November 19, I am pleased to submit to you the revised UC Davis proposal to establish a new school of nursing.

Transcription

1 BARBARA A. HORWITZ Interim Provost and Executive Vice Chancellor November 19, 2008 VICE PRESIDENT PATRICK LENZ INTERIM PROVOST ROBERT D. GREY COUNCIL CHAIR MARY CROUGHAN UCPB CHAIR PATRICIA CONRAD UCEP CHAIR STEPHEN MCLEAN CCGA CHAIR FARID CHEHAB RE: UC Davis School of Nursing Proposal Dear Colleagues: I am pleased to submit to you the revised UC Davis proposal to establish a new school of nursing. This revision has my full support and comes after months of concentrated effort to address suggestions and questions raised by the Academic Council and its committees following their first review of the proposal. This revision process was led by Dr. Heather M. Young, who joined the UC Davis Health System in August as the associate vice chancellor for nursing and future founding dean for the school (upon its approval). Dr. Young and her team collaborated with key faculty leaders from both the Davis Division of the Academic Senate and the system-wide Academic Council. Several other leaders provided valuable insight, including the UC Davis Office of Resource Management and Planning, our Graduate Studies office and several staff from the University of California Office of the President. Dr. Young and her team also continued to gather feedback and suggestions from the other UC nursing schools and programs as well as from leaders at California State University, Sacramento and the community college system. The team also hosted a Strategic Design Summit in September where a variety of nationallyprominent nursing science educators, researchers and thought leaders provided valuable input in the continued development of the school and its curricula. The proposal and its related attachments are preceded by a guide that indicates the issues raised by the committees and where in the proposal the corresponding responses are located. This guide was produced as a tool to ensure the revised proposal addressed all issues raised by the committees. The $100 million commitment from the Gordon and Betty Moore Foundation provides a remarkable opportunity to launch this school and expand nursing education at UC Davis and the campus fully supports the proposal as written. However, we all acknowledge this launch comes at a time of difficult financial constraints. As such, we have carefully considered a variety of contingency plans to ensure the long-term success and viability of the school. Fundamental to those plans is an aggressive approach to fundraising. The level of investment that you will see in the staffing plan is unusual for a new school.

2 UC Davis School of Nursing Proposal November 19, 2008 Page 2 However, we view this investment in fundraising as a critical component of ensuring our longterm success. Further, the leadership of UC Davis, the health system and the School of Nursing are committed to continual assessment of expenses and revenue to ensure that the implementation occurs at a pace that matches available resources while also protecting the integrity of the vision. Costs will be deferred and programmatic adjustments will be made to protect the education and research goals should actual resources lag our projections. In this way, quality is never a sacrifice. The School of Nursing is an essential component of the UC Davis health sciences vision and will contribute to meet societal need to transform health care. Upon approval by the Regents of the new school, it will be named the Betty Irene Moore School of Nursing at UC Davis in honor of the generous philanthropic grant that will make this school possible. I, along with the entire leadership of UC Davis, support the establishment of the Betty Irene Moore School of Nursing. In my capacity as the Interim Provost and Executive Vice Chancellor at UC Davis, I will continue to work with Dr. Young and my colleagues across campus to meet the goals and benchmarks required in the creation of a new school. I am happy to assist in whatever way is needed to ensure a comprehensive yet timely review of this revision, which we hope will culminate with a review by the UC Board of Regents in March. As noted above, the leadership of the Davis Division of the Academic Senate received a courtesy copy of the revised proposal and has been in close contact with Dr. Young. The members support this school moving forward. Best regards, /ers c: Chancellor Vanderhoef Director Copperud Associate Vice President Obley CCGA Committee Analyst Zárate UCPB Committee Analyst La Briola UCEP Committee Analyst Abrams Vice Chancellor Meyer Davis Division of the Academic Senate Chair Powell Associate Vice Chancellor Ratliff Analyst Klausner Principal Budget Analyst McKellar Barbara A. Horwitz Interim Provost and Executive Vice Chancellor

3

4 Proposal to establish the Betty Irene Moore School of Nursing GUIDE: Location of response to specific issues raised by the Committees of the Academic Council Issues Raised by the University Committee on Educational Policy (UCEP): 1) FTE structure and funding model unclear and optimistic; concern over sustainability 2) Undergraduate program a. Funding unclear b. How will these students depend on and/or impact existing undergraduate programs & curriculum? c. Categories of instructors, and associated costs? 3) Impact on other programs a. 200 BSN students-are these new students or do they replace existing students? b. PhD students how do they impact other graduate groups? Location in Proposal Where Issue is Addressed: Sections III-C-2 and III-C-3 address faculty/student ratios (pg , Appendix B) Operating budget described in Section III-B-1 and Section III-B-2 (pg 34-35, Appendix C) Section III-D describes the Advancement Plan to assure resources for sustainability (pg ) Sources of funds are described in Section III-B- 1 (pg. 34 and Appendix C) The School of Nursing will provide a new opportunity for undergraduates, as discussed at the end of Section I-D (pg. 3) and again in Section I-F (pg ) Faculty ratios and costs are address in Sections III-C-2, III-C-3 and III-C-4 (pg and Appendix C) Refer to Sections I-D (pg. 3) and I F (pg , 24) Graduate group formation is discussed in Section I-D (pg. 3) and again in Section I-G (pg and 17-24) Page 1 of 3

