exit Exam also assesses, leadership knowledge and skills, National Organization of Nurse Practitioner Faculty (NONPF) core competencies related to patient management, patient relationships, teaching, coaching, profession roles, managing/negotiation the health care delivery system, patient care safety and quality measures, and cultural competence. Students are given 2 opportunities to score 800 or higher on this exam. PCNP graduates will be able to score 800 or higher on the HESI APRN _ Family NP Exit Exam prior to graduation. HESI _Family NP Exit Exam is a copyrighted and secured document. However, the company provides content guides, live and on-line review courses and allows each student to sign-up and receive a 20-50 question practice exam.

Findings Nineteen (19) students completed this assessment measure. In review of the HESI report several areas of student strengths and weaknesses were identified. Analysis by the MSN Director and NP Coordinator noted strong scores by this cohort in regard to advanced practice nursing (APN)

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management. Scores from the first take HESI exam APN management results are provided below as compared to the 800 national benchmark score:

APRN Management Category Score # Item in Category

Legal/Ethical 965 6 Scope of Practice 1006 3 Health Care Delivery Systems 950 2 Theory/Research 860 2

Areas of improvement were noted in 4 of the 10 pediatric content areas related to cardiovascular, endocrine, neurosensory, and respiratory content areas.

HESI Class Scores - APN Maternity Category Score

# Items in Category

Cardiovascular 694 4 Endocrine 736 1 Neurosensory 731 11 Respiratory 797 1

How did you use the findings for improvement? HESI provides a detailed report that lists all of the specialty area and topic categories that were assessed by this exam. Average scores are provided for your institution/students as well as the national average with a breakdown of the specialty area and topic by item number. Individual institution scores are graphed in regard to exam score, acceptable sores, and recommended scores. Students are provided with an individualized student report that guides their remediation for the national certification exam. Pediatric clinical preceptors are the hardest clinical site to schedule for the PCNP students. After analysis of this data an increased effort will be made by the PCNP faculty to find more comprehensive pediatric clinical sites.

Additional Comments

Expected Outcome 2: Advanced leadership and health policy

The MSN prepared advanced practice nurse (APN) will understand the impact of health policy on health care. PCNP graduates will demonstrate knowledge of National Organization of Nurse Practitioner Faculty (NONPF) core competencies. Assessment Method 1: NURS 7256 Institutional Assessment (internal core)

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Assessment Method Description NURS7256 Institutional Assessment project challenges nurse educator and primary care nurse practitioner students to assess the current state of healthcare delivery and how to work with current and be a change agent for future health care policy development. This assignment requires the student to research an institutional by spending practicum hours on site and then present their project findings in a written form for faculty evaluation. AU/AUMSON expected outcome is an aggregate average of 80% or higher on both written and oral communication of project. The grading rubric for this project is below.

NURS 7256 INSTITUTIONAL ASSESSMENT CRITERIA Possible

Pts. Pts. Earned

Comments

Describe the nature of the change (for example, is it a policy, procedure, new skill or behavior) and identify the change as simple or complex.

10

Identify all stakeholders and state if and why it is a significant issue.

10

Is the focus of the change a national policy, guideline, or standard? If yes, describe.

10

Is the change a mandate with which the institution or agency must be in compliance? If yes, describe.

10

Are there major problems associated with the change, such as an increase in errors or resistance to the change by the inter or intra professional team? If yes, describe and state how the major problems will be addressed.

10

Are there vested interests? If yes, who is likely to gain from the change and who will view the change as a loss (e.g., power)

10

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Identify the human drivers by position (not name), and the human resistors of the change.

10

Are there resources implications other than human? If yes, describe

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Written Formal Report using APA style and format; proper use of English Language Conventions; Virtual Powerpoint presentation posted according to directions

20

Practicum Log completed and demonstrates a minimum of 20 hours collecting data for the assessment, writing a formal report of findings, and presented findings to a macro system leader.

