Should Ontario colleges offer stand-alone nursing degrees?

Transcription

1 Should Ontario colleges offer stand-alone nursing degrees? Key considerations for college students. October 2015 Page 1

2 For some time, Colleges Ontario (CO) has advocated for colleges to be able to offer stand-alone nursing degrees. In its 2015 proposal, Opening Doors to Nursing Degrees: Time for Action, CO notes that doing so, will make it possible for colleges to play a large and distinctive role within a long-term provincial strategy for sustaining and renewing the health human resources workforce. 1 At the same time, the College Student Alliance (CSA) has stated that it is open to expanding degree granting opportunities at colleges across Ontario when it makes sense to do so.2 The purpose of this document is to explore whether and how Ontario colleges should offer nursing degrees. To do so, the document is divided into three sections: the first discusses this issue in relation to the Phase I report prepared by R.A. Malatest & Associates Ltd.; the second discusses the issue in relation to the subsequent Phase II report; the last section explores some key considerations for college students. Phase I: Analyzing and Assessing Collaborative Nursing Partnerships In 2010, CO advanced a position paper proposing that colleges be allowed to offer stand-alone nursing degrees.3 4 On June 19, 2013, The Ministry of Training, Colleges and Universities commissioned R.A. Malatest & Associates Ltd. to undertake a two-phase project to identify the issues associated with stand-alone nursing degrees and to explore whether colleges and more universities should be allowed to offer standalone nursing degrees. 5 Phase I was completed in November, 2013, with the aim to, assess the efficacy of the partnerships in supporting collaborative program delivery. 6 To this end, the report notes that, there are challenges and successes associated with each type of model,7 and each model has its own strengths and weaknesses. This suggests that there is no standard solution in terms of what works. 8 Furthermore, the research shows that the success of a partnership depends to a large extent on the nature of the interaction among the partners. 9 In CSA s view, the Phase I report is inconclusive regarding whether colleges should be able to offer stand-alone nursing degrees. In turn, CSA agrees with the view that nursing partnerships should be assessed on a case by case basis instead of at the aggregate level. 1 (Colleges Ontario, 2015, p. 2) 2 (College Student Alliance, 2014, p. 1) 3 (R. A. Malatest & Associates, 2014, p. 13) 4 In 2005, Ontario s entry-to-practice regulation requirements increased the RN requirement from a three-year college diploma or a four-year university degree to a university degree only (R. A. Malatest & Associates, 2013, p. 13). 5 (R. A. Malatest & Associates, 2014, p. 5) 6 (R. A. Malatest & Associates, 2013, p. 5) 7 For a summary of the types of nursing degree models offered in Ontario see (R. A. Malatest & Associates, 2013, p. 14) 8 (R. A. Malatest & Associates, 2013, p. 15) 9 (R. A. Malatest & Associates, 2014, p. 45) Page 1

3 CSA also finds it concerning that the authors did not consult with students directly about their views and experiences relating to nursing partnerships.10 To this end, it is curious that section 5.8 discusses issues relating to the student experience. This concern extends into other areas of the report as well; for example, student voices should also serve to inform what metrics are considered regarding student outcomes.11 Phase II: Analyzing and Assessing Institutional Intentions and Preparedness The Phase II report was completed in May, 2014, with the goal of assessing, institutional intentions and preparedness for stand-alone nursing degrees The report concludes by noting that: Caution is required to discern the particular circumstances which may lend or remove support from a particular institution s case for stand-alone nursing degrees. Given that it was difficult to fully assess institutions preparedness due to the subjective and anecdotal aspects of the interviews, a cautious approach is appropriate given that there is no consensus on the stand-alone nursing degree issue. (R. A. Malatest & Associates, 2014, p. 46) Similar to the Phase I report, CSA views the results of the Phase II report as inconclusive regarding whether institutions are prepared to offer stand-alone nursing degrees. In addition, the Phase II report fails to consult with students directly; for example, students were not asked whether they felt that they received adequate support services as discussed in section CSA also agrees with the position advanced by the Phase II report as mentioned in the above excerpt on page 46. That said, it would be useful for CSA to have access to the information advanced by each college in relation to the questions posed in the Phase I and Phase II reports to help inform its decision making. In 2015, CO advanced a proposal advocating for colleges to be able to offer stand-alone nursing degrees. CO reasons that this change should be made because: Colleges have the ability to reach out to prospective students from diverse backgrounds who have the potential to be successful in nursing degree programs Many colleges are located where there is a need for expanded access to nursing education Colleges produce well-prepared graduates, many of whom want to work in their local communities 10 The beginning of Section 5.8 states that, most partnerships stated that they provide a positive student experience. (R. A. Malatest & Associates, 2013, p. 28) 11 For example, how do employer satisfaction and graduate outcomes interact with effective or ineffective partnerships? 12 (R. A. Malatest & Associates, 2014, p. 12) 13 The Phase II report notes that from the institutions surveyed, some are interested in offering stand-alone nursing degrees while other are not. However, it is important to note that report does not specify which colleges are interested in offering stand-alone nursing degrees. Please see APPENDIX 1 for a list of the institutions surveyed. 14 Moreover, what evidence was used to inform institutional positions regarding student support services? Page 2

