Approval Review Process: Baccalaureate Nursing Programs in New Brunswick
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- Sibyl Moody
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1 Baccalaureate Nursing Programs in New Brunswick
2 Mission The Nurses Association of New Brunswick is a professional regulatory organization that exists to protect the public and to support nurses by promoting and maintaining standards of nursing education and practice, and by promoting healthy public policy. NURSES ASSOCIATION OF NEW BRUNSWICK 2015 All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without prior written permission from the publisher. ISBN February 2015 (2/26)
3 TABLE OF CONTENTS INTRODUCTION... 4 APPROVAL CRITERIA... 4 NANB APPROVAL REVIEW PROCESS... 8 APPROVAL STATUS... 8 NANB STAFF RESOURCE PERSON... 9 APPROVAL REVIEW TEAM... 9 RESPONSIBILITIES OF THE APPROVAL REVIEW TEAM RESPONSIBILITIES OF THE SCHOOL OF NURSING SCHOOL VISIT APPROVAL REVIEW PROCESS FOR A CHANGING PROGRAM APPEAL PROCESS TOOL FOR APPROVAL REVIEW EVALUATION OF THE APPROVAL REVIEW PROCESS RELEVANT NANB DOCUMENTS APPENDIX A: Approval Review Process Overview APPENDIX B: NANB Tool for Approval Review of Baccalaureate Nursing Programs in New Brunswick February 2015 (3/26)
4 INTRODUCTION The Nurses Act gives the Nurses Association of New Brunswick (NANB) the legislated mandate to establish and maintain standards for nursing education and to approve nursing education programs in the province. The purpose of the NANB approval review process is to ensure that Baccalaureate Nursing Education Programs meet the NANB Standards for Nursing Education in New Brunswick and that program graduates achieve the NANB Entry Level Competencies for Registered Nurses in New Brunswick. The NANB Standards for Nursing Education have been developed by the Nursing Education Advisory Committee in consultation with the university schools of nursing and have been approved by the NANB Board of Directors. The standards serve as the framework for the approval review of baccalaureate nursing programs in New Brunswick. Standards are broad, principle based, authoritative statements that articulate the performance required of nursing education programs. The corresponding indicators describe the standard statements by illustrating how each standard is met or demonstrated. The indicator provides the criterion against which the school of nursing s actual performance may be measured. Graduates of NANB s approved baccalaureate nursing education programs are: eligible to write the registration examination; and prepared to practise in accordance with the Canadian Nurses Association s Code of Ethics for Registered Nurses, the NANB s Standards of Practice for Registered Nurses, and the NANB Entry Level Competencies for Registered Nurses in New Brunswick. APPROVAL CRITERIA The NANB Standards for Nursing Education serve as the framework for the NANB Baccalaureate Nursing Program Approval Review Process. The approval criteria are based on the standards indicators. STANDARD I The CURRICULUM provides learning experiences across the life span and the continuum of care necessary for students to achieve registered nurse entry level competencies established by the Nurses Association of New Brunswick. February 2015 (4/26)
5 Indicators: 1.1 Entry level competencies guide the development and implementation of the curriculum. 1.2 The curriculum describes the program of studies, and includes i) an organizing framework; ii) program goals and expected outcomes; iii) courses in nursing, the biological and physical sciences, the behavioural and social sciences, and the humanities; iv) course descriptions; v) sequence of learning activities; and vi) student evaluation. 1.3 Nursing courses (theory, clinical and laboratory) comprise no less than 50% of the curriculum as measured by course credits. 1.4 The philosophy of teaching and learning is current, evidence based and relevant to nursing education. 1.5 Teaching and learning activities provide students with the opportunity to achieve program goals and expected outcomes. 1.6 Clinical learning activities provide sufficient opportunities for students to meet the program goals and expected outcomes and the entry level competencies: i. Programs leading to initial entry to registered nurse practice have a minimum of 1400 hours of clinical practice in a variety of settings (acute, long term care, and community) with clients from across the life span and the continuum of care, and include a full time clinical preceptorship at the end of the program that consolidates theory and nursing practice. 1.7 Systematic and continuous evaluation of all curriculum components is carried out by students, educators and other key stakeholders to ensure ongoing development, maintenance and enhancement of the curriculum. 1.8 The curriculum maintains its relevance by responding to current and emerging trends in health care, nursing practice, and nursing education. 1.9 Learning takes place in a context that is sensitive to linguistic, ethnic, spiritual, cultural and social diversity The curriculum prepares students to work collaboratively within nursing and with other health care team members. February 2015 (5/26)
