COLLIN COUNTY COMMUNITY COLLEGE DISTRICT NURSING PROGRAM NURSING EDUCATION PERFORMANCE INITIATIVE RECOGNIZED BEST PRACTICE DISSEMINATION PLAN

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1 COLLIN COUNTY COMMUNITY COLLEGE DISTRICT NURSING PROGRAM NURSING EDUCATION PERFORMANCE INITIATIVE RECOGNIZED BEST PRACTICE DISSEMINATION PLAN SEPTEMBER 2009

2 Education Performance Initiative Page 2 Education Performance Initiative Recognized Best Practice I. Summary information In the space provided below, provide a summary of the process for establishing the best practice. With that summary, include totals for start-up and on-going costs. Summary: In 2003, the nursing faculty at Collin County Community College District (CCCCD) observed that students were demonstrating increased stress levels related to nursing school and additional life factors. The faculty also noted that students did not appear to have effective study habits nor have the skills necessary to answer higher level application questions on exams. At the same time, retention of students as well as NCLEX-RN scores were problematic. In response to this assessment, CCCCD s nursing program implemented several initiatives to facilitate student retention in the program and success on NCLEX-RN. These initiatives are primarily in two areas intervention efforts academic vs. nonacademic. In order to implement them effectively and without overloading faculty, faculty incentives were also utilized. These initiatives were also implemented during a time of steady growth of the program. In the Spring of 2005, CCCCD began admitting twice per year Fall and Spring. The initial Spring cohort was small (20) and has since grown to be equal to the Fall cohort (48). In this timeframe, CCCCD has nearly doubled its enrollment in the nursing department. The gradual growth of the program while retaining high standards and adding new initiatives have facilitated the students success within in the program as well as on NCLEX. As the program grew, additional FT faculty positions were obtained. The best practices that have been particularly effective regarding student retention and graduation include the following: Fall 2003 one initiative o Initiated ATI Standardized Across the Curriculum with the Incoming class; classes already admitted took the ATI tests specific to semesters remaining Fall 2004 four initiatives o Initiated Stress Reduction Workshop for nursing Students; o Initiated course content on time management, study skills, & test taking strategies; o Assigned each student to a specific academic faculty advisor who provided extra assistance with study skills, test taking, and/or content questions; and, o Provided FT faculty with a stipend above base pay to compensate for student contact not covered with load Fall 2005 two initiatives o Initiated new testing rubric across the curriculum; and, o Began requiring students to remediate ATI content specific exams

3 Education Performance Initiative Page 3 Total Start-up Costs: $240/student for ATI across the curriculum; $36,000 for faculty stipends Total On-going Costs: $358/student for ATI across the curriculum; $211,071 for faculty stipends For more information about this best practice, contact: Contact Person: Nell Ard, PhD, RN, CNE, ANEF Title: Institution: Collin County Community College District Address: nard@ccccd.edu Telephone Number:

4 Education Performance Initiative Page 4 II. Background Describe the institution s student population, including class size, student demographics, admission criteria, and other information that will provide context for the best practice. Describe previous student success practices. Collin College s nursing program has grown from admitting once per year to admitting twice per year. Currently 48 students are admitted twice per year in both Spring and Fall. See Table 1 for Demographics of program when initiatives began versus current students. Table 1: Comparison of Student Demographics Demographic Fall 2004 Fall 2009 Total Number of Students Gender Ethnicity Age Previous Degrees or Certifications Employment 90% female 10% male 75% Caucasian 8% Asian 7% Black, Non-Hispanic 5% Hispanic 5% Other 21% (25 & younger) 20% (26-30) 44% (31-40) 15% (41-50) 20% (Associates) 23% (Baccalaurate) 5% (Masters) 10% (Certifications EMT, CNA, Pharm Tech, Medical Asst) 43% (not working) 29% (< 20 hrs) 14% (>20 hrs) 14% (working FT hrs) 81% female 19% male 72% Caucasian 15% Asian 7% Black, Non-Hispanic 4% Hispanic 2% Other 23% (25 & younger) 21% (26-30) 39% (31-40) 14% (41-50) 3% (51-60) 26% (Associates) 27% (Baccalaureate) 5% (Masters) 5% (Certifications EMT, Paramedic, CNAs, Pharm Tech, Medical Asst) 42% (not working) 33% (<20 hrs) 20% (> 20 hrs) 5% (working FT hrs) Admission Criteria: Collin College Department uses a 16-point system. Points are achieved for prerequisite GPA, Cumulative GPA, number of prerequisites completed, and preadmission scores on the PSB- School Aptitude Examination (RN). (See Table 2). The student pre-requisite and cumulative GPAs are hand calculated and points are achieved based upon the GPA. Minimum GPA for consideration is 2.5. One point is given for each of the four (4) pre-requisites successfully completed with a C or better. One point is given in each of the five (5) sections (total academic aptitude math & word association, spelling, reading comprehension, natural sciences, and vocational adjustment) of the PSB when the student scores in the fortieth percentile or higher. A bonus point is given for Reading Comprehension scores in the seventieth percentile or higher.