5 Issues Raised by the University Committee on Planning and Budget (UCPB): 1) Curriculum-no detailed curriculum included 2) Matriculation dates for matriculation unclear 3) Faculty conflicting information about faculty FTE, and concern about funding for proposed student/faculty ratios 4) Library resources sources of funding for resource needs estimated by library 5) Capital projects concern that estimates of building costs and sources of funds not identified for space needs of 60,000 sq ft 6) Operating budget more detailed budget required 7) Fundraising request better explanation of fundraising plan, rationale for fundraising projections 8) External endorsement letters request letters of support from similar schools inside and outside UC system Location in Proposal Where Issue is Addressed: Master s degree curriculum; described in Section I-G- (pg ) PhD curriculum; described in Section I-G-2 (pg ) Matriculation for graduate degree programs will begin in the fall of 2010; baccalaureate matriculation begins in the fall of Sections III-C-2 and III-C-3 address faculty/student ratios (pg and Appendix B) Operating budget described in Section III-B-1 and Section III-B-2(pg. 34 and Appendix C) Addressed in Section II-B-2 (budget line item for library expenses) (pg and Appendix C) Space requirements are discussed in Section III-C-5 (pg ) and again in the contingencies Section III-E (pg. 43) Budget narrative is included in Section III-B (pg with detailed financial projections in Appendix C) A narrative description of the advancement plan is included in Section III-D (pg with fundraising projections included in Appendix C) Section I-E describes regular meetings with Deans at three other UC universities and anticipated letters of support (pg and letters of support in Appendix F). Section I-F has a paragraph on support of the UC Davis Medical Center management and staff nurses (pg. 10). Page 2 of 3

6 Issues Raised by the Coordinating Committee on Graduate Affairs (CCGA): 1) Faculty FTE clarification needed, number in text differs from number in Appendix 2) Given national shortage in nursing faculty, who will comprise pool of applicants; estimate number of qualified applicants per position? 3) 40% of faculty salaries secured from external sources supplement or substitute for state funding? 4) Graduate group structure needs to be better explained 5) What are future plans for the DNP (Doctor of Nursing Practice) given position of the Collegiate Commission on Nursing Education? Location in Proposal Where Issue is Addressed: Refer to Sections III-C-2 and III-C-3 (pg and Appendix B for faculty FTE projections) Refer to Section III-C-4 (pg. 40) Refer to Section III-C-4 (pg ) Section I-D: introduces the new Nursing Science and Health-Care Leadership Graduate Group, which is interdisciplinary in nature. First Chair of the Grad Group and several potential group members identified. (pg. 3-5, 14-15, 17-24) Section I-G discusses the DNP (pg ). Page 3 of 3

7 PROPOSAL BETTY IRENE MOORE SCHOOL OF NURSING AT UNIVERSITY OF CALIFORNIA, DAVIS November 3, 2008

8 Foreword Proposed is the establishment of a new school of nursing at UC Davis, to be named the Betty Irene Moore School of Nursing, whose long-term mission is the transformation of health care through nursing, contributing ultimately to new paradigms for nursing education and the delivery of health care in California and the United States. This unprecedented opportunity is made possible through a very generous $100 million grant from the Gordon and Betty Moore Foundation and through the shared visionary foresight of the Gordon and Betty Moore Foundation and the leadership of UC Davis Health System. The Institute of Medicine (IOM), in its 2001 publication Crossing the Quality Chasm, urges rethinking our approach to preparing health-care professionals to: redesign the way health professionals are trained. placing more stress on teaching evidence-based practice and providing more opportunities for interdisciplinary training. 1 The American Association of Colleges of Nursing (AACN) observes that: The realities of a global society, expanding technologies, and an increasingly diverse population require nurses to master complex information, to coordinate a variety of care experiences, to use technology for health-care delivery and evaluation of nursing outcomes, and to assist clients with managing an increasingly complex system of care (p. 5-6). 2 The primary goal of this initiative, then, is no less than the transformation of nursing education and nursing practice, fostering truly interdisciplinary approaches to health care early in the preparation of nurses, physicians and others; advancing health and systems knowledge and shepherding the effective translation of evidence into practice. The vision for the Betty Irene Moore School of Nursing calls for the development of a school that will use new approaches to nursing education. Instead of focusing only on supply, that is, graduating more nurses of similar caliber, this school aims to focus on demand, by addressing system and leadership issues that directly affect quality and efficiency of care as well as how nursing resources are used. An additional goal of this endeavor, integrally related to the primary goal, is to prepare excellent nurse researchers and educators, a critical prerequisite in elevating the quality of nursing practice. These scholars will contribute to the knowledge base for quality interdisciplinary health care and play a pivotal role, through their research, teaching and dissemination, in translating that evidence into practice and policy. This is no small task and in ordinary circumstances might have small chance of success. These are extraordinary circumstances, however, occasioned by the unprecedented commitment of the Gordon and Betty Moore Foundation that will enable UC Davis Health System to carefully design and execute long-term strategies that will assure success in the realization of this bold vision. 1 Report Brief: Crossing the Quality Chasm: A New Health System for the 21 st Century 2 American Association of Colleges of Nursing. (2007). White Paper on the Education and Role of the Clinical Nurse Leader. Washington, DC: Author. < ii