6 STANDARD II Indicators: The PROGRAM has the resources to support students in achieving the entrylevel competencies established by the Nurses Association of New Brunswick. 2.1 The organizational structure, leadership and committee system supports the administration of the program. 2.2 There are appropriate resources (fiscal, physical, technological, human, clinical) to facilitate the development and implementation of the curriculum and to foster ongoing improvement. 2.3 Nursing faculty size and composition is sufficient to provide teaching and guidance to students to ensure student progress toward practice readiness and meeting entry level competencies. 2.4 Nursing faculty to student ratio in clinical settings ensures optimal student learning and safe client care. 2.5 Nursing faculty possesses theoretical nursing knowledge and maintains clinical skills appropriate to teaching responsibilities. 2.6 Nursing faculty professional development activities support currency and relevance of the curriculum. 2.7 Nursing faculty works in a university culture where the sharing of a common philosophy and values is fostered through peer support, teamwork and team building. 2.8 Nursing faculty participates in research or scholarly activities that inform and advance the profession of nursing and nursing education in the public interest. 2.9 Orientation and support strategies for nursing faculty and preceptors are in place to ensure that expectations of student performance are consistent throughout the program Learning resources including library resources are current, accessible, innovative and consistent with new knowledge and technology 2.11 Formal systems and processes are in place to measure program effectiveness including methods to: i) examine and analyze factors contributing to student attrition and success, and ii) obtain feedback from students, educators and other key stakeholders. February 2015 (6/26)
7 STANDARD III Indicators: STUDENTS demonstrate progress towards achieving the entry level competencies as established by the Nurses Association of New Brunswick. 3.1 Policies and procedures for nursing students relating to admission, promotion, probation, failure, withdrawal, appeal, re admission and graduation from the program are established and adhered to by the university and the nursing education program and are clearly communicated to students, faculty and other key stakeholders. 3.2 Students meet established university admission requirements that are transparent and include: i) prerequisites that provide reasonable assurance of success in the program; and ii) the requisite skills and abilities needed to achieve entry level competencies. 3.3 Recruitment strategies attract qualified students in numbers to provide adequate future nursing resources. 3.4 The student evaluation system provides evidence that students are meeting the program goals and expected outcomes and developing the entry level competencies. 3.5 Students have access to support services including learning services, personal counseling, academic counseling, student health services, and financial aid. STANDARD IV Indicators: GRADUATES of the program are prepared to practise according to NANB standards and have achieved the competencies required for entry level registered nurse practice established by the Nurses Association of New Brunswick. 4.1 Final evaluation of graduating students confirms the achievement of the expected outcomes of the program and the NANB entry level competencies. 4.2 Graduate success rates on the registration examination are monitored, analyzed and used to inform program admission requirements and other program decisions. 4.3 Processes are in place for graduates, employers of graduates and other stakeholders to provide feedback regarding graduates preparedness to deliver safe, competent and ethical care. 4.4 Data collected from graduates, employers and other stakeholders, regarding graduates preparedness to meet NANB standards and entry level competencies, is analyzed and used to inform program decisions. February 2015 (7/26)
8 NANB APPROVAL REVIEW PROCESS The NANB Nursing Education Advisory Committee has the responsibility to act in an advisory capacity to the NANB Board of Directors in relation to the approval of schools of nursing in New Brunswick. An overview of the process including predetermined timelines is presented in Appendix A. The final responsibility for the approval of schools of nursing rests with the Board of Directors. Frequency of School Approval Reviews New Brunswick schools of nursing go through an approval review process every five years. In extenuating circumstances, schools may request a deferral of the approval review process for twelve months. Confidentiality All communications about the approval of a school are confidential. When the procedure is complete, the approval status of a school given by the Board of Directors will