4 National and provincial quality standards are already in place to guarantee the quality of baccalaureate nursing programs, and colleges remain committed to meeting these standards Expansion of the nursing degree options in the province can be accomplished within the province s current levels of funding support and will result in a more cost-effective use of existing resources There are an increasing number of Ontarians needing health care now and in the future; as such, it is time to eliminate unnecessary barriers and expand the range of options for creating a strong and diverse workforce15 From this, CO proposes implementation principles16 and an implementation strategy17 to guide the creation of stand-alone nursing degrees at Ontario colleges. But to what extent does evidence support this reasoning on a case by case basis? And importantly, what value will students see from this initiative? Key considerations for students: This section advances some initial questions that CSA would have in the event that Humber College18 formally expressed an interest in offering a stand-alone nursing degree.19 Specifically: How will accessibility for students from diverse backgrounds increase by offering a standalone nursing degree given that Humber already offers all four years of the program at its institution? Is Humber located in a region where there is a need for expanded access to nursing education? How does this interact with CO s commitment to not change the number of nursing graduates,20 and many institutions appreciation for the fact that the Ministry will not be increasing overall nursing degree education enrolment levels across the province for the foreseeable future? 21 Since quality standards are already in place to guarantee the quality of baccalaureate nursing programs, how will this initiative strengthen the quality of nursing program for students? 15 (Colleges Ontario, 2015, p. 3) 16 Please see APPENDIX 2 for a list of CO s implementation principles. 17 Please see APPENDIX 3 for a list of CO s implementation strategy. 18 Humber College was selected for example purposes only. To CSA s knowledge, Humber College has not advanced a formal intent, or a formal proposal, to offer a stand-alone nursing degree. 19 A particular institution was selected to provide a point of reference for questions that CSA may advance in relation to this issue. 20 CO report states that, Any change in a partnership should not change the total number of graduates annually. Colleges with the intent of establishing stand-alone nursing programs are committed to delivering the program within their share of the enrolment for the collaborative program (Colleges Ontario, 2015, p. 10) 21 (R. A. Malatest & Associates, 2014, p. 19) Page 3

5 Does Humber intend on increasing admission averages as a means to enhance the quality of its program?22 What are Humber current issues regarding program quality (if any)? What are students concerns regarding program quality (if any)? What do students suggest to resolve their issues? What evidence exists to substantiate that a stand-alone nursing degree will result in a more cost-effective use of existing resources?23 24 What does Humber currently pay to the University of New Brunswick per annum? What specific services does Humber College receive in return for this payment? What specific transaction and administrative costs does Humber College foresee relating to establishing and continuing new administrative structures, processes, and hiring? How does this interact with existing resource allocations? How does this figure interact with what Humber currently pays the University of New Brunswick (that is, what will the net savings be if applicable)? Where will Humber obtain funds from in the event that they experience unforeseen costs?25 26 How does Humber anticipate program enrollment interacting with costs relating to a stand-alone nursing degrees Although CO s 2015 proposal outlines broad considerations relating to colleges offering standalone nursing degrees, in CSA s view, more situation specific evidence- that relies in part on students voices and outcomes- is required to discern whether and how a stand-alone nursing degree should be offered. Additionally, CSA has questions that extend beyond whether partnerships are functioning effectively or whether institutions are interested and prepared to offer stand-alone nursing 22 The Phase II reports states that although some institutions would continue to use the same admission criteria, some indicated that, stand alone nursing degrees would provide them with the option of revising entrance criteria and increasing admissions averages. In doing so, it was envisioned that this would increase the overall performance of the program with respect to retention, graduation, and CRNE pass rates, as well as the quality of that institution s graduates. (R. A. Malatest & Associates, 2014, p. 20) 23 The Phase II report also notes that a number of these institutions also suggest that they will be able to mount a stand-alone nursing degree program on their current budget provided that they can redirect allocations intended for the collaboration towards stand-alone nursing degrees. (R. A. Malatest & Associates, 2014, pp. 44,45) 24 CO s report states that, some colleges would actually save by the discontinuation of the fee charged to the college by the university partner. (Colleges Ontario, 2015, p. 10) 25 CO s report states that, any costs associated with changing a partnership or creating a stand-alone program should be paid by the institutions, without additional costs to government or students. (Colleges Ontario, 2015, p. 11) 26 Please see APPENDIX 4 for Humber College s revenue for the academic year. 27 The Phase II report notes that, almost all institutions identify costs in the establishment of stand-alone nursing degrees, and a number of these institutions are expecting tuition revenue resulting from increased overall enrollment to support these additional costs. (R. A. Malatest & Associates, 2014, p. 44) 28 Please see APPENDIX 5 for the current and projected fiscal full time equivalent headcount enrolment levels for Humber s collaborative program. 29 Please see APPENDIX 6 for Humber s Health Human Resources Funding- Collaborative Nursing ( to ). Page 4