9 Table of Contents I. ACADEMIC RATIONALE... 1 A. Unique Opportunity... 1 B. Margin of Excellence and Culture of Transformation... 1 C. Core Attributes... 2 D. Position within UC Davis/Interdisciplinary Opportunities... 3 E. Relationship to Other University of California Nursing Programs... 5 F. Size, Scope and Organization G. Degree Program Curriculum and Requirements Program Launch Plan Doctor of Nurse Practice Doctor of Philosphy The Master of Science degree Baccalaureate Degree The Entry Level Master s degree H. Accreditation II. SOCIETAL AND STUDENT NEED A. The Need for Quality Interdisciplinary / Interprofessional Education and Practice Developing the Evidence Base Translating Evidence Into Practice B. The Need to Prepare Nursing Faculty C. The Need for More Nurses III. FEASIBILITY AND IMPLEMENTATION PLAN A. Introduction B. How Resources Will Be Allocated to Achieve Vision and Goals Sources of Funds Allocation of Funds C. Major Implementation Steps and Timetable Student Enrollment Projections Faculty Projections Student Ratios Salaries Recruitment of faculty Physical Facility Requirements iii

10 D. Advancement Plan E. Contingency Planning IV. SUMMARY Appendices Appendix A. Summary Description of Nursing Education in California Appendix B. Summary Financial Projections Spreadsheet Appendix C. Student Enrollment and Faculty FTE Projections Appendix D. Proposed Staffing Level Spreadsheet Appendix E. Budget Narrative Appendix F. Letters of Support Appendix G. Floor Plan of Current Space Appendix H. Betty Irene Moore School of Nursing Transition Team Org. Chart Appendix I. Bio-sketch of Associate Vice Chancellor Dr. Heather Young Appendix J. Letter from Dean of Graduate Studies and letter from Interim Chair of the Proposed Graduate Group Steering Committee iv

11 I. ACADEMIC RATIONALE A. Unique Opportunity The University of California, Davis (UC Davis) will create a School of Nursing that will establish innovative approaches for nursing education. The unprecedented grant from the Gordon and Betty Moore Foundation is the major factor making this opportunity so unique. The resources made available by this grant make this proposal different from most proposals for the establishment of new schools within the University of California system. Also, rather than a progression through new course offerings, new program development, creation of a new department and finally the establishment of a school, as is sometimes the case, this proposal begins with the creation of a new school, with various degree programs phased in over a period of a few years. This opportunity is also unique in that with the generous grant come high expectations. The Gordon and Betty Moore Foundation has considerable experience with the University of California system and many UC campuses have benefited from the foundation s support. Especially in the field of nursing, the Gordon and Betty Moore Foundation, through the Betty Irene Moore Nursing Initiative, has broad experience and deep understanding of the challenges and opportunities facing the nursing profession and the importance of nurse education in responding to those opportunities and challenges. The foundation s support of and experience working with UC San Francisco School of Nursing, as well as initiatives that have been funded at San Jose State University, community college nursing programs and other organizations have resulted in a clear vision of the leadership of the Gordon and Betty Moore Foundation for the potential future for nursing education. Third, the grant from the Gordon and Betty Moore Foundation makes possible the creation of a School of Nursing distinguished by a Margin of Excellence and a Culture of Transformation (described in more detail in the next section), that together will foster innovation to advance the field of nursing. Finally, UC Davis has a unique naming opportunity for the proposed new school, slated to be named the Betty Irene Moore School of Nursing at UC Davis. B. Margin of Excellence and Culture of Transformation As noted above, the commitment from the Gordon and Betty Moore Foundation positions UC Davis to develop a new School of Nursing at a high level of excellence and in a manner that has the potential to transform health care through nursing. The Margin of Excellence includes several specific elements. First is a well-funded, carefully-planned, well-executed and sustained fundraising effort. As generous as the grant of the Gordon and Betty Moore Foundation is, it is still finite, and sustaining a high level of excellence over time will require a considerable endowment. The Gordon and Betty Moore Foundation and UC Davis leadership have been in full agreement that advancement efforts be sufficiently funded, and advancement professionals at UC Davis have launched 1

