Assessment Report 12/02 Bachelors of Science Degree in Nursing

Transcription

1 Assessment Report 12/02 Bachelors of Science Degree in Nursing Campus Learning Objective: An educated person should have achieved depth in some field of knowledge. Program Objective: A nurse is a competent provider of health care who assumes the multiple dimensions of his/her role in structured and semi-structured health care settings. Assessment Criteria, Procedures, Results, Time table for implementation: 1. NCLEX passage rates will be equal to or greater than the national passage rate. National Passage Rate First Time IU East Passage Rate 4/2001-3/ % 88.5% / % 83.3% 2. On the Follow-up alumni survey, 80% will agree or strongly agree with items related to competent practice. Surveys are distributed on a two-three year cycle. The survey will be revised and distributed in summer 2003 to graduates. 3. Exit surveys will indicate students believed their nursing education prepared them to be a competent provider of care Exit survey-there were 23 respondents. 22 of the 23 ( 95%) respondents felt their nursing education prepared them to be a competent provider of care. 4.On an employer survey, 90% of employers will agree or strongly agree that our graduates were well prepared for an entry level nursing position. Feedback from employers also comes biannually (October and April) in the Nursing Advisory Board, which includes key nursing administrators in area hospitals and agencies. The advisory board indicated that the BSN graduates were prepared for the workforce. Each meeting agenda includes the opportunity to make specific comments and requests. The division will send out an employer survey in the Fall The program outcome related to competent provider of care (listed above) has been leveled into competencies expected in the sophomore and junior years; these competencies support the acquisition of the final graduate competencies. The student self-appraisals represent formative evaluations at two stages in their development. On the 2002 BSN sophomore year-end self appraisal (there were 36 respondents), 33 of the 36 (91%) respondents believed they were able to begin developing nursing knowledge base and skills as an outcome of guided self -evaluation. 31/36 (86%) respondents believed they would be able to provide safe, effective, nurturing care that is consistent with the student s level of knowledge and skills. On the 2002 BSN junior year-end self -appraisal (there were 18 respondents), 18 of the 18 (100%) respondents believed they were able to assess with guidance the degree to which outcomes of health care needs have been met for individuals and families. 17 of the 17 (100%) respondents believed they would be able provide safe, effective, nurturing care that is consistent with the student s level of knowledge and skills. The consistently high appraisals following the junior year are important because of the heavy emphasis on competent care in in-patient settings during the junior-year curriculum. This affirms

2 some of our work, and provides a strong foundation for the complexity and depth required in their final senior year. Use of Assessment/Data: Depth of Knowledge: 1. All results are discussed among faculty at a regularly scheduled division meeting. These discussions occur at our weekly division meetings, as well as being the focus of more lengthy conversations at division retreats beginning and ending each semester. Campus Learning Objectives: An educated person should have conceptual ability: i.e. the ability to think rationally, to develop informed opinions, and to comprehend new ideas. An educated person should be able to identify problems and to find efficient solutions to those problems to all areas of life. Program Objective: A nurse is a critical thinker who is able to demonstrate intellectual curiosity, rational inquiry, problem solving skills and creativity in framing problems. Assessment Criteria, Procedures, Results/Time table for implementation: 1. No student will be at risk for failing the NCLEX exam as indicated by Arnett testing/eri testing. In January 2002, 3 students were identified at risk to not pass their NCLEX exam, out of 22 students: 2 very low risk, 4 low risk. In the fall 2002, the nursing faculty made a decision to begin using the Educational Resources, Inc. (ERI) total testing Package to continue supporting students in NCLEX preparation. ERI exams are nationally standardized tests that use the NCLEX test writing guidelines and are validated against the most widely used nursing textbooks. Students are now required to take the ERI content area tests each semester throughout the program. Students who fall below the national passing average on these content exams are required to complete remediation in the content area in order to strengthen their knowledge base. This allows for enhancing the student s knowledge base while progressing through the program rather than waiting to the program s end immediately prior to the NCLEX-RN testing. During their final semester, students are required to take the ERI pre-rn assessment exam and the RN CAT assessment exam to identify risk of NCLEX failure. Those students identified at risk for NCLEX-RN failure are mandated to develop an intervention assistance plan to facilitate their success. This intervention plan may consist of students taking practice NCLEX questions in tutorial services or their NCLEX texts, listening to remediation audio CD s provided by ERI on content from nursing textbook readings in their curriculum, and being referred to ERI Web site for remediation on specific content assistance and taking practice exams. In February 2003, the BSN seniors took the pre-rn assessment exam. 2/20 students were identified at risk for not passing. Those 2 students developed an intervention plan with faculty to prepare them for the ERI RN CAT assessment test. The BSN seniors took the RN CAT assessment test in April students were identified at risk for not passing NCLEX exams. These students were encouraged to discuss their results with the Dean of nursing prior to NCLEX testing in order to develop a study/remediation plan to enhance NCLEX success.