5 Education Performance Initiative Page 5 Admission Criteria Rank Cumulative GPA 0 = < 2.5 1= 2.5 to = 3.0 to = 3.6 to 4.0 Pre-requisite GPA 0 = < 2.5 1= 2.5 to = 3.0 to = 3.6 to 4.0 Completion of Prerequisites Statistics Anatomy & Physiology I Anatomy & Physiology II Microbiology 0 = None 1= 1 out of 4 2 = 2 out of 4 3 = 3 out of 4 4 = 4 out of 4 PSB- School Aptitude Exam Total Academic Aptitude (>40 =1) Spelling (>40 =1) Reading Comprehension (>40 =1; >70 = 2) Natural Science (>40 =1) Vocational Adjustment (>40 =1) Total Score: Points Points = 1 st Priority Points = 2 nd Priority 8-10 Points = Not Competitive <8 Points = Not Qualified The point system was revised in the Spring of The extra point for Reading Comprehension was added at that time. The point system also was clearly delineated that a minimum of 11 points needed to be obtained to be qualified for the program.

6 Education Performance Initiative Page 6 III. Project Need Present the problem statement and provide a rationale for the proposed best practice. Include references to any previous educational research that supports the best practice. 1. To what extent could students retention in nursing school and success on NCLEX-RN be improved by utilizing a testing program across the curriculum? Rationale: The Program had previously been using a product at the end of the curriculum to determine the student s potential success on NCLEX-RN. This product was not consistently providing the student and/or program with accurate information. An opportunity to implement a product across the curriculum not only provided the student with information but also the program information regarding its curriculum. 2. To what extent can student retention be improved by providing nursing students with stress reduction strategies? Rationale: Student stress appeared to have a negative impact on their ability to be successful in the nursing program. The inability to handle the stress of nursing school along with life stressors appeared to be too much for many students. The faculty also believed the students could use these strategies to teach their patients. 3. To what extent could student retention be improved by providing students with time management strategies, study skills, and test taking strategies? Rationale: Many students admitted that previous to nursing school they did not need to study to achieve high grades. Many indicated that they were having to study for the first time and were not real sure how. They also expressed issues with managing their time effectively with nursing school as well as family and/or job responsibilities. Students also expressed concerns over the difficulty of nursing exams in comparison to previous academic testing. 4. To what extent could academic retention and NCLEX-RN pass rates be improved by changing the testing plan across the curriculum? Rationale: Students complained that tests jumped too much between first and second year in the nursing program. Student attrition was higher during third and/or fourth semester than elsewhere in the program. 5. To what extent could an individualized plan for NCLEX-RN preparation assist students in their success? Rationale: Students indicated that they did not know where to begin in preparing for the NCLEX-RN and did not always know where the weak areas were in their nursing knowledge. IV. Strategy Description Include a brief narrative for the best practice followed by a matrix for each of the four major stages of its development. There were seven (7) strategies initiated: Standardized Across the Curriculum standardized computer testing was initiated across the curriculum using the Assessment Technologies Institute (ATI) product Stress Reduction Workshop workshop was developed to teach student stress reduction techniques that they could use themselves as well as in patient teaching