12 an effort that includes the use of the best national and regional development consultants and a well-staffed advancement, marketing and communications organization within the proposed School of Nursing. Broad marketing and communications efforts to enhance visibility and recognition of the school, focused not only on potential donors but also on attracting high-caliber faculty and students, are a second important element of the Margin of Excellence. A third important element, in conjunction with the first two, is the provision of scholarships and stipends, again to attract and sustain the academic progress of the best and brightest nursing students, especially in the graduate programs where the focus is on preparation of future nursing faculty, researchers and leaders. The final critical element in maintaining the Margin of Excellence is the creation and ongoing application of rigorous evaluation mechanisms. These will be essential to continuous monitoring of the successes and shortcomings of all School of Nursing programs, and will enable continuous refinement and improvement of the offerings of the school. Creating a Culture of Transformation also encompasses several elements. Success in transforming nursing education will require excellent faculty with the resources and support to develop transformative approaches and establish robust research programs at UC Davis. Thus, offering attractive recruitment packages that ease transitions to UC Davis will be important. Second, faculty will be appointed well in advance of the first matriculation of students so that there is time for the faculty to work together in refining curriculum, planning innovative teaching strategies, developing as a collaborative team and launching key research initiatives. Again, this is a unique opportunity, as faculty are more typically appointed when students arrive and state financial support is in place. The final major element in developing a Culture of Transformation is creating and sustaining a Dean s discretionary fund, through sustained advancement efforts, to assure faculty are supported in scholarship, innovations in pedagogy, developing approaches for transforming practice and systems through research and evaluation. Accompanying this support are high expectations of faculty in these areas of scholarship, research and innovation. C. Core Attributes The Betty Irene Moore School of Nursing will be distinguished by five core attributes, briefly summarized here. The first of these is an interprofessional approach to nursing education. As the IOM report on the Quality Chasm revealed, a key element in improving health care is an integrated team approach, requiring close collaboration of nurses, physicians and others in a patient-centered approach. One of the reasons the Gordon and Betty Moore Foundation is choosing to work with UC Davis on this initiative is a campus tradition of collaboration and interdisciplinary education, exemplified in the longstanding UC Davis graduate group configuration for conferring post baccalaureate degrees, a unique approach to graduate education resulting in rich intellectual diversity. The second core attribute is scientific rigor, educating nurses in conducting research, thinking critically, and making decisions based on evidence. As mentioned above, 2

13 emphases on scholarship, research, excellence in pedagogy, and rigorous evaluation are essential to sustaining the margins of excellence and transformation. The third core attribute is innovative, patient-centered technology. Again, the Gordon and Betty Moore Foundation found attractive the national prominence of UC Davis in applications of technology in health care and health-care education, especially in the area of telehealth, to improve access to tertiary medical expertise and simulation, to improve clinical experience preparation of health professionals. A fourth core attribute is leadership. There are at least three major dimensions of leadership that will characterize the School of Nursing. The first is leadership in nursing education, with the school transforming nursing education. The second is the preparation of nurse leaders of the future, in scholarship, teaching, health-care delivery and public policy. The third is individual leadership, as exhibited by formal and informal leaders, from executives to bedside nurses, utilizing critical thinking, communication and collaborative skills in the interest of better care. The final, but by no means least important core attribute, is cultural competency. Both the recipients of health-care services and health-care professionals are becoming increasingly diverse in many dimensions, including race, ethnicity, national origin, language, age, education, socio-economic status and occupation. Health-care professionals of the future must be prepared to deliver truly patient-and-family-centered care, which will require an unprecedented level of competency, understanding and sensitivity to the diverse populations they serve. These five attributes serve as guideposts to the planning, development and implementation of each and every program and initiative of the proposed School of Nursing. D. Position within UC Davis/Interdisciplinary Opportunities Evidence of the effectiveness of interdisciplinary and interprofessional approaches to health care has been mounting for at least the last decade. Numerous studies support the positive impact of such approaches on patient outcomes and quality of care. In recent years, there has been a growing recognition of the need for more interprofessional education in the health-care professions, bringing nursing students, medical students and others together early in their didactic and clinical professional preparation, thus positioning health providers to think and act in the context of an interprofessional team. UC Davis has a strong tradition of interdisciplinary education in varied fields and a clear intention to expand interdisciplinary education in the strategic plan. 3 Indeed, that tradition and intent are among the reasons the Gordon and Betty Moore Foundation chose UC Davis as the site of the Betty Irene Moore School of Nursing. At UC Davis, a key concept of graduate education is the graduate group. UC Davis graduate programs are organized as interdisciplinary graduate groups, giving students 3 University of California, Davis. The UC Davis Vision: The Campus Strategic Plan, January 29, < 3