3 2. The nursing division used the Arnett Critical Thinking Outcome Evaluation computer based test. The students took this exam in January 2002 at the same time as the Arnett NCLEX computer-based exam. This exam is a 30-question open response exam. January 2002 results: On the BSN summary report, the critical thinking national BSN norms: lowest was 60, average (mean) was , and high: Out of the 22 students taking the test, 18 (82%) scored below the national norm. Of those 18, 5 (27%) students scored low to very low on their Arnett NCLEX computer exam. It was indicated to us that the lower the number, the higher the possibility the graduate will fail NCLEX state boards. On the overall critical thinking competency score, 17 of 22 (77%) BSN students scored below the national norm average score. On the overall school summary report for the BSN students, the total score was out of 300. The national BSN norm average was **This is an important finding because this critical thinking evaluation is based on nursing knowledge and is normed nationally with other nursing students. Critical thinking reflects both their knowledge and their ability to apply it in clinical situations. In April 2003, the BSN seniors took the ERI RN assessment test which included critical thinking skills assessment. Critical thinking topics included: prioritize/discriminate, inferential reasoning, interpretive reasoning, goal setting, application of knowledge, and evaluating outcomes. The average critical thinking score was 52. The critical thinking passing score was out of 20 BSN seniors had areas of concern with critical thinking topics. Three of those 6 had a below passing score in critical thinking skills. 3. Exit surveys will indicate 100% of students believed they will have developed critical thinking skills as a result of their nursing education. On the 2002 exit survey (23 respondents), 23 of 23 (100%) respondents believed that they had developed critical thinking skills. 4. On the BSN sophomore year-end self appraisal, 100% of the respondents will believe they are able to demonstrate intellectual curiosity, rational inquiry, problem solving skills, and creativity in solving problems. In 2002, on the sophomore year-end self appraisal, 30 of 36( 83%) respondents believed they were able to demonstrate intellectual curiosity, rational inquiry, problem solving skills, and creativity in framing problems. In 2002, on the junior year-end self appraisal, 18 of 18 (100%) respondents believed they were able to demonstrate intellectual curiosity, rational inquiry, problem solving skills and creativity in framing problems. Use of Assessment/Data: Conceptual Ability: 1. All results are discussed among faculty at a regularly scheduled division meeting. These discussions occur at our weekly division meetings, as well as being the focus of more lengthy conversations at division retreats beginning and ending each semester. 2. The NCLEX intervention plan has been and implemented and revised in fall The plan identifies as early as possible, students who would benefit from additional assistance beyond the classroom teaching environment. Any student with a point average of 80 or below at any time in the first amd second level BSN nursing courses will be referred to the course faculty as needed for assessment and assistance within 2 days of receiving their grade. Faculty will also refer students who have below a 77 in any didactic nursing course