5

GRADE

Findings NURS 7256, fall 2013, was completed by 54 MSN students from the nurse educator and primary care nurse practitioner tracks. Analysis by course faculty identified the following strengths and areas for improvement. Strengths:

Identification of need for change Constructing a plan for change Identification of organizational mandated verses research based practice

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Areas for Improvement:

Recognition of all stakeholders and parties impacted by any proposed change

Differentiation of vested interests

Student areas for improvement reflect the advanced practice nursing role and even though MSN students appreciate this new role they have trouble at times

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articulating the change process. How did you use findings for improvement? Ongoing assessment of student performance to health policy recognition and change is an important skill needed for both nurse educator and nurse practitioner students. Health care delivery is in the process of going through major changes that will impact all health care providers with the expected implementation of the Affordable Care Act in January 2014. Since this project meet the benchmark, minimal changes will be made in the assignment for the next cohort. Monitoring of this internal measure will continue to be assessed. Changes in future assignments will be made related to student outcomes as well as changes in the educational and health promotion literature. Additional Comments Assessment Method 2: PCNP Clinical Preceptor Evaluation of the Student Assessment Method Description Primary Care Nurse Practitioner (PCNP) students complete 690 clinical hours in the last 3 semesters of the curriculum. Students interact with multiple clinical preceptors in a variety of clinical specialty areas. A standardized preceptor evaluation form is used for all clinical courses. The Preceptor Evaluation of the Student asks the preceptor to rate the student and expected clinical behaviors using a 6-point Likert scale (5=consistently demonstrated; 0=not demonstrated). This evaluation is completed at the end of the clinical rotation. Below is a copy of this clinical evaluation tool:

AU/AUM MSN PROGRAM CLINICAL EVALUATION OF STUDENT

Student ________________Sem./Yr._____Course____________ # Hours ____Clinical Site__________________ Preceptor_________ For each item listed below, CHECK one block indicating your evaluation of the student. Scale: 5 = Consistently Demonstrated 0 = Not Demonstrated I. Professional Characteristics 5 4 3 2 1 0 Interpersonal relations with staff, patients, and other health professionals

■ ■ ■ ■ ■ ■

1. Uses effective communication 2. Performs in a cooperative manner 3. Demonstrates sensitivity and respect to staff 4. Uses time productively, is punctual 5. Identifies own learning needs and takes responsibility for own learning

II. Clinical skills 5 4 3 2 1 0 6. Records a clear and concise H & P

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7. Addresses health risks and health promotion in plan of care

8. Demonstrates competency in making clinical decisions

9. Correctly interprets common lab tests 10. Consults appropriately with preceptor

III. Overall Clinical Performance Above expected (90-100%) (Demonstrates above average knowledge and performs at a high level of sk with minimal guidance.) Expected (80-89%) (Demonstrates adequate knowledge and skill to perform in a competent manner. Needs moderate guidance.) Below expected (70-79%) (Performs with minimal knowledge for safe practice. Requires close supervision.) Unacceptable (69% & below) (Demonstrates inadequate knowledge and skill for safe practice.) IV. Comments Please make statements about your overall impression of the student’s strengths, weaknesses, and whether you consider the student’s clinical performance to be safe. (Use back of page if necessary.) _________________________________ ____________________ Preceptor’s Signature Date Course faculty also assess the student performance and preceptor perception of the student performance during site visits each semester. Data are aggregated each semester by the course faculty and analyzed in regard to the 3.5 out of 5.0 benchmark in numerous clinical settings. Findings PCNP Clinical Preceptor Evaluation of the Student: Aggregate evaluations well exceeded the 3.5 benchmark and showed improvement from the first clinical course (summer 2013) to the last clinical course (spring 2014). Strong clinical performance was noted by preceptors in the areas of student preparation, eagerness to learn, and improvement in clinical skills during the clinical rotation. Areas that were reflected in lower scores related to decision making and diagnostic test interpretation. However, clinical preceptors noted that these skills improved over time and scores in these areas were higher in the final clinical course.