14 intellectual freedom to transcend disciplines and areas of research. The core elements of a graduate group include: an emphasis on shared research interests among faculty and students, flexibility to grow and quickly change to reflect emerging areas of interdisciplinary knowledge and technology, and an acceptance that many research questions transcend traditional academic departmental boundaries. Graduate groups embody the collaborative spirit at UC Davis by bringing together faculty from departments across campus that share common research interests, either in academic discipline or area of application. For example, the Biochemistry and Molecular Biology Graduate Group provides students with access to more than 133 faculty with research and instruction interests in both basic and applied sciences. These faculty members hold appointments in more than 25 departments spanning the Colleges of Letters and Sciences and Agricultural and Environmental Sciences, the Schools of Medicine and Veterinary Medicine, and the College of Biological Sciences. This is just one example of the unique graduate groups offered at UC Davis. The graduate group concept has established a culture of interaction across departmental lines and has helped to shape the distinctive character of the campus. As part of a collaborative team, each student contributes his or her talent and expertise while learning from students and faculty across disciplines. The extensive use of graduate groups as a vehicle for administering graduate academic programs has expanded the scope and strengthened the quality of graduate education at Davis. The graduate group tradition at UC Davis offers an ideal environment for the interprofessional goals of the School of Nursing. It is the goal of the leadership of the Betty Irene Moore School of Nursing that the school becomes a national model for interprofessional/interdisciplinary nursing education and prepares nurses and nurse faculty to further interdisciplinary approaches to the delivery of health care. The Betty Irene Moore School of Nursing will have the substantial benefit of being established within a highly-regarded educational system that includes a top-rated medical school and medical center as well as a wide array of research departments, divisions and programs across the arts and sciences. School of Nursing faculty and students will collaborate with faculty and students in existing health-care degree programs including the M.D., the Master of Science in Health Informatics (M.S.), the Master of Public Health (M.P.H.) and Family Nurse Practitioner/Physician Assistant (F.N.P./P.A.) certificate programs administered by the School of Medicine. The existing Rural-PRIME (PRograms In Medical Education) program further extends the potential for interprofessional education and collaboration in the area of rural health. Simulations and telehealth capability already exist in the rural centers where medical, nurse practitioner and physician assistant students currently work and learn together. The education of nursing students at rural centers can make use of existing technology and provide immersive education with other health disciplines. Interdisciplinary learning must also extend beyond the health professions per se as health care grows increasingly complex. Solid grounding in cultural studies, for example, will enhance nurses abilities in working effectively with an increasingly diverse patient 4

15 population. Business management and leadership knowledge will be essential for nurses in a climate of greater emphasis on containing health-care costs while improving quality and the need for understanding and managing organizational change. Informatics is growing in importance as both health records and the research and evidence base are created, organized, stored and retrieved electronically; even much of the delivery of care can now be accomplished through telehealth. These are but a few examples of fields of study becoming more pertinent to nursing education. To that end, it is proposed that the graduate programs offered by the Betty Irene Moore School of Nursing become the core of a new graduate group at UC Davis, for Nursing Science and Health-Care Leadership with broad participation from the School of Medicine (especially in the areas of rural health, telehealth, health disparities and geriatrics) including existing programs leading to the M.D., M.P.H., M.S. in Health Informatics, F.N.P/P.A; Graduate School of Management; and programs or departments in fields such as health informatics, nutrition, cultural studies, epidemiology, human development, biostatistics and economics. The Nursing Science and Health-Care Leadership Graduate Group will confer the degrees of Doctor of Philosophy (Ph.D.) and Master of Science (M.S.). Opportunities also exist to create dual degree programs in several areas (e.g., M.S./M.P.H., M.S./M.B.A., and M.S.in Nursing/M.S. in Health Informatics). School of Nursing faculty will join other graduate groups across campus, just as faculty from a variety of areas have graciously agreed to work with the graduate students in nursing. Dr. Paul Fitzgerald, acting chair and professor in the Department of Cell Biology and Human Anatomy, will initially lead the formation of and serve as chair of the Nursing Science and Health-Care Leadership Graduate Group, upon its approval. Letters of support for the formation of such a new graduate group are included in Appendix F. The creation of the Betty Irene Moore School of Nursing is expected to be of significant benefit to undergraduate programs and enrollment in other schools, departments and programs at UC Davis. In any given year, there are approximately 5,000 undergraduate students in the biological sciences with an expressed interest in pursuing a course of study and career in the health professions (e.g., nursing, medicine, physical therapy). Incorporating a high quality School of Nursing into current degree programs in the health professions will help to retain those students who now must transfer to another institution to complete a nursing degree, and will likely strengthen undergraduate enrollment overall. E. Relationship to Other University of California Nursing Programs Inclusion of a School of Nursing at UC Davis is consistent with the interests of the University of California to increase enrollment in professional schools system-wide. In his September 19, 2000, letter to Provost King, President Atkinson articulated the need to plan for expansion of professional schools that will meet market needs, build on existing strengths of UC as a research university and academically strengthen and enrich the proposing campus. New professional schools were listed as one means of achieving the 5

16 goal and health sciences fields, including nursing, were specifically mentioned as areas for growth because of societal need. 4 Currently, four UC campuses (UCLA, UCSF, UC Irvine and UC Davis) offer a variety of undergraduate and graduate nursing programs: 1) undergraduate (B.S.) programs, 2) master programs, 3) R.N.-to-B.S.-to-M.S.N. degree programs for graduates of community college nursing programs, 4) master entry nursing programs, designed for second-career individuals who hold a baccalaureate degree in a related field, 5) post-master certificate and/or collaborative master s degree programs, 6) doctorate programs and 7) doctorate in nursing practice (D.N.P.) programs. The table below summarizes nursing programs in the UC system. ( X indicates a currently offered program, P a planned program.) Degree Focus UCSF UCLA UC Irvine UC Davis Ph.D. (Doctor of Philosophy D.N.P. (Doctor of Nursing Practice) Research doctorate requiring original, creative and rigorous scholarship (Note: UCSF offers Ph.D. in both Nursing and Sociology). Clinical professional doctorate requiring advanced clinical preparation and practica. Focus on advanced practice (typically understood to include nurse practitioners, clinical nurse specialists, nurse anesthetists and nurse midwives) and application of scholarship to clinical settings. Accrediting bodies recommend D.N.P. for advanced practice after X X P P P 4 Letter from President Atkinson to Provost King, September 19, < 6