6 degrees. These questions focus on whether there is value for students in this initiative, and if so, what that value specifically entails. In the same vein, CSA also considers the opportunity cost of concentrating on this endeavor. In light of scarce resources in Ontario s postsecondary sector it is important to target initiatives that generate the highest value for all stakeholders. To this end: What value will students see from this initiative (for example, lower tuition costs)? To what extent does this align with the value that students would want to see? How would savings be specifically used to strengthen the program for students? Position summary: CSA is open to expanding degree granting opportunities at colleges across Ontario when it makes sense to do so. However, at this juncture, it is CSA s position that there has been insufficient information advanced to determine whether and how a college should offer a stand-alone nursing degree. CSA also believes that value considerations for students and the opportunity costs of pursuing this endeavour should be examined. CSA remains committed to working in partnership with its post-secondary partners in relation to this issue. Page 5

7 Works Cited College Student Alliance. (2014). Should Ontario colleges offer 3 year degrees? Key considerations for college students. Toronto, Ontario, Canada: College Student Alliance. Colleges Ontario. (2015, January). Opening doors to nursing degrees: time for action. Toronto, Ontario, Canada: Colleges Ontario. Humber College. (2014) Business Plan. Ontario, Canada: Humber College. R. A. Malatest & Associates. (2014, May ). Analysis and assessment of collaborative nursing partnership surveys and stand-alone nursing degree delivery in Ontario (Phase II Report). R. A. Malatest & Associates. R. A. Malatest & Associates. (2013, November). Analysis and Assessment of Collaborative Nursing Partnerships. R. A. Malatest & Associates. Page 6

8 APPENDIX 1 Nursing partnerships that were selected for Phase II interviews:30 1. Humber University of New Brunswick (UNB) 2. Lakehead Confederation 3. Laurentian Boréal 4. Laurentian St. Lawrence 5. Nipissing Canadore 6. Ottawa Algonquin 7. Ryerson George Brown Centennial 8. Western Fanshawe 9. Windsor St. Clair Lambton 10. York Seneca Georgian 30 (R. A. Malatest & Associates, 2014, p. 5) Page 7

9 APPENDIX 2 CO s 2015 report proposes the following implementation principles to help guide colleges transition to offering stand-alone nursing degrees:31 32 Managed implementation: the government should continue to monitor enrollment levels in colleges to ensure that a stable and predictable supply of nurses is maintained. Continuity in the number of graduates produced province wide: Any change in partnerships should not change the total number of graduates annually. Continuity in clinical education placements: Any change in a partnership should include a plan for both partners to ensure that students will still have access to high-quality clinical education placements. Protection for students in program: Student who have enrolled in a collaborative program should have the opportunity to complete the program within a reasonable number of years. No additional provincial funding: Any costs associated with changing a partnership or creating a stand-alone program should be paid by the institutions, without additional costs to government or students. No orphan programs: If collaboration is to dissolve, both the college and the university partner must be in a position to continue to mount new stand-alone programs if they so wish. Reliance on national accreditation standards: Every program must be approved through the accreditation process of CASN. 31 CO s report notes that, policies and processes needed to implement stand-alone nursing degrees at colleges include a requirement for colleges to demonstrate that they can deliver high-quality nursing programs (Colleges Ontario, 2015, p. 11) 32 (Colleges Ontario, 2015, p. 11) Page 8

10 APPENDIX 3 CO s 2015 proposal advances the following implementation strategy:33 Regulation change: The government of Ontario should approach the College of Nurses of Ontario to seek a change in the current entry to practice regulation of the Nursing Act Pre-qualification review: The government should establish a process whereby each college that wishes to offer its own baccalaureate nursing degree program would be required to submit a pre-qualification application to demonstrate it has a robust plan to offer a stand-alone program. The application process: Colleges that successfully complete the pre-qualification review would be invited to submit a full application to offer a nursing degree program. Establishment of new programs: An evaluation of the policy change following the implementation of the first college stand-alone programs will provide government and the post-secondary sector with the information needed to move forward with broader implementation of stand-alone nursing degrees. 33 (Colleges Ontario, 2015, p. 12) Page 9

11 APPENDIX 4 Should Ontario colleges offer stand alone nursing degrees? Key considerations for college students. Humber College s revenue for the academic year: Revenue type $ (million) % of Total Budget Tuition and other fees Grants Other income Ancillary Amortization of DCC Investment income Source: (Humber College, 2014, p. 10) Page 10

12 APPENDIX 5 Current and projected fiscal full time equivalent headcount enrolment levels for Humber s collaborative program, second entry program, and RPN to RN bridge program (2012/2013 to 2017/2018): Collaborative Program FFTE 2012/ / / / / /2018 enrollment Second Entry RPN to RN Bridge Program Source: (R. A. Malatest & Associates, 2013, pp. 47, 49, 50) Page 11

13 APPENDIX 6 Humber s Health Human Resources Funding- Collaborative Nursing ( to ): $7,000,000 $6,000,000 $5,000,000 $4,000,000 $3,000,000 $2,000,000 $1,000,000 Humber s Health Human Resources Funding- Collaborative Nursing Linear (Humber s Health Human Resources Funding- Collaborative Nursing) $ Source: Government of Ontario- received July 30, Page 12