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How did you use findings for improvement? Feedback from these clinical preceptors is a valuable tool in program effectiveness, student performance, and appropriateness of each individual clinical site. Analysis of these evaluations and the faculty site visits are used to determine if a particular clinical site will be suggested for future PCNP student clinicals. Additional Comments

Expected Outcome 3: Clinical ethics, judgment, and evidence-based practice

Graduates for AU/AUMSON MSN program will be able to practice within ethical guidelines, using sound clinical judgment and teaching strategies based on the latest evidenced-based literature.

Assessment Method 1: NURS 7946 Evidence-Based Practice (EBP) Project Paper (inernal core)

Assessment Method Description AU/AUMSON Nurse Educator and Primary Care Nurse Practitioner students complete a 3 semester sequence of EBP courses. MSN program graduates will be able to apply evidence to practice through implementation of a small test of change project in EBP III. AU/AUMSON expected outcome is that students score 80% or higher on EBP III project. Thirty-six (36) students completed the EBP course series and the small test of change project. Small test of change project is evaluated using the following rubric:

NURS 7946 Paper Grading Rubric Total Points = 100 Part I Total points for Part I = 30

Introduction 5 points

Framework 5 points

Review of Literature 10 points

Critical Appraisal of Evidence 10 points

Part II Total points for Part II = 30 Needs Assessment 10 points

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Plans 10 points

Evaluation 10 points

Part III Total points for Part III = 40 Findings/Discussion 20 points

Recommendations for future research and/or practice change

10 points

Conclusions 10 points

Findings NURS 7946 EBP III (spring 2014) Small test of change paper was completed by 33 students. Students were able to successfully develop ideas and implement a small test of change project. Analysis by course faculty noted strengths in the areas of needs assessment and project planning. Areas of improvement include data analysis, data interpretation as it applies to the practice setting.

How did you use findings for improvement? Practice essentials and guidelines for advanced practice nurse educators and nurse practitioners come from the evidence-based literature making this content a cornerstone of a MSN program. To help improve student outcomes, course faculty will conduct an on-campus data entry and analysis lab in the first of the three EBP courses as a means to strengthen student application of evidence to individual practice areas.

Additional Comments Assessment Method 2: AACN/EBI Benchmarking related to Ethical Decision Making (external)

Assessment Method Description Distribution of American Association of Colleges of Nursing (AACN)/Educational Benchmarking (EBI) Master’s Level benchmarking assessments and graduation (exit) and one (1) year post graduation (Alumni). AACN/EBI are standardized assessment survey findings are provided for each individual school and compared to three (3) groups: (1) Select 6 –six (6) schools that are selected as comparable to Auburn University; (2) Carnegie Class - framework for recognizing and describing institutional diversity in U.S. higher education. This framework has been widely used in the study of higher education, both as a way to represent and

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control for institutional differences, and also in the design of research studies to ensure adequate representation of sampled institutions, students, or faculty; and (3) All institutions – represents all AACN/EBI participating institutions. Aggregate means for the 3 groups are reported and categorized as Issue (0-70%), Needs Work (71-74%), and Good (75-100%). Benchmark of 80% has been set by the MSN faculty. Expected AU/AUMSON outcome measure is that the student will rate themselves a five (5) or higher on a seven (7) point Likert-scale with 1 reflecting that the student feels they are “not at all” able to perform a particular assessment question to 7 reflecting that the student feels they are “extremely” prepared to perform a particular learning outcome. Assessment of EBI Exit survey question # 63, measure the degree that the student feels the AU/AUMSON MSN courses prepare then to make ethical decisions related to patient care. Assessment of EBI Alumni survey questions # 64 measures the degree that the student feels the AU/AUMSON MSN courses prepared then to make ethical decisions related to patient care.

Findings AACN/EBI Exit # 63 is reflected in EBI report “Use of ethical decision making model in practice settings”. 12 of 19 graduates spring 2014 graduates responded (RR 63%) with a score of 89%. AACN/EBI Alumni # 64 is reflected in the EBI report “Ethical-decision making”. This score is 7 of 30 alumni at 1 year post graduation (RR 23%) with a score of 90%. Analysis of these scores by the MSN Director and the NP Coordinator confirmed a similar understanding and use of an ethical-decision making model in advanced practice nursing setting at graduation and after one year of practice. These consist numbers can be explained by the focus of ethical decision making starting in undergraduate nursing programs. This score higher than our select 6, Carnegie Class and all institutions. This strong score of this cohort on the national benchmarking survey reflects student integration of ethical decision making across practice settings.