17 Degree Focus UCSF UCLA UC Irvine UC Davis M.S. (Master of Science) Master s degree with two main foci: Advanced practice nursing preparation (e.g., as nurse practitioner, nurse midwife, clinical specialist) Master s degree level preparation for leadership or educational roles. X X P X Family Nurse Practiti oner offered w/ CSUF P X Family Nurse Practitio ner offered w/ CSUS Master Entry Master s degree, prelicensure as an R.N. Focused on secondcareer individuals who hold a bachelor s degree in a related field and want to enter the nursing profession. Graduates can take R.N. licensure exam. X X P Post-master certificate Clinical specialty and role preparation for advanced practice (e.g., nurse practitioner, nurse midwife, clinical specialist). X X B.S. (Bachelor of Science) Prelicensure as an R.N. Prepares entry level R.N.s for practice and for pursuing graduate education. X X P R.N. to B.S. Postlicensure, allowing associate degree R.N.s to attain B.S. X Two campuses, UC Davis and UC Irvine, offer Family Nurse Practitioner certificate programs in collaboration with their respective schools of medicine. Both campuses also offer a master s degree option for graduates of baccalaureate nursing programs in conjunction with a California State University (CSU) campus. Students receive their core master courses at the CSU campus and their clinical preparation coursework and learning experiences through the UC program. UC Davis partners with CSU Sacramento and UC Irvine partners with CSU Fullerton. The UC Davis campus, through the School of Medicine, Department of Family and Community Medicine, has a very strong and well-established F.N.P/P.A. collaborative training program with more than 1,650 graduates deployed in primary care settings throughout California since The F.N.P. program is affiliated with California State 7

18 University, Sacramento, Division of Nursing for the conferral of the Master of Science in Nursing Degree to the UC Davis F.N.P. graduates. The hallmark of this program s success has been its record of recruiting and graduating underrepresented students from rural communities, varied ethnic backgrounds and those who are the first in the family to attend college. Recent changes within the UC system include the re-establishment of the undergraduate nursing degree at UCLA in 2006, at the same time that UC Irvine was approved for a Program of Nursing Science. The first cohorts of baccalaureate nursing students will graduate from both UCLA and UC Irvine in Even given this considerable capacity for preparing nurses and nurse faculty within the UC system, there has long been recognition that there remains a significant need for expansion of nurse education in California, and especially for preparation of nursing faculty. (See Appendix A, which provides a snapshot of nurse education in California, from a recent report on health profession education released by the University of California Office of the President.) Much analysis and thought has been devoted to defining that need and several concrete university-wide recommendations have been developed in recent years. That activity is summarized below. In 2001, the UC Director of Academic Health Sciences convened a Nursing Subcommittee of the University-wide Health Sciences Committee (HSC) to review the mission of UC in relation to nursing education. The report of the subcommittee is included in the H.S.C. report on workforce needs and enrollment planning, Health Sciences Education: Workforce Needs and Enrollment, released in The following summary points related to nursing and UC are included in the report: California s nursing workforce crisis is serious and growing. Among public nursing education programs, the California State University (CSU) and California Community College (CCC) systems offer the overwhelming majority of undergraduate nursing programs. Significant growth in undergraduate nursing education is needed to meet future demands. The growing shortage of nursing school faculty (in California and nationally) poses a major challenge for increasing enrollments in all programs. UC nursing schools play a central role in preparing future faculty for all California nursing programs. The absence of a UC nursing program for undergraduates has had negative consequences: o highly qualified students interested in nursing do not apply to UC. o lack of a strong pool for recruiting graduate students, reducing the number of students who might pursue graduate education and faculty careers. 5 5 Health Sciences Education: Workforce Needs and Enrollment Planning. (Oakland, CA: Office of Health Affairs, University of California, 2005), pg. 116 < 8