4 at midterm to the appropriate nursing advisor. A plan will be developed with the student, which may include referrals to tutorial services and the Center for Health Promotion, as appropriate. Referrals to the course faculty/faculty advisor may also be made for clinical failures during the semester, not meeting course objectives, unacceptable patterns of behavior, etc. Individual faculty members are also encouraged to use learning contracts with students, which will include specific behaviors, required outcomes, and timetable for achievement of the contract. Tutorial Services and the division of nursing are planning to develop a collaborative program for high-risk students to be implemented spring Goals for this program is to have the students successfully complete the nursing curriculum and for the students to pass the NCLEX exam. This program willl entail working with sophomore level BSN nursing students initially. Pretesting of reading comprehension, study skills, NET (nurse entrance exam) scores will identify at risk students. Assessments would then be reviewed, and learning contracts would be developed outlining timeline for completion and action to be taken. Lee Ann Adams would offer small group tutoring/ workshops and study sessions. An elective course with a focus on reading nursing textbooks critically will be offered. Students would meet regularly with nursing advisors, SI leaders, and tutorial services. After interventions, there would be post testing and followup with students as they progress through the curriculum. 3. Nursing faculty/advisors began keeping data on students being referred for remediation to tutorial services, student services, and Center for Health Promotion. Course faculty will continue to use learning contracts as needed with students. Faculty have discussed a plan to keep data (how many students were referred, number of times, who they were referred to), so that we will be able to trend the data and possibly correlate with NCLEX successes and failures. We will consult with the guidance of data specialist. Students were referred and learning contracts were developed this year. This data will be systematically tracked, beginning In May 2002, we organized and offered the Sylvia Rayfield exam review, a 3 day workshop, to graduating students. In conjunction with tutorial services and the nursing division, a Taming of the NCLEX Monster workshop series has been offered in the Spring to the graduating BSN students. General test taking strategies for the NCLEX-RN are covered, as well as 5 one-hour follow-up sessions to allow the students to practice these skills. 5. As part of the ERI total testing package, a 4 day NCLEX review will be offered in May Senior level course faculty are requiring their students to take practice NCLEX exam questions as part of some course requirements. In general, students are completing an average of 20 questions per week. 7. The NCLEX intervention program has been implemented/revised as discussed in the previous section. Students in each course have benefited from the intervention plan early on in their coursework. Faculty have seen improvement in test scores, and more student involvement with the Support staff. 8. Students at risk for poor performance at NCLEX with the Arnett Computerized Adaptive NCLEX Test Profile, are referred to course faculty/faculty advisors, the Center for Health Promotion, and tutorial/student services. Advisors and course faculty follow up on students, holding them accountable through course assignments. For 2003, students identified at risk on the ERI content exams were referred to course faculty/faculty advisors for remediation as discussed previously.

5 9. New tools added into the library and tutorial services for student use: Several NCLEX review series with CAI's, tutorials and exams included for preparation. Faculty and LeeAnn Adams continue to evaluate potential resources, and procure funding. Campus Learning Objective: An educated person should be able to express him or herself clearly, completely, and accurately. Program Objective: A nurse is an effective communicator who is able to share accurate information. Assessment Criteria, Procedures, Results/Time table for implementation: 1. As a part of a required nursing course in the final semester, 100% of a 25-30% random sample of student written work will be judged satisfactory in accordance with the IU School of Nursing Writing Competencies as judged by a jury of nursing faculty. (revised 2/96) S 473 has been selected as the course from which papers will be selected. A random sample of 30% of student papers was selected for review in accordance with developed and adopted the procedures for jury review. In 2002, 5 out of 8 papers (62%) were found to be satisfactory by at least two faculty evaluators. Of the 3 unsatisfactory papers, major areas of concern continue to be: rules of grammar and APA style. Improvement in critical thinking was demonstrated in the papers by linking the specific to the general. APA format also was improved from the previous year. 2. As part of a required nursing course on the junior year, 100% of a 25-30% random sample of verbatims will be satisfactory in accordance with IU EAST Nursing Communications Competencies.as judged by a jury of nursing faculty. (revised 2/96.) The Nursing Division has developed the following Communication Competencies for this outcome: (1) Initiating/Concreteness, (2) Empathic/Understanding, and (3)Respect/Nonpossessive Warmth. All the behaviors must be demonstrated at the level of good or very good response. The sample of verbatims was selected from the H 352 course. In 2002, 5 out of the 8(63%) were satisfactory. 3 of the papers were not satisfactory. The jury recommended the use of a longer verbatim next time, so that students would be better to demonstrate their abilities. Areas identified as weaknesses were: empathetic/understanding and initiating/concreteness. 3. On BSN exit surveys, 100% respondents will believe that they are prepared to communicate well in writing, that they have developed therapeutic communication skills as a result of their nursing education, and they have had ample instruction and opportunity to utilize computers during their nursing education. In 2002, 23 of 23 (100%) respondents believed their education prepared them to communicate well in writing. In 2002, 23 of 23 (100%) respondents believed that they developed therapeutic communication skills In 2002, 21 of 23 (91%) respondents indicated they had ample instruction to utilize computers during their education. Results from this 2002 exit survey indicated there was no change in the respondents believing that they were prepared to communicate well in writing, and that they had developed therapeutic communication skills. There was a decrease in the 2002 results (91%) from 2001 results (100%). 4. On the BSN sophomore year-end self-appraisal, 100% respondents will believe that they are effective communicators and will be able to share accurate information, use