be considered public information. APPROVAL STATUS In accordance with the NANB approval review process, the Nursing Education Advisory Committee will make recommendations to the NANB Board of Directors to grant an approval status to the baccalaureate nursing education program as follows: Approval Granted The school is functioning at a satisfactory level in keeping with the NANB Standards for Nursing Education in New Brunswick. The approval status is granted for a five year period. Notwithstanding the above, a school may be directed to implement minimal recommendations and report on same within a year from the time the report is received. Graduates from a program which has received this rating will be considered graduates of an approved nursing education program for the purpose of registration as a registered nurse with NANB. Approval Deferred Approval withheld for the time being; recommendations are made to address deficiencies of the school in meeting the standards. Action to address the recommendations must be initiated within 12 months after receipt of the report. February 2015 (8/26)
9 Graduates from a program which has received this rating will be considered graduates of an approved nursing education program for the purpose of registration as a registered nurse with NANB. Approval Denied Approval is denied when a school that has been given a deferred approval status fails to present sufficient evidence that the standards are being addressed within 12 months of the date of the deferred approval. Graduates from a program which has received this rating will not be eligible for registration as a registered nurse with NANB. NANB STAFF RESOURCE PERSON In relation to the nursing education approval review process, the NANB staff resource person is responsible for: 1. Informing, advising and supporting nursing programs preparing for the approval visit. The NANB staff resource person is available to visit the school to discuss the approval review process and also to do a follow up as required following the approval visit. 2. Consulting with the approval team members prior to, during, and following the visit and responding to general inquiries and correspondence related to the approval review process. The NANB staff resource person does not participate in the decision making about the approval status of a program. 3. The NANB staff resource person serves as an ex officio member of the approval review team. This role is comprised of secretariat responsibilities, such as preparing the visit agenda in consultation with members of the approval review team and the nursing program, facilitating the visit to the program site(s) and facilitating the work of the members of the approval review team. APPROVAL REVIEW TEAM The approval review team will consist of three members. The selection of the team members will be based on the following criteria: 1. A team leader: a nurse educator with a doctoral degree; current experience in nursing education at the level being evaluated; current knowledge of curriculum needs based on the present health care system; experience in nursing education program evaluation would be an asset; and fluent in the language of the school being visited. February 2015 (9/26)
10 2. Two team members: nurses with a minimum of a master s degree; one member must have current experience in nursing education at the level being evaluated; one member must have current experience in nursing practice or administration; current knowledge of curriculum needs based on the present health care system; experience in program evaluation for both members would be an asset; and fluent in the language of the school being visited. RESPONSIBILITIES OF THE APPROVAL REVIEW TEAM 1. Prior to the school visit, review all documents submitted. Attend all briefing and orientation sessions; identify additional documents that may be required from the program; formulate interview questions for the school visit; finalize the school visit schedule; and address concerns and questions concerning the visit. 2. During the school visit, meet with appropriate representatives from the school and clinical agencies, visit educational and clinical facilities, verify and clarify additional documents. 3. At the end of the school visit, present a verbal report to the school of general findings and of recommended approval status. 4. Submit to the NANB Nursing Education Advisory Committee a final written report within three weeks of the approval visit. This report will contain the review results presented in a document based on the NANB s Standards for Nursing Education using an NANB template which identifies whether each indicator is being met satisfactorily, partially met or not met. The report will also list strengths and weaknesses of the program, as well as areas in need of improvement. The report will also contain a recommendation regarding approval status. RESPONSIBILITIES OF THE SCHOOL OF NURSING The school of nursing must: submit to NANB a self evaluation based on the Standards for Nursing Education in New Brunswick; submit to NANB the required documents specified in the Tool for Approval Review of (Appendix B) suggest dates for the school visit which will permit the approval review team to observe various activities; schedule meetings with university administration, faculty, students, clinical agencies and others as appropriate; and collaborate with requests from team members for additional documents and/or meetings with key stakeholders. February 2015 (10/26)