19 Four recommendations related to undergraduate and graduate education for Nursing Science within UC were included: UC should participate in meeting the demand for baccalaureate-prepared nurses and should recreate an opportunity for students to earn a baccalaureate degree in nursing from UC. UC should expand programs that tap new and existing pools of students who are interested in working as registered nurses and who seek training at the master level. UC should, to the extent possible, expand access for community college nursing program graduates who wish to pursue a baccalaureate education. UC should develop a plan for supporting existing nurse practitioner and nurse midwifery programs that increase and diversify the skills of practicing nurses. Following the H.S.C. report, UC President Dynes appointed a special advisory council on future growth in the health professions. The advisory council was charged with reviewing the work of the H.S.C. to develop a new system-wide health sciences enrollment plan. The following are key advisory council s enrollment recommendations published in the council s 2007 report: 6 Substantial enrollment growth across all degree programs, including a focus on graduate education nursing and the need to trained increased numbers of future nurse faculty. o Increase master student enrollments by 130 percent between the years of (Equivalent to growing from approximately 773 students to 1,812 students, adding more than 1,000 students.) o Increase doctoral student enrollments by 425 percent between the years of (Equivalent to growing from approximately 80 students to 420 students, adding 340 students.) Subsequently, the University of California Office of the President Budget Office declared its intention to seek funding from the California Legislature to expand its current nursing programs and create new ones over and above present commitment for enrollment growth in the UC system. The creation of the Betty Irene School of Nursing at UC Davis then is fully in concert with the stated overall goals of the University of California system and will complement programs on other campuses and enhance the quality of nursing education throughout the state. Already, the leaders of the four programs (UC Irvine, UCLA, UCSF and UC Davis) are meeting on a monthly basis to assure collaboration and regular communication. This leadership group is working together to identify areas of synergy and areas for potential complementary research and educational development. 6 A Compelling Case for Growth: Special Report of the Advisory Council on Future Growth in the Health Professions (Oakland, CA: Office of Health Affairs, University of California, 2007) pg.28 < 9

20 As described above, however, the Betty Irene School of Nursing does not focus only on the supply side, which is simply an increase in the number of nurses prepared, but also on the demand side, addressing serious system and leadership issues in health care. The proposed school goes well beyond a contribution to meeting the quantitative goals of the University of California system to address vital quality concerns, advancing the capacity of the health-care system to meet the burgeoning societal need for health care. Letters of support for the establishment of the Betty Irene Moore School of Nursing at UC Davis, from the leadership of other UC schools of nursing, are included with this proposal in Appendix F. F. Size, Scope and Organization The Betty Irene Moore School of Nursing at UC Davis will phase in the major components and degree programs over the coming four years. Postdoctoral fellows: The first phase of development is creation of postdoctoral fellowships. Already, the first postdoctoral fellow is on site and is funded for two years by the John A. Hartford Foundation. In advance of the launch of the graduate group in Nursing Science and Health-Care Leadership, the school is actively recruiting additional postdoctoral fellows to begin by fall These postdoctoral fellows will focus on strategies to transform health care through nursing. By recruiting these positions now, the School of Nursing will begin the important work of advancing scholarship and visibility through published works while simultaneously moving closer toward the goal of developing new nursing faculty. UC Davis Medical Center Interface: A second, closely-following initiative will involve the nursing staff and managers at UC Davis Medical Center. Meetings with management and staff nurses have confirmed their enthusiasm for a progressive vision of nursing. In preparation for working with the School of Nursing students, a series of academic seminars will take place with health system nurses to acquaint them with new approaches to nursing education and to take advantage of their on-the-job experience with current health-care practice, and to prepare them for their roles as mentors and preceptors. Ph.D. Program: A Ph.D. program with several research foci, including health systems and leadership, health-care policy, gerontology, rural health and health disparities will also be launched under the graduate group in Nursing Science and Health-Care Leadership. Matriculation of Ph.D. students is planned for fall The Ph.D. program will prepare nurse scientists who will contribute to the body of knowledge in the field of nursing and healthrelated fields through theory development and empirical research. The Ph.D. program will be highly integrated with faculty research activity, with rigorous attention given to development of graduates who are exceptional scientists, educators and interprofessional collaborators capable of helping to meet the need for doctorally-prepared nursing faculty. Graduates will be prepared to change health care in response to evolving scientific and technological advances and social change; they will be future leaders within the profession, the broader field of health care and the health-care policy arena. Nursing is 10

21 fundamentally interdisciplinary and collaborative in its art and science. Application of knowledge from biological, social, behavioral, biomedical and information sciences contribute to the rich and varied background of nurse scientists resulting in research that overlaps and contributes to the sciences from which applied knowledge is drawn. Matriculation of at least eight Ph.D. students is planned for fall Master s Degree Programs: Upon creation of the graduate group in Nursing Science and Health-Care Leadership, the school will offer a Master of Science degree, including emphases in health system leadership, health outcomes, evidenced-based practice/informatics, and education. All master s degree program graduates will be exceptionally well prepared for health-care leadership roles in organizations focusing on the health-care needs of diverse patient populations. They will have the requisite knowledge and skills to assure that systems in hospital-based, outpatient and community settings promote high-quality health care and patient safety. They will apply in-depth knowledge and skills to a wide range of health-care issues related to health promotion and disease prevention as well as alleviation of health-care disparities. Scientific rigor will be a hallmark of the program. Preparation for evidence-based practice will be integrated throughout the didactic and clinical practice experiences. The program will also provide a strong background in: leadership, management, business and communications; incorporation of innovative, patient-centered technology; case-based approaches to critical thinking and problem solving; and cultural competency. Nurse educators prepared at the master s degree level will meet requirements for teaching in community college nursing programs where the M.S. degree is the minimum requirement for faculty. Graduates will also be prepared as leaders with specialized expertise who contribute to clinical instruction in colleges and universities by mentoring students in their areas of specialization. The master s degree also serves as the educational foundation for those who continue education for the Ph.D. There are two portals of entry to obtain the master s degree. o The first is for applicants who either 1) have a Bachelor of Science in Nursing (B.S.N.) or 2) hold R.N. licensure (associate degree or diploma) and a bachelor s degree in another field. These students will matriculate directly into a master s degree program. Matriculation of 25 such M.S. students is planned for fall This program will provide R.N.s who have completed undergraduate nursing education programs with an opportunity to strengthen expertise in a specialized area of practice, advance skills in theory and research, strengthen collaborative practice through interprofessional learning, as well as gain expertise in management and leadership skills. o The second portal to the master program is an Entry Level Master of Science (E.L.M.), offered for applicants who have a bachelor s degree in a non-nursing field. The E.L.M. program includes the 11