6 information technology to enhance communication, and identify opportunities for using On the 2001 sophomore year-end self appraisal, 19/22 ( 86%) respondents agreed/strongly agreed that they are effective communicators who are able to share accurate information through their written work.17/22 ( 77%) respondents agreed/strongly agreed that they can use information technology to enhance communication with faculty and peers. 21/22 (95%) agreed/strongly agreed to have identified opportunities for using On the 2002 sophomore year-end self appraisal, 32/36 ( 88%) respondents agreed/strongly agreed that they are effective communicators who are able to share accurate information through their written work.33/36 ( 92%) respondents agreed/strongly agreed that they can use information technology to enhance communication with faculty and peers. 31/36 (86%) agreed/strongly agreed to have identified opportunities for using On the 2001 junior year-end self appraisal, 23/23 (100%) respondents agreed/strongly agreed that they are effective communicators who are able to share accurate information through their written work. 23/23 (100%) respondents agreed/strongly agreed that they can use information technology to enhance communication with faculty and peers.23/23 (100%) respondents agreed/strongly agreed to have identified opportunities for using On the 2002 junior year-end self appraisal, 15/17 (88%) respondents agreed/strongly agreed that they are effective communicators who are able to share accurate information through their written work. 15/17 (88%) respondents agreed/strongly agreed that they can use information technology to enhance communication with faculty and peers.16/17 (94%) respondents agreed/strongly agreed to have identified opportunities for using Use of Assessment/Data: Communication: 1. All results are discussed among faculty at a regularly scheduled division meeting. These discussions occur at our weekly division meetings, as well as being the focus of more lengthy conversations at division retreats beginning and ending each semester. 2. In 2001, the nursing division examined courses for writing across the curriculum requirements to identify which courses/semester should have a writing requirement in them. Courses were identified for every semester. In 2002, BSN junior level 1 st semester added a formal writing component requiring APA format. Faculty continues to strongly emphasize APA format in writing assignments whenever possible. Faculty discussed the concerns about the weak writing competencies of students. These were discussed at a faculty workshop on assessment. Faculty discussed that the students were continuing to have difficulty with grammar, sentence structure, APA format, and communicating thoughts on paper. Faculty also discussed and voted that W 132 be required as a guided communication elective effective with the class entering Fall An APA worshop was offered by Tutorial Services. An APA workshop is also being considered as an option for nursing student orientation in fall A faculty writing workshop was proposed to equip the faculty to better teach and evaluate writing. 3. IU School of Nursing Writing Competencies have been included in the online Student Handbook, so that students are aware of the competencies for which they are held accountable.

7 4. Students are continually being referred to the writing lab in Tutorial Services for documentation (APA) assistance. 5. Faculty continue to integrate computer assignments in course work as well as assignments, to assist students in gaining more experience with computers. Also use of Oncourse for grades, syllabi, case studies, and access of clinical forms have been used. Students are exposed to computers in their clinical rotations, as well as WEB/Internet for clinical homework and literature reviews. The capstone course has the students journaling over the internet. Next Objectives: 1. Campus Learning Objective: An educated person should develop the skills to understand, to accept, and relate to people of different backgrounds. Program objective: A culturally competent person who provides holistic nursing care to a variety of individuals, families, and communities. a. On the BSN exit survey 100% respondents will believe that their education will prepare them to integrate and to evaluate the influence of the cultural beliefs, values and practices of individuals, families, and communities in nursing care. On the 2002 exit survey, 23/23 (100%) respondents agreed/strongly agreed that they were prepared to integrate and evaluate the influence of cultural beliefs on individuals, families, and communities. b. On the BSN sophomore year-end self- appraisal, 100% respondents will believe that they are able to examine their own/various cultural beliefs, values, and practices as well as assess culturally-tied health beliefs and practices to maximize health potential. On the 2002 BSN sophomore year-end self- appraisal, 31/36 (86%) respondents believed they are able to examine their own/various cultural beliefs, and assess health beliefs to maximize health potential. On the BSN junior year-end self- appraisal, 100% respondents will believe that they are able to integrate cultural beliefs with increasing self-direction, and to incorporate beliefs and practices to maximize health potential. On the 2002 BSN junior year-end self- appraisal, 14/17 (82%) respondents believed they are able to integrate cultural beliefs with self direction, and incorporate health beliefs and practices in nursing care. c. In the Spring 2001, the nursing division distributed the Inventory for Assessing The Process of Cultural Competence among Healthcare Professionals. This Is a 20-item tool to assess cultural competency. We give this to students when exiting the programs. The inventory determines the extent to which a healthcare professional is culturally competent and summarizes four categories. Those categories and associated ranges include culturally competent (20-30), culturally aware (40-59), culturally competent (60-74), and culturally proficient (75-80). The 2002 BSN graduating seniors reported a mean of 58, which falls into the culturally aware category. Their score range was *We also used this tool as a pre-post assessment of the cultural immersion experience in S473 among the Navajo. The pre assessment is completed in the fall during their preparation for travel and immersion. The post assessment is