How did you use findings for improvement? Although outcomes are met, ethical decision making is an important concept for the advanced practice nurse and therefore, program improvements are evolving such as increasing exposure to situations that require some level of ethical decision making process. Exit and Alumni surveys responses for this year exceeded the benchmark related to application of ethical decision making in practice settings. These results will continue to be studied for meaning as well as possible curricular revisions.

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Expected Outcome 4: Professional Role Development

AU/AUMSON MSN students will be able to articulate their transition from a student to a professional advanced practice nurse in the area of nursing education or primary care nurse practitioner. Internal and external outcome assessments will be described in regard to professional role development.

Assessment Method 1: NURS 7346 Concept Analysis Paper (Internal measure – core)

Assessment Method Description NURS 7346 – Concept Analysis Paper - This assignment helps the student reflect on current trends and issues in advanced practice nursing. Students choose from a list of current concepts identified by the course faculty to develop a paper that provides analysis of the topic as it related to advanced practice nursing. Summer course and with the draft and final evaluation, this assessment methods comprised 60% of the course grade.

NURS 7346 – Summer 2013 Concept Analysis Paper Guidelines and Grade Sheet

Paper Evaluation Criteria

Topic Possible Points

Points Earned

Introduction and Background of Concept 10 Concept Analysis: Uncertainty or Learned Helplessness

Identification of factors impacting application of advanced practice role as it relates to chosen concept

10

Identification of 4-5 strategies to minimize impact

20

Application details for strategies identified 20

Literature support 15 Conclusion 10 APA format, mechanics, scholarly writing reflective of graduate level

10

Submitted by due date and time 5 TOTAL 100

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Findings NURS 7346 Concept Analysis Paper: Thirty-three (33) MSN Students completed this course assignment in summer 2013. Uncertainty and Learned Helplessness in the advanced practice setting were the faculty selected topics. Student applied nursing theory to the current practice arena for advanced practice nurses in the education and/or primary care practice session. Student themes emerged related to (1) strategies to work in a dynamic healthcare environment; (2) role transition from a BSN to a MSN practitioner; (3) increased understanding or advanced practice role to decrease uncertainty in the education and practice arena.; and (4) confidence in new role to prevent learned helplessness that can happen in role transition.

How did you use findings for improvement? The Concept Analysis Paper is an early curricular measure of student transition to an advanced practice role. Findings will guide any needed project modifications or weighting.

Additional Comments Assessment Method 2: NURS 7926 Marketing e-Portfolio (internal measure – PCNP)

Assessment Method Description NURS 7926 – Primary Care Practicum: e-PORTFOLIO: CAREER PLANNING AND DEVELOPMENT The PCNP Marketing Portfolio is a reflection of the student’s achievement and growth. A portfolio is an excellent medium whereby the student can demonstrate knowledge attained in a broad spectrum of related topics and issues from the nursing educational experience. Each portfolio should reflect learning and accomplishment of program (PCNP) outcomes, but is expected to be individualized. Guidelines are provided and intended to assist the student in the development of the portfolio, but creativity is encouraged.

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NURS 7926 Marketing ePortfolio Grading Criteria

Possible Points

Points Earned

Effective Communication Biographical Narrative 15

Factors contributing to the pursuit of PCNP

Provide narrative that has a marketing message

Short and Long term goals Critical thinking through reflection Outcome Mastery – 10 points each 70

Health Promotion and Disease Prevention

Evidence-based research

Use of technology and information systems

Culturally competent primary care delivered in regard to quality and safety; socioeconomic, political, ethical, and diversity variables

Theoretical foundations and change principles

Ethical decision making across populations

Advocacy and leadership in primary care settings

Narratives are reflective; mastery substantiated with pertinent leaning activities and experience from clinical experiences and coursework

Technical Competency 10 ePortfolio demonstrates a range of technical skills with clear and effective navigation paths, accessible and functional links representative of a professional ePortfolio that could be used as a marketing tool for employment as a PCNP.