7 Education Performance Initiative Page 7 Time Management, Study Skills, & Test Taking Strategies Content information and suggestions were provided in all three areas to the first semester student & reemphasized as needed with individuals Assignment of Faculty Academic Advisor all students assigned a Full time (FT) faculty advisor each semester in the program to assist Rubric Across the Curriculum established a testing rubric weaning the student off of Comprehensive questions and increasing Application and Analysis type questions Individualized NCLEX-RN Success Plan each student meets with faculty regarding an individualized plan to facilitate success on NCLEX-RN Faculty Stipend faculty are provided a stipend, above base pay, to recognize the additional time involved in retention efforts

8 V. Strategy Description (cont.) A. Initiation Describe the resources and activities needed prior to implementing the best practice. Activity Description Expected Outcome (s)/s Position Initiate Standardized Across the Curriculum NCLEX-RN first attempt pass rates will increase by at least 5% and be maintained at 90% or higher Initiate Stress Reduction Workshop for nursing Students Participants will indicate increased knowledge related to stress reduction strategies and their effectiveness Initiate course content on time management, study 4. skills, & test taking strategies Assign each student to a specific academic faculty 6. advisor who provided extra assistance with study skills, 7. test taking, and/or content questions Previous attrition rates will decrease by 5% and be maintained after instituting a Stress Reduction Workshop for all incoming students. Attrition rates will decrease by 5% after implementation of content and be maintained. Attrition rates will decrease by 2% or greater and then be maintained. 5. Initiate new testing rubric across the curriculum NCLEX-RN first attempt pass rates will increase by at least 5% and then be maintained at 90% or higher. Committee; 1 st Semester Faculty; 1 st Semester Faculty All Faculty; Committee & Faculty; Completion Date Budget prep cycle $240/student divided across 4 semesters 2 months Faculty time to develop; $3.00 per student booklet to replicate 2 months Faculty time to develop One week then ongoing for each semester Faculty time to remediate & mentor students 3-4 months Faculty time to develop

9 Activity Description Expected Outcome (s)/s Position 6. Initiate individualized NCLEX-RN Success Plan for students Provide FT faculty with a stipend above base pay to 9. compensate for student contact not covered with load NCLEX-RN first attempt pass rates will increase by at least 5% and then be maintained at 90% or higher Retention of full time faculty will be improved by providing a stipend to supplement base salary and to recognize the extra time involved with retention efforts. 4 th Semester Faculty; ; Dean & Administration Completion Date 1 month Faculty time to develop Budget prep cycle Initially $3,000 per FT faculty member B. Implementation Describe the steps needed to implement the best practice. Activity Description Expected Outcome (s)/s Position Standardized ATI Across the Curriculum A. Obtain Administration approval to cover cost of student testing in Department budget. B. Contract with company to provide testing materials Stress Reduction Workshop A. Develop curriculum B. Develop schedule for event C. Print handouts and evaluation tool D. Complete evaluation of event and review for potential changes On-going use of a Standardized testing program across the curriculum maintained with each cohort of students; Justify costs & benefits to students & department Brief Power point presentation with hands-on opportunities Handout for student to take home Evaluation tool - Likert scale ; Dean 1 st Semester Faculty Completion Date Budget prep cycle 2 months prep Initially $240/student over 4 semesters; Currently $358/student over 4 semesters Faculty Development time & participation in workshop; $3.00/student for handouts