8 completed as they finish their travel. The pre group mean was culturally aware, increasing to culturally competent on the post-test, with an increase of points from pre and post means. In fall 2002, the BSN senior nursing students were tested on the RN assessment exam for cultural awareness. The therapeutic possible score was 7, and the group average was 4.5. Use of Assessment: This is a campus learning objective and program outcome that the division continues to explore. The BSN results appears compatible with the BSN program. Campus Learning Objective: An educated person should be able to relate computational skills to all fields so that he/she is able to think with numbers. Program Objective: A competent provider of health care who assumes the multiple role dimensions in structured and semi-structured health care settings. a. On the 2002 BSN exit survey, 23 of 23 (100%) of the respondents agreed/strongly agreed that the program provided them with the skills to give medications and compute drug dosages in accordance with nursing principles, policies, and procedures. Use of Assessment: All students take a drug dosage math test each semester throughout the curriculum. Students are required to pass the exam with a 90%. They have three attempts to pass the exam. If the students do not pass the third math exam, they fail to progress in the course. Students are required to meet with course faculty for optional remediation, and to complete a math counseling form after each math exam failure. In the fall 2002, the math policy, procedures and the math counseling forms were revised. There were no course failures due to inability to meet math requirement in academic year Campus Learning Objective: An educated person should be expected to have some understanding of and experience in thinking about moral and ethical problems. Program objective: An individual who practices within a legal framework of the nursing profession. a. On the BSN follow-up survey, 100% respondents will believe that the BSN program prepared them to demonstrate ethical and legal responsibility and accountability for professional nursing practice. This follow up survey will be distributed in Summer b. On a BSN sophomore year-end self appraisal survey, 100% respondents will believe that they will be able to practice within an ethical and legal framework for the nursing profession. On the 2002 BSN Sophomore year-end self appraisal, 33/36 (92% ) respondents believe that they can practice within an ethical and legal framework On the 2002 BSN Junior year-end self appraisal, 17/17 (100%) respondents believe that they can practice within an ethical and legal framework Program objective: A knowledgeable coordinator of community resources who facilitates individual's families' and communities' access to resources necessary to meet health care needs.

9 On the 2002 sophomore self-appraisal, 23 0f 36 ( 64%) respondents agreed/strongly agreed that they are knowledgeable coordinators of community resources. On the 2002 junior self-appraisal, 12 of 17 (71%) respondents agreed/strongly agreed that they are knowledgeable coordinators of community resources. On the 2002 BSN exit survey, 22/23 (96%) respondents agreed/strongly agreed that they are knowledgeable coordinators of community resources. This is an objective that we need to continue to explore. Program objective: A politically aware individual who participates in the profession and the practice of nursing with a global perspective. On the 2002 BSN sophomore self-appraisal, 24 of 36 (67%) respondents agreed/strongly agreed that they are a politically aware individual who participates in the profession and the practice of nursing with a global perspective. On the 2002 BSN junior self-appraisal, 12 of 17 (71%) respondents agreed/strongly agreed that they are a politically aware individual who participates in the profession and the practice of nursing with a global perspective. On the 2002 BSN exit survey, 14 of 23 (43%) respondents believed they are a politically aware individual who participates in the profession and practice of nursing. This is an objective that we are continuing to explore. Faculty continue to explore the concept of use of portfolios, and plan to develop a framework for their use in fall 2003.