22 R.N. licensure curriculum followed by coursework for the master s degree. Matriculation of 50 E.L.M. students is planned for fall of Applicants to the E.L.M. program will be required to have an excellent undergraduate record of achievement. Master entry programs are one of the fastest-growing routes to high-level nursing practice and draw on an especially eager constituency of mature, career-changing students. Baccalaureate Program: A four-year baccalaureate degree program will complete the phased opening of the Betty Irene Moore School of Nursing, matriculating the first cohort of 50 students in fall The program will award the Bachelor of Science (B.S.) degree. In addition to meeting the UC Davis undergraduate requirements, students will be prepared through an indepth transformative professional curriculum to apply theory and research for evidence-based nursing practice. Graduates will apply their knowledge and clinical and system skills in the resolution of acute, chronic and populationbased health-care problems. They will participate in efforts to eliminate health-care disparities and work with professional and community organizations devoted to care of individuals from diverse sectors of the population. They will be educated to apply research and technology within systems to assure high quality and safe care to the people they serve. The profession of nursing is unique in that pre-licensure nursing students may be prepared in vastly different educational programs - ranging from associate degree preparation, to baccalaureate and entry-level master preparation, - yet they all take the same licensure examination, the NCLEX-RN, to become registered nurses (The examination, which is designed to assess knowledge required for minimum safe practice, does not differentiate levels of knowledge and skill attributable to levels of education). To assure minimum levels of safe practice and preparation for the NCLEX-RN examination, the California Board of Registered Nursing stipulates, by law, curriculum content areas that must be included in all prelicensure nursing education programs. Baccalaureate and master programs educate students beyond the basic requirements of clinical practice in the areas of leadership and management, community health and incorporation of research for evidence-based practice. Graduates of these programs are highly desired in a wide array of health-care and health-related organizations and agencies. Students will complete coursework to meet the undergraduate degree requirements for all UC Davis students as well as the science, humanities and statistics prerequisite requirements for the professional courses. In addition to coursework required by the California State Board of Registered Nursing (BRN) for licensure, the major will include courses in leadership and community health. The program will emphasize critical thinking, evidencebased clinical practice, leadership and scholarship. Learning experiences will be immersive and interprofessional to produce new nurses who are exceptionally well-prepared and highly-skilled practitioners. 12

23 Clinical practica will prepare students for future nursing roles. Experiences will be developed in UC Davis Medical Center and other hospital and community settings in the greater-sacramento area, as well as rural regions serving diverse populations. Students will also complete a required internship experience to further hone interprofessional skills. Once all programs are in place, the school is expected to serve 456 graduate and undergraduate students, plus a small cohort of postdoctoral fellows. (Detailed projections of student enrollment may be seen in Appendix C.) Organizational Structure: The school will be led by the Associate Vice Chancellor for Nursing (AVC)/Dean who has ultimate responsibility for the operation of the school. The AVC/Dean reports to the Vice Chancellor for Human Health Sciences and also has direct access to the Provost/Executive Vice Chancellor to ensure the launch and expansion of the school is successful. The title of Associate Vice Chancellor for Nursing is important for two key reasons: 1) it enabled the health system to recruit a senior executive prior to the school receiving approval to ensure that the development of the academic programs were directed by a nationally-recognized leader in nursing science; and 2) it denotes that the incumbent also has a pivotal role in the leadership of health sciences at UC Davis Health System. Charged with the overall leadership of the School of Nursing, the AVC/Dean s responsibilities include: Strategic planning and program evaluation Policy and procedure development and implementation Academic and clinical program development and excellence Recruitment and retention of highly-qualified faculty and support staff Development and support of robust research programs likely to improve human health outcomes Philanthropic outreach and fundraising Fiscal, capital and related business activities Oversight of the allocation of School of Nursing FTE faculty to programs/centers/departments With UC Davis unique graduate group structure for faculty (both School of Nursing faculty and faculty from other schools and disciplines), it is important to note that the AVC/Dean s role is structured so she has the authority to establish priorities for recruitment which will help to assure appropriate faculty FTE within the School of Nursing. To ensure the vision carries throughout the launch and development of the school, the AVC/Dean s position will collaborate with the search committee to assure faculty hired are aligned with the vision and priorities of the school and are active in shaping the direction of the graduate group. Although the AVC/dean does not have direct oversight of the FTE from the interdisciplinary faculty, interdisciplinary faculty participation in graduate 13