11 SCHOOL VISIT The school visit will be planned for a period which will accommodate each delivery site. The visiting schedule will include additional days to allow time for preparation, travel, record keeping and follow up. The activities of the visit may change according to the team and the particular school situation. The school visit will normally take place over a five day period. Administrative processes, committee structures, the report of the last approval visit, and other relevant matters and structures will be reviewed. The visit will include observation of students in classroom and clinical situations. The team, individually or together, will meet with small groups of students, small groups of faculty, individual faculty members, as well as major clinical facility administrators and University administrators. The meetings will be arranged in advance of the school visit with as much notice as possible. The approval review team will meet with the faculty on the last day of the visit to give a brief verbal report. This will include comments on the indicators being met, partially met or not being met and may also include discussion of the strengths of the program(s) and suggestions for improvement, if appropriate. Clarification or additional information may be provided during this meeting. APPROVAL REVIEW PROCESS FOR A CHANGING PROGRAM The school of nursing shall advise the NANB if substantial changes to the nursing program are being planned for implementation within the approval time frame (5 years). Substantial changes would include, but are not limited to, alterations in the approved nursing education program which may jeopardize the ability of the graduates to meet the NANB Entry Level Competencies and professional practice requirements. Other substantial changes would include: changes in the program philosophy, conceptual framework, curriculum content; major alterations in learning activities including clinical placements; and changes in faculty resources. Once a change in the program has been identified, the Nursing Education Advisory Committee will, upon review of the change, recommend if the change needs further assessment. This will be based on whether the change is viewed as being positive or negative to the approved program as a whole. APPEAL PROCESS A school of nursing may appeal the approval decision. The notice of intent to appeal must be submitted to the Board of Directors of NANB within 30 days of receipt of the approval status as granted in a decision of the Board. When a decision is appealed, the previous approval status is maintained until the disposition of the appeal. February 2015 (11/26)
12 Upon receipt of the appeal notice, the Board of Directors appoints an appeal panel within two weeks. The appeal panel will be composed of three individuals: two nurse educators; one of these being from administration, the third member will be an educator with a specialty in evaluation. This individual may be a nurse or non nurse. The members of the appeal panel may not be a member of the Nursing Education Advisory Committee, a member of the faculty of the school which is appealing, or a member of the Board of Directors. All members must be acceptable to the school requesting the appeal. Representatives for the school shall present a written rationale for the appeal and may meet with the appeal panel to answer questions and provide additional information. The appeal panel rules within three months, either to uphold the original decision or to request the Board of Directors to reconsider its decision. TOOL FOR APPROVAL REVIEW The Tool for Approval Review of is found in Appendix B. For the school of nursing, the tool: 1. serves as a means to prepare for the approval visit; 2. serves as a guide for self evaluation by identifying if each indicator is met/partially met/not met; and 3. lists additional required information related to each standard. For the approval review team, the tool: 1. serves as a means to prepare for the school visit; 2. provides a framework for data gathered during the school visit; and 3. guides the approval review team in writing the approval report. February 2015 (12/26)
13 EVALUATION OF THE APPROVAL REVIEW PROCESS Once the approval review process is completed, the NANB staff resource person shall initiate an evaluation of the approval review process. The approval review team members, as well as the school of nursing, shall provide evaluation feedback. RELEVANT NANB DOCUMENTS Standards for Nursing Education in New Brunswick (2013) Entry Level Competencies for Registered Nurses in New Brunswick (2013) Becoming a Registered Nurse in New Brunswick: Requisite Skills and Abilities (2014) Nurses Act (2002) Code of Ethics for Registered Nurses (2008) Standards of Practice for Registered Nurses (2012) February 2015 (13/26)