Visual Literacy 5 ePortfolio is visually appealing and well designed

TOTAL 100

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Findings NURS 7926 Marketing ePortfolio: Nineteen (19) PCNP Students that graduated in spring 2014. All students submitted a very comprehensive and usable marketing e-portfolio. As the market changes students will be encourage to incorporate changes in the health care environment in their e-portfolios. Analysis by the course faculty confirmed the strength of faculty assisted clinical preceptor placements to meet clinical outcomes across the curriculum. Traditionally, students are resistant to move from settings that were comfortable as an undergraduate nurse to settings that would be the new practice focus for the advanced practitioner. Faculty guidance to structure clinical experiences to help this transition were evident in student reflections. Graduates were able to articulate the core and track specific courses that shaped their transition to an advanced practice nurse and short and long-term career goals.

How did you use findings for improvement? The Marketing Portfolio is an internal method of evaluation that asks the students to reflect on all of their classes in the 6 semesters of required coursework and provides information as to how the students feels they have mastered the PCNP program outcomes and what they feel has helped them with professional role development. Information from the student feedback is combined with appropriate curricular design and teaching-learning strategies.

Additional Comments Assessment Method 3: AACN/EBI Benchmarking survey related to the application of nursing theory to practice

Assessment Method Description Distribution of American Association of Colleges of Nursing (AACN)/Educational Benchmarking (EBI) Master’s Level benchmarking assessments and graduation (exit) and one (1) year post graduation (Alumni). AACN/EBI are standardized assessment survey findings are provided for each individual school and compared to three (3) groups: (1) Select 6 –six (6) schools that are selected as comparable to Auburn University; (2) Carnegie Class - framework for recognizing and describing institutional diversity in U.S. higher education. This framework has been widely used in the study of higher education, both as a way to represent and control for institutional differences, and also in the design of research studies to ensure adequate representation of sampled institutions, students, or faculty; and (3) All institutions – represents all AACN/EBI participating institutions. Aggregate means for the 3 groups are reported and categorized as Issue (0-70%), Needs Work (71-74%), and Good (75-100%). AUSON benchmark is 80%.

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Expected AU/AUMSON outcome measure is that the student will rate themselves a five (5) or higher on a seven (7) point Likert-scale with 1 reflecting that the student feels they are “not at all” able to perform a particular assessment question to 7 reflecting that the student feels they are “extremely” prepared to perform a particular learning outcome. Assessment of EBI Exit survey question # 91 measures the degree that the student feels the AU/AUSON MSN courses prepared then to apply nursing theory to guide practice. Alumni survey questions # 92 measuring the student’s assessment of how the MSN curriculum prepared then to apply advanced practice nursing collaboration skills when working with other health care providers in the delivery of education and primary care.

Findings AACN/EBI Exit # 91 is reflected in EBI report “Theories and evidence-based knowledge in leading the healthcare team to deliver appropriate health care” 12 of 19 graduates spring 2014 graduates responded (RR 63%) with a score of 85%. AACN/EBI Alumni # 92 is reflected in the EBI report “Application of theory to practice”. This score is 7 of 30 alumni at 1 year post graduation (RR 23%) with a score of 98%. Analysis of these scores by the MSN Director and the NP Coordinator confirmed that a higher understanding of the application of advanced nursing practice theory will be evident after one year of practice.

How did you use the findings for improvement? AACN/EBI is a rigorous, research-based assessment that provides meaningful data to assess current curricular practices and guide quality improvement efforts. Exit and Alumni surveys responses for this year exceeded the benchmark related to application of theory to practice. These results will continue to be studied for meaning as well as possible curricular revisions.

Expected Outcome 5: Program Effectiveness and Certification Exam pass rates

Program outcomes demonstrate program effectiveness. AU/AUMSON program effectiveness is measure each semester in the form of individual course evaluations. National certification examinations are available as a measure of competency for both nurse educator and nurse practitioner advanced practice

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nurses. Advanced practice as a nurse educator taking a certification examination. Nurse Practitioner students must sit and successfully pass a national certification examination to meet credentialing standards for all of the states in the United States.