10 Activity Description Expected Outcome (s)/s Position Course content on time management, study 4. skills, & test taking strategies A. Research literature regarding time management, study skills, and test taking strategies B. Develop two (2) 1.5 hour lectures Assignment of faculty academic advisor who provides 6. extra assistance with study skills, test taking, and/or 7. content questions rubric across the curriculum & Faculty 9. Handbook Explanation A. Review NCLEX-RN Blueprint & Bloom s Taxonomy B. Develop percentages of Knowledge, Comprehension, Application, and Analysis type questions for each exam across the curriculum C. Review compliance with rubric with each exam D. Develop detailed explanation of item writing and NCLEX-RN Categories for test blueprinting to include in Faculty Handbook 6. Individualized NCLEX-RN Success Plan A. Review each student s performance on standardized B. Meet with each student to develop individualized prescription for NCLEX-RN success. 7. Provide FT faculty with a stipend above base pay to compensate for student contact not covered with load Power point lecture to use for three (3) hours of content Equal distribution of students on a given level between FT faculty Exams will demonstrate gradual progression of item difficulty until a 90% Application and 10% Analysis level is achieved. Faculty will have available reference regarding test items and blueprinting Individualized plan to prepare for NCLEX-RN co-developed by student and faculty. Develop formula for compensation Use growth funds from the state to supplement college funds 1 st Semester Faculty All Faculty; Committee & Faculty; ; Test Compiler 4 th semester faculty; ; Dean; Human Resources, & Administration Completion Date 1 month Faculty time to develop & present content 3 hours Faculty time 1 month to review & develop 1-2 hours per student Dependent upon number of faculty Faculty & Director time to develop; Faculty Time Dependent upon formula developed

11 C. Evaluation Describe the activities needed to evaluate the best practice. Activity Description Expected Outcome (s)/s Position 1. Standardized ATI Across the Curriculum A. On-going comparison of each cohort to national and program benchmarks B. Comparison of several cohorts to determine weaknesses in curriculum C. Track Attrition in program Stress Reduction Workshop A. Complete Likert Scale evaluation with each cohort B. Review components of workshop and revise as needed compare cohort data C. Track Attrition in program Time management, study skills, & test taking strategies A. Complete evaluation of course content B. Track Attrition in program Assignment of Faculty Academic Advisor 4. A. Evaluate student placement within advisory groups 5. B. Track Attrition in program Each cohort will be at or above the national and program benchmarks Weak areas in curriculum will be revised for future cohorts Retention rates with each cohort of students will be maintained Each cohort will verify new knowledge regarding stress reduction strategies after workshop Workshop curriculum will be modified as needed Retention rates with each cohort will be maintained Student feedback will indicate new knowledge regarding content Retention rates with each cohort will be maintained Student feedback will indicate use faculty advisors to facilitate success in the program Retention rates with each cohort will be maintained Committee; 1 st Semester Faculty & DON 1 st Semester Faculty; Completion Date 30 minutes; 2 hours Faculty Time 2 hours Faculty Time 1 hour Faculty Time All Faculty 1 hour Faculty Time

12 Activity Description Expected Outcome (s)/s Position 5. rubric across the curriculum A. Review each exam for compliance B. Monitor exam adjustments C. Evaluate NCLEX-RN exam adjustments to blueprint and modify rubric accordingly C. Track Attrition in program 6. Development of Individualized NCLEX-RN Success Plan A. Monitor NCLEX-RN pass rates and individual s success B. Monitor consistency of ATI Comprehensive Predictor on NCLEX-RN Success rates 7. FT Faculty Stipend A. Monitor faculty turnover B. Monitor faculty salaries with stipend and compare to other nursing programs and service Level test compiler will make sure exam adheres to rubric Overall exam adjustments will be minimized Rubric will consistency mirror NCLEX-RN test blueprint Retention rates with each cohort will be maintained Student success on NCLEX- RN on first attempt Comprehensive Predictor will provide valid information to student and faculty FT faculty turnover will be minimized faculty will feel adequately compensated for their retention efforts Committee & Faculty 4 th Semester Faculty; ; Dean & Administration Completion Date 4 hours Faculty Time 2 hours Faculty Time 2 hours & HR time D. Refinement and Modification Describe the activities to refine and modify the best practice once initially introduced. Activity Description Expected Outcome (s)/s Position 1. Require students to remediate content specific exams when benchmark not achieved - use opportunity for student growth in knowledge of content area versus retention in program Attrition rates will decrease by at least 2% and be maintained. NCLEX-RN first attempt pass rates will increase by 5% and then be maintained. Committee Completio n Date One month Faculty time to monitor remediation

13 VI. Unanticipated Challenges and Benefits Present these observations (and any of the institution s possible responses) in bullet format. Not applicable