14 APPENDIX A: Approval Review Process Overview Approval Review Process 1. Notification to the university of intent to conduct an approval visit 2. Solicit and select approval review team members with input from school of nursing 3. Nursing Education Advisory Committee recommends approval review team members to the Board for approval 4. Final negotiation with the approval review team and signing of contract 5. Request for information to the school of nursing, i.e. approval tool as a basis for self evaluation 6. School of nursing will submit all requested documents to the NANB staff resource person (four copies of each) 7. School visit is planned to include all campuses/delivery sites, over a period of 5 days 8. Approval review team leader submits to NANB a written report including a recommendation on the approval status and any recommendations deemed appropriate 9. Written report is forwarded by NANB to the school of nursing. The school of nursing may respond in writing to NANB 10. Nursing Education Advisory Committee reviews the report and makes recommendations to the Board 11. Board of Directors gives a ruling on approval status including any recommendations and informs the school of nursing of its decision 12. If the approval is deferred, the Nursing Education Advisory Committee will oversee follow up activities Time Lines At least 12 months prior to approval visit 9 to 12 months prior to approval visit 9 to 12 months prior to approval visit 6 months prior to approval visit 20 weeks prior to the visit 6 weeks prior to the visit 3 weeks following the visit 2 weeks following receipt of the report Immediately following the Board meeting 12 months following the approval deferred status February 2015 (14/26)
15 APPENDIX B: Tool for Approval Review of 2015
16 STANDARD I: CURRICULUM The curriculum provides learning experiences across the life span and the continuum of care necessary for students to achieve registered nurse entry level competencies established by the Nurses Association of New Brunswick. Indicators *3 *2 *1 1.1 Entry level competencies guide the development and implementation of the curriculum. 1.2 The curriculum describes the program of studies, and includes i) an organizing framework; ii) program goals and expected outcomes; iii) courses in nursing, the biological and physical sciences, the behavioural and social sciences, and the humanities; iv) course descriptions; v) sequence of learning activities; and vi) student evaluation. 1.3 Nursing courses (theory, clinical and laboratory) comprise no less than 50% of the curriculum as measured by course credits. 1.4 The philosophy of teaching and learning is current, evidencebased and relevant to nursing education. Documents from school Follow up during visit *3 Met *2 Partially met *1 Not met February 2015 (16/26)
17 STANDARD I: CURRICULUM Indicators *3 *2 *1 1.5 Teaching and learning activities provide students with the opportunity to achieve program goals and expected outcomes. 1.6 Clinical learning activities provide sufficient opportunities for students to meet the program goals and expected outcomes and the entry level competencies: i) Programs leading to initial entry to registered nurse practice have a minimum of 1400 hours of clinical practice in a variety of settings (acute, long term care, and community) with clients from across the life span and the continuum of care, and include a full time clinical preceptorship at the end of the program that consolidates theory and nursing practice. Documents from school Follow up during visit *3 Met *2 Partially Met *1 Not met February 2015 (17/26)
18 STANDARD I: CURRICULUM (continued) Indicators *3 *2 *1 Documents from school Follow up during visit 1.7 Systematic and continuous evaluation of all curriculum components is carried out by students, educators and other key stakeholders to ensure ongoing development, maintenance and enhancement of the curriculum. 1.8 The curriculum maintains its relevance by responding to current and emerging trends in health care, nursing practice, and nursing education. 1.9 Learning takes place in a context that is sensitive to linguistic, ethnic, spiritual, cultural and social diversity The curriculum prepares students to work collaboratively within nursing and with other health care team members. Additional Information Required: a) copy of the curriculum (basic program) b) the means in which nursing service representatives and students participate in curriculum development c) forms used for evaluating the student s clinical performance d) evidence of coordination of clinical experiences across the program February 2015 (18/26)