Assessment Method 1: PCNP Exit Survey Assessment – Program effectiveness (internal)

Assessment Method Description Program effectiveness is measured through several different assessments completed by the MSN students. At the end of the PCNP clinical courses, students are asked to complete a one page PCNP Exit Assessment Survey that asks questions related to the faculty, program, and overall effectiveness of the program to prepare the PCNP student for an initial NP position. To assess student perception of PCNP program effectiveness, the MSN Director and the NP Coordinator analyze questions # 6 in the spring of each year. A benchmark of 3.5 out of 5.0 is set. Below is a copy of the PCNP Exit Assessment Survey that students complete at end of the semester of graduation.

AU/AUM School of Nursing PCNP Exit Assessment Survey

Response key for questions: 5=Exceeded expectations 4=Met expectations 3=Neutral 2=Did not meet expectations 1=Extremely dissatisfied Question # 1 PCNP Faculty provided applicable on-line instructional content materials.

5 4 3 2 1

Question # 2 Responsiveness of PCNP faculty to student question, concerns, and issues

5 4 3 2 1

Question # 3 Were you provided with a clear understanding of all the components of the PCNP role

5 4 3 2 1

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Question # 4 Ability to provide ethical, culturally sensitive and patient-centered primary health care

5 4 3 2 1

Questions # 5 Deliver primary health care with a focus on health promotion and disease prevention

5 4 3 2 1

Questions # 6 To what extent do you feel that the PCNP courses and clinical experiences prepared you for an initial NP position?

5 4 3 2 1

Findings In spring 2014, 16 of 19 (RR 84%) graduating PCNP students completed this survey. Student responses exceeded the benchmark of 3.5 as a reflection of effectiveness of the PCNP courses and clinical experiences as preparation for an initial NP position. No comments were provided by students for this question making further analysis impossible.

How did you use findings for improvement? Analysis of program effectiveness if an on-going process that is evaluated by the MSN Director, NP Coordinator, and PCNP faculty during and at the end of the PCNP program. Student feedback continued to be assessed and used as a means to improve curricular outcomes and student preparation for the advanced practice role.

Additional Comments Assessment Method 2: Family Nurse Practitioner Certification

Assessment Method Description Annual aggregate reports are provided to AU/AUMSON that provides the name of the certification examination, year of the exam, number of students that took each exam, program average, national average, pass rate, percentage of those taking the exam that passed, percentage of those that passed on the 1st take, and identification of major categories for each exam. The American Association of Nurse Practitioners (AANP) has four (4) major

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categories (Assessment, Diagnosis, Planning, Evaluation) in which questions are grouped. These national certification exams are updated each year to measure to current standards of practice for nurse educators and nurse practitioners. All graduates of the PCNP program (n=22) completed a Family Nurse Practitioner (FNP) certification examination in 2013.

Findings The 2013 AANP annual report related the results of the Family Nurse Practitioner (FNP) certification exam for the twenty-two (22) May 2013 nurse practitioner graduates revealed a 95% pass rate on the 1st take and 100% in 2 takes. Further results revealed that the school average was 581 with a national average of 583 In the subcategories the school average surpassed the national average in all 4 sections: Assessment – School = 36; National = 36 (48 test items) Diagnosis – School = 25; National = 25 (33 test items) Planning – School = 22; National = 21 (31 test items) Evaluation – School = 17; National = 16 (23 test items) The 2014 AANP or ANCC aggregate annual report will be released in February 2015 and provide the breakdown above for the nineteen (19) May 2014 nurse practitioner graduates.

How did you use findings for improvement? Our accreditation body, Commission on Collegiate Nursing Education (CCNE), states that the aggregate results from national certification examinations is evidence of a program outcome that demonstrates program effectiveness. Since these certification examinations are updated each year it is essential that the MSN faculty are aware of any revision and/or updates to the test plan and adjust course content accordingly. This is an ongoing assessment process and the responsibility of the individual MSN course faculty and the collective MSN administration and faculty.

Additional Comments