19 STANDARD II: PROGRAM The program has the resources to support students in achieving the entry level competencies established by the Nurses Association of New Brunswick. Indicators *3 *2 *1 2.1 The organizational structure, leadership and committee system supports the administration of the program. 2.2 There are appropriate resources (fiscal, physical, technological, human, clinical) to facilitate the development and implementation of the curriculum and to foster ongoing improvement. 2.3 Nursing faculty size and composition is sufficient to provide teaching and guidance to students to ensure student progress toward practice readiness and meeting entry level competencies. 2.4 Nursing faculty to student ratio in clinical settings ensures optimal student learning and safe client care. 2.5 Nursing faculty possesses theoretical nursing knowledge and maintains clinical skills appropriate to teaching responsibilities. Documents from school Follow up during visit *3 Met *2 Partially Met *1 Not met February 2015 (19/26)
20 STANDARD II: PROGRAM (continued) Indicators *3 *2 *1 2.6 Nursing faculty professional development activities support currency and relevance of the curriculum. 2.7 Nursing faculty works in a university culture where the sharing of a common philosophy and values is fostered through peer support, teamwork and team building. 2.8 Nursing faculty participates in research or scholarly activities that inform and advance the profession of nursing and nursing education in the public interest. 2.9 Orientation and support strategies for nursing faculty and preceptors are in place to ensure that expectations of student performance are consistent throughout the program Learning resources including library resources are current, accessible, innovative and consistent with new knowledge and technology 2.11 Formal systems and processes are in place to measure program effectiveness including methods to: i) examine and analyze factors contributing to student attrition and success, and ii) obtain feedback from students, educators and other key stakeholders. Documents from school Follow up during visit *3 Met *2 Partially Met *1 Not met February 2015 (20/26)
21 Additional Information Required: a) the program brochure b) list of current full time and part time faculty, their academic preparation, their date of initial appointment at the University, their tenure track status, their current teaching responsibilities, their relevant clinical preparation, their percentage of time spent in teaching, practice, research and administration c) professional information on the faculty for the past 5 years (full time, sessional, tenured, tenured track) d) the faculty orientation program e) the organizational chart representing the internal and external relations to the faculty f) criteria for faculty s performance appraisal, including the student s evaluation criteria of faculty g) method used to ensure liaison between the nursing faculty and the provincial professional association h) names of health care agencies involved in the education of students i) an example of the written agreements between the University and the affiliated agencies j) description of how the liaison between the faculty and the appropriate staff of the affiliated agencies are ensured k) the approval review team may seek evidence of the existence and confidentiality of the faculty, students and school files February 2015 (21/26)
22 STANDARD III: STUDENTS Students demonstrate progress towards achieving the entry level competencies as established by the Nurses Association of New Brunswick. Indicators *3 *2 *1 3.1 Policies and procedures for nursing students relating to admission, promotion, probation, failure, withdrawal, appeal, re admission and graduation from the program are established and adhered to by the university and the nursing education program and are clearly communicated to students, faculty and other key stakeholders. 3.2 Students meet established university admission requirements that are transparent and include: i) prerequisites that provide reasonable assurance of success in the program; and ii) the requisite skills and abilities needed to achieve entry level competencies. 3.3 Recruitment strategies attract qualified students in numbers to provide adequate future nursing resources. 3.4 The student evaluation system provides evidence that students are meeting the program goals and expected outcomes and developing the entry level competencies. 3.5 Students have access to support services including learning services, personal counseling, academic counseling, student health services, and financial aid. Documents from school Follow up during visit *3 Met *2 Partially Met *1 Not met February 2015 (22/26)
23 Additional Information Required: a) established policies and procedures regarding student s admission, promotion, graduation, right to be heard, right to appeal, financial assistance, health care services and guidance services. b) information on student attrition for the last 10 years (admitted, transfer, readmission, and attrition rate). The information must include all delivery sites. c) the approval review team may seek evidence of the existence and confidentiality of student files. February 2015 (23/26)
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